bhatthars/nbme_qna huggingface dataset:
Patient Note: Mr. Smith is a 17yo male c/o of chest pain since yesterday. The pain began abruptly is a sharp pain 5/10 at rest but reaching 8-9/10 on inspiration. Movement also exacerbates the pain. Tylenol and Albuterol has not helped but staying still does. He has also noted stuffy nose and muscle aches for the 3-4 days and a subjective fevr though he has not taken his temperature.
ROS: Denies cough, SOB, night sweats, chills, nausea, vomting, diarrhea, weight loss, palpitations, prior cardiac issues, or sleep disturbance
PMH: Exercise induced Asthma
Medications; Albuterol; 2 tylenol q4h
PSH: None
NKDA
FHx: Granfather had MI, father has asthma and high cholesterol
SHx: Ptx denies tobacco abuse, drinks beer 1X a month, and smokes marijuana socially. He is monogamous with his girlfriend and uses protection regularly. Uncertain vaccination history, though recieved childhood vaccines


Keywords and phrases relevant to diagnosis:
subjective fevr
male
17yo
stuffy nose
pain 8-9/10 on inspiration
Exercise induced Asthma
chest pain
since yesterday
Denies SOB
Albuterol has not helped
Patient Note: 17  YO MALE C/O CHEST PAIN  SINCE YESTERDAY. PAIN IS IN LEFT SIDE, SHARP, SUDDEN ONSET, CONSTANT, 5/10 WHILE SITTING STILL, 8/10 WHILE DEEP BREATING AND MOVING, NON RADIATING, AGGRAVETED BY DEEP BREATH AND MOVEMENT, ALLEVIATED BY SITTING STILL. ASSICIATED WITH FEVER, RUNNY/STUFFY NOSE ANFD MUSCLE SORENESS.
HE HAS H/O FLU 3-4 DAYS BACK.
HE DENIES SOB, PALPITATION, RASH, TRAUMA, SICK CONTACT, RECANT TRAVEL, COUGH, NIGHT SWEAT.
NO APPETITE, WEIGHT, MMOD, SLEEP, BOWEL/ URINARY HABITS, MOOD CHANGES.
ROS: _VE EXCEPT AS ABOVE
PMH: EXCERSISE INDUCED ASTHMA, MEDS ALBUTEROL.NHDA
FH: ASTHMA
SH: NO SMOKE, ETOH. DRUG: WEED  LAST USE: LAST WEEKEND
SXH: MONOGAMOUS . CONDOM USE CONSISTANTLY


Keywords and phrases relevant to diagnosis:
FEVER
MALE
17  YO
RUNNY/STUFFY NOSE
AGGRAVETED BY DEEP BREATH
EXCERSISE INDUCED ASTHMA
CHEST PAIN
YESTERDAY
DENIES SOB
SHARP, 8/10
Patient Note: 17 yo male with chief complaint of chest pain that began yesterday when he woke up. he states no other similar episodes. he took 2 tylenol yesterday and his albuterol inhaler for relief but it did not work. he state this pain is a sharp stabbing pain that occurs in his left chain that is worse with movement and deep breathing. better with rest.He states the pain is a 5/10 at rest and a 8/10 with movement. He states the pain does not radiate anywhere. He has been feeling "hot" for past 3,4 days
ROS negative unless stated above. denies any weight loss, nausea vomiting, 
Medications: albuterol, tylenol 
allergies: none
PMH exercise induced asthma 
PSH no surgeries 
Fhx dad asthma, high cholesterol. grandpa died of heart attack, mom healthy, older brother allergies 
Shx, senior in highschol works as a carpenter. tried marijuana. denies any tobacco products, sexually active uses condoms. is a rock climber

Keywords and phrases relevant to diagnosis:
feeling "hot"
male
17 yo
worse with deep breathing
exercise induced asthma
chest pain
began yesterday
rock climber
albuterol inhaler for relief but it did not work
sharp, stabbing, 8/10
Patient Note: 17 yo M with a hx of recent chest pain.  Began yesterday morning; has not changed in serverity since.  Pain is over the left upper chest for the 24 hrs. Described as constant, sharp, stabbing pain that is brough on by deep inhalation and movement.  Tried tylenol and albuterol, but didnt help.  At rest pain is 5/10, on movement or deep inhalation is a 8-9/10.  No relation to meals, no SOB, no tachycardia or palpitations, no sudden diaphoresis, no skin or hair changes, no rashes, no blood disorders, no cough, no nausea/vomiting.  Does endorse nasal congestion, muscle aches for last 3-4 days as well.  PMH significant for exercise induced asthma.  FamHx: dad - asthma and HLD, Grandpa- MI, now doing well. Current a senior in high school, also works as a carpenter assistant (wears mask at work), lives with parents, 1 beer/month, no tobacco, Marijuana a few times, Sexually active with GF, uses condoms consistently

Keywords and phrases relevant to diagnosis:
M
17 yo
congestion for last 3-4 days
brough on by deep inhalation, on deep inhalation is a 8-9/10.
exercise induced asthma
chest pain, Pain chest
Began yesterday
no SOB
albuterol, but didnt help
sharp, stabbing
Patient Note: Mr. Smith is a 17 yo M here today complaining of L sided deep chest pain that started yesterday morning. He does not recall an inciting event and denies any trauma to the area. He sys the pain is sharp and gets worse with deep breaths. He also admits to feeling warm recently but denies chills, night sweats, and cough. He says he has had a stuffy nose and muscle aches for the last 3-4 days. He says he has been taking tylenol every four hours for the pain and has tried his albuterol inhaler but neither have helped.
ROS: Negative except as above
PMH: Exercise induced asthma, has never been hospitalized for it and rarely uses his inhaler anymore
Surgeries: none
Hospitalizations: none
Meds: Tylenol q4hr for pain
FH: Father asthma, high cholesterol; Mother healthy, Bro allergies; Grandpa MI
SH: Alcohol once per month, no tobacco, uses marijuana occasionally, last time 4 days before the weekend. Works as carpenter. Likes rock climbing

Keywords and phrases relevant to diagnosis:
feeling warm
M
17 yo
stuffy nose
worse with deep breaths
Exercise induced asthma
chest pain
started yesterday
rock climbing
tried his albuterol inhaler but neither have helped
sharp
Patient Note: HPI: 17yo M comes to the office complaining of left chest pain since yesterday. The pain is sharp, mild-intensity, constant, and without further progression. No radiation. It increases with movements and deep breaths. He had an episode of an upper tract respiratory infection 4 days ago, with nasal congestion. No recent chest trauma. He feels warm. He negates rapid palpitations, cough, SOB, fatigue, weight loss, decreased appetite, nausea, vomiting, constipation, diarrhea, and changes in urination. 
ROS: negative except for above.
PMH: asthma, well controlled. 
PSH: none. 
Allergies: NKA. 
Medications: tynelol and asthma inhaler.
SH: high school student. No tobacco. Drinks 1 beer per month. Patient have tried marijuana at parties, no other drugs.

Keywords and phrases relevant to diagnosis:
feels warm
M
17yo
upper tract respiratory infection
increases with deep breaths
chest pain
since yesterday
He negates SOB
sharp
Patient Note: Kane Smith, a 17-year-old male, presents with a 1-days hitory of chest pain that occurs with inspiration. Pain started yesterday morning and is left-sided, worsens with deep breaths. Pain is 5/10 at rest and 8-9/10 with isnpiration. Patient also endorses 3-day hx of stuffy nose, muscle aches, and subjective fever. Denies recent trauma. Tylenol and albuterol inhaler have not alleviated the pain. Pain is not associated with difficulty breathing, cough, weight loss, chills, shortness of breath. PMH - exercise induced asthma, last inhaler used 6 months ago. Surgical hx - none. Meds - albuterol inhaler, q4 hour tylenol yesterday. Allergies - none. Social - alcohol occasionally; expressed interest in future counseling. No drugs or tobacco. Family hx - dad has asthma, grandfather had cardiovascular event at age 70

Keywords and phrases relevant to diagnosis:
subjective fever
male
17-year-old
stuffy nose
worsens with deep breaths
exercise induced asthma
chest pain
1-days hitory, started yesterday
not associated with shortness of breath
albuterol inhaler have not alleviated the pain
Patient Note: 17 yo m c/o left sided chest pain  since yeterday morning x 2 days,  started suddenly, the pain is continuous, progressively worseing, 5/10 with rest and goes up to 8/10 with deep breathing and movement alleviated partially with tylenol , associated with low grade continuous fever without rigors/ chills, he has a flu like illness with nasal stuffiness and myalgia  3-4 days before which has resolved, he denies chest wall trauma, dyspnea, palpitations, heart burn and metallic taste, change in appetite, weight, energy level.
ROS: -ve except  as above
PMH,MEDS: ashtma treated with albuterol inhaler last use 6 months ago

Keywords and phrases relevant to diagnosis:
fever
m
17 yo
nasal stuffiness 3-4 days before
8/10 with deep breathing
ashtma
chest pain
since yeterday
8/10
Patient Note: 17 yo m c/o L chest pain for 1d, 
+ sudden onset, constant, L middle chest pain, sharp, 5/10 when sitting still, 8/10 when move or taking deep breath,  aggrav by movement, deep breath
+ nasal congestion, muscle ache and fever for past 3-4 d,  
ros: no sore throat, dyspnea, palpitation, injury, cough,  leg swelling
pmh: exercise-induced asthma, well-controlled meds: albuterol when needed, tylenol no relieve. NKDA
FH: FATHER W/ ASTHMA, GRANDFATHER W/ HEART ATTACT
SH: STUDENT, wock as charpner , wear mask no smoking, beers occ, use majuana  occ. last use 1wk ago. 
sexually active w/ f, use condom

Keywords and phrases relevant to diagnosis:
fever
m
17 yo
nasal congestion for past 3-4 d
8/10 when taking deep breath, aggrav by deep breath
chest pain, chest pain
for 1d
sharp, 8/10
Patient Note: Kane Smith, a 17-year-old male, has come to the outpatient clinic with chest pain. 2-3 days ago the pt had stuffy nose and muscle ache. He has exercise-induced asthma, but the inhaler has not helped with the pain. Tylenol has not helped muxh either. The pain goes from 4/10 with resting to 7-8/10 with deep breathing. Pain has been constant, sharp, and has not improve;
PMHx: astham
Allergies none
all else none


Keywords and phrases relevant to diagnosis:
male
17-year-old
2-3 days ago the pt had stuffy nose
7-8/10 with deep breathing
exercise-induced asthma, astham
chest pain
inhaler has not helped
7-8/10, sharp
Patient Note: Mr. Smith is a 17 yo male presentign with a "sharp chest pain." The chest pain has been present since this morning, and is located in his upper left chest. The pain is constant and described as stabbing and it does not radiate. Taking a deep breath and any movement worsens the pain. The patient has tried tylenol and albuterol inhaler but it has not helped. The patient also reports rhinorrhea, and myalgia for the past 3 days. He has also "felt warm" today.

ROS: Negative for coughing, sputum production, headache, nausea/vomiting
PMH: exercised induced asthma
Surgical hx: none
Allergies: None
Medicine: albuterol inhaler PRN
FH: Father- asthma and hyperlipidemia; Grandfather: MI
SH: Senior in high school. Denies tobacco use. Patient has tried marijuana in the past. Reports only drink few beers at parties.

Keywords and phrases relevant to diagnosis:
felt warm
male
17 yo
rhinorrhea
Taking a deep breath worsens the pain
exercised induced asthma
chest pain
albuterol inhaler has not helped
sharp, stabbing
Patient Note: 17 yo m c/o left sided chest pain x 1 day. Pt reports to have sudden onset of left sided  sharp pain x yesterday, non progressive, non radiating, aggravated with deep inspiration and movement no alleviating factors. It is associated with nasal stuffiness x 3 days, low grade fever/ 100 f. Pt reporst to have muscle aches x 3 days. Pt reports to have SOB on exertion and relievd by rest.
Pt denies travel/trauma/sweating/pedal edema/urianry and bowel habit chnages/weight and appetite changes/nausea/vomitnig/sweating.
ROS:-ve xcept as above.
PMH:exercised induced asthma/using albuterol inhaler for it.
PSH/ALLERGIES:none.
FH:N/C.
SSH:no smoking/ocassional Etoh use/ocassional marjuana intake last intake was 1 week ago.
Sexually active with GF/using condoms.

Keywords and phrases relevant to diagnosis:
low grade fever
m
17 yo
nasal stuffiness
aggravated with deep inspiration
exercised induced asthma
chest pain
x 1 day
sharp
Patient Note: 17 YOM C/O CHEST PAIN X 1 DAY. IT WAS ACUTE IN ONSET, INTERMITTENT,AT THE LEFT CHEST, SHARP STABBING TYPE,NON RADIATING AGGRAVATED BY DEEP BREATHING AND CHEST MOVEMENTS;AND NOT RELIEVED BY TYLENOL AND ALBUTEROL.HE REPORTS FEVER, NOT DOCUMENTED, AND HX OF STUFFY NOSE, FLU LIKE SYMPTOMS 3-4 DAYS AGO. HE DENIES TRAUMA, COUGH, SOB,CHILLS , RIGORS, HEADACHE, FACE PAIN, PAIN IN THE BELLY, SLEEP/APPETITE IS NORMAL.NO WEIGHT CHANGES.
ROS:NEGATIVE EXCEPT AS ABOVE
PMH/PSH:EXCERISE INDUCED ASTHMA
MEDS:ALBUTEROL, TYLENOL
FH:GRANDFATHER DIED OF MI, FATHER HAVE DM, HIGH CHOLESTEROL
SH:MONOGAMOUS, NON SMOKER, NO ETOH USE, SMOKED WEED IN PARTY LAST WEEKENDS

Keywords and phrases relevant to diagnosis:
REPORTS FEVER
M
17 YO
HX OF STUFFY NOSE
AGGRAVATED BY DEEP BREATHING
EXCERISE INDUCED ASTHMA
CHEST PAIN
X 1 DAY
DENIES SOB
NOT RELIEVED BY ALBUTEROL
SHARP, STABBING
Patient Note: Kane Smith is a 17 yo M who presents with acute onset of chest pain. Pain began yesreday morning after he woke up with no prior inciting event. He has sharp pain the left upper part of anterior chest that is 5/10 at rest and can increase to 7-8/10 sharp pain with inspiration, movement, and whenever something touches the area. He has tried his albuterol inhaler and tried tylenol 4 hours for the pain yesterday but this did not help. Of note, he does endorse 3-4 days of feeling warm (did not check temp), runny nose, muscle aches before onset of chest pain. He denies any sick contacts. He denies shortness of breath, N/V/C/D, lumps/bumps, abdominal pain

ROS - negative except as above
PMH - exercise induced asthma
Meds - albuterol prn, tylenol yesterday
Surg - none
Fam - dad has asthma and high cholersterol, PGF had an MI
Soc - senior in high school, non smoker, drinks 1-2 beers a month, is sexually active w 1 F partner uses condoms

Keywords and phrases relevant to diagnosis:
feeling warm
M
17 yo
3-4 days of runny nose
pain with inspiration
exercise induced asthma
chest pain, pain chest, chest pain
began yesreday
denies shortness of breath
albuterol inhaler did not help
sharp, 7-8/10, sharp
Patient Note: Mr. Smith is a 17 m with exercise-induced asthma with c/o one day of stabbing L chest pain. He describes it as sharp and constant, in the L thorax, without radiation, at a severity of 7/10. It is worse with inspiration and movement. Tylenol and his albuterol didn't help. He has also had nasal congestion and muscle aches, and feeling feverish. He is generally active and doesn't remember any trauma or overactivity. He has not had a cough, abdominal pain, change in sleep, weight, bowel, or bladder. 
ROS: negative except as above. 
Meds: albuterol inhaler when needed, tylenol for the chest pain. No allergies
Med Hx: exercise induced asthma
Surg Hx: none
Fam Hx: P grandpa had MI, dad with hyperlipidemia and asthma
Social Hx: high school senior, carpentry assistant, drinks 1-2 per month, no tobacco use, occasional marijuana. Sexually active with girlfriend, uses condoms.

Keywords and phrases relevant to diagnosis:
feeling feverish
m
17
nasal congestion
exercise-induced asthma, exercise induced asthma
one day
"albuterol didnt help"
stabbing, sharp
Patient Note: 17yo male presents with chest pain and minor fever. chest pain with deep btreath and movement - started yesterday morning - constant, left upper chest, no radiation, 5-6 without movement, 9/10 with it. Tried tylenol and albuterol without help. wopke up with chest pain. Non posititional. He endorses runny nose and fever. He denies left arm pain, sorethroat, abdominal pain, bowle and bladder habit chagnes, Nausea and vomiting, SOB, tingling in figners or toes, headache, cough, wheeze, or skin changes.  His PMH is significant for exercise induced asthma for which he takes albuterol but hsnt had to use in 6 months.  He deneis surgery, NKDA, no tobacco, 1-2 beers at parties, no recreational drugs, lives with parents and brother in ATL, is sexually active with girlfriend and uses condoms, likes to rock climb. Fh of dad with asthma and high cholesterol. MI in grandfather. Patient wants a note for his school

Keywords and phrases relevant to diagnosis:
minor fever, fever
male
17yo
runny nose
pain with deep btreath
exercise induced asthma
chest pain, chest pain, chest pain
started yesterday
denies SOB
rock climb
Tried albuterol without help
Patient Note: 17 yo  c/o substernal constant chest pain  that started yesterday morninh, no progressive, no radiating , worsening with movement and deep breath, no alleviating factors, he takes tynolol and albuterol to help the pain goes away but no success , he also report muscle ache / stuffy nose and fever X 3 to 4 days ,he denies cough, phleghm, ill contact , no bowel movement change , no change in urinary habits, the patient feel scared , denies tremor, sweating, sleeping problem , weigh loss, changing in diet /appetite 

ros : -ve excpt as above 
pmh:  execise induced asthma
psh : none  
meds: albuterol, tynolol for the actual chest pain 
allergy: nkda 
fh : dad had asthma , grandfather had myiocardial infarction 
sh: no smoker, occational etoh on week ends, smokes matrijuana , sexually active with girl friend

Keywords and phrases relevant to diagnosis:
fever
17 yo
stuffy nose
worsening with deep breath
execise induced asthma
chest pain
started yesterday
takes albuterol to help the pain goes away but no success
Patient Note: CC: chest pain
HPI: 17 yo m presents with one day history of sharp chest pain, worse with deep inspiration, Of note he has been experiencing muscle aches and stuffed nose for the past 3-4 days alond with a mild subjective fever. Pain is worse with movement. Took tylenol (2 pills q 4 hrs) yesterday without relief. Also tried his albuterol inhaler this AM without relief. No known trauma to the area. Denies chills, shortness of breath, or other areas of pain. No sick contacts. 
ROS: negative except as above
PMH: asthma
Meds: albuterol inhaler, tylenol
Allergies: NKDA
PSH: none
FH: father with high cholesterol and asthma, grandfather dies of heart attack
SH: Senior in high school and works as carpenter. Sexually active with girlfriend. Uses condoms and no concerns for STIs. Uses alcohol and smokes marijuana occasionally.

Keywords and phrases relevant to diagnosis:
subjective fever
m
17 yo
stuffed nose
worse with deep inspiration
asthma
chest pain
one day history
Denies shortness of breath
tried albuterol without relief
sharp
Patient Note: 17 yo M complains of left chest pain, sharp in character, non-radiating, not alleviated by anything and exacerbated by deep breathing and moving. Onset was yesterday morning. Tylenol and Albuterol inhaler did not relieve pain. He reports having a stuffy nose and muscle aches 3-4 days ago. No palpitations, no cough, no fever, no nausea or vomiting nor dizziness. No recent stressor, no h/o trauma. No changes in urination or bowel movements, no appetite changes. 
ROS: negative except as above
Allergies: none
Medications: Tylenol, Albuterol
PMH: Exercise-induced Asthma for 4 years now
PSH: none
SH: no smoking, occasional beers on parties; takes weed occasionally, last intake was last weekend; works as a carpenter's assistant; sexually active with 1 partner; does rock-climbing
FH:

Keywords and phrases relevant to diagnosis:
M
17 yo
stuffy nose 3-4 days ago
exacerbated by deep breathing
Exercise-induced Asthma
chest pain
Onset was yesterday
rock-climbing
Albuterol inhaler did not relieve pain
sharp
Patient Note: Mr. Smith is a 17yr old M (whose mother gave consent for a history, physical examination, and treatment) is presenting with 1 day history 5-8/10 sharp left chest pain. He states that it is worsened with inspiration and movement and has not been relieved with tylenol or albuterol use. The pain does not radiate. He states that he went to a rock climbing gym 3 days ago and that he has had an improving illness involving stuffy nose and muscle aches for the last 3-4 days. 

ROS: negative except as above
PMH: Exercise induced asthma (last needed inhaler use 6 months ago)
PSH: none
Allergies: NKDA
Meds: albuterol, tylenol
Social: Denies tobacco use. Once monthly alcohol use. Endorses 2 occasions where he used marijuana at a party most recently 5 days ago. Denies other drug use. He is a carpenter's assistant.

Keywords and phrases relevant to diagnosis:
M
17yr old
stuffy nose for the last 3-4 days
worsened with inspiration
Exercise induced asthma
chest pain
1 day history
rock climbing gym 3 days ago
not been relieved with albuterol
8/10, sharp
Patient Note: 17 y/o M that comes to the office c/o chest pain that started yesterday morning. Described as constant, located on the left side, gets worse with inspiration, does not irradiate, 5/10 intensity when in rest, 8/10 intensity whith inspiration. Took tylenol and albuterol, but didn't alleviate the pain. Denies previous episodes. Also complains of feeling warm, having a runny nose, with whitish yellowish secretions and muscle ache for the last few days. Denies V/V, changes in stool, changes in urination, weakness, head aches, abdominal pain, or any other discomfort.
ROS: negative, except as above
PMH: Asthma with exercise
Med: Tylenol and albuterol
PSH: None
All: NKDA
FH: Dad has asthma and grandfather had MI
SH:Denies smoking. Uses marijuana, last time a week ago. Drink beer ocasionally. Sexually active with girlfriend, uses condoms. Is a senior in high school, also a carpinter asistant and rock climbs as hobby.

Keywords and phrases relevant to diagnosis:
feeling warm
M
17 y/o
runny nose, with whitish yellowish secretions
worse with inspiration
Asthma with exercise
chest pain
yesterday
rock climbs
"albuterol didnt alleviate the pain"
8/10 intensity
Patient Note: CC: my chest hurts 
HPI: 17 yo student c/o of acute chest pain that started yesterday morning. Pain is constant 7-8/10 severity, not associated with arm pain, does not radiate anywehere. Pain is worse with brreathing or moving. Pt tried to alliviate pain with tylenol q4 hours and albuterol but pain did not improve. Pt has had congested sinuses for 4 days that are improving. Pt had muscle aches for 4 days. No cough.
ROS: pt denies: headaches, weight changes, appetitie chages, diet changes, urinary changes, constipation, diarrhea 
Pt + for 2 days of feeling feverish, nasal congestion, muscle aches
PMH: exercise induced asthma 
Allergy-NKDA
Meds- albuterol for asthma
FH: dad-asthma, high scholesterol, grandfather MI 
SH: denies: smoking, traveling; occasional etoh use, tried marijuana, student and works as carpetner assistane, rock climbs, sleeps well


Keywords and phrases relevant to diagnosis:
feeling feverish
17 yo
congested sinuses for 4 days, 2 days of nasal congestion
worse with brreathing
exercise induced asthma
chest hurts, chest pain
started yesterday
rock climbs
albuterol but pain did not improve
7-8/10
Patient Note: 17yo M w/ excerise induced asthma (no hospitalizations, last use inhaler 6m ago) coming in with L chest pain starting 1 day ago. Woke up with pain, worse w/ inhalation or movement, improves when sitting still. Describes pain as sharp. Tried tylenol q4h yestreday with no relief. Has also experienced "stuffy nose" and muscle pains for past several days, and endorses feeling warm with no objective fever and denies night sweats, chills, diarrhea, throat pain, constipation, change in urinary symptoms.

Of note, patient is an avid rock climber. Was in car accident as kid 

ROS: see above:
PMH: exercise induced asthma
PSH: none
Meds: none
Alg: none
FHx: grandfather MI at age 70
SHx: never smoker, drinks beer ~1x/month, weed 3-4x in lifetime.

Keywords and phrases relevant to diagnosis:
feeling warm
M
17yo
stuffy nose for past several days, stuffy nose", "stuffy nose", "stuffy nose" for past several days
pain, worse w/ inhalation, worse w/ inhalation
excerise induced asthma
chest pain
starting 1 day ago
rock climber
pain as sharp, sharp