bhatthars/nbme_qna huggingface dataset:
Patient Note: HPI: 17yo M presents with palpitations. Patient reports 3-4 months of intermittent episodes of "heart beating/pounding out of my chest." 2 days ago during a soccer game had an episode, but this time had chest pressure and felt as if he were going to pass out (did not lose conciousness). Of note patient endorses abusing adderall, primarily to study (1-3 times per week). Before recent soccer game, took adderrall night before and morning of game. Denies shortness of breath, diaphoresis, fevers, chills, headache, fatigue, changes in sleep, changes in vision/hearing, abdominal paun, changes in bowel or urinary habits. 
PMHx: none
Rx: uses friends adderrall
FHx: mom with "thyroid disease," dad with recent heart attcak
All: none
Immunizations: up to date
SHx: Freshmen in college. Endorses 3-4 drinks 3 nights / week (on weekends), denies tabacco, endorses trying marijuana. Sexually active with girlfriend x 1 year, uses condoms

Keywords and phrases relevant to diagnosis:
dad with recent heart attcak
mom with "thyroid disease
chest pressure
intermittent episodes, episode
felt as if he were going to pass out
adderall, adderrall, adderrall
palpitations, heart beating/pounding
3-4 months of
17yo
M
Patient Note: 17 Y/O M CAME TO THE CLINIC C/O HEART POUNDING. STARTED 2-3 MO AGO. IT STARTED SUDDENLY. DOES NOT RECALL ANY TRIGGERING EVENTS. IT COMES AND GOES, IT HAPPENED 5-6 TIMES SINCE IT STARTED. IT LASTS 3-4 MIN, AFTER THAN  JUST GOES AWAY. HE HAS ALSO EXPERIENCING SOB, PRESSURE ON HER CHEST WHEN HE HAS THIS ATTACK. HE IS A COLLEGE STUDENT, EXPERIENCING SOME STRESS RECENTLY. 
DENIES COUGH, CHEST PAIN.
ROS NEG EXCEPT AS ABOVE.
PMH NONE. MEDS ATEROL, FOR HIS STUDIES, SHARING W HIS ROOMMATE. NKDA.
PSH/ HOSP/ TRAVEL/ TRAUMA NONE.
FH MOM HAS THYROID PROBLEMS.
SH SEX ACTIVE W GIRLFRIEND, NO STDS, USING CONDOMS. SMOKE NONE. ETOH ONLY WEEKENDS. DRUG ONLY ONCE, 1 MO AGO.

Keywords and phrases relevant to diagnosis:
MOM HAS THYROID PROBLEMS
PRESSURE ON HER CHEST
COMES AND GOES, HAPPENED 5-6 TIMES
SOB
HEART POUNDING
STARTED 2-3 MO AGO
17 Y/O
M
Patient Note: Mr. Cleveland is a 17yo M who was consented by parents to be alone today and provide information.  He has no notable PMH and presented today with palpitations that have been occurring sporadically for 2-3 months.  He started college 7-8 months ago and described feelings of nervousness and anxiousness with starting school and exams.  He endorses using his roommates prescription adderall to study for tests and this coincides with the palpitations at times.  Nothing makes his palpitations worse or better when they occur.  ROS is negative except for light headedness and SOB.  He has not had any cold/heat intolerance, diarrhea, changes in voiding habits, or weight loss.  Worried about being able to play basketball.

Meds:  Adderall from his roommate
PMH:  none
PSH:  none
All:  NKDA
Family:  mom: thyroid issues, father: heart attack
social:  no tob, occ EtOH, no illicits
sex:  with gf, use condoms
diet:  good
exercise:  basketball

Keywords and phrases relevant to diagnosis:
father: heart attack
mom: thyroid issues
sporadically
light headedness
has not had any cold/heat intolerance
adderall, Adderall
SOB
palpitations, palpitations, palpitations
for 2-3 months
17yo
M
Patient Note: 17 yo M w/ no cardiac or arrhythmia PMH presents complaining of 3 months of episodic heart pounding.  Pt reports sensation of heart racing and pounding out of chest about 5-6 times total over the past 3 months.  THis last episode the patient experienced light headedness and had some shortness of breath.  Pt is a college student and has recently began to "share" his roommates prescribed aderall approx 2 tabs/week over this time.  Pt does not report any adverse effects of the aderall and reports it has helped him study.  No changes in weight, dizziness, changes in appetite, fevers or chills.  PMH none, PSH none, FHx Father MI, Mom thyroid problem.  Meds none accept aderall (not prescribed) Social: college student in philosophy, 2-3 alcoholic drinks/week, does not smoke, tried marijuana once.  Sexually active w/ 1 female partner uses condoms.  ROS negative accept above.

Keywords and phrases relevant to diagnosis:
Father MI
Mom thyroid problem
episodic, 5-6 times
light headedness
aderall
shortness of breath
heart pounding, heart racing, heart pounding
3 months of, over the past 3 months
17 yo
M
Patient Note: HPI: Dillon Cleveland is an otherwise healthy 17 year old male presenting due to rapid pounding heart rate for 2-3 months. He has never experienced these symptoms before. Comes on randomly, nothing makes it better. Lasts 3-4 minutes. Has happened 5-6 times over last 2-3 months.  
-Endorses light headedness, chest pressure the last time. 
-Intermittent tachycardia and pounding heart beat.
-Denies throat pain, headache, dizziness, loss of conciousness, chest pain, nausea, vomiting, changes in bowel and urinary habits
ROS: as per HPI
PMH: no medical issues, no allergies, takes friend's adderall (dose unknown)
SOC: No tobacco use, EtOH use 3-4 drinks per week, smoked "pot" once, full time student
FAM: Mom-thyroid problem, Dad-MI last year

Keywords and phrases relevant to diagnosis:
Dad-MI
Mom-thyroid problem
chest pressure
5-6 times
light headedness
adderall
pounding heart, pounding heart
2-3 months, 2-3 months
17 year old
male
Patient Note: 17 y/o M , Dillon Cleveland comes with c/o of palpitaions.  Palpitaions are sudden onset ond have been occuring for the last 3-4 months.  He has had 1-2 episodes of palpitaions every month. The last episode was accompanied by breathlessness and constricting pressure over chest which releived on its own. No aggravating or relieving factors. No h/o fever, pedal edema, cough, hemoptysis. no h/o of dyspnoea, orthopnoea. no h/o weight loss, tremors.
PMH; not allergic to any medications. no known allergies. No similar episode in hte past. 
Psh; no history
Family h/o; Mother has thyroid condition, father had acute MI last year. 
Social drinker . Sexaully active with girlfriend sincea a year. No h/o STD.

Keywords and phrases relevant to diagnosis:
father had acute MI
Mother has thyroid condition
pressure over chest
1-2 episodes
breathlessness
palpitaions
3-4 months
17 y/o
M
Patient Note: 17 yo M college student comes to the clinic due to heart pounding.  He states the he has had episodes of heart pounding for the last 3-4 months.  Nothing makes it better or worse and it goes away on its own.  he denies any chest pain but does report chest pressure during some of the episodes.  He denies warmth or sweating, recent illness, abdominal pain or N/V, tingling in extremities, recent illness or trauma.  He is new to college and has been taking aderol a few times a week.  The last time he took aderol was 2 days ago, which was also the last time he had episode of palpitations.  
ROS: negative except for above
PMH, PSH: none, medications: aderol self administered.  knda, FH: Mother thyroid disease, father heart attach at 52 is okay now.  SH: no changes in weight or appetite, he is on the meal plan and tries to be healthy, he plays intermural soccer and runs, no smoking, alcohol hx.  Triend marijuanna, uses aderol. Stress college

Keywords and phrases relevant to diagnosis:
father heart attach
Mother thyroid disease
chest pressure
episodes, episodes
aderol, aderol, aderol
heart pounding, heart pounding, palpitations
for the last 3-4 months
17 yo
M
Patient Note: HPI: Patient is a 17 yo m with a c/o of palpitations.  Palpitations began a few months ago. States that palpitations are sudden, unpredictable and feel like his heart is pounding fast/jumping out of his chest. Typically these episodes last 3-4 minutes and resolve on their own. His most recent episode was 2 days ago and lasted about 10 minutes. During this epsiode he felt lightheaded, Short of breath and had chest pressure located in the middle of his chest. Denies any sweating, changes in hair or bowel movements.
ROS: Negative except as stated above
PMH: None
Meds: Takes his roommates Adderall to help study
Allergies: NKDA
PSHx: None
FH: Mother has a thyroid problem, Father had a MI this past year at age 53
SH: denies to

Keywords and phrases relevant to diagnosis:
Father MI
thyroid problem, Mother has a thyroid problem
chest pressure
episodes
lightheaded
Denies sweating
Adderall
Short of breath
palpitations, Palpitations, palpitations, heart is pounding, heart is fast
began a few months ago
17 yo
m
Patient Note: Pt is a 17 y/o M w/ episodic feeling of "heart pounding" and "jumping out of chest." cannot identify a pattern, and seem to come and go without clear trigger..  Also notes some chest pressure during episodes.  Denies any tingling or numbness associated.  At times during these events he feels like he will pass out although denies oss of ocnsciousness. The episodes last 3-4 minutes. He does not note any undue stressors. 

PMHx: None
PSH: None  
FM: Mom has "thyroid disorder," dad had recent MI. 
Social history: Notes trying some of his roommates adderral. Denies other drug use. Alcohol use socially. College freshman studying marketing.
Meds: None.
Hospitaliaitons: None.
Ros: Dizziness, lightheadedness during episodes. Denies tingling/numbness. Denies any feelings of dread or anxiety.

Keywords and phrases relevant to diagnosis:
dad had recent MI
Mom has "thyroid disorder
chest pressure
come and go
lightheadedness
adderral
heart pounding
17 y/o
M
Patient Note: 17 y/o previously healthy male here with heart pounding. States a few months ago, he started having episodes of feeling like his heart is pound/jumping out of his chest. Denies any anxiety, sweating, shaking, or sense of impending doom during these episodes. States he also had shortness of breath with his last episode. Denies any temperature intolerance, jitteriness, chest pain, abdominal pain, GI symptoms, GU symptoms, or easy bruising/bleeding. States he drinks about 3-4 cups coffee/day and several energy drinks throughout the week. Denies any recent stressors in his life.
ROS: negative except for above
PMH, Surg hx, hospitalizations - none
Meds: occasionally take roommate's adderall
NKDA
FH: mom has thyroid problems, dad had heart attack last year
Social: started college 6-7 months ago, denies tobacco use, drinks 3-4 drinks/day on weekends (neg CAGE screening), tried MJ a few months ago. Sexually active with gf, no STD concerns

Keywords and phrases relevant to diagnosis:
dad had heart attack
mom has thyroid problems
episodes
Denies any temperature intolerance
adderall
shortness of breath
drinks coffee, drinks energy drinks
heart pounding, heart is pound
few months ago
17 y/o
male
Patient Note: 17 yo M complains of heart pounding since 2-3 months. He had 5-6 episodes in the past 2-3 months. It is progressively worsening. No specific triggers noticed when these happen. No sweating/chest pain/N/B, SOB. The last episode was severe that he thought he would passout. Denies headaches/ blurry vision/cough/swelling of legs
ROS- negative except as above
PMH/Allergies/PSH- none
Meds- takes adderall since college 
FH- Mother has thyroid issues, Father has heart problem
SH-smoked pot once, nonsmoker, Etoh on weekends occasionally, college student, sexually active with girlfriend

Keywords and phrases relevant to diagnosis:
Father heart problem
Mother thyroid issues
5-6 episodes, episode
thought he would passout
adderall
heart pounding
since 2-3 months, in the past 2-3 months
17 yo
M
Patient Note: 17 yo m c/o palpitations for the last 3 months. Patient referred having 5- 6 episodes of palpitations in total that comes all of the sudden. He described the episodes as his heart is pounding and in the last episode had SOB and chest pressure. He is started college a few months ago and have no stressors except for recent MI of his father. Denies sweating, tingling, weakness, fear, changes in bowel  habits or skin, anxiety.
ROS: Negative excepts as above
PMH: None
Meds: Adderall from a friend's prescription since high school but have been taking it more now in college ( 2-4/ week) All: none
PSH: none
FH: Mother had thyroid disease, Father had MI at 50yo
SH: He is a college student, does not smoke, drink 3-4 beers in the weekend, marihuana once, monogamous with girlfiend, no STI in the past, use condoms regularly. Excercise by playing basketball and running, eat a healthy diet. Drinks 3-4 cups of coffee/day, 2-4 energy drinks/week.

Keywords and phrases relevant to diagnosis:
MI of his father, Father had MI
Mother had thyroid disease
chest pressure
episodes, episodes
Adderall
SOB
coffee, energy drinks
palpitations, palpitations, heart is pounding
for the last 3 months
17 yo
m
Patient Note: Patient is a 27 yy/o male with consent from his mother to talk to physician about complaints of pounding heart beat. The palpitations have been occuring for the past 3-4 months 1-2 times perweeek. When experiencing this episodes the symptoms last for 3-14 mionutes. There are no alleviating or precipitatiing factors. He also endorses 1 episode of non radiating midsternal pressure with associated shortness of breath. He does not notice an increase of symptoms with exertion or alcohol. He denies any nausea, pallor, or diaphoresis. He has no PMHx or SHx. He endorses family history of thyroid disease in the mother and MI in the father. He has no allergies and is taking no medications. He endorses occasional alcohol use but denies the use of cigarretes. He endorses use of marijuana once and uses his friends Adderral a few times a week to prepare for exams. He is sexually active with his girlfriend and uses condoms. He is a college Freshman.

Keywords and phrases relevant to diagnosis:
MI in the father
family history of thyroid disease
midsternal pressure
uses Adderral
shortness of breath
pounding heart beat, palpitations
past 3-4 months
male
Patient Note: Dillon Cleveland is a 17yo otherwise healthy M presenting with 5-6 episodes of palpitations within the duration of past 3 months. 2 days ago, the patient also experience a chest tightness during basketball and was relieved by rest. Basketball seemed to have made the chest tightness come on, but the palpitations have no associated trigger, and both are relieved by rest and resolves on its own. Patient endorses using Adderall taken from a friend's bottle a few times/wk or more depending on the college work.

PMH: None
PSH: None
Meds: Adderall that is from a friend's bottle a few times a week; patient cannot recall the dosage or specific frequency
Allergies: NKDA
SH: Freshman in college as a 17yo majoring in Philosophy. Drinking on the weekends 3-4 beers. Denies use of marijuana and recreational drugs; denies smoking; has a girlfriend and are sexually active
FH: Mother with "thyroid" and father with heart attack recently

Keywords and phrases relevant to diagnosis:
father with heart attack recently, father with heart attack
Mother with "thyroid"
chest tightness, chest tightness
using Adderall
palpitations
duration of past 3 months
17yo
M
Patient Note: Pt is a 17 y/o male presenting with heart pounding. For last 2-3 months has sensation of heart jumping out of chest not necessariy associated with anything including activity. During the last episode he was playing basketball and also had SOB and chest pressure. Occasionally will feel light headed too. Denies palpitations, leg swelling, diaphoresis, headaches, changes to vision, joint pain, diarrhea/constipation, nausea, vomiting, abd pain, skin/hair changes, heat/cold inotlerance. No LOC. No psychiatric hx or hx of ADHD
FH: mom thryoid issues, dad MI in 50's. No hx of sudden death in childhood
PMH: None
Allergies/Meds: NKA, occasional aderol to help study and focus
SH: 1st year in college, not too stressful, no smoking or illiict drugs, alcohol 3-4 x two days out of the week, once tried marijuana

Keywords and phrases relevant to diagnosis:
dad MI
mom thryoid issues
chest pressure
light headed
Denies hair changes, Denies heat/cold inotlerance
aderol
SOB
heart pounding
2-3 months
17 y/o
male
Patient Note: 17 YO M C/O HEART POUNDING X 4 MONTHS
-ONSET DURING A SOCCER GAME, FELT AS IF HE WAS GOING TO LOSE CONSCIOUSNESS
-EPISODES OCCUR 1-2 TIMES EVERY MONTH, DESCRIBES THE SENSATION OF PRESSURE IN HIS CHEST
-COLLEGE FRESHMAN, OCCASIONALLY USES FRIEND'S PRESCRIPTION ADERALL TO HELP HIM STUDY
-DENIES ANY WEIGHT OR APPETITE CHANGES, DENIES ANXIETY AND NAUSEA, VOMITING, DIARRHEA OR CONSTIPATION
-DENIES FEVERS OR CHILLS
ROS: NEGATIVE EXCEPT AS ABOVE
PMH: NONE 
PSH: NONE
ALLERGIES: NKDA
MEDICATIONS: ADERALL (PRESCRIBED TO HIS FRIEND) TO HELP HIM STUDY
FH: MOTHER HAS A THYROID PROBLEM, FATHER HAD AN MI AT 52
SH: COLLEGE FRESHMAN, PLAYS SOCCER, DENIES SMOKING, DRINKS ETOH ON THE WEEKENDS,  SMOKES MARIJUANA OCCASIONALLY.

Keywords and phrases relevant to diagnosis:
FATHER HAD AN MI
MOTHER HAS A THYROID PROBLEM
PRESSURE IN HIS CHEST
OCCUR 1-2 TIMES EVERY MONTH
USES ADERALL, ADERALL
HEART POUNDING
X 4 MONTHS
17 YO
M
Patient Note: PMHx: 17 yo male with episodic heart palpitations. episodes started 2-3 months ago, all of a sudden and would last 3-4 minute and go away on their own . but last episode lasted 10 minutes and was accompanied by chest pressure like sensation and shortness of breath. denies warning sign, confusion, LOC, head trauma, vision changes, SENSITIVIty to 
ALLERGIES:none
Meds: Addrell since high school. last pill was taken 2 days ago to focus on studies.
PSHx:none
FHx:mom has thyroid, dad had MI at age 52 and he is a smoker.
SSHx: he started college 7 months ago. denies smoking and recreational drug use. takes addrell from friend. takes 3-4 beers on weekends.smoked pot once in hight school but never again . sexually active with gf and uses condoms always. never tested for any STIs.

Keywords and phrases relevant to diagnosis:
dad had MI
mom has thyroid
chest pressure
episodic, episodes, episode
Addrell, addrell
shortness of breath
heart palpitations
started 2-3 months ago
17 yo
male
Patient Note: Patient is a 17yo m with no PMH, presented with complaint of heart palpitation. Palpitation going on for 3-4 months, 5-6 episodes, last 3-4 min (comes and goes, self resolves). Last episode 2 days ago, had pressure, SOB, and lightheadness, no LOC. Hx of hyperthyroidism with mother, and heart disease in father similar symptoms and hx of MI. HX of using prescription drugs not prescribed to him, Adderol, for studying. DRinks 3-4 drinks, 3 times a week. Denies tobacco use. Marijuana use a few weeks ago. Sexually active with GF, condom use. 
ROS: Denies fever, chills, weight change, nausea, vomiting, abdominal pain. NKDA.

Keywords and phrases relevant to diagnosis:
father hx of MI
Hx of hyperthyroidism with mother
5-6 episodes
lightheadness
Adderol
SOB
heart palpitation
for 3-4 months
17yo
m
Patient Note: The mother has given verbal consent for a history, physical examination, and treatment. 17 yo M comes to the clinic c/o intermittent heart pounding which started a few months ago, he reaclls between 2-3 months ago. He has had no prev episodes, not precipitated by anything, not allev or aggrav by anything. 2 days ago while playing basket ball he presented w/lightheadedness, SOB and chest pressure.
Denies LOC, falls, chest pain, numbness, tingling, changes in bowel habits and changes in urinary habits
ROS: none except for the above
PMH: none. Meds: non prescribed adderall, 1 pill a few times a week
HOSP/TRAUMA/SURG: none
FH: mother has thyroid condition, father had a heart attack
Social: college student, lives w/room mate in dorm, drinks 3-4 beers on weekends, CAGE:0/4, denies tobacco, denies other rec drugs.
Sexual: active w/gf, wears condom, monagomous, no stds

Keywords and phrases relevant to diagnosis:
father had a heart attack
mother has thyroid condition
chest pressure
intermittent
lightheadedness
adderall
SOB
heart pounding
started a few months ago, 2-3 months ago
17 yo
M
Patient Note: 17 Yo M c/o intermittent feeling of heart racing/palpitations for past 2-3 months. He says the episodes happen randomly sometimes during rest/sometimes during strenous activity and he doesnt notice a pattern, the last episode he felt some chest pressure and SOB that resolved after the episode. He has never had a syncopal episode and does not feel anxiety/panic/ or a sense of doom during or before the episode. He drinks 3-4 cups of coffee today, intermittently uses redbull and takes his friend's adderall intermittently to help with school. He did notice that he took an adderal the morning before the last episode of palpitations. No reported weight loss/cold and heat intolerance

Ros: - except what is mentioned
PMH: -
PSx: -
Med/Alg: NKDA, intermittently uses friends adderal
Fam: Mom has thyroid disease otherwise noncontributory
Soc: Freshman in college, uses firends adderal intermittently, otherwise no tobacco/drug use sparse etoh

Keywords and phrases relevant to diagnosis:
Mom has thyroid disease
chest pressure
intermittent, episodes, episode
No cold and heat intolerance
adderall, adderal, adderal, adderal
SOB
coffee, redbull
heart racing/palpitations
for past 2-3 months
17 Yo
M
Patient Note: CC: "heart pounding episodes" 
HPI: 17 yo M presents with 2-3 mo history of heart pounding with a total of 5-6 episodes. The episodes last about 3-4 min usually but last episode was 10 min and assoiciated with some SOB as well as chest pressure/discomfort. Last episode was brought on when playing sports with friends. Pressure/pain does not radiate elsewhere and there have been no similar prior episodes. He would rate the chest pressure a 4/10 severity. Denies any sweating, heat/cold intolerance, changes in bowel movements, nausea/vomiting, fever chills, weight loss or gain.
ROS: Negative except as above
Allergies: none 
Medications: taking roommate's adderall pills occasionally 
PMH: none 
SH: Drinks 3-4 beers or mixed drinks on weekends, 3-4 cups of coffee per day and 1-2 energy drinks per week, no tobacco use, or regular drug use
FH: Father had MI at 52, Mother has thyroid problems


Keywords and phrases relevant to diagnosis:
Father had MI
Mother has thyroid problems
chest pressure, chest discomfort
5-6 episodes
Denies heat intolerance, Denies cold intolerance
adderall
SOB
coffee, energy drinks
heart pounding, heart pounding
2-3 mo
17 yo
M
Patient Note: 17yo M with "heart pounding" for few months. Feels like heart is racing. Usually comes out of nowhere, happens when just sitting. Happens 1-2x/month. Last episode was during soccer game, felt chest pressure, light-headed, thought was going to pass out. Does not notice association with any activities, time of day, or activities. Additionally, drinks 3-4 cups of coffee/night and 3-4 energy drinks per week. Has had some increased anxiety since starting college recently, does not have trouble sleeping. Otherwise feels well, no additional symptoms. Has been able to play soccer. 

PMH: none
Meds: uses friends adderal few x per week
Allergies: none
FH: father with MI at age 52
SH: does not smoke, drinks 3-4 alcoholic beverages/week, no illicit drugs

Keywords and phrases relevant to diagnosis:
father with MI
chest pressure
Happens 1-2x/month
light-headed
adderal
drinks coffee, drinks energy drinks
heart pounding, heart is racing
for few months
17yo
M
Patient Note: 17yo M presents with 2-3month history of "heart feeling like it is going to beat out of my chest". Feeling comes and goes, has happened a total of 5-6 times, lasts 3-4min per time, can occur at any time of day, and is not alleviated or exacerbated by anything. Never had palpitations in past. Also reports feeling of pressure in center of chest 2 days ago described as "someone sitting on me", lasting 10min as well as SOB during episode. Stressed with recently starting college, and taking roommate's adderall 2x/week. Denies diaphoresis, nausea, vomiting, skin or hair changes, weight changes, and appetite changes.
ROS: negative except as above
PMHx, allergies, surgeries: none
Meds: adderall (see HPI)
SH: EtOH: 3-4 on weekends (negative CAGEx4), marijuana once at party, denies tobacco, sexually active with girlfriend, uses condoms
FH: mother with thyroid disease, father with MI last year

Keywords and phrases relevant to diagnosis:
father MI
mother thyroid disease
pressure in chest
comes and goes
Denies hair changes
adderall, adderall
SOB
heart feeling like it is going to beat out of my chest
2-3month history
17yo
M