bhatthars/nbme_qna huggingface dataset:
Patient Note: HPI :  Pt presents with headache with photophobia. complains of a stiff neck and body aches. Hurts all over her head. NO Weakness. numbness or tingling. No recent ill contact, flu or ear infectionm no recent travel , no Trauma and no stress. She complains of severe N/V and no weight losss
PMH : none
ALlergy NKDA
Medication - Oral Contraceptive
Family Health : kMOm has migranes and dad has hypercholestrolemia
OBGYN : LMP 2 weeks ago and regular 
Social and sexual : No smoking 2- 3Etoh per week 
3-4 joinjts of marijyuanna a week 
active iwth BF

Keywords and phrases relevant to diagnosis:
body aches
headache all over her head
stiff neck
V
N
MOm has migranes, Family Health migranes
photophobia
No recent ill contact
Patient Note: HPI: 20 yo F headache from yesterday norning with vomiting and nausea, photophobi, 8/10 no radiation, worse with time and bending forward  lending, neck pain , nofever,
pmh:no admiton in hospital, no weakness and numbnesss
FH: father hyperlipidemia , mother migrine headach
SH, sexually active with boyfriend for 1 year use OCP


Keywords and phrases relevant to diagnosis:
20 yo
yesterday
neck pain
vomiting
nausea
mother migrine, FH migrine
F
photophobi
Patient Note: The patient is a 20 year old female who presents with a severe headache. She has no PMH. She states that the headache started yesterday morning and has since been worsened. She reports that she has severe photophobia. She has never had a headache this bad in the past. She reports that nothing is helping her severe pain. She has tried "ibuprofen, tylenol, and trying to get some sleep, but none of those helped." She takes birth control pills. She states that she has been nauseas for the past day, and she has vomited 3 times yesterday. Feels feverish. No night sweats. She denies any diarrhea, constipation, chest pain, abdominal pain. 
PMH: No allergies. Her only medication is birth control. 
PSH: no surgeries. No trauma. No pregnancies
Social hx: No tobacco use. She drinks 2-3 drinks every other weekend. She reports that she has not thought about cutting back. No travel history. Does not live in close quarters
FMH: Mother had migraines

Keywords and phrases relevant to diagnosis:
ibuprofen none of those helped, tylenol none of those helped
20 year old
yesterday
vomited
nauseas
Mother had migraines, FMH migraines
female
photophobia
feverish
Patient Note: CC: headache
HPI: Ms. Madden is a 20yo F who presents to the clinic with 1 day hx of dull constant headache that has gotten progressively worse and ranks it 8/10 pain. She has tried taking tylenol, ibuprofen, resting and sleeping, but has had little relief. She has also experienced nausea, vomitting, and subjective fevers and chills. Has been vomiting mostly food and also green sputum, denies any blood. Also complains of scratchy throat, runny nose, body aches, photophobia, and phonophobia. Denies any exposure to anyone with recent illness.
PMH: none
Meds: OCPs x2 years
All: NKDA
PSH: none
SH: lives at home with roommate, works as salesperson at sporting goods store. denies tobacco, ethanol, or drugs. 
FH: mother with migraines, father with hyperlipidemia

Keywords and phrases relevant to diagnosis:
tylenol little relief, ibuprofen little relief
20yo
1 day
body aches
vomitting, vomiting
nausea
scratchy throat, runny nose
lives at home with roommate
mother with migraines, FH migraines
F
photophobia
Denies any exposure to anyone with recent illness
subjective fevers
Patient Note: 20 yo f with h/o headache since waking yesterday. Headache is dull and constant without radiation. No previous episodes. Symptoms are progressive. Patient unable to quantify headache intensity. Headache is associated with nausea and vomiting (3X yesterday, green, nonblood), as well as decreased appetitie and URI symptoms including sore throat, fever and running nose. Denies sick contacts, urinary or bowel changes, photophobia, cough, dyspnea and chest pain.
ROS negative except as above. 
PMH/Surgeries: none, no surgeries/hospitalizations
Allergies: NKDA
Meds: OCPs
FH: migraines (mom)
SH: works at sporting goods store, lives with roomate, no tobaco or illicit drug use, drinks 2-3 beers/week, smokes marijuana 3-4 times/week, runs 1x/week for exercise, balanced diet

Keywords and phrases relevant to diagnosis:
20 yo
yesterday
vomiting
nausea
URI symptoms, sore throat, running nose
lives with roomate
FH: migraines, migraines (mom)
f
Denies sick contacts
fever
Patient Note: Ms. Madden is a 20yo F who presents for 1 day of severe headache which she describes as the "worst hangover of her life" (without alcohol use). The pain is generalized in her head and is dull, 8/10 intensity. Ibuprofen and tylenol have not relived the pain. The pain is worse while walking and while bending over. She has nausea for the past 2 days and vomited 3x (food, then green on subsequent vomit, no blood). No changes in stool. She notices no weakness or loss of sensation during this time. No known sick contacts
PMH: None
ALLERGIES: NKDA
MEDS: OCPs x 2 years, no side effects
PSH: None, no prior hospitalizations
FH: Mother has migraines, Dad has high cholesterol
Social: Lives with roommate, smokes marijuana 2-3x/week (discussed reduction), drinks 2-3 alcoholic beverages per day on weekend (CAGE 0/4), sexually active with men, monogamous with 1 boyfriend, uses OCPs and condoms. Works at sporting store.

Keywords and phrases relevant to diagnosis:
tylenol have not relived, Ibuprofen have not relived
20yo
1 day
headache generalized in her hea
vomited
nausea
Lives with roommate
Mother migraines, FH migraines
F
No known sick contacts
Patient Note: Ms. Madden is a 20 yo woman with a c/o of headache. The headache came on suddently, and was present when she awoke 1 day ago. She has body aches all over. Not improved with ibuprofen or tylenonl. It is worse when tying her shoes. She has vomitted 3x, non bloody non bilioius. No other bleeding. Endorses photophobia. No hx of migraines. This is the worst headache of her life. Denies loss of conciousness. Pain is 'bad' did not provide a number on 1-10. Up to date on vaccinations. Denies sick contacts.
ROS: no chest pain, no ringing in ears, no SOB, no problems walking. No skin changes or hair changes
PMH: none
Past Surg Hx: none
Fam hx: Mom migranies, dad high cholesterol
Social: Denies smoking, no concern for etoh abuse. monogamous with one male. Uses condoms. 
Meds: In addition to above, uses oral contraceptive pills.
Gyn: No changes to menstural cycle



Keywords and phrases relevant to diagnosis:
Not improved with ibuprofen, Not improved with tylenonl
20 yo
1 day
body aches
vomitted
Fam hx migranies, Mom migranies
woman
photophobia
Denies sick contacts
Patient Note: HPI: 20yo F complains of intense headache for the past day
- Had previous headaches before but nothing like this
- Headache is all over the head and constant
- Associated with nause and vomit x 3 of gastric contents with no blood
- Today she has photophobia and feels hyperthermia
ROS: Denies vision or Hearing changes, no tinnitus, double vision or vertigo, no chest pain or palpitations, no changes in weight or appetite, slept normal through the night.
PMH: Denied
Surgeries: Denied
Allergies: Denied
Medications: Birth control pill
OBGyn: Regular menses, with normal flow (3-4 towels on heaviest day) G0, LMP 2 weeks
SH: Sales person, lives with roomate, drinks 2-3 beers or wine on weekends, doesnt smoke, smokes 3-4 marihuana per week. Sexually active with boyfriend uses condoms

Keywords and phrases relevant to diagnosis:
20yo
past day
Headache is all over
vomit
nause
lives with roomate
F
photophobia
Patient Note: HPI:20yo c/o headach which started 1 day ago, its all over the head, constant and progressively worsen, associated nausea, no vomitting. family hx of migraine. patient says these is the worse headach in her life.hx of OCP used. she is on Ibuprofen.
ROS:as above
ALLERGY:
PMH:
PSH:
FH/SH:
SH:


Keywords and phrases relevant to diagnosis:
20yo
1 day ago
headach all over the head
nausea
family hx of migraine
Patient Note: 20yo female came in with constant headache started yesterday morning. It involves the whole head and it is dull pain. It gets worse with walking and bending over. It is associated with 3 vomiting episodes. the vomitus was in green color. She complains of photophobia and neckstiffness. Denies of fatigue, weight loss but she noticed poor appetite. She has whole bodyache started yesterday. She feels warm. Denies of trauma, changes in bowel/urinary habits
ROS none except the above
PMH none 
current medications OCPs for 2yrs
PSH : none
SOCIAL hx : denies smoking, 2-3 beer or wine on the weekends, marijuana for 3-4 times a week last marijuana was 4 days ago and she used marijuana for few years. 
Sexual hx

Keywords and phrases relevant to diagnosis:
20yo
yesterday
bodyache
headache whole head
neckstiffness
vomiting
female
photophobia
feels warm
Patient Note: Ms Madden is a 20yr old female who presents today with a chief complaint of headache x1 day duration. She describes the pain feels "like the worst hangover" she's ever had, however she has not been drinking. She first noticed the headache when she first woke up yesterday morning. Associated symptoms include nausea, vomiting, photophobia, and "feeling warm". She denies noticing any preceeding symptoms such as blurred vision. She tried Ibuprofen and tylenol which failed to improve her symptoms. Walking and bending over makes her headache worse. Denies sick contacts. PMHx is unremarkable. She is on combination OCPs. NKDA, no hx of surgeries. LMP was 2 weeks ago. She is sexually active with one partner and uses condoms consistently. Denies tobacco use, drinks 2-3 glasses of wine/week. FHx is positive for mother with a hx of migraine headaches.

Keywords and phrases relevant to diagnosis:
Ibuprofen failed to improve, tylenol failed to improve
20yr old
x1 day, yesterday
vomiting
nausea
mother migraine, FHx migraine
female
photophobia
Denies sick contacts
feeling warm
Patient Note: 20 yo f c/o bilateral Headache in all the head (the worst of her life) graded 8/10 constant since yesterday morning, the pain radiates to the neck and shoulder. the pain does not improve with acetaminophen and ibuprophen. the pain worsen when movement of the neck and limited neck movility. Associated vomits in 3 episodes since yesterday with food and green content. Denies rash in the skin, recent travel or contact with sick person, change in urine or bowel movements.
ROS: none except as above.\
PMH/PSH: none.
Meds: acetaminophen and ibuprofen. oral contraceptives. NKA
SH: Alcohol 2-3 glasses of wine on weekends. Marijuana ocassional on weekends. Denies tobacco use. Sexually active with boyfriend use condoms



Keywords and phrases relevant to diagnosis:
pain does not improve with acetaminophen, pain does not improve with ibuprophen
20 yo
yesterday
Headache in all the head
pain radiates to the neck
vomits
Denies rash
f
Denies contact with sick person
Patient Note: 20 year odl female c/o headaches x few hrs. Headches is dull in nature with associated fever and vomiting. Headache is worse in the morning and on bending over. Ibuprofen does not make it better. She also complains of neck pain when she moves the neck.She takes oral contraceptives for contraception. Feels better with the light turnes out. Positive history of migranes in mother
LMP 2 weeks ago
ROS: no change in bowel or urinary habits. No cough, breathlessness or palpitations. No abdominal pain. no numbnes or weakness
Medication:OCP
allergies: none
PMH: none
PSH: none
FH: history of migraines in the mother. Father has high blood cholesterol
SH: works in a gym goods store. No tobacco. Takes marijuana 3-4 times a week . Last use was 3 days ago


Keywords and phrases relevant to diagnosis:
Ibuprofen does not make it better
20 year odl
neck pain
vomiting
migranes in mother, migraines mother, FH: history of migraines
female
Feels better with the light turnes out
Patient Note: Pt is 20 yo F w headache since yesterday morning. Pt states that she woke up w a dull headache of her entire heard, that is progressively getthing worse. Has neck pain, subjective fever. Tried ibuprofen, tylenol, sleeping with little relief. Walking , bending over makes it worse. Has had nausea, vomitting x3 of food and green colored. Sensitive to light, not sound, no auras. States "this is the worst headache of my life"

PMH: none
Meds: OCP
PSH: none
Allergies: none
Family: mother migraines, father high cholesterol
SH: in high school, 2-3 glasses of wine per week, smokes 3-4 joints of cannabis/wk
ROS: denies weight change, appetitie change, recent travel, sick contacts, cough, bowel/urinary changes

Keywords and phrases relevant to diagnosis:
20 yo
yesterday
headache entire heard
neck pain
vomitting
nausea
mother migraines, Family migraines
F
Sensitive to light
denies sick contacts
subjective fever
Patient Note: 20 F no PMH, lives w/ roommate in apartment has severe headache and photosensitivity x2 days. URI symptoms x2 days, as well. No sick contacts. UTD on vaccines. No hx spinal Surgery or instrumentation.

Keywords and phrases relevant to diagnosis:
20
2 days, 2 days
URI symptoms
lives w/ roommate in apartment
F
photosensitivity
No sick contacts
Patient Note: 20 y/o F with no PMH is presenting with 1 day history of headache. Patient said is started yesterday morning as a dull headache that has been constant since then. Patient also has had some nausea, and 3 episodes of vomiting with no blood in the vomit. Patient is also sensitive to the light. Patient has tried tylenol and ibuprofen which has not helped. Patient says that she feels warm but denies chills, chest pain, or neck pain. 
ROS: NEgative except for above. 
NEgative PMH, Surgical Hx. 
PAtient is on OCP
Patient's Mom has a Hx of migraines. 
She smokes 3 joints of marijuana every week. 
EtOH use soical

Keywords and phrases relevant to diagnosis:
tylenol has not helped, ibuprofen which has not helped
20 y/o
1 day
vomiting
nausea
Mom has a Hx of migraines
F
sensitive to the light
feels warm
Patient Note: Ms. Madden is a 20 yo female presenting w/ the worst HA of her life, unlike anything that she has had before. It is a dull + constant pain, it has gotten progressively worse, started yesterday morn. It is a diffuse pain felt around her head and is nonpulsating. She has photophobia but no phonophobia, has nausea, and vomited 3x yesterday. No sick contacts. Felt warm earlier. No chills, fatigue, CP, SOB, abd pain, or rashes. No sx before the onset of this HA. Ibuprofen, tylenol, sleep have not helped. Walking + bending over makes the pain worse. She has had HA before once or twice a yr but they are usually very mild. 
Meds: OCPs
FH: mother w/ migraines, dad w/ HPL
Social alcohol use, 3 or 4 marijuana joints per week, no tobacco use
PMH: none significant

Keywords and phrases relevant to diagnosis:
tylenol not helped, Ibuprofen not helped
20 yo
yesterday
HA around her head, HA diffuse
vomited
No rashes
nausea
mother migraines, FH migraines
Ms, female
photophobia
No sick contacts
Felt warm
Patient Note: Stephanie madden is a 20 year old woman complaining of headache. Pain began yesterday morning and has been getting worse. Dull constant ache bilaterally, worse with walking, bending over, no alleviating factors. Did not respond to ibuprofen, Tylenol, or sleep. Complains of photobia, but not phonophobia, no aura. Subjective fever today. Neck stiffness. Nausea and vomiting. No dizzyness or lightheadedness, no weakness, no sick contacts.
ROS: otherwise negative
PMH: none
PSH: none
Hosp: none
Med: Birth control pill
Allergies: none
Soc: works at sporting good store, lives with roomate, no tobacoo, etoh 2-3 drinks on weekends, marijuna 3-4 joints a week, sexually active and uses condoms

Keywords and phrases relevant to diagnosis:
Did not respond to ibuprofen, Did not respond to Tylenol
20 year old
yesterday
Neck stiffness
vomiting
Nausea
lives with roomate
photobia
no sick contacts
Subjective fever