bhatthars/nbme_qna huggingface dataset:
Patient Note: 17 yo male presents with chest pain since yesterday morning. Patient awoke with left-sided chest pain, described as diffuse, non-pinpoint, and like a 'sharp knife stabbing him.' Pain is constant, 5/10 when not moving but 8/10 with deep breath or movement. Tried taking Tylenol and albuterol inhaler with no relief. Also had congestion, rapid onset of diffuse muscle aches, and subjective fevers for multiple days before. Denies sick contacts, shortness of breath, nausea/vomiting, sore throat, cough. 

ROS: As per HPI
PMH: Exercise-induced asthma
PSH: None
FH: Father - asthma; grandfather - heart attack
Medications: Tylenol, albuterol inhaler as needed
Allergies: NKDA
SH: In high school. Denies tobacco use. Drinks alcohol occassionaly on weekens with friends. Smokes weed on weekends. Sexually active with girlfriend only.

Keywords and phrases relevant to diagnosis:
subjective fevers
male
17 yo
congestion days before
8/10 with deep breath
Exercise-induced asthma
chest pain
since yesterday
Denies shortness of breath
Tried taking albuterol inhaler with no relief
sharp, stabbing
Patient Note: 17 yo m c/o right sided chest pain started yesterday morning , sharp , non radiating ,constant , 4/10 at rest  and 8/10 with movement , aggrab by deep breathing and movement , no allev , takes tylenol doesnt help ,has fever ,h/o of stuffy nose and muscle ache in past 4 days .Denies any prev similar attack , palp , SOB , cough , HA , dizziness, HA 
ros neg 
PMH asthma med albuterol inhaler , tylenol 
PSH , NONE  ,
FH granddad had heart attack , dad asthma 
sh carpenter , etoh ocassionally , use weel last used last weekend , no smoking 
sex with gf using condoms

Keywords and phrases relevant to diagnosis:
fever
m
17 yo
stuffy nose in past 4 days
aggrab by deep breathing
asthma
chest pain
started yesterday
Denies SOB
sharp, 8/10
Patient Note: CC: Chest Pain. HPI:17yo male presenting with new onset chest pain for one day. Pain is localized to the left upper chest. It is constant, sharp, and 6/10 at rest and 8/10 w/ deep breaths. Palpating the area reproduces the pain. He denies radiation, trauma, or an inciting event.Also,reports a runny nose and muscle aches for the past 3-4 days. He has tried tylenol and his albuteral inhaler without relief. ROS: negative: cough, sore throat, lymphadenopathy, shortness of breath, palpitations, rashes, change in bowel/bladded habits, & back pain.Positive: runny nose, muscle aches
PMH:Pt has exercise induced asthma with a prn abuterol inhaler, not used for 6 months before now. NKDA, no surgeries
FMH:Dad, alive, asthma & hypercholesterolemia. Mom, alive and healthy. Grandfather alive, hx of MI. Sister,seasonal alergies
SH:Senior in high school, carpenters assistant. Occational EtOH and cannabis use. No Tobacco. 1 sexual partner, uses condom

Keywords and phrases relevant to diagnosis:
male
17yo
runny nose past 3-4 days, runny nose
8/10 w/ deep breaths
exercise induced asthma
chest pain
for one day
negative shortness of breath
albuteral inhaler without relief
sharp, 8/10
Patient Note: HPI: 35 yo F c/o mens cycles dysregularities
- started 6 m ago. LMP 2 m ago, has menorrhagea
- before 6 m, cycles were regular, 3-4 d/m. G0P0. No hot flashes. No vaginal discharge. 
- sex active with boyfriend, no contraception, wants to be pregnant 
- 10-15 p/last months
- no N/V, change in bowel habits, urination 

ROS as above
All: NKDA
Meds: none
PMH:none
PSH: none
FH: breast and cervical cancer h/o in family

Keywords and phrases relevant to diagnosis:
F
menorrhagea
LMP 2 m ago
no contraception
35 yo
6 m, 6 m
Patient Note: Ms. Tompkins is a 35 yo G0P0 woman with irregular, heavy periods over the past 6 months. Menarche was at 12, with periods every 30-35 days, lasting for 3 days, without pain. Now her periods occur every other month and last for 7 days, with heavy bleeding requiring her to change tampons every 2 hours. She had unprotected sex for 9 years with her ex-husband but never became pregnant and eventually adopted 2 children. She never pursued an infertility work-up. She is sexually active with her current boyfriend without birth control and has not become pregnant. She has gained 10-15 pounds in the past 6 months and feels tired. No hirsutism, acne, spotting, changes in bowels. 
ROS: otherwise negative. 
OBGYN history: Last pap 6 months ago, no hx of abnormal paps. No hx STIs. 
PMH: none
Meds: none
Surgeries: none
Allergies: none
FH: Aunt with breast cancer @ 51, grandmother with cervical cancer @ 62
SH: No tobacco or drugs. EtOH occ.

Keywords and phrases relevant to diagnosis:
Ms, woman
gained 10-15 pounds
heavy periods, irregular periods, heavy bleeding, change tampons every 2 hours
without birth control
tired
never became pregnant, infertility
35 yo
6 months, 6 months
Patient Note: HPI: 35 yo, F, c/o irregular and heavy period* 6 mos
- since 6 mos ago, no ppt factors, needs to change pads/few hrs, heavier in first day, no dysmenorrhea, LMP 2 mos ago
- associated w/black pigmentations in hands and neck * 1 yrs, gain 10-15 lbs/6 mos, feeling fatigue because pt has 2 kids to take care
- denial cold/heat intilerance, swellings, depressed mood, anhedonis, skin/hair changes, acne, breast tenderness, vision changes, nausea, vomiting
ROS: no changes in appetite, bowel or urinary habits
PMH/FH/Meds: None, NKA
PSH/hosp: two nl vaginal delivery
SH: clerk ,etoh occ, no tobacco, illict drug use. diet nl, monogamous w/boy friend, couldn't conceive w/o condoms

Keywords and phrases relevant to diagnosis:
F
gain 10-15 lbs
irregular period, heavy period
LMP 2 mos ago
fatigue
"couldnt conceive"
35 yo
6 mos, 6 mos
Patient Note: Case of a 35 yo F presenting for heavy menses. The patient had menarche at 12 yo. She used to have regular period lasting 7 days/ 4 weeks with 3 tampons/day. For the past 6 month she had only 2 periods with heavy bleeding  changing tampons every couple of hourse, but no clots.  The patient denies abdominal pain, no spotting between periods and no post-coital bleed. She rhad 10 lbs weight gain in the past 6 month with no change in appetite along with fatigue. She reports darkening of her skin on both hand and L neck for the past year. She denies change in vision, vaginal discharge or itching. She reports being infertile without investigation. No pap smear or mammography done. 
ROS: negative except as above
PMH: Infertile
PSH: None
Medications/Allergy:NKFDA
FH: Grandmother had cervical ca and aunt had breast ca
SH: Social worker. No smoking, occasional EtOH. No illicit drug use. Sexually active with boyfriend of 1 year no condomns.

Keywords and phrases relevant to diagnosis:
F
weight gain
heavy menses, heavy bleeding, changing tampons every couple of hourse
no condomns
fatigue
infertile, Infertile
35 yo
6 month, 6 month
Patient Note: Ms Tompkin is  35 yoF with "problems with periods". The last five months she has noticed irregularity with her cycles and heavier bleeding. She started menstruation at 12 and her cycles were every 30-35 days. She went through 3 pads per day and had moderate bleeding. In the past five months she has only had two periods, and her last period was 2 months ago. She now changes her pad every couple hours and notices "a lot of blood". She has not had any increased pain with menstruation. She has a 10 pound weight gain in the past six months, and increased fatigue. Her last pap smear 9 months ago was normal. She has a history of infertility. Her mother and sister have regular periods

ROS: no nipple discharge, breast tenderness, vaginal pain, itching, discharge or dryness, no dry skin, no hair loss, no urinary syptoms

PMH: none
PSH: none
Meds: none
FH: grandomther - cervical cancer, aunt - breast cancer
SH: sexually active, no condoms

Keywords and phrases relevant to diagnosis:
Ms, F
weight gain
irregularity with her cycles, heavier bleeding, changes her pad every couple hour
last period was 2 months ago
no condoms
fatigue
infertility
35 yo
five months, five months, six months
Patient Note: 35 year-old female presents with heavier and longer periods onset 6 months ago. Previously they were 3-4 days with 4 tampons this first day tapering down to 1 near the end. Now they last 7 days with tampons changed every few hours, her last one was 2 months ago and she's had 2 in the last 5 months. She denies any pain but does report fatigue and a 10-15 pound weight gain. She has no change in her vision. Unable to get pregnant. No irregular hair growth. No h/o STDs. 

Gyn: periods began age 12 were irregular then placed on birth control at age 12 to regulate. stopped 11 years ago. Pap smear 6 months ago normal (no abnormal)
PMH: none
PSH: none
Allergy: NKDA
FH: Aunt breast cancer 51 maternal, grandmother cervical cancer 62 maternal
Med: none
SH: alcohol 1-2 beers rarely, tobacco none, drugs none, work: scheduling administrator, sexyally active with boyfriend (monogamous)

Keywords and phrases relevant to diagnosis:
female
weight gain
heavier periods, tampons changed every few hours
last one was 2 months ago
fatigue
Unable to get pregnant
35 year-old
6 months
Patient Note: Angela Tompkins is a 35yo F who presents to clinic complaining of "period problems." She states that her menstrual flow is heavier than usual. She usually uses 4 pads/day at the beginning of period, tapering to 1 by the end of period. Now she has to change pad every 2 hrs. Her LMP was 2 months ago. Periods are regular, occurring every 4-5weeks and lasting 3-4days. She has never been pregnant, stating "I can't get pregnant." This change in flow has never happened before. Endorses acanthosis nigrDenies hair loss, fevers, abd pain, joint pain.
PMH: none
PSH: none
SexualHx: active w/ boyfriend, no H/o STIs, no longer uses condoms
Allergies: none
Meds: none
SocialHx: 2 adopted children; nonsmoker, 1-2 beers/month, no illicit drug use.

Keywords and phrases relevant to diagnosis:
F
menstrual flow is heavier, change pad every 2 hrs
LMP was 2 months ago
no longer uses condoms
"I cant get pregnant"
35yo
Patient Note: CC: Abnormal Menses
35 yo F with 6 months of irregular and heavy periods, shs has had 2 periods in 5 months, LMP 2 months ago. The bleeding is heavier than her normal period, using 7 pads/day instead of her normal 3, but there are no clots. Menarche was at age 12, and she has a history of irregular periods requiring OCPs. Menses were previously every 4-5 weeks, with 3 days of bleeding and mild cramping. She notes a 10lb weight gain in last 6 months, fatigue of 2 years duration and darkening of the skin over her knuckles and neck. She was unable to concieve after trying for 9 years. At present the patient has no pain with her periods, no vaginal dryness, no hot flashes, hirsutism, sleep changes, acne, breast discharge/pain, consipation or swelling.
ROS: No headache.
PMHx: None, no meds, NKDA. No Surgeries. SHx: Employed, drinks rarely, no tobacco or durg use. FHx: Maternal Grandmother Cervical CA, Maternal aunt Breast CA. OBGYN: G0,

Keywords and phrases relevant to diagnosis:
F
weight gain
Abnormal Menses, irregular periods, heavy periods, 2 periods in 5 months, bleeding is heavier, 7 pads/day
LMP 2 months ago
fatigue
unable to concieve
35 yo
6 months
Patient Note: 35yo F presents with irregular periods. She has had 3 periods in the past 5 months, irregular onset, lasting 7 days, needs to change tampon every few hours for the first day. In the past, her periods were regular, every 5 weeks, lasted 3-4 days, 4 tampons on first day. LMP was 2 mos ago. Periods associated w minor cramping only. Also reports gaining 10-15 lbs in the past 6 months, but no increased appetite. No acne, fatigue, lightheadedness, headache, fever, hirsutism, voice changes.

OBGYN Hx: Menarche age 12. Had irregular periods then and was put on oral contraceptive age 13-24; periods were regular then and remained regular after that. Tried to get pregnant for many yrs but never pregnant. No hx of STIs, tested negative 1 yr ago, no new partners since then. Sexually active with 1 male partner; no condoms or other contraceptive use.
PMH: no meds, allergies, health issues, or surgical hx
SH: occasional alcohol, no tobacco/drugs

Keywords and phrases relevant to diagnosis:
F
gaining 10-15 lb
irregular periods, change tampon every few hours, periods irregular
LMP was 2 mos ago
no condoms, no contraceptive use
Tried to get pregnant but never pregnant
35yo
5 months, 6 months
Patient Note: 35 yo F comes into the office complains of heavy menses.  It started 6 months ago, when her period started to get heavy and she use to use 3-4 pads per day now increased to changing pads every couple of hours. Menses use to be 3-4 days now lasts 7 days.  Menarche was 12 years old, no pregnancy, normal pap smear 6 months ago.  Associated with dark spots on skin, fatigue, 10-15 lbs weight gain in last 6 months unable to get pregnant.  Denies changes in vision, neck lumps, fever, night sweats, abdominal pain, changes in stool caliber, bowel movement, urination, nausea vomiting, changes in breast, breast discharge, changes in hair.
ROS-none except listed above
PMH-NC; MEDS-NC; NKDA
Hospitalization/PSH- NC
family history- aunt died of breast CA; grandma died of cervical CA
SH- social woker scheduler, no smoking, occasional alcohol, no illict drug use, sexually active with boyfriend, no condom no use of STD, lives with 2 adopted children

Keywords and phrases relevant to diagnosis:
F
weight gain
heavy menses, period heavy, changing pads every couple of hours
no condom use
fatigue
unable to get pregnant
35 yo
6 months, 6 months
Patient Note: Ms. Tompkins is a 35 yo F who presents due to a h/o irregular, heavy, and painful periods for the past 6 months. She has had 2 periods in the last 5 months, with her LMP being 2 months ago. She had her menarche at age 12, began taking birth control pills at age 13 to regularize her periods, and stopped taking birth control 11 years ago. She attempted to get pregnant with her ex husband for a period of 9 years, but was not able to. She is currently sexually active with her boyfriend, and they do not use protection because she "cannot get pregnant." She denies any irregular bleeding prior to the last 6 months, dyspareunia, problems with blood sugar, painful defecation, changes in bladder habits, abnormal discharge, itching, or any past h/o STIs. 

Social Hx: lives a stressful life with her job, and 2 adopted children, denies smoking, drug use, or drinking
FHx: None

Keywords and phrases relevant to diagnosis:
Ms, F
heavy periods, irregular periods
LMP being 2 months ago
do not use protection
get pregnant not able to, cannot get pregnant
35 yo
6 months, 5 months, 6 months
Patient Note: Patient is a 35 yo F presenting with period problems. She states that she has had heavy period flow for past 6 months. Previously her menstrual period occured every 4-5 weeks, lasting 3-4 days and requiring 3-4 pads/day. Now she states that she has had 2 periods in last 5 months, lasting 7 days and requiring up to 7 pads per day. She also notes some fatigue and states she has gained 10 pounds in the past 6 months. She denies any vaginal discharge, dysmenorrhea or any breast tenderness/discharge. 
ROS: negative except as above
Medications: none
Allergies: NKDA
PMHx: none
PSHx: none
FHx: grandmother died from cervical cancer. Aunt died from breast cancer at 51
SHx:2 adopted children, no tobacco or illicit drug use. Drinks alcohol socially on occasion. Sexually active with boyfriend. Does not use contraceptives.
OB/GYN: LMP - 2 months ago. Never pregnant. Pap smear 2 months ago - normal. no vaginal discharge or associated symptom

Keywords and phrases relevant to diagnosis:
F
gained 10 pounds
heavy period, Now lasting 7 days, Now up to 7 pads per day
Does not use contraceptives
fatigue
35 yo
6 months
Patient Note: Ms. Tompkins is a 35 yo Female presenting for problems with her periods. Reports she has been having irregular heavy periods for the last 6 months. Used to have periods every 4-5 weeks lasting 3-4 days, she would need 4 tampons on day 1 and then tapered down. Over the last 5 months she has had 2 periods with the last one 2 months ago. She goes through a tampon every 2 hours for the first day and her periods last 7 days. Has light cramping with her periods which has not changed. Has noticed skin discoloration on the back of her neck and the knuckles of her hands over the last 1-2 years. Has history of trouble getting pregnant. Tried for 9 yrs with research into the best strategies and could never get pregnant. Was never evaluated for this issue. Not on any contraception, no history of STDs, last pap 6 months ago was normal and has no history of abnormal paps. 
FH: cervical and breast cancer
SH: never smoker, 1-2 alcoholic drinks a week

Keywords and phrases relevant to diagnosis:
Female
heavy periods, irregular periods, tampon every 2 hours
periods last 2 months ago
Not on contraception
history of trouble getting pregnant, could never get pregnant
35 yo
6 months
Patient Note: 35 y/o female with on significant past medical history presents with heavier menstrual cycles. Her last regular menstrual period was 6 months ago. Her periods were previously on regular 1 month cycles. Her periods are still on 1 month cycles but she expereinces heavier bleeding with no pain. Has not noticed any vaginal discharge or clots. Denies any inciting factors. Does not think she is pregnant as she previously tried for 9 years and was unable to become pregnant. Has been having unprotected sex for the past year. Also reports gaining 10 pounds in the last 6 months. No fevers, chills, chest pain, shortness of breath, night sweats, hot flashes.

PMH: None
FMH: Aunt with breast cancer and grandmother with cervical cancer
Social: Never tobacco user. No alcohol or illicit drug use
Surgery: None

Keywords and phrases relevant to diagnosis:
female
gaining 10 pounds
heavier menstrual cycles, heavier bleeding
unprotected sex
unable to become pregnant
35 y/o
6 months
Patient Note: HPI  40 y/o F c/o iregular periods for 6 monts, Right now she has period every 2 month but havier than before, last for 7 days and change tampons every 3 h on first day. NO tissue  coming out,  No fever, no constipation, no change in urinary habits. NO palpation.
PMH try to be pregnat for 9 y and could not . Adoppted two kids
PSH none
SF parents in good healt but aunt died of brest ca and grandmother hed cervical ca.
SH sexualy active with husband no history of STD.
SOcial  h drinks 1 glass of beer evry night but no tabbaco prodact nor illicit drugs
Married, has to adopted daughters

Keywords and phrases relevant to diagnosis:
F
iregular periods, period havier, now 7 days, now change tampons every 3 h on first day
try to be pregnat for 9 y and could not
6 monts
Patient Note: 35 yo F presenting for heavy periods. For the past 6 months she has noticed an increased length and heaviness of periods. Previously periods were 3-4 days in length requiring 4 tampons on first day, 1 subsequent days; now with 7 day periods requiring change of tampon every couple of hours. No spotting between periods. She denies dizziness, SOB, N/V, abdominal pain, or clotting problems, but does endorse fatigue. Denies soaking through clothing. Patient also stating she is unable to get pregnant after years of attempts with her ex-husband. 
ROS: per HPI
PMH: none
PSH: none
Gyn: 12/irreg prior to BC/3-4 days, now 7 days; no h/o STI, Pap smear 6 months ago normal, sexually active with boyfriend, previously used condoms, but no longer
Allergies: NKDA
Med: none
FHx: aunt with breast cancer, grandmother with cervical cancer
Social: administrator, denies tobacco and drug use, social drinker, lives at home with her 2 adopted girls

Keywords and phrases relevant to diagnosis:
F
heavy periods, increased length and heaviness of periods, now with 7 day periods, now requiring change of tampon every couple of hours
previously used condoms, but no longer
fatigue
unable to get pregnant
35 yo
6 months
Patient Note: 35 year old F complaining of missed period for the past 2 months. Reports that for the past 6 months, had heavy menses and irregular, was given Orthotricycline (OCP) by MD to help regularize menses, last dose taken 11 years ago, then menstruation became regular. Patient is divorced with husband, been trying to get pregnant and has adopted two kids. Had a boyfriend, sexually active, no condom or protection. Reports weight gain 15 lbs for the past 6 months, feeling of tiredness. Denies any depression, weight loss, hair changes, voice changes. Adopted 2 kids.
ROS: none
PMH: none
FH: Aunt has breast Ca. grandmother has cervical cancer. 
OB/Gyne: LMP 2 months ago, Menarche 12 years old, initially irregular, then became regular. Uses a lot of pad every couple of hours during the first day of mens. Denies spotting but reports mild cramping or dysmenorrhea. 
SH: denies smoking but has 1-2 beers occasionally. no illict drug,masters scho

Keywords and phrases relevant to diagnosis:
F
weight gain
heavy menses, menses irregular, Uses a lot of pad every couple of hours
no condom, no protection
tiredness
35 year old
6 months
Patient Note: 35 yo F, presents with 6 months of oligomenorrhea and heavy menses. She has had only 2 menses during this perios, which lasted 7 days, and required changing pads every hour the first day. No clots seen. No previous history of amenorrhea. She reports a 10 pounds increase in weight but no change in appetite. Lives with her two adopted children (3, 4 years-old). Has seen a physician few years ago for check up and repors having been found to have infertility. Reports hyperpigmentation of her left neck and finguer knukles. No hirsutism. no cold intolerence, no tremors. No headache or visual changes, no galactorrhea. Has not had fever/chills, abdominal pain or changes in bowel movement. No urinary symtoms.
ROS: 
Allergies: none
PMH: infertility
PSH: none
SH: lives with 2 adopted daughters, works as sche

Keywords and phrases relevant to diagnosis:
F
increase in weight
oligomenorrhea, heavy menses, 6 months only 2 menses, lasted 7 days, changing pads every hour
infertility, infertility
35 yo
6 months
Patient Note: Ms. Tompkins is a 35 y.o. F with 6 months of heavy periods. Last normal period was 2 months ago. LMP May 27, which lasted for 7 days. Used to only last for 3-4 days, and used to be regular. No intermenstrual bleeding. No bleedng or pan with sex. No vaginal d/c, odor, or pruritis. Also reports fatiues, weight gain, and rash on neck and fngers x2 years Reports abd cramping, but denies any other pan including in joints. No other bruisng, f/c, SOB, CP, palpitiations, change n BM/voiding, appeitite, mood or anxiety.

PMHx: difficulty conceiving. No hx STI, last pap smear nml a month ago, menarh 12 y.o. Adopted 2 children.
No PSHx, meds, allergies.
FHx: aunt breast CA, grandma cervical ca.
social hx no tobacco or drugs. occasonal beer. sexually active with one male partner. no condoms or contracepton.

Keywords and phrases relevant to diagnosis:
F
weight gain
heavy periods
Last period was 2 months ago
no condoms, no contracepton
fatiues
difficulty conceiving
35 y.o
6 months
Patient Note: 35 y/o F presents to the clinic for heavy periods 6 months in duration. Pts previous periods were regular, but she reports now that she has had 2 periods in 5months. She reports heavy bleeding on the first day of her period, now requiring 7 tampons on the first day where previously she required 3 -4. Pt has some minimal  cramping, and some skin discolouration on her 2nd knucles as well as on her L neck. Pt reports feeling fatigued for 2 years, and 10 lb weight gain with balanced diet. She reports that she believes she is infertile after failing to concieve for years. 
OBGYN: LMP 2 months ago, heavy flow, 7 tampons used for 1st day, Menarche at 12 y/o, G0P0, no pain during sex and no postcoital bleeding, last pap 6 months ago (normal), no hx of abnormal pap
ROS: Negative except as above
PMH and PSH: None
FH: Aunt died of breast cancer, grandmother died of Cervical cancer 
SH: Rarely drinks alcohol, sexually active with Boyfriend,

Keywords and phrases relevant to diagnosis:
F
weight gain
heavy periods, heavy bleeding, heavy flow, now requiring 7 tampons on the first day, 7 tampons used for 1st day
LMP 2 months ago
fatigued
infertile, failing to concieve
35 y/o
6 months