bhatthars/nbme_qna huggingface dataset:
Patient Note: HPI: 20 yo F, c/o lower quadrant pain for the last 10 hours. It started when she was sleeping, and it is constant, dull and achy quality, 5/10 intensity and getting worse. It is aggravating with walking, ibuprofen helped a little. She had similar symptoms 3-4 times in the last 6 months. The pain hapenning randomly, no activity related. She also has diarrhea, 4-5 times a day, no blood in it. It is watery brown.
She has no appetite, and she didn't check her weight but her clothes getting loose. She is on a healthy diet. No travel outside the country recently. 
OB/GYN: last menstraul period was 2 weeks ago. sometimes cramps with her menses
ROS: negative
PMH: none
allergies: NKDA
Med: ibuprofen
PSH: none
FH: noncontributary
SHx: no smoking, no illcit drugs, no EtOH, she is a student. She is not sexually active


Keywords and phrases relevant to diagnosis:
clothes getting loose
not sexually active
diarrhea
20 yo
diarrhea no blood
similar symptoms 3-4 times in the last 6 months
no appetite
last menstraul period was 2 weeks ago
pain for the last 10 hours
F
Patient Note: 20-year-old female complaining of abdominal pain. The pain is in the LRQ and started 8-10 hours ago, it is about a 5/10 dull aching cramp that does not radiate. She has had watery non-bloody diarrhea/loose stools for the past 2 days with 4-5 stools per day. She denies sick contacts or recent travel. Ibuprofen helped moderately with pain. Pain is worse with walking. Not currently sexually active. regular menstrual periods every 28 days. Denies Nausea/vomiting. Loss of appetite since last night. 
No known allergies.
No PMH or surgeries/hospitalizaitons
Meds: ibuprofen 
FH: none
SH: not sexually active
EtOH: 1 beer monthly
Tobacco: no
Illicit drugs: no

Keywords and phrases relevant to diagnosis:
Not currently sexually active, not sexually active
diarrhea/loose stools for the past 2 days
20-year-old
non-bloody diarrhea
pain is in the LRQ
Loss of appetite
pain started 8-10 hours ago
female
Patient Note: 20 y/o F here for LRQ abdominal pain that started 8-10 hr ago when she was sleeping. She pain is dull and a 5/10, but does not radiate. It is a constant pain and has progressed over the past few hours. Ibuprofen alleviated the symptoms some what, and walking aggrevates it. She denies nausea, vomiting, constipation. She has had diarrhea for the past 2-3 days. She says she has had 4-5 BM/day, up from 2x/d normally. She denied blood, mucous or pain with defacation. She denies pelvic pain, vaginal d/c or pain, cp, sob, headache, fatigue, or fever. She is not as hungry and has noticed some weight loss as her clothes are fitting loser. LMP 2 weeks ago with moderate pain. Last sexual partner 9 mo ago with condom no OCP. Menarche at 13. No pregnancies. No dyspareunia. 
ROS neg except for above
PMH neg 
Meds ibuprofen 
all nka
surgreies none 
fh: noncontributory 
sh: student who lives alone no tobacco/drug use, occasional EtOh use.

Keywords and phrases relevant to diagnosis:
denies vaginal d/c
weight loss, clothes are fitting loser
Last sexual partner 9 mo ago
diarrhea
20 y/o
denied blood with defacation
LRQ abdominal pain
not as hungry
LMP 2 weeks ago
pain started 8-10 hr ago
F
Patient Note: Patient is a 20 year old woman who presents with 8 hours of right lower quadrant pain. Pain started suddenly this morning, feels dull and achy. Does not radiate, has not moved. Associated with diarrhea the past few days and no appetite since last night. Pain 5/10. Has occured 3-4 other times the past 6 months, this time is the most painful. Took ibuprofen, helped a bit. Episodes usually last a couple hours and resolve on own. No known triggers, occurs seemingly randomly. Worse with walking. Endorses weight loss with no chnage in diet. Denies consptipation, bloody stool, pain with defication, urinary changes, nausea/vomitting, lightheadedness, joint pain, rashes. 

ROS: negative except above
Med hx: none 
meds: ibuprofen today 
Surgery: none 
Family hx: none 
Soc: drinks 2x a month, no tobacco or drug use. Goes to school as a pre-med
Allergies: none

Keywords and phrases relevant to diagnosis:
weight loss
diarrhea the past few days
20 year old
Denies bloody stool
occured other times the past 6 months
right lower quadrant pain
Denies urinary changes
no appetite
8 hours started suddenly
woman
Patient Note: HPI: Ms Powelton is a 20yo female coming for abdominal pain. it has been present for 8-10 hours and has been getting worse. The pain is constant and the patient rates it 5/10 in intensity. It is located in the Right lower quadrant of the abdomen, does not radiate anywhere. The patient has no appetite, has not eaten since the pain started, denies any vomiting. The has had diarrhea for the past few days. The patient took 3 Ibuprofen tablets which seemed to relief the pain. Movement and walking make the pain worse. No additional associated symptoms, no fever, headache, change in urination. 
ROS: negative except as above
PMH: none
PSH: none
Allergies: NKDA
Meds: no medication
OB gyn - regular periods, every 28 days, moderate flow for 4 days. last sexual contact was 9 months ago with boyfriend.
Social: patient is a student, does not use illicit drugs, alcohol twice per month socially, no tabacco


Keywords and phrases relevant to diagnosis:
last sexual contact was 9 months ago
diarrhea
20yo
Right lower quadrant of the abdomen
No change in urination
no appetite
for 8-10 hours
female
Patient Note: Ms. Powelton is a 20yo F with no sig PMHx who presents to the ED with 8-10 hour of RLQ abdominal pain. Pt describes this pain as dull/alchy, without radiation. Patient does endorse similar episodes ~3/4 times though with less severeity. Pt endorses decreased appetite, diarrhea of 2 days without hematochezia or melena. Pt denies subjective fever, chills, nausea, vomitting. Patient denies dysuria. Patient has 28 day menstrual cycle with 4 days of moderate flow, last one was 2 weeks ago. Patient is currently no on contraceptive, and was last sexually active with a male partner 9 months ago, using condom consistently.
PMHx: Negative, uses ibuprofen for pain currently
Past Surgical Hx: negative
FHx: healthy parents
SHx: does not smoke, drinks EtOH a couple times a month, does not use illicit drugs, has not travelled anywhere recently

Keywords and phrases relevant to diagnosis:
ast sexually active 9 months ago
diarrhea
20yo
without hematochezia, without melena
similar episodes ~3/4 times
RLQ abdominal pain
denies dysuria
decreased appetite
menstrual cycle last one was 2 weeks ago
8-10 hour of pain
F
Patient Note: Suzanne Powelton is a 20 yo F presenting with abdominal pain.
-Started 8-10 hours and is localized to the right lower quadrant, was never periumbilical in nature.
-Pain is constant, dull, achy, crampy, and was preceded by 2 days of diarrhea with 4-5x bowel movements a day
-Walking aggravates the pain, ibuprofuen did not alleviate the pain. Pain is getting worse with time.
-Patient reports no appetite.
-Patient denies any nausea or vomiting
-LMP was 2 weeks ago and sexual history is negative for intercourse in the last 9 months and negative for history of STIs. 
-PMHx and FHx are non-contributory

Keywords and phrases relevant to diagnosis:
sexual history is negative for intercourse in the last 9 months
preceded by 2 days of diarrhea
20 yo
abdominal pain right lower quadrant
no appetite
LMP was 2 weeks ago
pain Started 8-10 hours
F
Patient Note: 20 yo F presents w 5/10 dull, achy abd. pain in the RLQ for 8-10 hrs. She has had intermittent 3 or 4 episodes over the past 6 mo. but they dont last this long. It is progressing. She tried ibuprofen, with no relieve.  no alleviating factors, exacerbated by walking. it is limiting her school schedule and it is causing her incr. stress.  Pain is non radiating. Reports watery non bloody diarrhea over the past couple of days. decappetited and looser fitting clothing. Denies: radiating pain, blood in stools, change in stool colo, association with food. Nausea, vomitting, fevers or chills. 
OB: sexually active last time 9 mo ago. 2 M partners, cons. condom use. no other contraception. LMP: 2 weeks, menarche: 13 yo. periods are regular associated w som light cramping in between. no spotting in between. No vaginal discharge, itching, pain today. Never pregnant. 
 SIGECAPS 0/7
PMH: none, PSH: none, meds: ibuprofen, FH: none. SH: no tob. ETOH

Keywords and phrases relevant to diagnosis:
No vaginal discharge
looser fitting clothing
sexually active last time 9 mo ago
diarrhea over the past couple of days
20 yo
non bloody diarrhea, Denies blood in stools
3 or 4 episodes over the past 6 mo
abd. pain in the RLQ
LMP: 2 weeks
for 8-10 hrs
F
Patient Note: Patient is a 20 F c/o of RLQ abdominal pain that suddenly started while she was sleeping 8 hours ago. The pain is constant and has progressively gotten worse. Pain is ranked as 5/10 in severity, is an aching, cramping pain that does not radiate. Ibuprogen relieves the pain while walking makes the pain worse. The RLQ pain is a/w diarrhea. She has had past episodes of diarrhea 2-3 times with both increase in frequncy of bowel movement as well as volume. The diarhea is nonbloody, watery, and brown in color.  She has noticed some weight loss w/ clothes fitting looosely and has had decreased appetite despite a balanced, regular diet. She denies travel, sick contacts, energy changes, constipation. 
ROS negative as above 
PMH noncontributory, MEDs ibupren NKA no surgeries or hospitalizations  FH noncontributory 
SH drinks occ twice a month, does not use tobacco or rec drugs. exerices w/ pilates, diet balanced 
SX sex active bf, no stds

Keywords and phrases relevant to diagnosis:
weight loss, clothes fitting looosely
diarrhea, past episodes of diarrhea
20
diarhea is nonbloody
RLQ abdominal pain, RLQ pain
decreased appetite
suddenly started 8 hours ago
F
Patient Note: 20 yo F presents to the ED with right lower quadrant pain started 8-10 hours ago.
-5/10 constant dull and achy pain. better with ibuprofen and worse with walking. 
-Previous episode: happened 3-4 times in the past, gradual onset, dully ache

-diarrhea started 2-3 days ago. 4-5 times/day, no blood in the stool. 
-denied similar illness in the household, no recent ill contacts
OB Hx:G0 menarche age of 13. no vaginal discharge. 4/28, 3-4 pads/day.  slight cramping, no intermenstrual period bleeding or postcoital bleeding. Sexually active 9 months ago.
PMH: none
PSH: none
Allergies: NKDA
Medications: Ibuprogen 200mg X3 times a day
FM: noncontributory
SH: no smoking, social drinker, no illicit drugs. exercise regularly 2-3/week. Regular diet.


Keywords and phrases relevant to diagnosis:
no vaginal discharge
Sexually active 9 months ago
diarrhea
20 yo
no blood in the stool
happened 3-4 times in the past
ight lower quadrant pain
started 8-10 hours ago
F
Patient Note: HPI: 20yo F c/o 5/10 dull and achy constant nonradiating RLQ pain that started 8-10 hours ago and was preceded with diarrhea. Patient tried to use ibuprofen, but it wasn't helpful, nothing ,makes worse. She said that she has low appetite and she didn't eat anything since last dinner (salad, icecream). Patient denies any sensation of hottness, chills, rashes, pain anywhere else.
OB/Gyne: LMP 2w ago, menarche 13y, every 28d amd lasts 4d
PMH/PSH: she had similar pain in the same place for a while, which happens every 6w and not related to menses
Medications: ibuprofen 
Allergies: NKDA
FH: noncontributory
SH: no smoking, elicit drug use, EtOH occasionally, last sexual intercourse was 9mo ago and she have never had an STD.

Keywords and phrases relevant to diagnosis:
last sexual intercourse was 9mo ago
preceded with diarrhea
20yo
similar pain in the same place for a while
RLQ pain
low appetite, "didnt eat anything since last dinner"
LMP 2w ago
pain that started 8-10 hours ago
F
Patient Note: Pt is a 20 yo otherwise healthy female presenting to the ED with 8 hours of non radiating RLQ abdominal pain and fever. Sudden onset while sleeping, progressively worsening. Not associated with eating. Has had 3-4 similar episodes in the past that resolved on their own. Has taken ibuprofen which has helped minimally. Movement makes pain worse. It is dull and aching. Patient denies subjective fever, chills, N/V. Admits loss of appetite and potentially mild weight loss recently. Has had diarrhea for 2 days, non bloody. LMP was 2 weeks ago. Has not had sex in over 9 months. No STD history. No abdominal surgeries.
ROS: aside from mentioned in HPI, no changes in urination or vision, no chest pain, no SOB, no weakness
PMHx: none
Hospitalizations: none
PSHx: none
Social: non smoker, rarely drinks alcohol, no recreational drugs, pre med student

Keywords and phrases relevant to diagnosis:
weight loss
Has not had sex in over 9 months
diarrhea for 2 days
20 yo
diarrhea non bloody
Has had 3-4 similar episodes in the past
RLQ abdominal pain
no changes in urination
loss of appetite
LMP was 2 weeks ago
8 hours of pain
female
Patient Note: HPI: Suzanne Powelton is a 20-year old female presenting with a chief complaint of "lower right quadrant abdominal pain". She states the pain awoke her from her sleep 8-10 hours ago. It has progressively worsened. Dull, achy pain. Rated 5/10. Took ibuprofen, helped some. Walking worsens pain. Does not radiate. Diarrhea for past couple of days. No nausea or vomiting. LMP was 2 weeks ago. Last sexual intercourse was 9 months ago. 
PMH: None
PSH: None 
Meds: Ibuprofen PRN
Allergies: None 
Family: No pertinent history 
Social: Drinks 1-2 beers 2x a month. No recreational drugs or tobacco use. Has history of sexual activity with multiple male partners; used condoms. Has been tested for STDs in past. In college, biology major.

Keywords and phrases relevant to diagnosis:
Last sexual intercourse was 9 months ago
Diarrhea for past couple of days
20-year old
lower right quadrant abdominal pain
LMP was 2 weeks ago
pain awoke her 8-10 hours ago
female
Patient Note: Chief Complaint: Right Lower Quadrant Pain
Suzanne Powelton is a 20 y.o. F presenting w/ RLQ pain. This pain started suddenly about 8-10 hours ago and has been getting worse since. Pt states the pain doesn't radiate and describes it as dulll and achey. She rates it a 5 of 10. She has had no ververs or chills. No nausea or vomiting but has had no appetite. Pt states that she has had diarrhea for the past cople of days. She denies blood in her stools. She reports stooling 4-5 times a day and describes them as loose or watery. She denies travel out of the country, recent sick contacts or change to diet. She denies any vaginal bleeding or pain w/ urination. Walking makes the pain worse pt has tried ibuprofen w/ minimal response.  Pt's last menses was 2 weeks ago. Cycle is regular

PMHx: None. No surgeries 
Medications: None
SocHx: Occasional alcohol use. No tobacco or drug use. Last intercourse 9 months ago
FamHx: Non contributory

Keywords and phrases relevant to diagnosis:
Last intercourse 9 months ago
diarrhea, stooling 4-5 times a day loose or watery
20 y.o
denies blood in her stools
Right Lower Quadrant Pain, RLQ pain
denies pain w/ urination
no appetite
last menses was 2 weeks ago
pain started suddenly about 8-10 hours ago
F
Patient Note: 20 yo F c/o abdominal pain
onset: 8-10 hrs ago, right lower quadrant, dull and achy and cramping pain, no radiation, 5/10 severity, constant progressive pain, no precipitating factor
worse with walking, better with ibuprofen but now doesn't work
no nausea, no vomiting, no fever sense,
diarrhea (+) since 2-3 days ago, brownish non bloody stool
PMHx: none
no surgery history, no allergies, no hospitalization, no recent travel history, no ill contact
FMHx: none
SHx: student, no smoking, social alcohol drinking, no recreational drug, currently not sexually active since 9 MA
OBGY: LMP 2 weeks ago, regular period, no pain between periods, no STD history, no pregnancy history

Keywords and phrases relevant to diagnosis:
not sexually active
diarrhea (+) since 2-3 days ago
20 yo
non bloody stool
abdominal pain right lower quadrant
LMP 2 weeks ago
onset: 8-10 hrs ago
F
Patient Note: This is 20 year old female with RLQ abdominal pain.  Patient reprot that pain started 8-10 hours a go.  It woke her up from sleep. She have similar symptoms before 3-4 times each month over the last 6month. She describes the pain as dull ache pain. She reprot walking make her symptoms worse.  She denies fever, chills, trauma, urinary symptoms. She reprot having brown color diarrhea. She had similar diarrhea before.  
Allergy:
Med: 

Family history: both family are health
Social history:  she is sexual active with one pattern.  She does not smoke or or do illicity drugs. She drink occasional on the weekend.  LMP 2 weeks a go. 



Keywords and phrases relevant to diagnosis:
similar diarrhea before
20 year old
similar symptoms over the last 6month
RLQ abdominal pain
denies urinary symptoms
LMP 2 weeks a go
started 8-10 hours a go
female
Patient Note: Ms. Suzanne Powelton is a 20 y/o F who presents with abdominal pain. Patient notes RLQ pain that started 8-10 days ago, constant, dull, achy cramping pain. No precipitating events. No radiation of pain. 5/10 severity. Pain is worse with walking; Ibrofen no longer helps with pain. No fever, chills, nausea, or vomiting. No recent illness.
ROS: low appetite, as noted in HPI
PMH: No history of STDs/STIs. 
PSH: none
OB hx: Last  menstural period 2 weeks ago. 28 day cycle, 4 day duration, regular
Meds: none
Allergies: none
Family hx: none
Social hx: No smoking, EtOH, drugs. Occupation: student, studying biology/pre-med. Sexually active with male partner, use condoms.

Keywords and phrases relevant to diagnosis:
20 y/o
abdominal pain RLQ pain
low appetite
Last  menstural period 2 weeks ago
started 8-10 days ago
F
Patient Note: 20 yo F comes with pain in LLQ for the last 8-10 hours. Pain is constant ,crampy, non radiating ,achy ,5/10 , relived by ibuprofen and aggravated by walking . h/o similar pains for last 6 months. she has been having diarrhea for 2 days with 4-5 episodes per day. the stool is watery brown with no blood in it. h/o diarrhea multiple episodes in the past also. no h/o painful joint fever rash . c/o no appetite fr 1 day and weight loss (undocumented).no nausea or vomiting. pain and diarrhea r not related to food. no changes in urination.
ROS: as above
PMH: noncontributory
FH: noncontributory
OBGYN: LMP 2 wks ago menstrual cycle regular with crampy pain during menstruation. no c/o discharge
SS: non smoker occasional alcohol drinks no illicit drug use. had sexual intercourse 9 months ago. always use condoms.

Keywords and phrases relevant to diagnosis:
no c/o discharge
weight loss
had sexual intercourse 9 months ago
diarrhea, stool is watery brown, diarrhea multiple episodes, diarrhea
20 yo
stool no blood
similar pains for last 6 months
no changes in urination
no appetite
LMP 2 wks ago
pain last 8-10 hours
F
Patient Note: hpi:20 y old female presented with complains of rlq abdominal pain. pain started about 8-10 hours ago. it is dull aching crampy in nature, 5/10 on intensity, has been bcoming worse and is constant in nature. ibuprofen relives it mildly and walking makes it worst.  she also had  4/5 episodes of episodes of diarrhea per day starting from 2/3 days back. stools are loose and watery and do not contain blood.
ros: denies nausea vomiting, denies loc, dizziness, denies any urinary complains. no ill contacts rcently. no history of travel.
pmh: none
allergies: nkda
meds: ibuprofen
psh: none
occupation: student
sh: occasional etoh twice a month, no smoking, no recreational drugs
obgyn: lmp 2 weeks ago, regular cycles(28 days, last for 4 days, normal flow). last sexually active 9 months ago. G0P0

Keywords and phrases relevant to diagnosis:
last sexually active 9 months ago
diarrhea
20 y
stools do not contain blood
rlq abdominal pain
denies any urinary complains
lmp 2 weeks ago
started about 8-10 hours ago
female
Patient Note: 20 yo, f, presents with abdominal pain since 8-10 Hours ago, pain was on the RLQ, dull and crampy in nature, non radiating, constant, getting worse, alliviated with Ibuprofen, exacerbated with walking, pain is 5/10 in severity, accompanied with Diarrhea, 4-5 times in the last few days, which was loose and watery, no blood noticed, patient reports cloths to be loose, patient reports decrease in appetite, exercises regularly, 2-3 times per week, regular diet.
OBGYN: LMP= 2 weeks ago, regular and lasted for 4 days with a 28 day cycle, have never had any previous pregnancies.
PMH: healthy. PSH: non. Allergies: non.
SH: drinks alcohol once every 2 months, does not smoke, does not use illicit drugs.
occupation: student.

Keywords and phrases relevant to diagnosis:
cloths to be loose
Diarrhea
20 yo
Diarrhea no blood
pain RLQ
decrease in appetite
LMP= 2 weeks ago
since 8-10 Hours ago
f
Patient Note: 20 ye F presenting to ED with abdominal pain that began 8-10 hours ago. no precepitating events. has been constant and progressively worsening. it is dull. achy, and crampy rated 5/10. does not radiate similar episodes 3-4x over past 6 months lasting only a cuople hours in duration. worse with walking. improved with Ibuprofen. associated with diarrhea. denies recent flu, fever/chills, chest pain, sob, problems with urination. 
PMH/surgeries: none
Meds: Ibuprofen for this pain
Allergies: NKDA
OB/GYn: last sexually active 9 months prior with partner, condoms for protection, LMP 2 weeks ago and is regular, no previous pregnancies

Keywords and phrases relevant to diagnosis:
last sexually active 9 months prior
associated with diarrhea
20 ye
similar episodes 3-4x over past 6 months
denies problems with urination
LMP 2 weeks ago
abdominal pain that began 8-10 hours ago
F
Patient Note: This is a 20 year old F who presents complaining of right lower abdominal pain for the past 8-10 hours. The pain is described as dull/achey; patient unable to quanitfy 1-10 how bad it is but states that here has been minimal improvement with Ibuprofen. No exacerabting factors. She has had 3-4 similar episodes of pain over the past 6 months but states this is the worst it's been. She reports her last LNMP was 2 weeks ago. Has regular 28 day cycles. 4-5 pads/tampons first day of period which gradually tapers off over a few days. No previous cramping history with periods. Denies vaginal pain, discharge, bleeding. No STD history. Last sexually active 9 months ago. 
ROS: as above and negative for chills, fever, nausea, vomiting, . Positive for diarrhea for 2 days. Positive for loss of appetite
-No PMHx/PSHx. No medications other than PRN Ibuprofen
-alcohol twice a month. No tobacco or drug use.

Keywords and phrases relevant to diagnosis:
Denies discharge
Last sexually active 9 months ago
diarrhea for 2 days
20 year old
3-4 similar episodes of pain over the past 6 months
right lower abdominal pain
loss of appetite
LNMP was 2 weeks ago
past 8-10 hours
F
Patient Note: patinet is a 20 yO f COMPLANING OF rlq ABDOMINAL PAIN THAT STARTED 8-10 HOURS AGO, the pain is 5/10 in intensity, dull/aching in nature, nonradiating, gets worse with walking, partially relieved by ibuprofen, it is associated with diahrrea 4-5 times a day, no pain or tenesmus. had similar pain before. No nausea or vomitting, no jaundice or heart burn. She hasn't noticed any hotness and hasn't been in contact with anyone ill. She feels like she has lost weight, and has a reduced appetite. Her LMP was 2 weeks ago, every 4 days lasting 4 days. no change in menstrual flow, no dysmenorrhea or vaginal discharge.
ROS: negative except as above.
PMH: negative
Allergies: NKDA.
Medications: ibuprofen,
PSH: none.
FH: negative
SH: last sexually active 9 months ago withprevious partner, uses condoms, previously tested for STDs but were negative, NO tobacoo, EtOH, or illicit drugs.

Keywords and phrases relevant to diagnosis:
no vaginal discharge
lost weight
last sexually active 9 months ago
associated with diahrrea
20 yO
similar pain before
rlq ABDOMINAL PAIN
reduced appetite
LMP was 2 weeks ago
STARTED 8-10 HOURS
f