bhatthars/nbme_qna huggingface dataset:
Patient Note: CC: 35 yo m c/o stomach problems
HPI: burning epigastric pain, x 2 months, progresion: worse, 5/10 in intensity, No radiation. Allev by: thums at the begining, now by nothing. Aggrav by nothing. No precipitating events.
He refers dark brown stools since 2 weeks and nausea. No red blood in his stools.
Denies fever, weight change, no diarrhea or constipation. No fatigue. The pain is not related with food. No dysphagia. No vomiting. No cough, no change in his skin, no pale. 
PMH: no prior hx of CC. No illnesses
NKDA
Meds: Ibuprofen 1 time/week x 10 years. No Rx
FH: uncle h/o bleeding gastric ulcer
SHx: smoking 0.5-1 pack/day/20 years. No drug use. ETOH: social
No sexual active

Keywords and phrases relevant to diagnosis:
uncle h/o bleeding gastric ulcer
epigastric pain
dark brown stools
Ibuprofen
burning
progresion: worse
ETOH: social
m
x 2 months
No red blood in his stools
Allev by: thums at the begining
nausea
35 yo
Patient Note: 35 y/o M complains of worsening epigastric pain that started 2 months ago. Pain is intermitent, burnig, 5/10 in severity , and last 1-2hrs. Associated with nausea. Patient also reports passing dark brown stool.

Keywords and phrases relevant to diagnosis:
epigastric pain
dark brown stool
burnig
worsening
M
started 2 months ago
intermitent, last 1-2hrs
nausea
35 y/o
Patient Note: Mr. Hamilton is a 35 y/o male with PMHx significant for back pain/muscle spasms who presents with 2 months of epidural abdominal pain which he describes as a gnawing burning sensation in his epidrual region with no radiation. Pt is currently not experiencing the pain, but when he does he reports a pain level of 5/10. Pain was originally 1 x week but currently getting worse as patient is experiencing the pain 2-3 times per week. Patient attempted the use of tums to alleviate pain, but reports not working. Furthermore, pt reports a darkening of stool (melena) more so than usual. Denies any bright red blood per rectum, changes in stool, diarhea, nausea, vomiting, chest pain, SOB. Denies nocturnal asthma. Denies recent travel, pets at home, denies sick contacts. Medications: motrin 1 x week Allergies: None; Social: smokes 1/2 a pack to 1 pack per day since he was 15 (20 year pack year history), drinks socially.

Keywords and phrases relevant to diagnosis:
pain epidrual region
darkening of stool
motrin
gnawing burning
getting worse
drinks socially
Mr, male
with 2 months
Denies any bright red blood per rectum
tums not working
35 y/o
Patient Note: CC: stomach hurts". HPI: Mr. Hamilton is a 35 y/o Male complaining of epigastric pain for the past 2 months that has progressively become worse. Pain comes and goes, feels like "burning, knawing" and is 5/10 on the pain scale. Tums helped at first but patient stopped taking them now as they no longer provide relief. Nothing makes the pain worse. Patient confirms nausea and 2 week history of dark stools. Pain occurs at random, day or night and has woken him from sleep. ROS: Denies vomiting, blood in stools, stool caliber change, cough, SOB, CP, palpitations, fevers, weight loss. PMHx: back aches, muscle spasms from construction work. PSHx: None. Allergies: None. Meds: Tums as need (now stopped) and Motrin 200 mg once a week for back pain. FHx: Uncle had bleeding ulcer. SHx: Smokes 1-2 PPD x 20 yrs. Used to drink a few beers a week but has stopped drinking. Denies drug use. Works as construction worker, lives alone, not sexually active.

Keywords and phrases relevant to diagnosis:
Uncle had bleeding ulcer
epigastric pain
dark stools
Motrin
burning, knawing
progressively become worse
few beers a week
Mr., Male
past 2 months
Pain has woken him from sleep
Denies blood in stools
comes and goes
Tums helped at first, Tums no longer provide relief
nausea
35 y/o
Patient Note: 35 year old malepresents with complaint of epigastric pain associated with nausea that has been affecting him about 2-3 times per day. Patient describes pain as Burning pain that is 5/10 severity that is non radiating. Initially the pain was relieved by Tums, but that is no longer the case. The patient also states that he feels bloated after eating, but that eating does not affect the pain or nausea. Pt has also nnoticed increased fatigue and darkening of his stools recently.  Patient denies headache, dizzyness, chest pain, fever, chills.

ROS: none other than above
PMH: none
PSH: none
Meds: Motrin

Keywords and phrases relevant to diagnosis:
epigastric pain
darkening of his stools
Motrin
Burning
bloated after eating
2-3 times per day
male
pain was relieved by Tums, but that is no longer
nausea, nausea
35 year old
Patient Note: 35yo M presents with c/o stomach pain
-Begin 2 months ago, buring, gnawing, intermittent pain
-5/10 pain, initial relieved by Tums but not now
-Has black/tarry stools
+Nausea, -vomiting, +burping
-Not associated with food intake
-Slightly relived after stopping alchohol intake
-Denies fever, infection, changes in weight
-Uses Motrin for back pain
PmHx: Denies
Allegies: None
Medications: Motrin
SHx: None
S: last sexually active w/ wife 6 mo. ago. Pending divorce. No children.
-has worked in construction for 10 years

Keywords and phrases relevant to diagnosis:
black/tarry stools
Uses Motrin, Motrin
buring, gnawing
M
Begin 2 months ago
intermittent
initial relieved by Tums but not now
Nausea
35yo
Patient Note: 35M with CC of epigastric pain. The pain is burning in sensation with no radiation, has occurred for the past 2 months and is getting worse. Tums initially helped but is no longer helping. Every time he eats he feels bloated but food is not associated with the pain. He states that his stools have also been darker than usual. He also endorses nausea but no vomiting. No fevers, chills, no increased urinary frequency, no pain with urination. No chest pain or other abd pain. No yellowing of skin. He has never had anything like this before.

PMHx
Takes motrin, but only once a week for aches and pains from his work as a construction worker.
Healthy, no hospitlizations or surgeries. NKDA.

FHx
Uncle with gastric ulcers. Mother, father, alive and healthy. 

Shx
Works as construction worker. Smoked 0.5-1ppd since his teenage years. Had about 2-3 drinks per week but has stopped since the pain started. No other drug use.

Keywords and phrases relevant to diagnosis:
Uncle with gastric ulcers
epigastric pain
stools have also been darker
Takes motrin
burning
Every time he eats he feels bloated
getting worse
2-3 drinks per week
M
past 2 months
Tums initially helped but is no longer helping
nausea
35
Patient Note: 35yo M Chad Hamilton intermittent epigastric gnawing burning pain. Onset 2 months ago. Pain worsening. Last 2 weeks pain now wakes him at night. Feeling fatigued. TUMS was working but now does not. Nothing makes it worse. 5/10 pain. Stools dark. No blood in stool. Feels bloated when eating. Mood is good. Nauseous.
ROS: No coughing. No SOB. No vomiting. No headache. No fever. No change in diet. No night sweats.
PMH: none
PSH: none
Meds: TUMS, motrin for pain relief
FH: negative for IBS/IBD. Uncle positive for peptic ulcer disease.
SH: smokes 1PPD since 15yo. Quit beers couple weeks ago. Construction worker that lives alone.

Keywords and phrases relevant to diagnosis:
Uncle positive for peptic ulcer disease
epigastric pain
Stools dark
motrin
gnawing burning
Feels bloated when eating
Pain worsening
M
Onset 2 months ago
pain now wakes him at night
No blood in stool
intermittent
TUMS was working but now does not
Nauseous
35yo
Patient Note: HPI- 35 yo m c/o abd pain x 2months.
- epigastric, burninng and worsening, intermittent intially 1xs/week but now 2xs/week. tums relieved it but nothing makes it worse.non radiating
-assoc bloating, anorexia, poor sleep due to pain waking him up, nausea but no vomiting,belching and anorexia.
-denies fever, trauma, heartburn, sob, sweating, cough, chest pain, wt loss or urinary symptoms.
ROS- neg except as above.
PMH- back ache and spasm treated with motrin. MED_ tums, motrin. ALLERGIES- NKA.
FH- uncle had a bleeding ulcer.
SH- construction worker, 1ppd  since 15yrs, quit beer 2 weeks ago due to pain. exercises and sexually active, no sti

Keywords and phrases relevant to diagnosis:
uncle had a bleeding ulcer
pain epigastric
motrin, motrin
burninng
bloating
worsening, intially 1xs/week but now 2xs/week
quit beer 2 weeks ago
m
x 2months
poor sleep due to pain waking him up
intermittent
nausea
35 yo
Patient Note: 35 year old male with no significant past medical history presenting with epigastric pain and nausea. The pain is a burning quality and is rated at a 5/10 on the pain scale. the pain has become more frequent and occurs twice daily. the pain lasts 1 to 2hrs and is associated with nausea. Eating food does not make it better or worse. tums used to help with the pain but has now stopped working. denies trauma to the area. reduced apeptite due to nausea but denies weight loss. no vomiting or diarrhea.
ROS: muscle aches and spasms in lower back
PMH: none
Medications: Motrin for back pain
SHx: none
FH: uncle with bleeding ucler
SH: works as a high elevation construction worker, 1-2 beers/week no longer drinks due to nausea, smoked 1/2pack to 1 pack per day for 15 years, no illicit drug use, not sexually active

Keywords and phrases relevant to diagnosis:
uncle with bleeding ucler
epigastric pain
Motrin
burning
has become more frequent, occurs twice daily
1-2 beers/week
male
tums stopped working
nausea, nausea, nausea, nausea
35 year old
Patient Note: CC: 35 yo male c/o stomach pain
HPI: pt c/o epigastric pain 5/10 for the past 3 months, pt awakens at night laying down with pain, the pain doesnt radiate, pain has been getting progressively worse, never happened before, comes and goes 3x per, tums used to alleivate the pain, no longer does, food does not make it worse. Pt reports darkened stools (melena) for the past 2 weeks, caliber is unchanged, endorses nausea and bloating following meals, pt denies fever, chills, myaglias, unintentional weightloss, joint pain, steatorrhea, fatigue, hematemesis
ROS: negative excpet as per HPI
Alleriges: none
PMHX: no hospitalizations, surgeries, trauma, or medical illnesses
RX: motrin 1x /week 
Social: high altitude concentration worker, smokes 15 years 1PPD, used to drink a couple of beers a week, recently stop ETOH, no recreationla drug use, diet is balanced
FHX: uncle had bleeding peptic ulcer


Keywords and phrases relevant to diagnosis:
uncle had bleeding peptic ulcer
epigastric pain
darkened stools, melena
motrin
bloating following meals
getting progressively worse
couple of beers a week
male
past 3 months
awakens at night
comes and goes
tums used to alleivate the pain, no longer does
nausea
35 yo
Patient Note: 35-year-old previously healthy man here with 2 months of burning, gnawing epigastric pain and nausea. Pain used to occur once per week now 2-3 times per day. Tried taking TUMs which seemed to help for awhile but now no longer offer relief. Nothing in particular seems to make pain worse. Does not associate pain with eating, though does describe a sense of bloating and fullness after eating. No difficulty swallowing. No fever, emesis, diarrhea, constipation, rashes. Says occasionally stool is dark in color but denies seeing frank blood or black color. 
PMHx: back pain, muscle spasms. 
Meds: motrin 1x/week. 
Allergies: none
Surgery: none
Family hx: uncle with h/o bleeding ulcer
Social history: works high elevation construction. Lives alone. Endorses recent increase in stress level as is separating from wife. Smokes 1/2 - 1 pack per day. Previously drank 3-4 beers per week, no alcohol in past 2 weeks. No other drug use.

Keywords and phrases relevant to diagnosis:
uncle with h/o bleeding ulcer
epigastric pain
stool is dark in color
motrin
burning, gnawing
bloating and fullness after eating
used to occur once per week now 2-3 times per day
3-4 beers per week
man
with 2 months
denies seeing frank blood or black color
Tried taking TUMs which seemed to help for awhile but now no longer offer relief
nausea
35-year-old
Patient Note: 35 yo M with h/o chronic NSAID use presents for 2 months of worsening epigastric pain
- Epigastric pain started two months ago, associated with nausea. Describes pain as a "gnawing" and rates it as a 5/10 at its worst
- says episodes of pain occur intermittently and last for an hour; previous once per week but have increased in frequency to once/day
- Has attempted tums with minimal relief; denies aggravating factors including meals or fatty foods 
- denies pmh but reports h/o NSAID use (1 motrin per week) for chronic pack pain; otherwise denies pmh, surgical history, medications, allergies
- Paternal uncle with "bleeding ulcer"; other denies FH. 
- Drinks 1-2 alcoholic beverages per week but has stopped drinking since onset of pain, smokes 1/2 pack of cigarettes per day for last 15 years, no rec drug use. not sexually active. works as constructino worker. li

Keywords and phrases relevant to diagnosis:
Paternal uncle with "bleeding ulcer
epigastric pain, Epigastric pain
NSAID use, NSAID use, motrin
gnawing
worsening, increased in frequency to once/day
1-2 alcoholic beverages per week
M
for 2 months, started two months ago
occur intermittently
tums with minimal relief
nausea
35 yo
Patient Note: Mr. Hamilton is a 35 yo male who presented with stomach pain. Pain started about 2 months ago. The pain is described to be sharp and in the epigastric region. Patient states that he does not notice anything that makes it worse. Seems to be "random" in timing. Does not notice any food that makes it worse or better. Has tried tums which helps relieve the pain, but recently it has not worked as well as it used to. Pain is 5/10. Has felt naussous but has not vomited. Has noticed darker stool recently, but no blood or diarrhea. Denies any fever, chills or cough.
ROS: all other negative
PMH: Back pain for which he takes Motrin
Meds: Motrin
Surg Hx: none
FH: parents both alive and healthy. Has uncle with stomach ulcer.
SH: smokes 1ppd x 20 years. Used to drink 1 to 2 beers per week but has now stopped due to stomach problem. No drugs. Not currently sexually active.

Keywords and phrases relevant to diagnosis:
uncle with stomach ulcer
epigastric region
darker stool
Motrin, Motrin
1 to 2 beers per week
Mr, male
started about 2 months ago
no blood
tried tums which helps relieve the pain, but recently it has not worked
naussous
35 yo
Patient Note: 35 YO M COMES WITH C/O STOMACH PROBLEMS X 2 MONTHS. IT IS GRADUAL, PROGRESSIVE,GRADUAL, PROGRESSIVE, LOCATED IN EIGASTRIUM, 5/10, BURNING, NON-RADIATING, BURNING, NON-RADIATING, NO AGGRAVATING FACTORS AND RELIEVING FACTORS. PT WAS TAKING TUMS NOW NOT USING. PT IS CONSTRUCTION WORKER TAKING MOERTIN FOR BACK PAIN, STOOLS ARE DARK IN COLOR. PT HAS BELCHING AND BURPING, NAUSEA X 2 MONTHS, ABDOMEN IS BLOATED AFTER EATING.
DENIES FEVER, VOMITING, JAUNDICE, CHANGE IN TASTE OF MOUTH, SLEEP/BLADDER CHANGES.
ROS: -VE EXCEPT AS ABOVE
PMH: BACK PAIN X 10 YRS
MEDS: TUMS AND MORTIN
FH: H/O SIMILAR PROBLEMS 
SSH: SMOKING SINCE AGE OF 15 YRS, CUT DOWM BEERS FROM MANY TO FEW, NO DRUD USE, SEXUALLY INACTIVE


Keywords and phrases relevant to diagnosis:
LOCATED IN EIGASTRIUM
STOOLS ARE DARK IN COLOR
TAKING MOERTIN, MORTIN
BURNING, BURNING
BLOATED AFTER EATING
PROGRESSIVE, PROGRESSIVE
M
X 2 MONTHS
NAUSEA
35 YO
Patient Note: 35 y/o M presenting with 2 mo history of abdominal pain. has been getting progressively worse, previously relieved by TUMS, but no longer effective. Pain comes and goes, maximum 5/10. No precipitating factors, nothing improves or worsens pain, and no association with meals. Pt also notes some increased bloating with food, so has been eating some smaller meals. Does not note any weight loss. Also denies lightheadness or dizziness. Has some nausea but no vomiting. Has also noted some darkening of his stool over the past few weeks, but no frank blood.
ROS: As per above. - headaches, myalgia/arthralgia, no change in urinary function or stool caliber.
PMH: none
PSH: none
FH: paternal uncle- bleeding ulcer
SH: 1/2 to 1 ppd smoker since age 15y. Previously drank a couple beers a week, quit drinking several months ago. No drug use. Works in construction, has some associated muscle aches and pains due to phyiscal labor.
MEds: Motrin 400mg

Keywords and phrases relevant to diagnosis:
uncle- bleeding ulcer
darkening of his stool
Motrin
increased bloating with food
getting progressively worse
couple beers a week
M
2 mo history
of his stool no frank blood
Pain comes and goes
TUMS, but no longer effective
nausea
35 y/o
Patient Note: HPI 35 yo M complains of epigastric pain for 2 mo. pain is burning sensation, no radiarion, episodic, 2/daily and each episode last for 1-2h, 5/10 on severity scale. doesnt relate to food, denies hurtburn or vomiting but he has nausea. wake up at night cause of pain. TAMS helped but not anymore. darker stool and feels more tired. denies fever or weight loss, diahrrea or constipation. 
ROS negative except as above. 
PMH backaches. 
PSH none
MEDS NSAID
ALLERGIES none
SH smoke 0.5-1PPD*20y, stopped drinking previous couple beers/wkdenies illicit drugs. not sexually active. exercise. regular diet. divorce process. 
FH unkle ulcer 


Keywords and phrases relevant to diagnosis:
unkle ulcer
epigastric pain
darker stool
NSAID
burning
2/daily
couple beers/wk
M
for 2 mo.
wake up at night cause of pain
episodic
TAMS helped but not anymore
nausea
35 yo
Patient Note: Chad Hamilton is a 35 yo male who came in with complaint of stomach pain. Patient localized pain to epigastric area. Pain started 2 months ago and has been getting progressively worse. Described pain as burning and gnawing and 5/10 in severity. Sometimes the pain would wake him up at night. Pain has been intermittent, seeming to come randomly with no associating to eating. Patient stated Tums used to make it better, but no longer works. Patient states nausea, but denies vomiting, dirrhea, constipation, night sweats, weight loss, and fever. 
PMHx: back pain that spasms due to construction
Surgical Hx: none
Allergies: none
Meds: Motrin 400 mgs 1x week
FHx: parents are healthy
SHx: Works in construction. Has a 20 year smoking history, drinks 1-2 beers a week, doesn't do drugs.

Keywords and phrases relevant to diagnosis:
localized pain to epigastric area
Motrin
burning and gnawing
getting progressively worse
1-2 beers a week
male
started 2 months ago
pain would wake him up at night
intermittent
Tums used to make it better, but no longer works
nausea
35 yo
Patient Note: Pt is a 35 YO w CC of stomach prob
Pts has epigastrium pain, burning, nagging, 5/18 pain for last 2 months associated w/ bloating, Nausea and darkened stool. He denies any urinary or bowel changes. He denies any greasy stool or diarrhea and urinary symptoms and fever or chills. He tried tums which used to help but not anymore.  Eat fast food mostly. He feels worried about it  affecting his job. his uncle has PUD. He is a current smoker 25 Pack year and drinks alcohol 2-3 night. He is not sexually active.

Keywords and phrases relevant to diagnosis:
uncle has PUD
epigastrium pain
darkened stool
burning, nagging
bloating
alcohol 2-3 night
last 2 months
tums used to help
Nausea
35 YO
Patient Note: Chad Hamilton is a 35 y.o. male who has been having burning eipgastric pain 2x per day for the past 2 months. Pain lasts 1 hour and is 5/10 and occasionally wakes him from sleeping. Not related to eating. Tums initially made pain better but is no longer helping. He has also been feeling stomach bloating during this period. Endorses fatigue and darker stools. Takes motrin occasionally for back pain and muscle spasms. Has not noticed any weight loss or bright red blood in stool. No chest pain, shortness of breath, or other abdominal pain. no cough
ROS: negative except as above
Medications: motrin occasionally for back pain. TUms
allergies: None
PMHx: none
PSHx: none
Social. 1/2 to 1 ppd since age 15. Few drinks per week until recent pain started. No drug use.


Keywords and phrases relevant to diagnosis:
eipgastric pain
darker stools
motrin, motrin
burning
stomach bloating
2x per day
Few drinks per week
male
past 2 months
wakes him from sleeping
not noticed bright red blood in stool
Tums no longer helping
35 y.o
Patient Note: Chad Hamilton is a 35 M presenting with midline epigastric pain with onset 2 months ago. He reports no inciting event or illness. Pain does not radaite to chest or back. It is not effected by eating. He has experienced no chnage in his appetite but reports eating less as he has had feeling of early satiety and bloating. Has noticed darkened stools in last 2 weeks but no frank blood. No cosntipation or diarrhea. Intermittent nasea but no vomiting. Reports taking Motrin weekly for back pain and myalgias secondary to job in construction. Moderate EtOH use without bingeing but has abstained for last 2-3 weeks due to EtOH exacerbating feeling of bloatedness. No weight loss or fatigue.

PMH: none
Meds: only Motrin
SocHx: 15 PY smoking hx, counsled about quitting, EtOH as above, no drug use


Keywords and phrases relevant to diagnosis:
epigastric pain
darkened stools
taking Motrin, Motrin
bloating
Moderate EtOH use
M
onset 2 months ago
no frank blood
nasea
35
Patient Note: Chad Hamilton, a 35-year-old male, has come to the physician's office today because of stomach problems. 
began 2 months ago, midepigastric, no radiation, burnning , 5/10
intermittent, 2 time per day, last 1 hour
has nausea, melena x 2 week, use NSAID, 
denies, chest p;ain, urinary and cough, sob, palpitation, regurgitatoin , not related to meal and food, 
aggravated by nothing, relieved by Rx for heart burn
all; none   pmh; none
psh; none med; NSAID, Thymm for GERD
fh; non rele\vant
sh; 1/2 pppd x 15, no drug,etooh, live aloen   , constructon worker, 
feel tired for \pain, 



Keywords and phrases relevant to diagnosis:
problems midepigastric
melena
use NSAID, NSAID
burnning
2 time per day
male
began 2 months ago
intermittent
nausea
35-year-old
Patient Note: Patient is a 35 yo male who presents with epigastric pain. Pain started about 2 months ago. He describes burning, nawing pain. 5/10 in severity. Pain has be geting progressively worse. He uses tums for relief, but now they dont help much. He also endoses bloating, feeling full, nausa, dark stools. He denies fevers, chills, chest pain, vomiting, diarrhea. He also uses mortrin.
PHMX= Back pain from work
NKDA
- No recent hospitalizations
FH- Uncle - bleeding ulcer
No surguries, no travel.
Social- Lives in phily, works construction. smokes 1/3-1pack for 15 years. Drinks couple of beers a week, CAGE 0/4


Keywords and phrases relevant to diagnosis:
Uncle - bleeding ulcer
epigastric pain
dark stools
mortrin
burning, nawing
bloating
geting progressively worse
couple of beers a week
male
started about 2 months ago
tums for relief, but now they dont help much
nausa
35 yo
Patient Note: CC: "pain in mid epigastric area"
35 yo M c/o 2 mo of constant, intermittent epigastric abdominal pain. Pain is 5/10 and is present at least 2X daily and wakes him up 3X each night.  There are no precipitating or exacerbating factors. Pain was alleviated by tums in past but no longer helps. patient has no past medical history but reports that an uncle had h/o peptic ulcer disease. Patient reports darker stools for 2 months, + nausea but denies vomitting. There has been no changes in frequency or texture of stools. He feels bloated after food. 
PMH: backache and spasms PSH: none SH: recently divorced and is stressed about that. Recently stopped alcohol but has smoked 1/2 pk for 15 yrs. no illicuit drugs use. 
FH: Uncle - bleeding ulcers. Health maintenance: Last visit to physician was long time ago. 
ROS: negative except as in HPI

Keywords and phrases relevant to diagnosis:
uncle had h/o peptic ulcer disease, Uncle - bleeding ulcers
epigastric area, epigastric abdominal pain
darker stools
bloated after food
2X daily
Recently stopped alcohol
M
wakes him up 3X each night
intermittent
alleviated by tums in past but no longer helps
nausea
35 yo