bhatthars/nbme_qna huggingface dataset:
Patient Note: 44 F with HTN here for irregular menses of 3 year, stating her menses come without a pattern, lasts 2-6 days, can involve minimal to heavy bleeding, no pain. She also noticed that 1 week ago she had nausea and NBNB emesis that has since resolved. She states she had hot flashes for 1 year, and 1 episode of night sweat 1 week ago, and vaginal dryness for which she uses lubricants. She took 2 home pregnancy tests, both were negative. ROS neg.

LMP 2 months ago, menarche 14, regular, lasts 5 days, 2-3 tampons/day, mild cramping, denies fibroids/cyts, last Pap 1 year normal
G2T2P0A0L2

PMHx: HTN
PSHx: none 
Hospitalized for 2x vaginal deliveries
Med: HCTZ
NKDA
FHx: Mother obesity, OA; Brother HTN
SHx: never smoker, occasional drinker, no recreational drug use. Office manager, lives at home with husband & 2 sons, not stressed at home/work. Low fat & salt diet. Exercise moderately. Sexually monogamous with husband, no hx of STIs

Keywords and phrases relevant to diagnosis:
last Pap 1 year
Sexually monogamous
vaginal dryness
irregular menses
1 week ago she had nausea and NBNB emesis
F
LMP 2 months ago
hot flashes
menses come without a pattern, lasts 2-6 days, minimal to heavy bleeding
of 3 year
night sweat
44
Patient Note: Ms. Montgomery is a 44 YOF G2P2002 with Hx of HTN here with cheif complaint of irregular periods.
-Irregular periods last 3 years with cycles between 3 weeks and 4 months
-Vaginal dryness, occasional hot flashes, no changes in weight
-Other symptoms: episode of drenching night sweats last week, two days of N/V last week as well, no headaches, changes in vision, dysuria, diarrhea, or constipation
-Meds: HCTZ
-Allergies: none
-Surgeries: none
-FHx: mom with OA, brother with HTN
-Gyn: started periods at age 14, been on copper IUDs for 20 years, last one place 4 years ago, regular 28-29 day periods up until 3 years ago
-SocHx: denies smoking, reports occasional social drink at events, denies recreational drug use; sexually active only with her husband of 14 years; has 2 kids and is an office manager at an investment firm; no increased stressors


Keywords and phrases relevant to diagnosis:
regular 28-29 day periods up until 3 years ago
IUDs
sexually active
Vaginal dryness
irregular periods
F
hot flashes
cycles between 3 weeks and 4 months
last 3 years
drenching night sweats
44
Patient Note: HPI: 44 yo F with co irregular mentrual cycles for the past 3 years used to have her periods reularly ever 28d/5d with moderate flow and light PMS, now between 3 weeks and 4 months with very heavy to very light flow for 2-6 days. Menarche at age 14. recently started having hot flashes and excessive sweating. woke up drenched in sweat last night. uses lubricant against vaginal dryness, menarche at age 14, 2P2G, last PAP 1 y ago normal, no Hx of abnormal PAP smears. no abdomninal pain, no vaginal discharge, no weight change, no change in appetite, no change in bowel movements, no fatigue
OBGYN as per HPI
ROS negative except as above
Allergies: NKDA
FH: noncontributory
PSH: none
PMH: hypertension
Meds: HCTZ
SH: lives with husband and 2 sons, works as office manager, sexually active with husband only, uses IUD for contraception, excersis 3-4 times a week

Keywords and phrases relevant to diagnosis:
used to have her periods reularly, used to have her periods ever 28d, used to have her periods ever 5d, used to have her periods with moderate flow
PAP 1 y ago
IUD
sexually active
vaginal dryness
irregular mentrual cycles
F
hot flashes
now between 3 weeks and 4 months, with very heavy to very light flow, for 2-6 days
for the past 3 years, for 3 years
sweating, drenched in sweat
woke up drenched
44 yo
Patient Note: Ms. Montgomery 44 yo F who presents w/ irregular periods for 3 yrs. States that they are unpredictable with no pattern; lasts 2-6 days with light or heavy menstraution. LMP was 2 months ago. Patient does endorse having a copper IUD, non hormonal; last pap smear was 1 year ago and was normal. Patient denies having any abdominal pain, or changes in bowel/bladder habits; denies fevers, chills, nausea, vomiting, no changes in diet or recent sick contacts, no vaginal odors or discharge. Patient does endorse one episode of night sweats one week ago, has not had a repeat episode since then.

Keywords and phrases relevant to diagnosis:
last pap smear was 1 year ago
IUD
irregular periods, periods are unpredictable, periods with no pattern
Ms, F
LMP was 2 months ago
lasts 2-6 days, with light or heavy menstraution
for 3 yrs
night sweats
44 yo
Patient Note: CC: irregular periods
HPI: 44 y/o F G2T2P0A0L2 presents w/ 3 years of irregular periods lasting 2-6 days in length. periods are variable in length and flow, varies between light or heavy. she has had hot flashes and sweating for the past year. LMP 2 mo ago. Last saw OB/GYN 3 yrs ago, last pap smear 1 yr ago, was wnl. she has also had vaginal dryness for 1 yr, uses lubricant.
ROS: denies headache, lightheadedness, fatigue, weight gain/loss, vaginal discharge/spotting, vaginal pain, NVD
PMHx: HTN
Meds: HCTZ
Allergies: none
Hospitalizations: only for birth of 2 children
FHx: mom has osteoarthritis and obesity. brother has HTN. 2 healthy children.
SHx: works as office manager, "loves it", married to husband, monogamous. exercises and eats healthy diet. no tobacco or drugs, social EtOH. 2 pregnancies, both term, no history o STI. uses IUD for contraception.

Keywords and phrases relevant to diagnosis:
last pap smear 1 yr ago
IUD
vaginal dryness
irregular periods
F
LMP 2 mo ago
hot flashes
varies between light or heavy, variable in flow, variable in length
3 years of
sweating
44
Patient Note: Dolores Montgomery is a 44 y.o. G2P2 presenting to the clinic today for irregular periods starting 3 years ago. LMP was 2 months ago. Periods previously regular, now up to 4 months apart with 2-6 d of bleeding. She experiences no pain with these periods and flow can range between heavy and light. She is sexually active and monogamous with her husband. She uses a copper IUD for contraception. She does not have increased fatigue but does report night sweats (with one particularly bad episode last week), hot flashes, and vaginal dryness that began a year ago. Denies diarrhea, constipation, heart racing, and states mood is ok today. She had flu like symptoms last week which have resolved. Births were SVD, no complications.

PMH: HTN, on HCTZ
Surgeries: None
FH: Mom osteoporosis, Brother HTN; no hx early menopause
SHx: Office manager, no current/former tobacco use, no drug use, no travel hx, occasional wine, sexually active w/ husband

Keywords and phrases relevant to diagnosis:
Periods previously regular
IUD
sexually active, monogamous, sexually active
vaginal dryness
irregular periods
flu like symptoms last week
LMP was 2 months ago
hot flashes
now up to 4 months apart, with 2-6 d of bleeding, flow can range between heavy and light
starting 3 years ago
night sweats
44 y.o
Patient Note: Dolores Montgomery is a 44yo G2P2 female presenting with irregular periods. Periods used to be regular at 28-29 days with moderate flow. Now they range from 3 weeks to 4 months and are "consistently inconsistent" in timing, and her flow ranges from light to heavy. She reports hot flashes and sweating recently, and a bout of PMS a few days ago with breast tenderness. She denies fatigue, headache, changes in diet or exercise. She does not have any vaginal discharge. She reports vaginal dryness over this period of time and is now using lubricant. She is monogamous with her husband and has no history of STIs. She denies urinary, bowel, digestive symptoms.
PMH: HTN
Meds: HCTZ
Allergies: NKDA
FHx: older brother HTN, mom osteoarthritis
SHx: no smoking, 1 glass of wine sparingly, no drugs. Works as office manager in investment firm. denies increased stress.


Keywords and phrases relevant to diagnosis:
Periods used to be regular
monogamous with her husband
vaginal dryness
irregular periods
female
hot flashes
range from 3 weeks to 4 months and are "consistently inconsistent" in timing, flow ranges from light to heavy
sweating
44yo
Patient Note: 44yo F who presents with 3 years of increasingly irregular periods. Reports no pattern to her period, the interval between periods can be up to 8 weeks. When they occur, they can be either heavy or light. Previously, her periods occured montly, lasted 2-3 days and she used approximately 3 pads per day. Now, when bleeding is heavy, she uses around 5-6 pads. She also has been experiencing occasional hot flashes that last 1-2 minutes, they primarily occur during the day. She has noted vaginal dryness, for which she uses lubricant during sexual activity. One episode of night sweating. No vision 

OB/GYN: G2P2, vaginal deliveries. Menarche at 14

PMH: hypertension
FH: mother with osteoarthritis and obesity, unsure when she went through menopause. Father alive and well, brother with hypertension
PSH: no surgeries
SH: no tobacco, no illicit drug use, occl EtOH at celebrations. Sexually active with husband, uses lubrication
MEDS: HCTZ

Keywords and phrases relevant to diagnosis:
Previously periods occured montly, Previously periods lasted 2-3 days
Sexually active, sexual activity
vaginal dryness, uses lubricant during sexual activity, Sexually active uses lubrication
irregular periods, no pattern to her period
F
hot flashes
interval can be up to 8 weeks, can be either heavy or light
3 years of
night sweating
44yo
Patient Note: Ms Montgomery is a 44F who presents with irregular periods. She reports that over the last 3 years her periods have become irregular and she has had variable amount os bleeding. She got her first period when she was 14 and had 28 day cycles with 3-4 days of moderate bleeding (3-4 pads/day) with mild cramping. She has had two pregnancies. Her LMP was 2 mongs ago and lasted 4 days with moderate flow. She reports that her periods over the last 2 years have been variable in flow. She notes that she has had occasional hot flashes/sweating episodes as has had one night sweat recently. She does not notice any changes in her mood. Doesn't know when her mom got her period, doesn't know sister's menstrual history
PMH: HTN, meds: HCTZ
SH: no drugs, occasional glass of wine, lives with husband and two kids
FH: no cancer known, older brother with HTN
ROS: no change in bowel habits, no change in urination, no change in mood, no headaches

Keywords and phrases relevant to diagnosis:
had 28 day cycles with 3-4 days of moderate bleeding
periods have become irregular, irregular periods
F
LMP was 2 mongs ago
hot flashes
had variable amount os bleeding, periods have been variable in flow
over the last 3 years
sweating episodes
44
Patient Note: 44 yo F presenting with a 3 year histpry of irrgular periods. Her periods had previously been regular, every 4 weeks lating 4-5 days, with moderate bleeding, using about 3-4 pads a day. In the last 3 years, it had been irregular, ranging from a light period to a heavy bleed, requiring 5-6 pads a day. Her LMP was 2 months ago, with moderate bleeding. Denies any other symptoms. No excessive fatigue, double vision, changes in bowel movements, breast changes. 
No dysuria or dyspareunia. No abnormal vaginal discharge. Does endorse vaginal dryness, relieved with ointment. No changes in mood or irritabillity. No hot flashes. 
ROS otherwise negative. 
PMH: HTN
PSH: None
Meds/allergies: HCTZ
Obgyn: G2P2. Normal vaginal deliveries, with no pre pr post partum compllication. Menarche at 14. regular periods until recently. Has sex with her husband. Uses IUD for protection. No dyspareunia. Endorses vaginal dryness, relieved with ointments


Keywords and phrases relevant to diagnosis:
periods previously every 4 weeks, periods previously lating 4-5 days, periods had previously been regular, periods previously with moderate bleeding, regular periods until recently
IUD, Uses IUD
sex with her husband, Has sex with her husband
vaginal dryness, vaginal dryness, Does endorse vaginal dryness
irrgular periods, it had been irregular
F, 44 yo F
LMP was 2 months ago, Her LMP was 2 months ago
ranging from a light period to a heavy bleed, requiring 5-6 pads a day
3 year histpry of, In the last 3 years, 3 year histpry
44 yo, 44 yo F
Patient Note: A 44 F presents with irregular periods for the past three years. She states that there is no pattern; they can last from 2-6 days and can be heavy and light reuqiring as little as 1-2 tampons or 5-6 tampons. She describes having hot flashes and sweating. She denies visual changes, nipple discharge or mood changes. Her LMP was 2 months ago and sge described it as regular (3-4 tampons a day for 4 days)
Ob: Her first period was at the age of 14, her periods would occur every 28 days, last 4 days and would require 3-4 tampons per day. She also had back pain, breast tenderness, cramps. She currently denies vaginal discharge. She has vaginal dryness. She currently has an IUD. 
PMH: HTN on HCTZ 12.5 
Sexual history: no STIs, monogamous with husband
Social history: 1-2 glasses of wine. NO drugs/ smoking/ lives with her husband and son
FH: osteoperosis for mom/ HTN for brother


Keywords and phrases relevant to diagnosis:
periods would occur every 28 days, periods would last 4 days, periods would require 3-4 tampons per day, described it as regular (3-4 tampons a day for 4 days)
IUD
monogamous
irregular periods, periods there is no pattern
F
LMP was 2 months ago
hot flashes
last from 2-6 days, can be heavy and light, reuqiring 1-2 tampons or 5-6 tampons
for three years
sweating
44
Patient Note: Ms Montgomery is a 44 yo female who presents with a 3 year history of irregular periods. There is no pattern, the longest she has gone without a period is 4 months. Bleeding lasts 2-6 days and can be heavy or light, not related to the elapsed time between periods. Up until 3 years ago, her periods were very regular. She has noticed vaginal dryness that has been relieved with lubricant. She has also noticed hot flashes and sweating. She had one episode of drenching night sweats last month. She denies spotting between the periods, weight change, dyspareunia, and fatigue. She rarely even feels her normal PMS symptoms with periods (cramps, breast tenderness). Mood is good.
Gyn history: two vaginal deliveries, no abortions, last PAP 1 year ago, normal, menarche at age 14.
ROS: negative except as above
Meds: HCTZ
Allergies: none
PMH: HTN, no surgeries
SH: sexually active with husband, has IUD. Never smoker, rare EtOH, no drugs
FH: HTN

Keywords and phrases relevant to diagnosis:
until 3 years ago, periods were regular
PAP 1 year ago
IUD
sexually active
vaginal dryness, dryness relieved with lubricant
periods no pattern, irregular periods
Ms, female
hot flashes
gone without a period is 4 months, Bleeding lasts 2-6 days, can be heavy or light
3 year history of
sweating, drenching sweats
44 yo
Patient Note: HPI: 44F who presents with irregular periods for the past 3 years. Her last menstrual period was 2 months ago, with moderate flow (2-3 pads or tampons per day) and lasted 4-5 days. Prior to 3 years ago, she had regular periods every 28 days, which lasted 4-5 days. Her first menstrual period was at age 14. Reports hot flashes, weating and vaginal dryness and night sweats (1 week ago). Reports nausea and vomiting (nonbloody, unsure color) 1 week ago. Denies weight changes, dysmenorrhea, or spotting in between periods. Sexually active with husband with IUD as only contraception. 2 prior pregnancies, both normal sponataneous vaginal births with no complications. 
PMH: hypertension (diagnosed 6 years ago)
PSH: none
Meds: HCTZ: 12.5 mg/day
NKDA
FH: mom with osteoarthritis, overweight, brother: HTN
SH: lives with husband and 2 sons, feels safe at home. Occupation: office manager. Alcohol: 1 glass of wine socially. Drugs/smoking: never.

Keywords and phrases relevant to diagnosis:
Prior had regular periods, Prior periods every 28 days, Prior periods lasted 4-5 days
IUD
Sexually active
vaginal dryness
irregular periods
nausea 1 week ago, vomiting 1 week ago
F
last menstrual period was 2 months ago
hot flashes
for the past 3 years, for 3 years
weating, night sweats
44
Patient Note: Dolores Montgomery is a 44 year old female who presents with a history of irregular periods. She noticed a change 3 years ago; before this time she had regular 28 day cycles that had moderate flow (of note, before each menstruation she had low back pain and breast tenderness). Over the last 3 years her periods are "unpredictable" happen every 3 weeks to 4 months, last 2 to 6 days, and the flow is anywhere from light to very heavy. She has also had occasional hot flashes and night sweats- the other day she woke up covered in sweat and decided it was time to see a doctor. 
She has an IUD in place- put 4 years ago. Last pap smear was 1 year ago. Denies fatigue, chest pain, SOB
PMH- HTN, only hospitalization was for her 2 childbirths, no surgeries
Medications- IUD, HCTZ 
allergies-none 
Family history- dad healthy, mom osteoarthritis (not sure when she started menopause)
Social- no smoking, rare drinker, no illicit drug use

Keywords and phrases relevant to diagnosis:
Last pap smear was 1 year ago
IUD
irregular periods, happen every 3 weeks to 4 months, periods are "unpredictable"
female
hot flashes
flow is anywhere from light to very heavy, last 2 to 6 days
Over the last 3 years, 3 years ago
night sweats, covered in sweat
44
Patient Note: Dolores Montgomery is a 44yoF presenting with irregular periods. For the past 3 years, she has experienced periods that can last 2-6 days, occur every 3 weeks to 4 months, and are sometimes light and sometimes heavy. She endorses hot flashes and vaginal dryness for 1 year, and 1 episode of night sweats last week. She has a copper IUD and is sexually active with her husband. She took 2 pregnancy tests last week and both were negative. Her old periods were predictable lasting 4 days and occuring every 28-29 days. She denies vaginal discharge. Denies dizziness, lightheadedness, changes in hair, cough, chest pain, shortness of breath, recent travel, weight gain, or weight loss. 
PMHx: Hypertension
Surgical history: None
Meds: HCTZ
Allergies: None
FamHx: Mother - osteoarthritis, brother - HTN, father healthy
SocHx: Works as an office manager. No new stressors. No smoking. Drinks occasionally at celebrations. No drugs. 
ROS: Above

Keywords and phrases relevant to diagnosis:
old periods were predictable, old periods lasting 4 days, old periods occuring every 28-29 days
IUD
sexually active
vaginal dryness
irregular periods
F
hot flashes
occur every 3 weeks to 4 months, sometimes light and sometimes heavy, last 2-6 days
For 3 years
night sweats
44yo
Patient Note: This is a 44 year old female with a past medical history of HTN (taking HCTZ, presenting today with a 3 year history of irregular bleeding.  Patient states that periods are unpredictable lasting any where from 2-6 days and sometimes the bleeding is light and sometimes it is heavy.  Periods were regular prior to 5 years ago with moderate bleeding.  Patient does endorse some vaginal dryness, some day time sweating, and one episode of drenching night sweat.  She denies weight changes, fatigue, appetite changes, fever, nipple dischartge, bleeding after sex, or skin changes.  Patient also denies abdominal fullness, pain or bloating.  No nausea or vomiting.

OBGYN:  Pap smear was 1 year ago was normal.  She has had two uncomplicated vaginal pregnancies. has IUD.
PMH:  HTN, HCTZ, no sugeries, no allergies
Family:  Mom has osteoarthritis and is overweight, dad is fine
social:  no tobacco, drinks rarely, walks 4-5 times a day, and no drug


Keywords and phrases relevant to diagnosis:
Periods were regular prior to 5 years ago
Pap smear was 1 year ago
IUD
vaginal dryness
irregular bleeding, periods are unpredictable
female
lasting any where from 2-6 days, sometimes the bleeding is light and sometimes it is heavy
a 3 year history
sweating, drenching night sweat
44
Patient Note: 44 y/o F comes in due to irregular periods that being going on for the past 3 years. She states that her periods use to be every 28 days that will ast 5 days. But now her periods range between 3 weeks to 4 months lasting between 2-6 days. She states that she also has menstraul cramping. She states that she has nausea for 48 hours with the color being her food she eat before. Pt feels hot with some sweating, but denies feeling cold. She states she experiences hot flashes. 
ROS: negative except above
OBGYN: P2A0P2- no complications during pregnacy
SH: married, has intrauterine device. sex with husband. drinks Etoh 1/3 months. denies smoking and recreational drug use. pt exercises 3/week. diet consist of meats and fruits
OBGYN; G2/A0/P2

Keywords and phrases relevant to diagnosis:
periods use to be every 28 days
intrauterine device
sex with husband
irregular periods, now her periods range between 3 weeks to 4 months
F
hot flashes, feels hot
going on for the past 3 years
sweating
44
Patient Note: HPI:
Dolores Montgomery is a 44 year old female with a history of hypertension who presents with 3 years of irregular menstrual periods. She relays that the interval between periods is irregular, and they last between 2-6 days, sometimes heavier with 6-7 pad changes/day, and sometimes lighter. She denies any pain or fullness in the pelvis. She has occassional breast tenderness before her periods. She denies any change in vaginal discharge or fevers. She also denies any headaches, visual changes, galactorhea, constipation, diarrhea, abdominal pain, fatigue, or cold/heat insensitivity. No significant change in weight or exercise habits.

FH: HTN and obesity

PMH: HTN- takes HCTZ
no other meds or over the counter supplements.

OB/GYN: menarche at 14 with regular periods until 3 years ago. G2P2 with 2 vaginal deliveries

Keywords and phrases relevant to diagnosis:
regular periods until 3 years ago
irregular periods
female
sometimes heavier sometimes lighter, sometimes with 6-7 pad changes/day, and sometimes lighter, interval is irregular, last between 2-6 days
3 years of
44 year old
Patient Note: Mrs. Montgomery is a 44yo female presenting with irregular periods for the last 3 years. These range from 2-6 days in length with her cycles lasting from 3 weeks to 4 months. Her menstrual flow can be either heavy or light ranging fro 2-3 pads/day to 5-6 pads/day. Her periods are not painful. She has also had night sweats and hot flashes during this time period. She has not experienced dizziness, palpitations, intermentrual bleeding or vaginal discharge. She is sexually active with her husband (monogamous) and has no dyspurinia but does experience some vaginal dryness which she uses lubrication for. 1 weeks ago did have some nausea and vomitting for a day which resolved on its own. 
Denies changes in mood or energy.
PMHx: HTN, takes HCTZ, no surgeries
FMHX: OA, obsesity in mom and HTN in brother

Keywords and phrases relevant to diagnosis:
sexually active, (monogamous)
vaginal dryness
irregular periods
1 weeks ago have nausea and vomitting
female
hot flashes
range from 2-6 days, lasting from 3 weeks to 4 months, flow can be either heavy or light, ranging fro 2-3 pads/day to 5-6 pads/day
for the last 3 years
night sweats
44yo