bhatthars/nbme_qna huggingface dataset:
Patient Note: Dillon Cleveland is a 17 year old male with no significant past medical history who presents for evaluation of episodic palpitations, chest pressure, and light headedness. He reports that these issues started after he started taking adderall given to him by a friend to help with studying at college. He also drinks energy drinks from time to time. He reports that his mood is good and college has been fine but a little hectic. He has not noted any particular triggers. Denies recent weight changes or changes to hair and skin.
No prior surgeries or hospitalizations.
Meds: Adderall from a friend. Denies others.
Allergies: NKA
FmHx: Father- MI at 52
Mother; Thyroid issue
SHx: College student for 1 year. Living on campus. School is "hectic"
High risk: Denies smoking. Drinks 3-4 drinks per weekend. Tried marajuana once. Denies other drugs.

Keywords and phrases relevant to diagnosis:
Father- MI
Mother; Thyroid issue
chest pressure
episodic
light headedness
Denies changes to hair
adderall, Adderall
energy drinks
palpitations
17 year old
male
Patient Note: 17 yo male with no PMH presents with 3-4 months of palpitations
-episodes occur randomly, no associated with activity, associated with shortness of breath and pre-syncope
-no sweating, feeling of impending doom, anxiety with episodes, no diarrhea
-takes adderall a few times that is prescribed to friend, however has been taking this for a year now
-no history of thyroid problems
PMH: none
Meds: adderall (not prescribed)
FamHx: Mom- "thyroid problem"; dad- heart attack at 52
Social: lives with roomate; 3-4 alcoholic beverages/week, no durgs, sexually active w girlfriend and uses condoms

Keywords and phrases relevant to diagnosis:
dad- heart attack
Mom- "thyroid problem
episodes
adderall, adderall
shortness of breath
palpitations
3-4 months of
17 yo
male
Patient Note: MR clevland is a 17 year old male ho presetn wth episodes of his heart pounding and racing, they hve happended 5-6 times in the past 3 months, nothing seems to set the episodes off or make them go away, he felt short of breath in one episode while he was playing basketball, there is no pain. there are no asosiated syptoms such as headaches, lightheadenss, consistant shortness of breath, feelings of impending doom, fear, 

PMHx- no medical diagnosis, healthy
Meds- admits to taking friends prescription adderal for study usage, no othe meds
Allegeries- nka
Surg hx- none
Fam hx- mom has some thyoid disorder he is unsure of, father had heart attack last year
Social- doesnt smoke, drinks with friends on weekends 3-4 beers, uses a Designated Driver, tried pot once but hasnt since then, no IVD use

Keywords and phrases relevant to diagnosis:
father heart attack
mom thyoid disorder
episodes, 5-6 times in the past 3 months
adderal
short of breath
heart pounding, heart racing
past 3 months
17 year old
male
Patient Note: History: The patient is a 17-year-old male presenting with chief concern that his heart is pounding. His episodes started 3-4 months ago without any identifiable stressor, occuring intermittently 1-2 times per month at rest or while exercising. They go away on their own afer 3-4 minutes and are associated with a pressure sensation in the center of the chest. His most recent episode occured 2 days before presentation during a soccer game, lasted for 10 minutes, and was associated with shortness of breath + lightheadedness. No , unexpected weight loss, chest pain.
ROS: Negative except HPI
PMH: N/A
PSHx: N/A
Allergies: N/A
Medication: Takes friend's adderal a few times per week 
FH: mother with "thyroid" condition; father (52) with heart attack 
SH: Student. Drinks 3-4 drinks per week (CAGE = 0 for all questions); no tobacco use; tried marijuana once not using. Vaginal intercourse w/ monogamous female; uses condoms; no hx STIs

Keywords and phrases relevant to diagnosis:
father with heart attack
mother with "thyroid" condition
pressure in chest
occuring intermittently, 1-2 times per month
lightheadedness
Takes adderal
shortness of breath
heart is pounding
3-4 months ago
17-year-old
male
Patient Note: 17 yo male with no significant PMH presenting with 3-4 months of episodes where his "heart is pounding and going to jump out of my chest." The episodes each last 3-4 minutes, and he has had 1-2 espisodes per month. he has not noticed a pattern or trigger. they resolve on their own, nothing makes them better or worse. the last time it occured, also had chest pressure and felt that he couldn't catch his breath (during a soccer game) and felt that he was going to pass out, though didn't. has not experienced lightheadedness, dizziness, LOc, otherwise. Reports taking his roommate's adderall "a few times per week" for the past year. Also drinks 3-4 cups of coffee per night, plus 1-2 energy drinks a few times per week also. No PMH. no PSH, NKDA, no recent travel, no recent illness. No other meds. no smoking, drinks 3-4 drinks alcohol on weekends, sexually active with one partner, no recent STD testing. Dad had MI age 52. Mom has thyroid dz

Keywords and phrases relevant to diagnosis:
Dad had MI
Mom has thyroid dz
chest pressure
episodes, episodes, 1-2 espisodes per month
felt that he was going to pass out
adderall
"couldnt catch his breath"
coffee, energy drinks
heart is pounding and going to jump out of my chest
3-4 months of
17 yo
male
Patient Note: 17 yo M who presents with episodes of heart palpitations. He has had 2-3 episodes per month for the past 2 months. Most recent episode was yesterday. Episodes last 3-4 minutes, and he reports no known triggers, can occur at rest or with exercise. Patient denies chest pain, dyspnea, sweating, dizziness, or LOC. Denies fevers, diarrhea, constipation. Patient reports using friend's Adderall 2-3 times weekly to help him focus. Last use was yesterday. Drinks 3-4 beers on weekends. Tried marijuana use, denies other drug use. Nothing known to alleviate or exacerbate symptoms.

PMH: none
Meds: none
Allergies: none
SH: ETOH and substance use above, lives in dorm at school, sexually active with girlfriend only
FH: mother has thyroid condition, father had MI 1 year ago

Keywords and phrases relevant to diagnosis:
father MI
mother thyroid condition
2-3 episodes per month
Adderall
heart palpitations
past 2 months
17 yo
M
Patient Note: 17 yo CC palpitation 
-Started 3 months ago, , has experienced 5-7 episodes wich last 3-4 minutes, sudden onsent, no precipitations factor, no alleviating or aggravating factor 
-Do not has any visual disturbances, sweating. has has episodes during rest and exertion. has been progressively worsened. 
-Last episode associated SOB no chet pain 
-No changes in bowel movement, no heat intolerance, no skipped meals, no fever. No mood changes, no weigth loss
-Good relationship with friends, good school grades. 
-ROS: Negative except above
PMH: None 
AllergiesNKDA-NKA
Meds: Nones
FH: Mother hx of thyroid disease, Father IM at 52 
SH: College student, live with roomates, no tobacco, drinks socially,  One use of marijuana and stopped. Sexually active 1partner last yr, +Condoms. Exercises regualrly Healthy diet

Keywords and phrases relevant to diagnosis:
Mother hx of thyroid disease
5-7 episodes
no heat intolerance
SOB
palpitation
Started 3 months ago
17 yo
Patient Note: dillon cleveland is a 17yo male with no PMH that comes in with palpitations. the last time he felt them, about 2 days ago, he also felt short of breath and some chest pressure, and like he was going to "pass out". he denies sweating, loss of consciousness, he says these palpitations happen a couple times a month and have been going on for a few months. he does not associate any pattern with when the palpitations happen. the only medication he takes is adderall a few times a week that he gets from his roommate. his family history consists of his mother with a thyroid problem and his father who had a heart attack at age 52. he does not smoke, drinks 3-4 beers on the weekends, and used marijuana once.

Keywords and phrases relevant to diagnosis:
father heart attack
mother hyroid problem
chest pressure
felt ike he was going to "pass out"
denies sweating
adderall
short of breath
palpitations
going on for a few months
17yo
male
Patient Note: Mr. Cleveland is a 17 yo male who presents with a chief complaint of heart pounding. Patient has experienced this sensation for the past 2-3 months, 5-6 times total, roughly 2x/month. The last episode was 2 days ago while playing basketball. Patient describes heart racing, pressure, shortness of breath, and light headedness. Episodes have occured variably, some while exercising, some while resting. He reports the use of a friend's adderall roughly 2x/week for the past 7 months to help with concenctration. He also endorses drinking 3-4 cups of coffee/day and energy drinks as well. Patient is a freshman in collee, sexually active with his long term girlfriend, uses condoms, but denies use of tobacco products and ilicit drugs. He reports drinking 3-4 alcholoic drinks on weekends. Family hx is positive for thyroid dx in his mother and a MI in his father. He has no significiant medical/surgical hx. No allergies or weight/appetite changes.

Keywords and phrases relevant to diagnosis:
MI father
thyroid dx mother
pressure
5-6 times, Episodes
light headedness
adderall
shortness of breath
drinking coffee, drinking energy drinks
heart pounding, heart racing
for the past 2-3 months
17 yo
male
Patient Note: CC: Dillon Cleveland is a 17 year old male with a 2-3 month history of chest palpitations 

Dillon has had chest palpitations for the last two to three months. He has not found anything that has made them worse or given him relief at this time. The palpitations usually self resolve. Dillon had a particularly bad episode during a basketball game yesterday with strong shortness of breath. Dillon has had no changes in weight, sweating, nausea vomiting or diarhea at this time. Particularly chest fluttering  in particular due to the fact his father had a heart attack last year. Dillon is taking two adderal per week since starting school.

NKDA.Patient takes no medications other than the two adderal from his roommate per week, Patient is a college student living in the dorms. Drinking 3-4 drinks per week. Remote use of marijuana, no tobbacco, advised to not play basketball for now, Mother thyroid issues.Father MI. Sexually active w/gf,use

Keywords and phrases relevant to diagnosis:
Father MI, father had a heart attack
Mother thyroid issues
adderal
shortness of breath
chest palpitations, chest palpitations
2-3 month
17 year old
male
Patient Note: 20 y/o F c/o abdominal pain  
5/10. from last 10 hours.
dull and ache.,cramping pain in the right lower quadrant.
no radiation.
walking makes it worse.took ibuprofen but not much help.
no fever chills,no discharge,no dysuria,no blood in the urine.
pat h/o of similar episodes 3-4 in the last 6 months..not allergic .no medicines other than ibuprofen..no hospitalisation trauma or surgeries .no past illness.
family h/o not significant..
lmp 2 weeks ago.regular 28 days lasts for 4 days.moderare flow.age of menarche 13.
last sexual encounter 9 months ago with boy friend always uses condoms.

Keywords and phrases relevant to diagnosis:
no discharge
last sexual encounter 9 months ago
20 y/o
similar episodes 3-4 in the last 6 months
pain in the right lower quadrant
no dysuria
lmp 2 weeks ago
last 10 hours
F
Patient Note: 20 yo F c/o abdominal pain
HPI : onset 8-10 hours, RLQ abd pain, achy and crampy, PS 5/10, no radiated, getting worse, better with ibuprofen, worse with walking, poor appetite, + diarrhea 2-3 d, loose and watery stool, 4-5 times a day, no blood in stool, no mucus.
neg Vaginal discharge, dysuria, fever, headache, nausea, vomiting

+previous similar episodes in the past, same site, characteristic, didnot see a doctor, went away spontaneously
PMH/PSH : neg
neg smoking/ alcohol/ ilicit drug
no sexual intercourse for 9 months
FHX none
no previous hospitallised
normal

Keywords and phrases relevant to diagnosis:
neg Vaginal discharge
no sexual intercourse for 9 months
diarrhea, loose and watery stool
20 yo
no blood in stool
+previous similar episodes in the past
RLQ abd pain
neg dysuria
poor appetite
onset 8-10 hours
F
Patient Note: 20 yo female presents with RLQ pain for the past 10 hours. Pain is 5/10, dull and crampy. She has assoicated nausea and loss of appetitie since the pain started. She has had 3-4 similar episodes in the past 6 months. She notes intermittent diarrhea for the past 6 months with or without association with pain. Bowel movements do not improve pain. Pain does not radiate or change with position. Ibuprofen has helped some. Walking makes the pain worse. She has noticed that her clothes fit looser over the past 6 months.
ROS: denies chills, sweats, vomiting, or recent infection
PHM: none
Meds: ibuprofen as needed
NKA
SH: lives alone, family is in California, not sexually active for past 9 months
OB/GYN: last period 2 weeks ago, regular cycles

Keywords and phrases relevant to diagnosis:
clothes fit looser
not sexually active
diarrhea
20 yo
3-4 similar episodes in the past 6 months
RLQ pain
loss of appetitie
last period 2 weeks ago
pain for the past 10 hours
female
Patient Note: Suzanne Poweltor is a 20 yo F with no significant PMHx who presents with a cc of abdominal pain. She states that the pain began about 8 hours ago and is located in her RLQ. The pain began there and has presisted there since. She describes it as a dully, achy pain that worsens with walking. The patient has had this happen before. She states that it has resolved in the past on its own. She reports having nonbloody diarrhea today and a decreased appetite. She denies any chills, chest pain, dyspnea, nausea/vomiting, dysuria, hematuria, or concerns for STIs. She has tried taking ibuprofen and states that it has helped with the pain. 

PMHx - None
PSurgHx- None
Meds - Ibuprofen prn
Allergies - NKDA
FamHx - None
SocHx- Drinks alcohol 2x/month. No tobacco or recreational drug use.

Menstrual Hx - Last period was 2 weeks ago. Regular cycles. Last sexually active 9 months ago. Last STI check was 1 year ago.

Keywords and phrases relevant to diagnosis:
Last sexually active 9 months ago
diarrhea
20 yo
nonbloody diarrhea
patient has had this happen before
RLQ
denies dysuria, denies hematuria
decreased appetite
Last period was 2 weeks ago
began about 8 hours ago
F
Patient Note: 20 year old woman presenting for RLQ abdominal pain which started 8-10 hours ago and woke her up from sleep. The pain in 5/10 in severity, does not radiate, dull and aching in nature, constant, not relieved by ibuprofen, exacerbated by walking. No nausea or vomiting. Has had diarrhea for the past few days, loose stools that are nonbloody nonmucoid.
She reports having similar but milder abdominal pains 3-4 times in the past 6 months that resolve spontaneously as well as diarrhea, but not concomitantly. No joint pain or skin rashes. 

Past medical and surgical hx: none
Meds: ibuprofen for the abdominal pain
Allergy: NKDA
Family hx: noncontributory
OBGYN: regular cycles, LMP 2 weeks ago, last sexual activity 9 months ago
Social: biology premed student, no smoking, occasional alcohol

Keywords and phrases relevant to diagnosis:
last sexual activity 9 months ago
diarrhea, loose stools, diarrhea
20 year
stools nonbloody
abdominal pains 3-4 times in the past 6 months
RLQ abdominal pain
LMP 2 weeks ago
started 8-10 hours ago
woman
Patient Note: PT 20 YO F C/O PAIN IN RLQ  x 8-10 HOURS SUDDEN IN ONSET, DULL, 5/10, AGGRAVATES WITH WALIKING AND RELIEVED PARTIALLY BY TAKING IBUPROFEN A/W DIARRHEA x 2D(BROWN IN COLOR, WATERY, CONTAIN NO BLOOD) , FEVER. PT HAS PMH OF 3 4 EPISODES OF SIMILAR PAIN EPISODES ASSOCIATED WITH DIARRHEA BUT NOW THE PAIN IS WORSE THAN EVER BEFORE.PT ALSO REPORTS DECREASE IN APETTITE, WEIGHT(NOT MEASURED) FOR PAST ONE MONTH. PT EATS HEALTHY DIET.
PT DENIES EATING OUTSIDE , NAUSE , VOMITING , ANY CHANGE IN URINARY HABITS. PT ALSO DENIES ANY PREVIOUS H/O KIDNEY STONES.
ROS: -VE EXCEPT AS ABOVE
PMH: AS PER HPI
MED: IBUPROFEN FOR PAIN
PSH/HOSP: NONE
ALL: NKA
FH: N/C
SSH: NO SMOKING/ETOH/DRUGS. HAD SEX WITH HER BOY FRIEND 9 MONTHS AGO USING CONDOMS.
OBGY: LMP 2 WEEKS , REGULAR PERIODS 4-5/28

Keywords and phrases relevant to diagnosis:
DECREASE IN WEIGHT
SEX 9 MONTHS AGO
DIARRHEA x 2D, 3 4 EPISODES OF DIARRHEA
20 YO
DIARRHEA NO BLOOD
3 4 EPISODES OF SIMILAR PAIN
PAIN IN RLQ
DENIES CHANGE IN URINARY HABITS
DECREASE IN APETTITE
LMP 2 WEEKS
8-10 HOURS SUDDEN IN ONSET
F
Patient Note: HPI: 20 y F complains of sudden onset right lower quadrant pain for 8-10 hours, states pain is aching and cramping, non-radiating and about a 5/10 on severity. Not relieved by ibuprofen, aggravated by walking. Associated with diarrhea that began 3/7 ago, contains no mucus or blood, has 3-4 episodes a day. Denies fever, vomiting or ill-contacts. Of note, patient gives history of 3-4 episodes of right lower quadrant in the past year of similar characteristics but states that this pain is worse.  Admits to decreased appetite, and last meal was last night. Denies vaginal discharge or bleeding. 
OBGYN: LMP 2/52 ago. Regular 28 day cycle, uses 4-5 tampons on first day but decreases over 5 days of menses. Not currently sexually active. Last sexual encounter 9/12 ago with a male. 
PMH: Nil 
Allergies: Nil 
FH: Nil
SH: No smoking. Drinks alcohol twice a month. No recreational drug use. Student, studying biology. Normal diet and exercise.

Keywords and phrases relevant to diagnosis:
Denies vaginal discharge
Not currently sexually active, Last sexual encounter 9/12 ago
diarrhea that began 3/7 ago
20 y
diarrhea no blood
3-4 episodes of right lower quadrant in the past year
right lower quadrant pain
decreased appetite
LMP 2/52 ago
pain for 8-10 hours
F
Patient Note: HPI : a 20 yo f , complains of right lowe quadrant pain for 10-12 hr ago , pain is constant , non radiating , 5/10 in severity , increase with walking , decrease a little bit with ibuprofen , patient reports diarrhea since couple of days , watery brown loose stool , with no blood , no mucus , no nausea or vomiting , patients reprots no feeling of hotness , has decreased appetite , and seems to be loosing weight , but not sure how much , patients reports no urinary changes , and pain not related to food , she has regular periods evey 28 days , and LMP was 2 weeks ago , patient has a good sleep . 

ros : negative except as above 
allergies : NKDA 
meds : none 
pmh : none 
psh : none 
sh : no smoke , drinks wine occasionally ,work as student , sexually active with her boyfriend uses condoms eveytime she has sex . 
fh : non contributory 



Keywords and phrases relevant to diagnosis:
loosing weight
reports diarrhea
20 yo
stool , with no blood
right lowe quadrant pain
no urinary changes
decreased appetite
LMP was 2 weeks ago
for 10 ago
f
Patient Note: Pt is a 20 year old female who presents with abdominal pain. Pain is a constant dull ache of 5/10 in severity, is located in the RLQ, started suddenly 8-10 hours ago and awoke the patient from sleep. Endorses non-bloody diarrhea for the past 3 days and loss of appetite since last night. Denies nausea, vomiting, chills. Last PO intake was dinner last night. Pt experienced similar episodes 3-4x in the past 6 months which resolved spontaneously. Ibuprofen helps the pain, walking worsens the pain. 
ROS negative except as above. 
PMHx: none. LMP 2 weeks ago, 28d cycle, lasts 4 days, moderate flow. 
Allergies: NKDA
Surghx: none
FH: noncontributory
SH: lives alone, biology student, 1 beer 2x/month, denies tobacco or drug use. No recent travel. Sexually active, only male partners, most recent activity 9 months ago, uses condoms consistently.

Keywords and phrases relevant to diagnosis:
most recent activity 9 months ago Sexually active
diarrhea for the past 3 days
20 year
non-bloody diarrhea
similar episodes 3-4x in the past 6 months
Pain RLQ
loss of appetite
LMP 2 weeks ago
8-10 hours ago
female
Patient Note: Suzanne Powelton is a 20y/o female with no PMH who presents to the ED for abdominal pain. 
-pain located in right lower quadrant.
-progressively worsening pain rated 5/10 and described as dull, achy
-she has had diarrhea the last few days with no blood in the stool
-she has had a few episodes like this in the past 6 months that have resolved spontaneously
-she tried ibuprofen without much relief
-LMP 2 weeks ago
-has not been sexually active for 9 months
-no previous surgeries
-no nausea, urinary frequency, urinary urgency, discharge

Keywords and phrases relevant to diagnosis:
no discharge
has not been sexually active
has had diarrhea
20y/o
no blood in the stool
few episodes like this in the past 6 months
abdominal pain right lower quadrant, abdominal pain. right lower quadrant
no urinary frequency, no urinary urgency
LMP 2 weeks ago
female
Patient Note: 20 yo Suzanne Powelton presents to ED with complaints of sudden onset of ABD pain. The pain is in RLQ, started 8-10 hr back, dull and achy in character, does not radiate anywhere, constant and seems to be worsening. The pain is aggravated with walking but relieved a little with ibuprofen. It is 5/10 in severity. The patient also complains of having diarrhea for few days back with nausea or vomiting present. The diarrhea is watery, no blood present. There was no sense of incomplete evacuation or alernating diarrhea and constipation.
Temp: 100.8F
HR: 88bpm
BP: 126/78
Allergies: NKDA
Meds: Ibuprofen
PMH: None
Obs/Gyn: Menarche 13 yr of age, LMP 2 weeks ago, Regular cycle with 4/28 days, 4 tampons/day, no vaginal discharge or spotting present, PAP Smear negative
SH: sexually active 9 months back but not anymore, used condoms, alcohol twice a month,

Keywords and phrases relevant to diagnosis:
no vaginal discharge
sexually active 9 months back
diarrhea, diarrhea
20 yo
diarrhea no blood
pain is in RLQ
LMP 2 weeks ago
started 8-10 hr back
Patient Note: Suzanne Powelton is a 20 YP F complaining of abdominal pain. Pain is in right lower quadrant and is dull/achey like a bad cramp. 5/10 on pain scale. Does not radiate, worse with walking, IBU helps. Decreased appetite since yesterday has not eaten. Patient says she has had 4 similar episodes, but none of this severity and length. No nausea, vomiting, or constipation, Diarrhea past few days nonbloody 5x/day. No sick contacts. 
PMH: none, Allergies: none, meds: ibuprofen for pain, surgeries: none, family: none
ob/gyn: never had pap or STD, LMP was 2 weeks ago and she is regular, experiences moderate cramps, last time sexually active 9 months ago
social: no smoking or drugs. alcohol 2x/month, lives by herself, full time student.

Keywords and phrases relevant to diagnosis:
sexually active 9 months ago
Diarrhea past few days
20 Y
Diarrhea nonbloody
similar episodes
abdominal pain right lower quadrant
Decreased appetite, since yesterday has not eaten
LMP was 2 weeks ago
F
Patient Note: Ms. Powelton is a 20 year old female presenting to the clinic with right lower abdominal pain. For the last 8-10 hours she has had constant right lower badominal pain. SHe has had 3-4 similar episodes over the last 6 months. the pain is dull and achy. She has not noticed any activities or foods that bring on her pain. The pain does not radiate anywhere. Walking makes her pain worse. She has trie ibuprofen with no relief. She has had diarrhea for the last 4 days, with 4-5 large volume stools per day. SHe has not noticed blood in her stool. Her last mestrual period was 2 weeks ago and normal for her. She is sexually active wit hone partner and uses condoms for contraception. Denies nausea, vomiting, fevers, chills, palpitations, shortness of breath, and dizziness. She has no chronic medical conditions and has never had surgery. She does not take any medications, supplements, or herbals. Family history noncontributory.

Keywords and phrases relevant to diagnosis:
diarrhea
20 year
has not noticed blood in her stool
3-4 similar episodes over the last 6 months
right lower abdominal pain, right lower badominal pain
last mestrual period was 2 weeks ago
For the last 8-10 hours
female