bhatthars/nbme_qna huggingface dataset:
Patient Note: Mr. Smith is a 17 year old male who presents to clinic with chest pain. Pain is in left upper chest, non-radiating, sharp, 5/10 at rest, 9/10 with deep breathing or movement. Started yesterday, is constant, no change, not relieved with Tylenol or Albuterol inhaler. Reports 3-4 days ago flu symtpoms of rhinorhea, muscle aches, fever. Denies nausea, vomiting, abdominal pain, constipation, diarrhea, headache, cough, swollen lymph nodes.
Medication: albuterol PRN for exercise induced Asthma, and tylenol; Allergies - no
PSH: no, Family history: Father asthma, high cholesterol, grandfather MI - alive
Social: Senior in high-school, lives with parents, things are "okay" at home. Sexually active with girlfriend, always use condoms. Denies tobacco and ilicit drugs, occasional beer

Keywords and phrases relevant to diagnosis:
fever
male
17 year old
3-4 days ago rhinorhea
Pain 9/10 with deep breathing
exercise induced Asthma
chest pain
Started yesterday
not relieved with Albuterol inhaler
sharp
Patient Note: 17 yo M comes to the clinic with mothers verbal consent for a history, physical examination, and treatment, c/o chest pain. Patient refers pain occurs everytime he takes a deep breath. This started yesterday morning, it has been constant, located in the upper Lt chest. He has used tylenol, and his albuterol inhaler with no significant relief. Deep breathing and movement make pain worse. Since started pain has been the same, he recalls no precipitating event, and this has never happened before. Patient adds feeling warm, muscle aches, and stuffy nose, for which he has been feeling better recently. Patient has an active excercise regimen where he goes rock climbing for 2-3 x a week.
ROS: neg exc as above
PMH: ASthma excercise induced
ALL: NKDA MEds: ALbuterol inhaler
Hosp/surg: no FH: Father with asthma
Social: student and carpenter/ no excess alcohol, smoke marijuana ocasionally

Keywords and phrases relevant to diagnosis:
feeling warm
M
17 yo
stuffy nose
Deep breathing make pain worse
ASthma excercise induced
chest pain
started yesterday
rock climbing
used albuterol inhaler with no significant relief
Patient Note: Mr. Smith is a 17 y.o M who presents with sudden onset L-sided chest pain. Three days ago he had a stuffy nose, fever, and muscle aches. Yesterday he woke up with severe pain on inspiration. He describes it as a constant pain that worsens with inspiration and movement. He has been taking tylenol for the pain but it has not helped much. He denies abodminal pain, SOB, changes in bowel habits. He endorses muscle aches. 
PMH: exercise induced asthma
Meds: albuterol 1-2x/week
Surg: none
Allergies: NKDA
FHx: Dad with asthma and high cholesterol, grandfather with MI
SoHx: sexually active with girlfriend, uses condoms consistently, never smoker, occasional beer at parties, has tried weed a couple times, no other illicit drug use, works as a carpenter and uses protective gear

Keywords and phrases relevant to diagnosis:
fever
M
17 y.o
Three days ago stuffy nose
severe pain on inspiration, worsens with inspiration
exercise induced asthma
chest pain
Yesterday
denies SOB
Patient Note: KANE SMITH IS A 17 Y/O M WITH PMH OF EXERCISE-INDUCED ASTHMA WHO PRESENTS WITH 1 DAY OF CHEST PAIN TO HIS UPPER RIGHT CHEST. HE DESCRIBES THE PAIN AS SHARP AND STABBING. IT IS NONRADIATING AND WORSE WITH BREATHING AND MOVEMENT. HE TRIED TAKING TYLENOL AND ALBUTEROL INHALER BUT HIS PAIN PERSISTED. IT IS CONSTANT AND HE RATES IT AS 5/10 AT REST AND 8/10 WITH MOVEMENT OR COUGH. HE ALSO COMPLAINS OF NASAL CONGESTION AND MUSCLE ACHES THAT STARTED A FEW DAYS PRIOR AND HE FEELS WARM BUT DID NOT MEASURE A TEMPERATURE. HE DENIES CHILLS, NIGHT SWEATS, APPETITE CHANGE, WEIGHT CHANGE, PALPITATIONS, ORTHOPNEA, COUGH, SOB, WHEEZING, RASH, SKIN LESION. HE DENIES ANY RECENT TRAUMA OR INJURY TO THE CHEST.
ROS: PER HPI, ALL OTHERS NEGATIVE
PMH: EXERCISE-INDUCED ASTHMA, LAST EXPERIENCED SYMPTOMS 6 MONTHS AGO
MEDS: ALBUTEROL, TYLENOL
ALLERGIES: NONE
PSH: NONE
FH: MI IN GRANDFATHER, FATHER HAS ASTHMA AND HLD
SH: NONSMOKER, 1-2 DRINKS/MONTH. 


Keywords and phrases relevant to diagnosis:
FEELS WARM
M
17 Y/O
NASAL CONGESTION
WORSE WITH BREATHING
EXERCISE-INDUCED ASTHMA, EXERCISE-INDUCED ASTHMA
CHEST PAIN
1 DAY
DENIES SOB
TRIED ALBUTEROL BUT HIS PAIN PERSISTED
SHARP, STABBING, 8/10
Patient Note: 17 yo m comes to the office complaining of sharp L constant chest pain that worsenes with deep breaths. Pt had a stuffy nose and muscle aches 3-4 days ago but feels better. Tylenol and albuterol have not relieved his symptoms. Pt denies previous chest pain an dill contacts. Denies cough, rash, changes in urine or bowel habits, nausea/vomit, fevers and weigth/appetite changes.
ROS: - except as above
PMHx: exercise induced asthma
Allergies: none
meds: tylenol and albuterol (does not need it as much anymore)
hospitalizations: none
vaccines: unsure
FH: father has asthma and high cholesterol; grandfather had an MI
SH: senior at high school, lives with mom and dad and get along well, gets good grades in school, does rock climbing (last time 3 days ago), occasionally drinks alcohol, has tried weed at parteis (last use: weekend), no smoking, sexually active with girlfrined and uses protection.

Keywords and phrases relevant to diagnosis:
m
17 yo
stuffy nose
exercise induced asthma
chest pain
rock climbing
albuterol have not relieved his symptoms
sharp
Patient Note: Mr. Kane Smith is a pleasant 17 yo M with PMHx exercise-induced asthma presenting with 1 day history of acute onset CP. Pt states yesterday in the morning he woke up with CP over his left pectoralis muscle. The pain is constant, stabbing in nature and not alleviated by tylenol or albuterol. Deep breathing, movement make this pain worse. Assocaited symptoms include stuffy nose and muscle aches diffusely. Of note, pt rock climbs and climbed 3 days ago.
PMHx: as above
PSHx: None
Rx: Albuterol prn, tylenol q4 hours PO prn for pain
Allergies: NKDA
FHx: Father: asthma HLD
Mother: healthy, brother, healthy
Social Hx: senior in high school, carpentry assistant for side work, denies Tobacco, endorses occasional drinking and marijuana use.
ROS: Endorses pleuritic CP, denies SOB, Nausea, vomiting, diarrhea, constipation, diaphoresis


Keywords and phrases relevant to diagnosis:
M
17 yo
Assocaited symptoms include stuffy nose
Deep breathing make this pain worse, pleuritic
exercise-induced asthma
CP, CP, CP
1 day history
denies SOB
rock climbs and climbed 3 days ago
not alleviated by albuterol
stabbing
Patient Note: 17y/o male c/o chest pain
he woke up with the chest pain yesterday monining, it is a sharp pain that is every time when he brathes in. denies trauma. no radiation of pain. Took tylonol several times, helped a little. 
(-) sick contacts, cough. 
(+) muscle aches, 
NKDA. Exercise induced-asthma. Takes albuterol inhaler . 
Father: asthma, high cholesterol, Mother: no known diseases. 
Climber, lives with parents and sister and brother. 
(-) smoking. drinks beers on parties. 


Keywords and phrases relevant to diagnosis:
male
17y/o
Exercise induced-asthma
chest pain, chest pain
yesterday
sharp
Patient Note: Mr. Smith is a 17 yo M here with chest pain. He woke up yesterday with sharp chest pain localized over the L side of his chest. The pain is associated with breathing and does not radiate. He rates it as 5/10 with spikes to 8-9/10 when he takes a big breath or moves around. The pain is relatively constant. He tried tylenol and his albuterol inhaler but those did not help. He has also been experiencing "stuffy nose" and muscle aches and is feeling "hot". He is not sure if he had a flu shot this year. 
ROS: no headache, sore throat, palpitations, SOB, nausea/vomiting, diarrhea/constipation, no dysuria/increased frequency. no rashes.
MedHx: exercise induced asthma, on PRN albuterol (last inhaler use 6 mo ago)
rx: PRN albuturol, PRN tylenol
allergies: NKDA
surg: none
Fam: dad has asthma, mom healthy, grandfather had MI 
Soc: drinks beer 1/month, never tobacco, never drugs, sexually active with girlfriend (always uses condoms)

Keywords and phrases relevant to diagnosis:
feeling "hot
M
17 yo
stuffy nose
exercise induced asthma
chest pain, chest pain
yesterday
no SOB
albuterol inhaler did not help
sharp
Patient Note: Mr. Smith is a 17 year old African American male with a past medical history of exercise induced asthma who presents with one day of chest pain. He describes "very sharp" pain "like a knife" in the left side of his chest. It does not radiate or move. The pain is worse with deep breaths and with movement, and better when he rests. Tylenol and albuterol have not helped. He does report several days of stuffy nose and muscle aches. He reports some fever. He exercises often.
ROS: No nausea, vomiting, diarrhea, constipation, cough, shortness of breath, changes in urination, numbness, tingling
PMH: exercise induced asthma
PSH: none
Meds: albuterol inhaler as needed
NKDA
FH: Father with asthma and hypercholesterolemia, paternal grandfather with heart attack. Mother healthy
SH: Senior, planning on attending college. Works for a carpenter.  Reports one beer a month, no drug use, no tobacco use, sexually active with girlfiend, uses condoms

Keywords and phrases relevant to diagnosis:
fever
male
17 year old
days of stuffy nose
worse with deep breaths
exercise induced asthma, exercise induced asthma
chest pain, pain in chest
one day of
No shortness of breath,
albuterol have not helped
sharp, like a knife
Patient Note: HPI: 17 yo m c/o left-sided chest pain. It suddenly started yesterday during walking. It is constant, non-progressive, sharp, non radiating, no alleviating factors amd aggravated by movement and deep breathing. He also has subjective fever for the past 2-3 d. He had runny nose and muscle aches 1 w ago.
RoS: he denies cough, SoB, weight loss, abdominal pain, sore throat, rash.
PMH/PSH: he has exercise-induced asthma, well controlled w/ albuterol. Allergies: NKDA, NKA. MEds: albuterol occasionally
FH: none
SexH: active w/ girlfriend only for the past y, use condoms consistently. No h/o STI
SH: no tobacco/EtoH socially/ marijuana 2 times.

Keywords and phrases relevant to diagnosis:
subjective fever
m
17 yo
runny nose
aggravated by deep breathing
exercise-induced asthma
chest pain
started yesterday
denies SoB
sharp
Patient Note: Kane Smith is a 17 yo man with history of exercise-induced asthma presenting with sharp pain on his left-mid upper chest since yesterday morning. Pain started when he woke up, noticed no preceding events. Sharp quality, severe pain when moving or taking a deep breath. Tylenol and albuterol have not helped. +stuffy nose, muscle aches, and fevers. Denies fatigue, sore throat, coach, chills, night sweats, headache, dizziness, urinary or bowel changes. PMH: asthma Meds: albuterol PRN (last use 6 mo ago), 2 tylenol pills q4h for this pain. FH: dad with asthma and high cholesterol, grandmother with heart attack. SH: no smoking or concerning drinking. no cocaine. Senior in high school, also works as carpenter assistant. Sexually active with his girlfriend and uses condoms.

Keywords and phrases relevant to diagnosis:
fevers
man
17 yo
+stuffy nose
severe pain taking a deep breath
exercise-induced asthma
pain chest
since yesterday
albuterol not helped
sharp pain, Sharp
Patient Note: CC - chest pain
HPI - 17 yo M complains of sharp consistent chest pain x 1 day. Woke up with chest pain yesterday. Worse with deep breath and movement. Tried ttylenol and albuterol without improvement of pain. Pain improves with leaning forward. Nasal congestion/rhinorrhea, body aches, subjective fever x 3 days. Denies cough, shortness of breath, breathing fast, N/V, diarrhea, constipation, headache, change vision, tingling arms/legs
PMH - asthma, well controlled
Meds- albuteral, tylenol q4h PRN
NKDA
Sh - alcohol use 2 beers/month, no tobacco or drug use. Lives with parents. Likes to rock climb.
FH - grandfather myocardial infarction age 70, still living
dad - asthma
otherwise healthy

Keywords and phrases relevant to diagnosis:
subjective fever
M
17 yo
Nasal congestion, rhinorrhea
chest pain, chest pain
x 1 day, yesterday
Denies shortness of breath
rock climb
Tried albuterol without improvement
sharp
Patient Note: 17 year old male who comes in for chest pain. It started yesterday morning when he woke up, and is located at the chenter left chest above his sternum. Its a constant pain, sharp in nature, and worsens on deep breath. It does not radiate, and the severity ranges from 4/10-8/10. He tried tylenol but it provided no relief. He has had fever. He denies cough, sweating, chills, fatigue, palpitations, shortness of breath, weight change, appatite change, nausea, vomiting, or change in bowel habits.
ROS- As above
PMH- exercise induced asthma
PSH- none
Meds- albuterol
Allergies- none
FH- father has asthma and HLD, grandfather had MI
SH- is sexually active with girlfriend and uses protection. No hx of STIs. No smoking, drinks only at parties, and doesn't use drugs.
Has not recieved flu shot.
Exercises by rockclimbing

Keywords and phrases relevant to diagnosis:
fever
male
17 year old
worsens on deep breath
exercise induced asthma
chest pain
started yesterday
denies shortness of breath
rockclimbing
sharp, 8/10
Patient Note: Patient is a 17 yo M presenting with 1 day left sided nonradiating chest pain that is worsened with deep inspiration and movement. It is described as sharp and stabbing, is constant, and not relieved by tylenol or albuterol. Patient also reports stuffy nose, fever, and muscle aches for 3-4 days. He has not recieved a flu shot or had recent travel. He reports no recent sick contacts, heartburn, SOB, wheezing, chills, fatigue, abdominal pain, diarrhea, or cough. 
ROS: negative except above
PMH: Exercise induced asthma, car accident at young age 
PSH: None
Medications: albuteral inhaler PRN, tylenol PRN 
Allergies: none 
FH: Asthma and hyperlipidemia in father, MI in grandfather at age 70
SH: Patient is a Philadelphia school student. He reports no usage of tobacco. He has tried marijuana, most recently 1 week ago, and drinks 1-2 beers when he attends parties, less than once a month.

Keywords and phrases relevant to diagnosis:
fever
M
17 yo
stuffy nose
worsened with deep inspiration
Exercise induced asthma
chest pain
1 day
no SOB
not relieved by albuterol
sharp, stabbing
Patient Note: 17 YO M came to Clinic with consent from parents, he has been having Chest pain from yesterday,its sharp stabbing pain,which started suddenly when he woke up,gradually worsening,aggrav by deep breath and allev by nothing, he also Reports FEVER from last 3-4 days he didnt checked,and he is having body aches, he feels fatigued.
Denies SOB,Vomittings,wheezing, headache,weakness in body parts,abd pain.
ROS neg except abv
PMH excercise induced asthma,
Meds Albuterol,advil,tylenol
PSH/HOSP none, NKDA
SH work as corporate,lives with parents and siblings,drinks 1-2beers/months,no smoking,Drugs weed occasionally,last weknd was last time he took. sexually active w girl frind,uses protection

Keywords and phrases relevant to diagnosis:
Reports FEVER
M
17 YO
aggrav by deep breath
excercise induced asthma
Chest pain
Denies SOB
sharp, stabbing
Patient Note: 17 yo male presents with sharp acute chest pain since yesterday
- pain strated since yesterday while patient wokeup
- pain is not radiating, while sitting 5/10 - when moving pain worsens to 9/10
- no SOB, headache, cough, palpitations

ROS: negative except as above
PMH: Asthma
PSH: none
Allergies: NKA
Medication: Albuterol
FH: father: Astham, grandfather: MI 
SH: denies smoking, occasional alcohol, tried weegd otherwise no drugs, sexual active with girlfrined using condoms

Keywords and phrases relevant to diagnosis:
male
17 yo
chest pain
since yesterday, since yesterday
no SOB
sharp
Patient Note: 17 yo male Hx of Exercise Induced Asthma with c/o  L sided Chest pain
-started yesterday, sharp in quality, nonprogressive, constant, nonradiating, aggravated by deep breathing and movement, relieved by nothing, took tyelonol which did not help
-reports having fever, stuffy nose, muscle ache for the past 3-4 days, did not take anything for it
-denies racing of heart, sweating, recent trauma, appetite loss or weight loss, bowel or bladder movemnt changes
PMH-Exercise induced Asthma took albuterol inhaler 
MEDS-TYELONOL, 
FH- Father had Asthma and hypercholesterolemia, Grandfather had heart attack once
ALL/PSH-None
SSH-sexaully active with girlfriend for 1 yr, drinks etoh occ, denies smoking, smokes weed , last use last weekend

Keywords and phrases relevant to diagnosis:
reports having fever
male
17 yo
stuffy nose
aggravated by deep breathing
Exercise Induced Asthma, Exercise induced Asthma
Chest pain
started yesterday
sharp
Patient Note: - 17yr male with L sided sharp chest pain with deep breaths. Also endorses stuffy nose and myalgias. Pain does not radiate and is a 4/10 at rest and 7/10 with deep breaths
- Pt also has "felt warm" at home, but not measured temp. Sxs serious enough for him to call out from work as a carpentry assistant
- Tylenol does not help and albuterol inhaler has not helped sxs
- PMH: exercise-induced asthma, never hospitalized; No PSH
- Med: albuterol inhaler prn, tylenol for pain; NKDA
- FH: Dad with asthma and HLD, Grandfather with MI at age 81
- SH: Lives at home with parents, senior in high school, works as carpentry asst, rock climbs for hobby, never smoker, occasional social beer, has tried marijuana on some occasssions at parties, sexually active with girlfriend and uses condoms, denies depressive sxs
- ROS: neg except noted

Keywords and phrases relevant to diagnosis:
felt warm
male
17yr
endorses stuffy nose
chest pain with deep breaths, 7/10 with deep breaths
exercise-induced asthma
chest pain
rock climbs
albuterol inhaler has not helped
sharp, 7/10
Patient Note: Mr Smith is a 17 y/o M who presents for chest pain. He reports the pain started yesterday morning without any precipitating factor. Since then the pain is sharp in nature, 5/10 at rest and 8/10 when worsened by deep breathing or movement. He reports little improvement with albuterol and tylenol. The pain does not radiate. He also reports a 3-4 day history of mild warmth, myalgia and stuffy nose. Denies any burning sensation in the epigastrum, shortness of breath, wheezing, palpitations or cough. Denies any recent sick contacts or travel.  

ROS negative except as above.
PMH excercise induced asthma
Medications albuterol rarely and 2 tylenols q4hr
PSH no surgeries
Social history - Is a senior at school and a carpenter. Drinks 1-2 beers at parties, denies tobacco use. Occasional marijuana use. Sexually active with 1 female partner in the past year and uses condoms. 
Family history - asthma in the father, grandfather had MI

Keywords and phrases relevant to diagnosis:
warmth
M
17 y/o
3-4 day history of stuffy nose
worsened by deep breathing
excercise induced asthma
chest pain
started yesterday
Denies shortness of breath
little improvement with albuterol
sharp, 8/10
Patient Note: HPI: Pt. is a 17y/o male who is complaining of left sided chest pain for the last 1 day. The chest pain is unprovoked, and occured when he woke up. Described as sharp, 4/10 intesnsity, but 7/10 intensity when breathing in deep. Deep inspiration and movement worsen the pain. The pain is not worse when supine, or when leaning forward. Tylenol does not improve the pain. He has a subjective fever, and associated malaise and nasal congestion for the past 3 days. He is unsure of his vaccine status, and did not recieve an influenza vaccine this year. He denies palpitations, dyspnea, and trauma to his chest.
ROS: Negative.
Meds: Albuterol inhaler, Tylenol
Allergies: NKA
PMHx: Exercise induced asthma 4 years.
PSurg Hx: None.
Fam hx: Dad - asthma, hypercholesterolemia, Grandfather - MI
Social Hx: Never smoker, drinks occassional beer at parties, denies drug use. Sex with girlfirend only, uses condoms. Carpenters assistent. Rock climbs.

Keywords and phrases relevant to diagnosis:
subjective fever
male
17y/o
nasal congestion for the past 3 days
7/10 intensity when breathing in deep, Deep inspiration worsen the pain
Exercise induced asthma
chest pain, chest pain
for the last 1 day
Rock climbs
sharp, 7/10
Patient Note: 17 yo male with CP that started yesterday morning and has worsened. Now 8 or 9/ 10 pain. Worse with inspiration and movement. Denies trauma, SOB, N/V. Tried albuterol inhaler and tylenol but did not relive pain. 3-4 days ago experienced nasal congestion and muscle aches. Those symptoms resolved. 

PMHx- exercise induced asthma (well controlled w/ inhaler)
Meds- albuterol inhaler and tylenol
PSHX- none
PFamHx- grandpa MI age 70yo
Soc HX- lives with parents and older brother, drinks 1-2 beers per month, used weed 3x in life, does not smoke or vape, senior in highschool, works as carpenter assistent
NKDA



Keywords and phrases relevant to diagnosis:
male
17 yo
3-4 days ago nasal congestion
Worse with inspiration
exercise induced asthma
CP
started yesterday
Denies SOB
albuterol inhaler did not relive pain
8 or 9/ 10
Patient Note: 17 yr old male c/o sudden, sharp, pleuretic left chest pain that started yesterday, after a recent URI when he experienced nasal stuffines, rhinorrhea, for 3-4 days. Chest pain is aggrevated and triggered by sudden positional changes, and deep breaths and alleviated by shallow breathing. Tylenol and albuterol did not alleviate the pain. H/O subjective fever. The patient denies any previous similar episodes, palpatations, trauma, rash, weight or appetite changes, dyspnea, bowel or urinalry changes neck swellings or pain or abdominal discomfort.
PMHX: Exercise induced asthma, for 4 yrs stopped medications 
PSH: none. MEds: Tylenol and albuterol yesterday only
ALL: nka
FHX: NC
Social HX: Part time carpenter, College student, Non smoker, drinks occassionally at parties, and smokes marijiuana at social events/parties.
Exercises at the gym.

Keywords and phrases relevant to diagnosis:
subjective fever
male
17 yr old
recent URI, nasal stuffines, rhinorrhea, for 3-4 day
pleuretic, aggrevated by deep breaths
Exercise induced asthma
chest pain, Chest pain
started yesterday
albuterol did not alleviate the pain
sharp
Patient Note: a 17-year-old male, has come to the outpatient clinic with chest pain
-began yesterday morning, suddenly, woke him up, constant, staying the same, no previous episodes
-left side, no radiation, 5/10 when sitting, 8/10 when taking deep breath, no trauma or injury, sharp pain
-has nasal congestion, muscle ache, and fever for 4 days
-denies dyspnea, nausea, vomiting, palpitation, dizziness, diaphoresis, cough, weight/appetite/sleeping changes, sick contact, night sweats
-alleviated by nothing, aggravated movement and deep breath
PMH: exercise induced asthma for 4 years PSH: none Meds: ibutoral inhaler, Tylenol All: NKDA FH: father has asthma and hypercholesteremia, grandfather has myocardial infarction
SH: denies smoking, uses weed, last use was last weekend, drink etOH once a while, monogamous with girlfriend, exercises regularly, twice/week, high school student

Keywords and phrases relevant to diagnosis:
fever
male
17-year-old
nasal congestion
8/10 when taking deep breath
exercise induced asthma
chest pain
began yesterday
denies dyspnea
8/10