bhatthars/nbme_qna huggingface dataset:
Patient Note: Angela Tompkins, a 35-year-old female, with c/o irrgualr uterine bleeding. For the past 6 motnsh she ahs noted heavyier periods and irregulites in her period frequency. her LMP was 2 months ago and she had to change her tampons "every few hours." Normally her peirods came regularly every 4-5 weeks last 3-4 days and she would use 4 tampons on the heaviest days. She also notes mild abdominal crmaping. She notes infertilliy after trying wiht he husband for several years. she has notice a 10-15 pound weght gain
ROS - for Nausea vomiting, chest pain, vaginal discharge, dysuria, diarreha constipation, heat intolerance. 
PMHx, PSHx NA
Allergies NKDA
Meds: NA
Fhx: + for grandmother with cervical CA, aunt with breast CA
OBGYN: G0. two adopted children
Social, works in administration. drinks occationally denies tobacco and illict drug use
Sexual Hx: Sexually active with husban, no longer uses condoms, No STI hx in her or her partner

Keywords and phrases relevant to diagnosis:
female
weght gain, 10-15 pound gain
irrgualr uterine bleeding, heavyier periods, irregulites in her period, change her tampons "every few hours
LMP was 2 months ago
no longer uses condoms
infertilliy
35-year-old
6 motnsh
Patient Note: 35 YO F C/O MENSTRUAL PROBLEMS
5 MONTHS OF HEAVY FLOW, IRREGULAR, INFERTILITY, 10 LBS WEIGHT GAIN, DARKNESS NECK AND KNUCKLES
DENIES HEADACHE, LIGHTHEADEDNESS, SOB, CHEST PAIN, ABD PAIN, CHANGES IN BOWEL URINARY HABITS 
ROS: NEGATIVE EXCEPT ABOVE
PMH: NONE
OBGYN: MENARCH 12 YO, LMP 2 MONTHS AGO, MENSES BEFORE 3/30 MODERATE FLOW, CURRENT 7/60 HEAVY FLOW. LASP PAP 6 MONTHS AGO NORMAL, PREGNANCIES 0 
PSH: NONE 
FH: AUNT BREAST CA, GRANDMOTHER CERVICAL CA 
MEDS: NONE
ALL: NKDA
SH : SCHEDULING COORDINATOR, DENIES SMOKING, ETOH OCCASIONAL, DENIES DRUGS, NO DIET OR EXERCISE, SEXUAL ACTIVITY NO BARRIER CONTRACEPTION 


Keywords and phrases relevant to diagnosis:
F
WEIGHT GAIN, 10 LBS GAIN
HEAVY FLOW, FLOW IRREGULAR
LMP 2 MONTHS AGO
NO BARRIER CONTRACEPTION
INFERTILITY
35 YO
5 MONTHS
Patient Note: Mrs. Tompkins is a 35 yo F presenting with heavy menstruation. Her sx began 6 mo ago. Previously she had her period every 4-5 weeks, lasting 3 days. Now her periods have become irregular, lasting 7 days. Also, she previously used 3 pads a day for her periods, she now uses about 7 pads. Her last menstrual period was 2 mo ago and she had her first period at age 12. She has not complained of any vaginal itchiness, discharge, dryness. She does not experience intense cramps during her cycle. No spotting is noted. She has tried to get pregnant for 7 years with no success. Last Pap smear was 6 mo ago - normal

ROS: 10 lb weight gain in 6mo; eats out often; decreased energy. Discoloration of knuckles and neck 
PMH/PSH: None
Allergies: NKFDA
Meds: None
Fam hx: GM- cervical CA; Aunt - breast CA
Social: divorced, 2 adopted daughters; works in social work. No smk/drugs, rare alcohol use
sexual hx: sex with bf, no condom

Keywords and phrases relevant to diagnosis:
F
weight gain
heavy menstruation, periods irregular, Now lasting 7 days, now uses about 7 pads
last menstrual period was 2 mo
no condom
decreased energy
tried to get pregnant for 7 years with no success
35 yo
6 mo
Patient Note: 35 yo F presenting with 6 mos of heavy periods. She used to have periods every 4-5 weeks lasting 3-4 days now has had 2 periods in the last 5 months with increased tampon use. She denies passage of large clots. No dysmennorhea. She has been more fatigued over the past 2 years. No alleviating or aggravating factors. She has had a 10 lb weight gain in the past year and attributes it to eating out more. She has low fruit and vegetable intake. No abdominal pain. 
ROS: No h/a, visual changes, n/v, constipation, diarrhea, melena, hematochezia, dysuria, vaginal discharge, leg edema
PMH: None
PSH: none
FH: Gma died of cervical cancer, aunt died of breast cancer
SHX: works for state social services, has 2 kids (adopted), has never been able to get pregnant
No tobacco use, social ETOH use, no OCP or barrier protection, sexually active with boyfriend only
NL pap smear 6 mos ago
Meds: none

Keywords and phrases relevant to diagnosis:
F
10 lb weight gain
heavy periods, 2 periods in the last 5 months, increased tampon use
no OCP or barrier protection
fatigued
35 yo
6 mos
Patient Note: 35 YOF C/O HEAVY MENSTRUAL BLEED, HER CYCLE HAS BECOME IRREGULAR,  SHE BLEEDS HEAVILY FOR 7 DAYS AND HAS 2 CYCLES X 6M. THIS IS NOT A/W ANY PAIN OR FEVER. SHE ADMITS FAMILY HISTORY OF ENDOMETRIAL AND BREAST CANCER, GAINING 10LB IN THE PAST 6 MONTHS, STRESS AND FEELING TIRED, INFERTILITY( PAST 9 YEARS BUT SHE HAS 2 CHILDREN).  SHE DENIES ANY HEAT INTOLERANCE, VOICE CHANGES , OR TRAUMA, LIGHTHEADEDNESS, BOWEL CHANGES OR URINARY CHANGES, USING OCPS.
ROS: NEGATIVE EXCEPT ABOVE
PMH: NONE   PSH: NONE  MEDS: NONE   ALLERGIES: NONE   
SSH: NON SMOKER DRINKER OR DRUG USER
SEXUALLY ACTIVE WITH  BOYFRIEND WITHOUT ANY PROBLEMS
UTD WITH SCREENINGS

Keywords and phrases relevant to diagnosis:
F
GAINING 10LB
HEAVY MENSTRUAL BLEED, CYCLE HAS BECOME IRREGULAR, BLEEDS HEAVILY FOR 7 DAYS
TIRED
INFERTILITY
35 YO
6M
Patient Note: Ms. Tompkins is a 35 yo F c/o dysmenorhea. She noticed her menstrual cycle stop 6 months ago with breakthrough bleeding occuring every few months with alot of blood. 
-Her LMP was 2 months ago using several pads and lasting a week. Did not have fatigue during this time. 
-She ALSO GAINED 10 PUNDS DURING THIS TIME. aLSO, noticed dark skin changes on her knuckles and neck over the past 2 years.
-unable to conceive a child with no protection for 9 years
-ros therwise negative 
- works as an analyst, adopted 2 children with boyfriend, sexually active with no protection, no hx of STIS
PMh/PSH: NONE, NO MEDS, NO ALLERGIES
-FAM HX OF OVARIAN CANCER AT 65 IN GRANDMA AND BREAST CANCER AT 51 IN AUNT


Keywords and phrases relevant to diagnosis:
F
GAINED 10 PUNDS
alot of blood
LMP was 2 months ago
no protection
unable to conceive
35 yo
6 months
Patient Note: 35 yo F c/o menorrhagia.
-began 5 weeks ago, LMP 6 month ago, before that  perioids are regular, 3/30days, 4 pads on the heavy day, now every other months, lasting 7 days and pad change every several hours
-noted skin pigmentation on the dorsal hands and wt gain of 10-15 lbs over past 6 months, no pain, no itching
-history of difficulty pregnancy for 9 yr
-no pain or spotting during the peroids, no pain or bleeding the sexual intercourse, no vaginal discharge, no belly pain, no prevous pregnancy, no abortion, 
-normal PAP smear, sexually active with boyfriend, no condom use or OCP
ROS: no fever, no night sweats, no cold intolerance, no dry skin, no voice change, no change in urination or bowel movement, no change in sleep, no fatigue,no felling of depresion
PMH/PSH:nONE. All:NKDA. Meds:None. FH: Mother with breast Ca, prandmorther with cervical Ca. SH: coordinaotr, occasional EtOH., living with 2 adopted children,no abuse

Keywords and phrases relevant to diagnosis:
F
wt gain, gain of 10-15 lbs
pad change every several hours, perioids every other months
no condom use, no OCP
35 yo
6 months
Patient Note: Miss. Tompkins is a 35 y/o female with no sig. PMH who presents with painless vaginal bleeding onset 5 months ago gradually worsening. Prior menstrual cycles utilized 3 tampons and not as severe. LMP 2 months ago. No hx of sti/std. Last pap smear 6 months ago normal. FHx significant for grandmother with cervical cancer. Ho social hx of smoking. Started menses at 12 y/o with menstrual cycles occuring 4-5 weeks. Sexually active with boyfriend with no contraception. Denies abdominal pain, nausea, vomting, pain with urination or defecation, pain with sexual intercourse, trauma to area, changes in hair, HA, visual changes, breast discharge.

Keywords and phrases relevant to diagnosis:
female
LMP 2 months ago
no contraception
35 y/o
5 months
Patient Note: 35 year old female c/o heavy menstrual bleeding over the past 6 months. LMP reported as 2 months ago. Pt states she normally gets her menses every 4-5 weeks and they last 3 to 4 days; Pt states she normally uses 4 pads on the first day then it slowly tapers down to one. Pt however states that she has been skipping periods and that she now uses 7 pads on first  day which is unsual for her. Pt denies any pelvic pain. Associated sxs consist of 10-15 lbs weight gain over the past 6 months along with feeling tired more often and a dark rash over the neck and hands. Pt denies any abnormal vaginal discharge. Pertinent negatives includes no breast discharge or tenderness, no hot or cold intolerance, no abdnormal hair growth, no HA or vision problems; CP/SOB. 

PMHx is unremarkable. No current meds; No recent hospitalizations or past surgeries. 
Social hx: EtOH: 1-2 beers/ month; no tobacco or other drugs; no recent travels; pt is

Keywords and phrases relevant to diagnosis:
female
weight gain
heavy menstrual bleeding, skipping periods, 7 pads on first  day
LMP reported as 2 months ago
tired
35 year old
6 months
Patient Note: HPI:A 35 yo F present with problems in her mentrual period. For the last 6 months is being hevier. Before use 4 tampons and now change tampons every hr. Feel tire. GAin weight 10-15 lbs last month. Denies other complaints.
ROS: negative except as above.
OBGYN: LMP 2 month ago, mense regular 4 TPD,  now change tampons every hr, No STD hx, LPS 6 month ago was normal and no previous positive sresults. No contraception. G0P0
ALL: none
Meds: None
PMH: none
PSH: none
FH: Aunt breats cancer, grandmother cervical cancer
SH: administrator, no smoke, ocassional etOh, no drug, no excersice, diet, new boy freind since last year no contraception use, previous boyfriend triend to get pregnant for 9 yaer witout sucess.

Keywords and phrases relevant to diagnosis:
F
GAin weight 10-15 lbs
problems in her mentrual period, mentrual period hevier, now change tampons every hr, now change tampons every hr
LMP 2 month ago
no contraception
triend to get pregnant for 9 yaer witout sucess
35 yo
6 months
Patient Note: 35 year old F presents with irregular periods. states that her periods used to be regular every 4-5 weeks lasting 3 days but for the past 6 months her periods are irregular, she has only had 2 periods in the last 5 months and they have been heavier than usual requiring more tampons and lasting for 7 days. reports weight gain of 10 lbs in the past 6 months and a new dark skin rash on her hands and neck but denies any fevers, chills, abd pain, bleeding off cycle, spotting, discharge, breast lumps, nipple discharge. has been unable to get pregnant for 9 years of trying. no obvious improving or worsening factors

pmh none
psurg none
all none
meds none
obgyn: menarche 12, last pap was 6 months ago was normal, 
fhx: cervical cancer in grandmother (65 yrs old), aunt with breast cancer (51)
soc: etoh 1-2x monthly, no tobacco or illicit drugs,works as social work scheduler,sexually active with boyfriend uses condoms occasionally,no STDhx

Keywords and phrases relevant to diagnosis:
F
weight gain, gain of 10 lbs
irregular periods, periods are irregular, requiring more tampons
uses condoms occasionally
unable to get pregnant
35 year old
6 months
Patient Note: Ms. Angela Tompkins, 35, 6 month history of heavy periods
LMP: 5 weeks ago, changing tampon every couple of hours, periods are lasting for 7 days. She denies bleeding or pain during intercourse. She denies any abdominal pain or fullness. She denies cramping. 
Patient has infertility and has two adopted children, ages 3 and 5. Patient has gained 10-15 pounds in the last 6 months. She denies a change in appetite though she has been eating out more frequently. Patient has never had an STI. She has no previous mammogram. Her last pap smear was 6 months ago and was normal. 
PMH: None
FH: Mom: cervical cancer, Aunt breast cancer
SH: Patient is a scheduling coordinator. 
ROS: Patient denies changes in vision, headache, night sweats, changes in urinary habits, changes in bowel habits. She denies joint pain.

Keywords and phrases relevant to diagnosis:
Ms
gained 10-15 pounds
heavy periods, changing tampon every couple of hours
LMP: 5 weeks ago
infertility
35
6 month, 6 months
Patient Note: The patient is a 35 yo G0P0 obese female with no significant PMH who presents of heavy and irregular periods starting 5 months ago. She states her periods have been coming once every two months, and last 7 days. The bleeding is heavy, with her having to change her tampon every two hours during the first day. Her periods were previously regular, occuring every 30-35 days, and lasting 3 days. She also states that she has never been pregnant despite trying for several years previously. Menarche was at ge 12. No pain or cramping during her periods. ROS: postive for fatigue. Negative for nausea, vomiting, diarrhea, constipation, CP, SOB. PMH: none Med: none Allergies: none FH: parents healthy, mat aunt died from breast cancer. mat GM died from cervical cancer. PSH: none SH: works as a scheduling coordinator. Has two adopted daughers, ages 3,5. No smoking, occasional alc. Sexually active with boyfriend, no condom use. no STI

Keywords and phrases relevant to diagnosis:
female
heavy periods, irregular periods, periods have been coming once every two months, periods last 7 days, bleeding is heavy, change her tampon every two hours
no condom use
fatigue
never been pregnant despite trying
35 yo
Patient Note: Angela Tompkins is a 35yo female having irregular, heavy menstrual cycles. It began 6 months ago. Previously her periods occured every 4-5weeks needing 4 tampons at the heaviest flow. Now, she has periods irregularly and changes multiple tampons every few hours. Menarche at 12 years old but needed OCPs to control periods since 13 until she stopped. She tried to conceive for 9 years with prior husband off birth control without success. The patient last had a period 2 months ago. No abnormal discharge. Normal pap. Sexually active. No STIs as of 6 months ago. Increased in weight 10-15 lbs. Denies nausea, vomiting, polyphagia, polydypsia, ulcers, changes in hair, voice depening, palpitations, breast swelling or exudate.
ROS: Neg exept above
PMH, allergies, meds: none, no surgeries
FHx: Aunt died of breast CA,  grandmother had cervical cancer
Social: - smoke, drugs, + 1-2 beers during outings, monogamous, sexually active, 2 adopted sons

Keywords and phrases relevant to diagnosis:
female
Increased in weight
irregular menstrual cycles, heavy menstrual cycles, periods irregularly, changes multiple tampons every few hours
last had a period 2 months ago
tried to conceive without success
35yo
6 months
Patient Note: CC: Problem with periods
HPI: Pt is a 35-year old G0P0 F that comes into the office with a CC of irregular periods of 5 months durations. Periods come every 2 months. Lasts 7 days. Heavy bleeding (changes tampons q1-2h during first day). Mild cramping with periods. Hx of infertility and does not use condoms with bf. No clots. No urinary complaints; 10-15lb weight gain over 6 months. No cold or heat intolerance. LMP was 2 months ago. No nausea or vomiting; no pain with sex. No history of STD's. Last pap was normal (6 months ago). 
ROS: negative unless indicated above
Allergies: NKDA
Meds: None
Surgical: None
PMH: None
Social History: Lives with bf and 2 children (adopted). Divorced. No history of STD's. No tobacco. No drugs. Drinks 1-2 beers/month. 
Family Hx: Aunt deceased- breast cancer; Grandmother deceased-Cervical cancer


Keywords and phrases relevant to diagnosis:
F
weight gain
irregular periods, Heavy bleeding, changes tampons q1-2h
LMP was 2 months ago
does not use condoms
infertility
35-year old
5 months, 6 months
Patient Note: Angela Tompkins is a previously healthy 35 yo F presenting with irregular periods and increased mensrtrual bleeding.  In the last 6 months she has noticed increased bleeding especially on the first day of her period so that she now uses 7 tampons/day verses her normal 3.  Her periods have also become irregular with only 2 in the last 6 mo.  Her last period was 2 mo ago.  Her periods were previously ever 4-5 wks.  She also endorses fatigue which has preceded the menstrual symptoms by couple years.  She is sexually active with her boyfriend.  Denies dyspareuna, cervical or vaginal tenderness, or easy bruising.  She has also no notice changes in facial hair or a deeping voice. Endorses 10 pound weight

PMH: none
FH: Breast cancer - aunt; Cervical cancer - Mom
SH: No smoking history, rare alcohol use, no substance use

Keywords and phrases relevant to diagnosis:
F
irregular periods, increased mensrtrual bleeding, increased bleeding, uses 7 tampons/day, periods irregular
last period was 2 mo ago
fatigue
35 yo
6 months, 6 mo
Patient Note: Mrs. Tompkins is a 35 year old previously healthy female who presents with chronic dysmenorrhea, most notable over the past  6 months. She reports her periods are very heavy and she sometimes skips her period. She is currently sexually active with her boyfriend and they dont use condoms because she states " I cant get pregnant" She explains she was with her ex husband for 9 years and could not get pregnant during that time. She was as young as a teenager when her periods were irregular, skipping months. she started taking birth control at this time which resulted in normalization of her periods, but stopped when she saw she was unable to get pregnant. She has some cramping that goes along with her periods. Denies SOB, chest pain, nausea vomiting, fever and chills

PMH: no history of STIs
Meds: None
Social: 2 adopted kids. Has 1 partner. does not use condoms. alcohol 1-2 drinks/ mo.
Family: no family history of bleeding disorders

Keywords and phrases relevant to diagnosis:
Mrs, female
periods are very heavy, sometimes skips her period
dont use condoms, does not use condoms
cant get pregnant, could not get pregnant, unable to get pregnant
35 year old
6 months
Patient Note: 35 yo, F, nulipara, c/o  heavy menses X 3mo
-started 3 mo ago, volumous brigh red mesntrual flux, w/o clot, no foul smeal, no alleviated , constant in all last months, no associated with abdominal pain, dysmenorrha, or dyspareunia, no spots, menarche at 
-also refers unvoluntary wt gain (10-15 Lb /6mo), and some dark color in hand and left neck
-denies hot/cold intolerance, denies skin changes, changes in sleep, cough, fever, changes in bowell/urination 
PMH- none ALL= none ALL NKA
FH- mother- cervical ca , aunt- breast ca
SSH- monogamous w boy frined, no smoker, illict drugs or ETOH, 
worsk as skeduller administration

Keywords and phrases relevant to diagnosis:
F
wt gain, gain (10-15 Lb
heavy menses
35 yo
Patient Note: HPI: 35 YO F C/O PERIOD PROBLEMS X 6 MONTHS. IT STARTED SUDDENLY, SHE HAD HER LAST PERIOD 2 MONTHS BACK THAT LASTED FOR 7DAY AND SHE SOAKED A PAD AFTER EVERY AN HOUR. SHE REPORTS TIREDNESS, WEIGHT GAIN 10-4LBS IN 6 MONTHS WITHOUT ANY CHANGE IN HER APPETITE. SHE REPORTS BLACK DISCOLORATION OVER HER NECK. SHE IS TRYING TO CONCIEVE, MONOGAMOUS WITH HUSNBNAD NOT USING ANY CONTRACEPTION. SHE DENIES LOW MOOD, EXERTION SOB,SLEEPING PROBLEM, COLD INTOLERANCE, CHANGE IN BOWEL/URINARY HABITS.
ROS: -VE EXCEPT AS ABOVE 
PMH/PSH: NONE
MEDS: NONE
ALLERGY: NKDA
FH: NONE
OBS & GYN: SHE ADOPTED 2 KIDS, NO VAGINAL DISCHARGE, BEFORE 6 MONTHS HER CYCLES WERE REGULAR 
SSH: 1-2 BEERS/WEEK, DENIES SMOKING/ILLICIT DRUG USED

Keywords and phrases relevant to diagnosis:
F
WEIGHT GAIN, GAIN 10-4LBS
PERIOD PROBLEMS, LASTED FOR 7DAY, SOAKED A PAD AFTER EVERY AN HOUR
LAST PERIOD 2 MONTHS BACK
NOT USING ANY CONTRACEPTION
TIREDNESS
35 YO
6 MONTHS, 6 MONTHS
Patient Note: Ms. Tompkins is  35 year old female complaining of period pains. She notes that for the past 6 months her periods have been irregular and she has had heavy flow. Her periods used to be regular, every 4-5 weeks lasting 3-4 days. however she has recently had periods every 2  months, and they now last longer. she must change her pad or tampon every 2 hours due to heavy flow. She notes new, light cramping while on her period now. 
ROs: Patient elicits that she has had a recent weight gain of 10-15 lbs in recent months, due to eating habit chages. She denies any headaches, vision problems, trouble swallowing, chest palpitations, abdominal pain except for period cramping, bowel changes. 
PMH: None
PSH: None
Allergies:  No known allergies
Meds: None
Mentrual history: LMP was 2 mo ago. No prior pregnancies, patient elicits that she "cannot get pregnant" as she has never gotten pregnant despite years of trying with no contraception

Keywords and phrases relevant to diagnosis:
female
weight gain
periods have been irregular, periods heavy flow, periods have been irregular heavy flow, periods
LMP was 2 mo ago
no contraception
cannot get pregnant
35 year old
6 months
Patient Note: Ms. Tompkins is a 35 yo F presenting with a change in her menstruation. She normally has monthly periods that last about 3 days and require about 3 tampons per day, but she has only had 2 periods over the last 6 months, with the most recent lasting about 7 days and requiring a nw tampon every 3 hours. She denies pain except for her normal menstrual cramps. She endorses an unintentional weight gain of about 10 pounds over the last 6 months as well as fatigue. She had attempted to conceive for 9 years with her ex husband unsuccussfully and believes she cannot get pregnant and for this reason does not use contraception with her new boyfriend. 
PMH: None
ROS: Otherwise -
NKDA
No meds or vitamins
No hospitalizations, trauma, recent illness
Family Hx: Cervical cancer in grandmother (age 65), breast cancer in aunt (age 51)
Sexually active with boyfriend, no condoms for 10 months
Social: Denies tobacco, drugs, rarely will have 1 drink

Keywords and phrases relevant to diagnosis:
F
weight gain, gain of about 10 pounds
nw tampon every 3 hours, change in her menstruation
does not use contraception, no condoms
fatigue
attempted to conceive unsuccussfully
35 yo
6 months, 6 months
Patient Note: 35 yo F complains of heavy menses since the past 5 months. She reports she used to have regular periods 6 motnhs ago, they were every 30 to 35 days, lasting 3 days, she used 4 tampons daily. Her last normal menstrual period was 6 motnhs ago, since then she has had heavy menses, she uses tampons every 2 hours. She also reports dark lesions in her neck and hands since the past 1 to 2 years. She has never been able to be pregnant despite regular sexual activity. She denies constipation, cold intolerance, loss of hair. She has 2 adopted daughters. Denies nipple discharge, vaginal dryness or itching. She has gained 10 to 15 pounds in the last 6 months.
ROS> Negative except as above
PMH> None
Medication> None
Allergies> NKDA
PSH> None
FMH> Aunt died of breast cancer, grandmother died of cervical cancer
SH> Denies tobacco, alcohol ocassionally, denies illicit drug use. Sexually active with his husband, no contraceptive methods used

Keywords and phrases relevant to diagnosis:
F
gained 10 to 15 pounds
heavy menses, heavy menses, tampons every 2 hours
no contraceptive methods
never been able to be pregnant
35 yo
5 months, 6 motnhs