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The dataset generation failed because of a cast error
Error code: DatasetGenerationCastError
Exception: DatasetGenerationCastError
Message: An error occurred while generating the dataset
All the data files must have the same columns, but at some point there are 16 new columns ({'辅助检查', '现病史', '编号', '主诉', '多次病情评估', '初步诊断', '既往史', '初步诊断依据', '查体', '最终诊断依据', '科室', '鉴别诊断', '原病历', '基本信息', '首次治疗方案', '最终诊断'}) and 14 missing columns ({'chief_complaint', 'preliminary_diagnosis_basis', 'first_treatment', '_id', 'measures.', 'past_medical_history', 'present_medical_history', 'description', 'basic_information', 'final_diagnosis_basis', 'clinical_department', 'differential_diagnosis', 'preliminary_diagnosis', 'final_diagnosis'}).
This happened while the json dataset builder was generating data using
hf://datasets/hzyue/ClinicalMC/data_zh.json (at revision d0e223de210b0174850ee794ce20c7159529a8cd), [/tmp/hf-datasets-cache/medium/datasets/99739922623203-config-parquet-and-info-hzyue-ClinicalMC-22a1928f/hub/datasets--hzyue--ClinicalMC/snapshots/d0e223de210b0174850ee794ce20c7159529a8cd/data_en.json (origin=hf://datasets/hzyue/ClinicalMC@d0e223de210b0174850ee794ce20c7159529a8cd/data_en.json), /tmp/hf-datasets-cache/medium/datasets/99739922623203-config-parquet-and-info-hzyue-ClinicalMC-22a1928f/hub/datasets--hzyue--ClinicalMC/snapshots/d0e223de210b0174850ee794ce20c7159529a8cd/data_zh.json (origin=hf://datasets/hzyue/ClinicalMC@d0e223de210b0174850ee794ce20c7159529a8cd/data_zh.json), /tmp/hf-datasets-cache/medium/datasets/99739922623203-config-parquet-and-info-hzyue-ClinicalMC-22a1928f/hub/datasets--hzyue--ClinicalMC/snapshots/d0e223de210b0174850ee794ce20c7159529a8cd/synonym_en.json (origin=hf://datasets/hzyue/ClinicalMC@d0e223de210b0174850ee794ce20c7159529a8cd/synonym_en.json), /tmp/hf-datasets-cache/medium/datasets/99739922623203-config-parquet-and-info-hzyue-ClinicalMC-22a1928f/hub/datasets--hzyue--ClinicalMC/snapshots/d0e223de210b0174850ee794ce20c7159529a8cd/synonym_zh.json (origin=hf://datasets/hzyue/ClinicalMC@d0e223de210b0174850ee794ce20c7159529a8cd/synonym_zh.json)], ['hf://datasets/hzyue/ClinicalMC@d0e223de210b0174850ee794ce20c7159529a8cd/data_en.json', 'hf://datasets/hzyue/ClinicalMC@d0e223de210b0174850ee794ce20c7159529a8cd/data_zh.json', 'hf://datasets/hzyue/ClinicalMC@d0e223de210b0174850ee794ce20c7159529a8cd/synonym_en.json', 'hf://datasets/hzyue/ClinicalMC@d0e223de210b0174850ee794ce20c7159529a8cd/synonym_zh.json']
Please either edit the data files to have matching columns, or separate them into different configurations (see docs at https://hf.co/docs/hub/datasets-manual-configuration#multiple-configurations)
Traceback: Traceback (most recent call last):
File "/usr/local/lib/python3.12/site-packages/datasets/builder.py", line 1800, in _prepare_split_single
writer.write_table(table)
File "/usr/local/lib/python3.12/site-packages/datasets/arrow_writer.py", line 765, in write_table
self._write_table(pa_table, writer_batch_size=writer_batch_size)
File "/usr/local/lib/python3.12/site-packages/datasets/arrow_writer.py", line 773, in _write_table
pa_table = table_cast(pa_table, self._schema)
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
File "/usr/local/lib/python3.12/site-packages/datasets/table.py", line 2321, in table_cast
return cast_table_to_schema(table, schema)
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
File "/usr/local/lib/python3.12/site-packages/datasets/table.py", line 2249, in cast_table_to_schema
raise CastError(
datasets.table.CastError: Couldn't cast
编号: int64
原病历: struct<病案介绍: struct<主诉: string, 现病史: string, 既往史: string, 查体: string, � (... 224 chars omitted)
child 0, 病案介绍: struct<主诉: string, 现病史: string, 既往史: string, 查体: string, 辅助检查: string, � (... 17 chars omitted)
child 0, 主诉: string
child 1, 现病史: string
child 2, 既往史: string
child 3, 查体: string
child 4, 辅助检查: string
child 5, 个人史: string
child 1, 诊治过程: struct<初步诊断: string, 诊断依据: string, 鉴别诊断: string, 诊治经过: string, 诊� (... 31 chars omitted)
child 0, 初步诊断: string
child 1, 诊断依据: string
child 2, 鉴别诊断: string
child 3, 诊治经过: string
child 4, 诊断结果: string
child 5, other: string
child 2, 分析总结: string
child 3, 其他: string
基本信息: string
主诉: string
科室: string
现病史: string
既往史: string
查体: string
辅助检查: struct<实验室检查: struct<血常规: string, 痰液检查: string, CRP: string, 肝功能: stri (... 24106 chars omitted)
child 0, 实验室检查: struct<血常规: string, 痰液检查: string, CRP: string, 肝功能: string, 血肌酐: string, � (... 12660 chars omitted)
child 0, 血常规: string
child 1, 痰液检查: string
child 2, CRP: string
child 3, 肝功能: string
child 4, 血肌酐: string
child 5, 血红蛋白: string
child 6, 尿素氮: string
child 7, 红细胞沉降率测定(ESR): string
child 8, 降钙素原检测(PCT): string
child 9, 超敏C反应蛋白测定(CRP): string
child 10, LIGHT: string
child 11, 传染病三项: string
child 12, 两对半定量检测: string
child 13, 脑脊液常规+生化: string
child 14, 血沉: string
child 15, 心脏生物标志物: string
child 16, 炎
...
94, UBM检查: string
child 295, OCT: string
child 296, 眼压监测: string
child 297, 房角镜: string
child 298, 头颅CT+MRA: string
child 299, 膀胱彩超: string
child 300, 甲状腺超声: string
child 301, 产科超声: string
child 302, 术后评估: string
child 303, 副鼻窦CT: string
child 304, 鼻副窦CT: string
child 305, 颈部增强CT: string
child 306, 电子喉镜: string
child 307, 鼻窦CT: string
child 308, 胸腰椎MRI: string
child 309, 全腹部增强CT: string
child 310, 临床评估: string
child 311, 脑MRI: string
child 312, 头颅磁共振: string
child 313, CT引导: string
child 314, 术中监测: string
child 315, 喉镜: string
child 316, 脑增强MR: string
child 317, 颈椎MR: string
child 318, 全腹CT: string
child 319, MRU: string
child 320, 增强CT/MRI: string
child 321, 随访影像: string
child 322, 纤支镜: string
child 323, 骨扫描: string
child 324, 胸CT: string
child 3, 评估: string
child 4, 处理: string
最终诊断: list<item: string>
child 0, item: string
最终诊断依据: string
course_record: extension<arrow.json>
physical_examination: extension<arrow.json>
auxiliary_examination: null
-- schema metadata --
huggingface: '{"info": {"features": {"\u7f16\u53f7": {"dtype": "int64", "' + 134189
to
{'_id': Value('string'), 'description': Value('string'), 'basic_information': Value('string'), 'chief_complaint': Value('string'), 'past_medical_history': Value('string'), 'present_medical_history': Value('string'), 'physical_examination': Json(decode=True), 'auxiliary_examination': {'Imaging examination': Json(decode=True), 'Laboratory examination': Json(decode=True), 'Pathological examination': Json(decode=True)}, 'clinical_department': Value('string'), 'preliminary_diagnosis': List(Value('string')), 'preliminary_diagnosis_basis': Value('string'), 'differential_diagnosis': Value('string'), 'first_treatment': Value('string'), 'course_record': Json(decode=True), 'final_diagnosis': List(Value('string')), 'final_diagnosis_basis': Value('string'), 'measures.': Value('string')}
because column names don't match
During handling of the above exception, another exception occurred:
Traceback (most recent call last):
File "/src/services/worker/src/worker/job_runners/config/parquet_and_info.py", line 1347, in compute_config_parquet_and_info_response
parquet_operations = convert_to_parquet(builder)
^^^^^^^^^^^^^^^^^^^^^^^^^^^
File "/src/services/worker/src/worker/job_runners/config/parquet_and_info.py", line 980, in convert_to_parquet
builder.download_and_prepare(
File "/usr/local/lib/python3.12/site-packages/datasets/builder.py", line 882, in download_and_prepare
self._download_and_prepare(
File "/usr/local/lib/python3.12/site-packages/datasets/builder.py", line 943, in _download_and_prepare
self._prepare_split(split_generator, **prepare_split_kwargs)
File "/usr/local/lib/python3.12/site-packages/datasets/builder.py", line 1646, in _prepare_split
for job_id, done, content in self._prepare_split_single(
^^^^^^^^^^^^^^^^^^^^^^^^^^^
File "/usr/local/lib/python3.12/site-packages/datasets/builder.py", line 1802, in _prepare_split_single
raise DatasetGenerationCastError.from_cast_error(
datasets.exceptions.DatasetGenerationCastError: An error occurred while generating the dataset
All the data files must have the same columns, but at some point there are 16 new columns ({'辅助检查', '现病史', '编号', '主诉', '多次病情评估', '初步诊断', '既往史', '初步诊断依据', '查体', '最终诊断依据', '科室', '鉴别诊断', '原病历', '基本信息', '首次治疗方案', '最终诊断'}) and 14 missing columns ({'chief_complaint', 'preliminary_diagnosis_basis', 'first_treatment', '_id', 'measures.', 'past_medical_history', 'present_medical_history', 'description', 'basic_information', 'final_diagnosis_basis', 'clinical_department', 'differential_diagnosis', 'preliminary_diagnosis', 'final_diagnosis'}).
This happened while the json dataset builder was generating data using
hf://datasets/hzyue/ClinicalMC/data_zh.json (at revision d0e223de210b0174850ee794ce20c7159529a8cd), [/tmp/hf-datasets-cache/medium/datasets/99739922623203-config-parquet-and-info-hzyue-ClinicalMC-22a1928f/hub/datasets--hzyue--ClinicalMC/snapshots/d0e223de210b0174850ee794ce20c7159529a8cd/data_en.json (origin=hf://datasets/hzyue/ClinicalMC@d0e223de210b0174850ee794ce20c7159529a8cd/data_en.json), /tmp/hf-datasets-cache/medium/datasets/99739922623203-config-parquet-and-info-hzyue-ClinicalMC-22a1928f/hub/datasets--hzyue--ClinicalMC/snapshots/d0e223de210b0174850ee794ce20c7159529a8cd/data_zh.json (origin=hf://datasets/hzyue/ClinicalMC@d0e223de210b0174850ee794ce20c7159529a8cd/data_zh.json), /tmp/hf-datasets-cache/medium/datasets/99739922623203-config-parquet-and-info-hzyue-ClinicalMC-22a1928f/hub/datasets--hzyue--ClinicalMC/snapshots/d0e223de210b0174850ee794ce20c7159529a8cd/synonym_en.json (origin=hf://datasets/hzyue/ClinicalMC@d0e223de210b0174850ee794ce20c7159529a8cd/synonym_en.json), /tmp/hf-datasets-cache/medium/datasets/99739922623203-config-parquet-and-info-hzyue-ClinicalMC-22a1928f/hub/datasets--hzyue--ClinicalMC/snapshots/d0e223de210b0174850ee794ce20c7159529a8cd/synonym_zh.json (origin=hf://datasets/hzyue/ClinicalMC@d0e223de210b0174850ee794ce20c7159529a8cd/synonym_zh.json)], ['hf://datasets/hzyue/ClinicalMC@d0e223de210b0174850ee794ce20c7159529a8cd/data_en.json', 'hf://datasets/hzyue/ClinicalMC@d0e223de210b0174850ee794ce20c7159529a8cd/data_zh.json', 'hf://datasets/hzyue/ClinicalMC@d0e223de210b0174850ee794ce20c7159529a8cd/synonym_en.json', 'hf://datasets/hzyue/ClinicalMC@d0e223de210b0174850ee794ce20c7159529a8cd/synonym_zh.json']
Please either edit the data files to have matching columns, or separate them into different configurations (see docs at https://hf.co/docs/hub/datasets-manual-configuration#multiple-configurations)Need help to make the dataset viewer work? Make sure to review how to configure the dataset viewer, and open a discussion for direct support.
_id string | description string | basic_information string | chief_complaint string | past_medical_history string | present_medical_history string | physical_examination string | auxiliary_examination dict | clinical_department string | preliminary_diagnosis list | preliminary_diagnosis_basis string | differential_diagnosis string | first_treatment string | course_record string | final_diagnosis list | final_diagnosis_basis string | measures. null |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
pmc-8674153-1 | A 45-year-old female was brought in by ambulance after collapsing at home secondary to a hypoglycemic event (capillary blood glucose of 1 mmol/L with paramedics). She had a history of restrictive AN, binge-purge behaviour, and an old traumatic brain injury, leaving her with memory problems. She was well known to mental... | Female, 45 | Hypoglycemic event | History of restrictive anorexia nervosa, binge-purge behavior, old traumatic brain injury with memory problems, well known to mental health services, multiple admissions to eating disorder centers. | Collapsed at home due to hypoglycemic event (capillary blood glucose of 1 mmol/L). On admission, malnourished, cachexic, and dehydrated. Experienced decreased consciousness, bradypnoea, and hypotension on the second day. Right upper quadrant pain developed, with worsening liver enzymes. Treated for cholecystitis with a... | "Blood pressure: 106\/85 mmHg, Respiratory rate: 20 breaths\/minute, Heart rate: 64 beats\/minute, Temperature: 35.1 \u00b0C, Capillary blood glucose: 6 mmol\/L, Weight: 37.3 kg (BMI = 12.6). Clear malnutrition, cachexia, and dehydration observed on examination." | {
"Imaging examination": "{\"Chest radiograph\":\"Patchy consolidations in the right middle and lower lobes\",\"Abdominal ultrasound\":\"Multiple small calculi and biliary debris, gallbladder oedema, and a small amount of peri-cholecystic fluid\",\"MRCP\":\"Negative for intra-biliary pathology\"}",
"Laboratory exam... | Gastroenterology Dept. | [
"Anorexia Nervosa",
"Cholecystitis",
"Hypoglycemia",
"Malnutrition"
] | 1. Anorexia Nervosa: history: history of restrictive anorexia and binge-purge behavior. symptoms: severe weight loss, malnourished appearance. signs: BMI = 12.6 indicating severe underweight. auxiliary_examination: previous admissions to eating disorder centers; history of nasogastric feeding. 2. Cholecystitis: history... | 1. Acute Pancreatitis: potential abdominal pain and elevated liver enzymes may suggest pancreatitis. 2. Hepatitis: elevated liver enzymes could also be indicative of hepatitis. 3. Diabetic Crisis: hypoglycemic events can resemble or occur in the context of poorly controlled diabetes, but there is no history of diabetes... | Initiate nasogastric feeding, prescribe appropriate antibiotics (amoxicillin, clavulanic acid, clarithromycin) for cholecystitis, switch opiates to reduce risk of respiratory depression, and closely monitor liver enzymes and nutritional status. Consultation with surgery for elective laparoscopic cholecystectomy once st... | {"first_course_record":{"chief_complaint":["The patient collapsed at home secondary to a hypoglycemic event."],"physical_examination":["Blood pressure: 106\/85 mmHg, respiratory rate: 20 breaths\/minute, heart rate: 64 beats\/minute, temperature: 35.1 \u00b0C. The patient appeared malnourished, cachexic, and dehydrated... | [
"Anorexia Nervosa",
"Cholecystitis",
"Hypoglycemia",
"Dehydration",
"Malnutrition"
] | 1. Anorexia Nervosa: history: history of restrictive AN and binge-purge behaviour; symptoms: severely low body weight (37.3 kg, BMI = 12.6); signs: malnourished, cachexic; auxiliary_examination: multiple admissions to eating disorder centres. || 2. Cholecystitis: history: right upper quadrant pain; symptoms: elevated l... | null |
pmc-8674153-2 | A 29-year-old male was brought to the hospital by ambulance after collapsing at home. He was found to be bradycardic and hypoglycaemic with a capillary blood glucose level of 2.3 mmol/L. He had a history of eating and anxiety disorders and was not on any regular medications. On admission, his weight was 37.3 kg (BMI = ... | Male, 29 | Collapse at home | History of eating disorders and anxiety disorders, no regular medications. | The patient presented with bradycardia and hypoglycemia, with a capillary blood glucose level of 2.3 mmol/L. He has a history of eating and anxiety disorders. During his hospital stay, he displayed severe malnutrition and experienced multiple hypoglycemic events. Following a mental capacity assessment, he was placed un... | "Weight: 37.3 kg (BMI = 11.6), Blood pressure: 104\/72 mmHg, Glasgow Coma Scale score: 15\/15, severely malnourished and cachectic." | {
"Imaging examination": "{\"Ultrasound\":\"Normal\",\"Non-invasive liver screen\":\"Normal\"}",
"Laboratory examination": "{\"Liver function tests\":\"Very abnormal results\"}",
"Pathological examination": "{}"
} | Gastroenterology Dept. | [
"Hypoglycemia",
"Severe Malnutrition",
"Liver Dysfunction",
"Eating Disorder"
] | 1. Hypoglycemia: history: History of eating disorder. symptoms: Found to be hypoglycaemic with a capillary blood glucose level of 2.3 mmol/L. signs: Bradycardia noted on examination. auxiliary_examination: Capillary blood glucose levels indicate hypoglycemia. 2. Severe Malnutrition: history: History of anxiety disorder... | 1. Anorexia Nervosa: Recognized by weight loss and fear of gaining weight, with potential for hypoglycemia. 2. Bulimia Nervosa: Characterized by episodes of binge eating followed by purging, could explain eating behavior and nutritional deficits. 3. Liver Cirrhosis: Chronic liver disease could explain abnormal liver fu... | Initiate nasogastric feeding, monitor blood glucose levels, provide psychological support and assessment, and ensure compliance with treatment while addressing severe malnutrition and liver functioning. | {"first_course_record":{"chief_complaint":["The patient collapsed at home and was found to be bradycardic and hypoglycaemic."],"physical_examination":["The patient was severely malnourished and cachexic; blood pressure was initially un-recordable, later recorded at 104\/72 mmHg."],"auxiliary_examination":{"Imaging exam... | [
"Anorexia Nervosa",
"Hypoglycemia",
"Severe Malnutrition",
"Liver Dysfunction"
] | 1. Anorexia Nervosa: history: History of eating disorders; symptoms: Severe malnutrition, cachexia; signs: Weight of 37.3 kg (BMI = 11.6); auxiliary_examination: Poor liver function tests (LFTs). || 2. Hypoglycemia: history: Previous history of hypoglycemic events; symptoms: Bradycardia, hypoglycemia (capillary blood g... | null |
pmc-8700756-1 | A 45-year-old, multiparous, overweight female with a history of OHP use for 13 years (levonorgestrel 0.15 mg and estradiol 0.03 mg daily) consulted the emergency room of our institution following a one-week clinical course of worsening dyspnea, general malaise, headache, and ageusia. At admission, the patient reported ... | Female, 45 years | Worsening dyspnea | History of OHP use for 13 years (levonorgestrel 0.15 mg and estradiol 0.03 mg daily). | Patient experienced a one-week clinical course of worsening dyspnea, general malaise, headache, and ageusia. Upon admission, dyspnea at rest with intermittent retrosternal chest pain radiating to the back. Diagnosis confirmed as COVID-19 via RT-PCR test, with subsequent complications including septic shock, respiratory... | "Tachypnea, tachycardia, desaturation; pulmonary aggregates on auscultation." | {
"Imaging examination": "{\"CT pulmonary angiography (CTPA)\":\"Massive PTE with compromise to the posterior basal segmental artery of the left lower lobe, inferior lingula, and apical-posterior segment of the left upper lobe.\",\"Echocardiogram\":\"Right ventricular dysfunction.\"}",
"Laboratory examination": "{\... | Respiratory Medicine Dept. | [
"COVID-19 pneumonia",
"Pulmonary embolism",
"Septic shock",
"Anemia",
"Respiratory failure"
] | 1. COVID-19 pneumonia: history: One-week worsening dyspnea, general malaise, and headache; symptoms: Dyspnea at rest, ageusia; signs: Tachypnea, desaturation, lung aggregates on auscultation; auxiliary_examination: Positive RT-PCR for SARS-CoV-2, elevated D-dimer, troponin, ferritin, and lactate dehydrogenase levels. 2... | 1. Bacterial pneumonia: Symptoms may include fever, increased sputum production, and localized lung sounds. 2. Heart failure: Symptoms may include dyspnea, orthopnea, and edema, with associated signs of volume overload. 3. Acute respiratory distress syndrome (ARDS): Symptoms may include severe hypoxemia and respiratory... | Initiate anticoagulation therapy, continue broad-spectrum antibiotics for secondary infections, manage respiratory support with invasive mechanical ventilation if needed, and monitor blood parameters closely for anemia management. Evaluate the need for additional interventions based on clinical evolution. | {"first_course_record":{"chief_complaint":["The patient presented with worsening dyspnea, general malaise, headache, and ageusia for one week."],"physical_examination":["The vital signs showed tachypnea, tachycardia, and desaturation. Pulmonary aggregates were noted on auscultation."],"auxiliary_examination":{"Imaging ... | [
"COVID-19",
"Pulmonary Embolism",
"Septic Shock",
"Respiratory Failure",
"Severe Anemia"
] | 1. COVID-19: history: 1-week clinical course of worsening dyspnea, general malaise; symptoms: dyspnea at rest, ageusia; signs: tachypnea, desaturation; auxiliary_examination: positive RT-PCR test for SARS-CoV-2. || 2. Pulmonary Embolism: history: significant elevation of D-dimer; symptoms: retrosternal oppressive chest... | null |
pmc-8408423-1 | A 33-year-old female living in Fresno, California presented to the hospital with progressively worsening diplopia and headache for 5 days. Chart review showed that she had been diagnosed with coccidioidal meningitis three years ago when she presented with similar headaches and reduced visual acuity. Computed tomography... | female, 33 | progressively worsening diplopia and headache | coccidioidal meningitis diagnosed 3 years ago, syphilis diagnosed 2 years ago | Patient presented with diplopia and headache worsening over 5 days. History of coccidioidal meningitis, previously treated but lost to follow-up. Current symptoms led to CT which showed hydrocephalus and shunt tube. Symptoms of neurosyphilis also being treated. | "Vital signs stable, physical examination benign except for oblique diplopia" | {
"Imaging examination": "{\"CT of the head\":\"hydrocephalus and right posterior parietal ventriculoperitoneal shunt tube\",\"Repeat imaging (Day 22)\":\"worsening ventriculomegaly with bifrontal hemorrhage\"}",
"Laboratory examination": "{\"CSF analysis\":\"leukocytes 51\\/uL with 69% lymphocyte predominance, glu... | Neurology Dept. | [
"Coccidioidal meningitis",
"Neurosyphilis"
] | 1. Coccidioidal meningitis: history: history of coccidioidomycosis with previous meningitis and hydrocephalus symptoms: diplopia, headache signs: hydrocephalus on CT, elevated CSF pressure auxiliary_examination: positive Coccidioides complement fixation in CSF at 1:32, CSF protein elevated at 324 mg/dl. 2. Neurosyphili... | 1. Viral meningitis: characterized by fever, headache, neck stiffness, and lymphocytic predominance in CSF. 2. Bacterial meningitis: generally presents with more severe symptoms such as fever, neck rigidity, and a lower glucose level in CSF. 3. Tuberculous meningitis: typically seen with a more chronic presentation and... | Start Fluconazole 1000 mg daily for CNS infection due to Coccidioides and administer Penicillin G 4 million units IV every 4 hours for 14 days for treatment of neurosyphilis. | {"first_course_record":{"chief_complaint":["The patient presented with progressively worsening diplopia and headache for 5 days."],"physical_examination":["Vital signs stable within normal range; physical exam benign except for oblique diplopia."],"auxiliary_examination":{"Imaging examination":{"CT of the head":"Showed... | [
"coccidioidal meningitis",
"neurosyphilis",
"hydrocephalus"
] | 1. coccidioidal meningitis: history: diagnosed with coccidioidal meningitis three years ago; symptoms: progressively worsening diplopia and headache; signs: oblique diplopia; auxiliary_examination: positive Coccidioides complement fixation at 1:32 in CSF. || 2. neurosyphilis: history: diagnosed with syphilis 2 years ag... | null |
pmc-8655486-1 | An 83-year-old female with a history of cold agglutinin hemolytic anemia requiring transfusions, chronic anemia with hemoglobin levels between 7-8 g/dl, hypothyroidism, hypertension, deep vein thrombosis in bilateral lower extremities, and chronic lymphedema, presented with shortness of breath, cough, weakness, lighthe... | Female, 83 | Shortness of breath and cough | Cold agglutinin hemolytic anemia requiring transfusions, chronic anemia, hypothyroidism, hypertension, deep vein thrombosis in bilateral lower extremities, chronic lymphedema | Presented with shortness of breath, cough, weakness, lightheadedness, acrocyanosis, jaundice, and darkening of urine. Productive cough with yellow sputum and worsening shortness of breath over the last four days. Orthopnea requiring sleeping upright, denied chest pain, leg swelling, paroxysmal nocturnal dyspnea, and wh... | "Afebrile, normotensive, normal heart rate, severe hypoxia (88% on room air), mucosal pallor, acrocyanosis, icterus, diffuse bilateral rhonchi, pitting edema in bilateral lower extremities below the knee." | {
"Imaging examination": "{\"Chest X-ray\":\"Enlarged cardiac silhouette, perihilar vascular fullness, bilateral interstitial prominence indicative of pulmonary vascular congestion.\",\"Cardiac echocardiogram\":\"Ejection fraction 60-65%, mild left ventricular wall thickness, grade I diastolic dysfunction.\"}",
"La... | Hematology Dept. | [
"Cold agglutinin hemolytic anemia",
"COVID-19 pneumonia",
"Hypoxemia",
"Pulmonary congestion",
"Acute kidney injury"
] | 1. Cold agglutinin hemolytic anemia: history: history of cold agglutinin hemolytic anemia requiring transfusions symptoms: shortness of breath, jaundice, darkening of urine signs: mucosal pallor, icterus, acrocyanosis, positive direct Coombs test auxiliary_examination: cold agglutinin titer of 1:512. 2. COVID-19 pneumo... | 1. Congestive heart failure: presenting with dyspnea and fluid retention due to fluid overload could mimic pulmonary congestion and shortness of breath. 2. Other forms of anemia: could present with fatigue and pallor but may not have the same hemolytic indicators. 3. Pulmonary embolism: could present with sudden shortn... | 1. Continue transfusions of packed red blood cells as needed for anemia. 2. Continue treatment with remdesivir and dexamethasone for COVID-19 pneumonia. 3. Manage fluid status with diuretics if pulmonary congestion persists. 4. Follow-up with the oncology team for rituximab treatment. | {"first_course_record":{"chief_complaint":["The patient presents with shortness of breath, cough, weakness, lightheadedness, acrocyanosis, jaundice, and darkening of urine."],"physical_examination":["The patient is afebrile, normotensive, and has severe hypoxia with 88% saturation on room air, 95% with oxygen. Mucosal ... | [
"Cold Agglutinin Hemolytic Anemia",
"SARS-CoV-2 Pneumonia",
"Chronic Anemia",
"Chronic Kidney Disease (Stage 1)",
"Hypothyroidism",
"Hypertension",
"Deep Vein Thrombosis",
"Chronic Lymphedema"
] | 1. Cold Agglutinin Hemolytic Anemia: history: history of cold agglutinin hemolytic anemia requiring transfusions; symptoms: jaundice, darkening of urine; signs: mucosal pallor, acrocyanosis; auxiliary_examination: positive Direct Coombs test and elevated cold agglutinin titer. || 2. SARS-CoV-2 Pneumonia: history: posit... | null |
pmc-8656134-1 | A 32-year-old male patient with no significant past medical history other than COVID-19 infection, months prior to admission, presented to ED complaining of dysphagia. Symptoms began about 1 week prior to presentation with difficulty swallowing liquids that progressed to involve solids as well. Dysphagia was described ... | male, 32 | dysphagia | COVID-19 infection | Dysphagia began about 1 week prior to presentation with difficulty swallowing liquids progressing to solids. Described as a choking sensation, partially relieved with belching. Symptoms include pyrosis and occasional vomiting, with a history of subacute nonproductive cough lasting 3-4 weeks, worsening with exertion and... | "afebrile, HR: 94, RR: 19, O2sat: 100% RA, BP: 129\/81. Mild wheezes over lung bases bilaterally, no palpable lymphadenopathy." | {
"Imaging examination": "{\"CT-chest\":\"prominent mediastinal and bilateral hilar adenopathy, multiple pulmonary nodules, mild interlobular septal thickening, peripheral left lower lobe ground-glass opacities.\",\"Esophagram\":\"extrinsic mass effect involving the middle esophagus, compatible with bulky mediastinal... | Gastroenterology Dept. | [
"Mediastinal adenopathy",
"Granulomatous disease"
] | 1. Mediastinal adenopathy: history: Recent COVID-19 infection and presenting symptoms indicative of mediastinal involvement; symptoms: Dysphagia, choking sensation, and dyspnea; signs: Mild wheezes over lung bases; auxiliary_examination: CT-chest showed prominent mediastinal and bilateral hilar adenopathy. 2. Granuloma... | 1. Esophageal cancer: Common presenting symptom of dysphagia and weight loss, which this patient denies; 2. Lymphoma: Can present with adenopathy and respiratory symptoms, but pathology did not show malignancy. | Continue with oral prednisone 40 mg daily for granulomatous disease; monitor symptoms and consider further gastroenterological evaluation for persistent dysphagia. | {"first_course_record":{"chief_complaint":["The patient presents with dysphagia, describing a choking sensation and feeling of food getting stuck in the chest."],"physical_examination":["Afebrile, HR: 94, RR: 19, O2sat: 100% on room air, BP: 129\/81. Examination revealed mild wheezes over lung bases bilaterally."],"aux... | [
"Granulomatosis (non-necrotizing granulomas)",
"Mediastinal lymphadenopathy",
"Dysphagia",
"Interstitial pulmonary edema"
] | 1. Granulomatosis: history: Previous COVID-19 infection; symptoms: Persistent cough, shortness of breath; signs: Mild wheezes over lung bases; auxiliary_examination: Pathology report showing abundant non-necrotizing granulomas and negative cultures. || 2. Mediastinal lymphadenopathy: history: Complaints of dysphagia; s... | null |
pmc-8671579-1 | An 88-year-old woman (height, 150 cm; weight, 41 kg) with no history of drug allergy or general anesthesia was scheduled for transfemoral TAVI because of severe aortic stenosis (AS). The surgery was performed under general anesthesia to facilitate the use of transesophageal echocardiography and to manage any intraopera... | Female, 88 | Severe aortic stenosis | Hypertension and chronic atrial fibrillation; no history of drug allergy or general anesthesia. | The patient was diagnosed with severe aortic stenosis which was managed through transfemoral TAVI. She experienced complete atrioventricular block during surgery and developed distributive shock classified as anaphylactic shock due to sugammadex, characterized by rapid onset severe hypotension and bronchospasm. Treatme... | "Height: 150 cm; Weight: 41 kg; Systolic arterial blood pressure (ABP) decreased to less than 40 mmHg during surgery, elevated peak and plateau airway pressures (60 and 40 cmH2O, respectively)" | {
"Imaging examination": "{}",
"Laboratory examination": "{\"Total serum tryptase level at 1 h post-onset\":\"7.3 ng\\/mL\",\"Total serum tryptase level at 24 h post-onset\":\"1.2 ng\\/mL\"}",
"Pathological examination": "{}"
} | Cardiovascular Medicine Dept. | [
"Severe Aortic Stenosis",
"Anaphylactic Shock"
] | 1. Severe Aortic Stenosis: history: Patient has a history of severe aortic stenosis noted in preoperative echocardiography; symptoms: Symptoms indicate aortic stenosis potentially leading to surgery; signs: Signs include myocardial hypertrophy observed via echocardiography; auxiliary_examination: Transthoracic echocard... | 1. Hypovolemic Shock: Characterized by low blood volume leading to hypotension which may present similarly; 2. Cardiogenic Shock: Caused by inadequate blood flow due to heart dysfunction, could be confused with shock symptoms; 3. Septic Shock: Caused by infection leading to hypotension and possibly elevated airway pres... | Initial treatment included two boluses of 0.05 mg adrenaline and rapid volume resuscitation with crystalloid. Addition of glucagon (1 mg IV) due to persistent hypotension, following increased doses of adrenaline and noradrenaline infusion. | {"first_course_record":{"chief_complaint":["The patient is scheduled for transfemoral TAVI due to severe aortic stenosis."],"physical_examination":["Vital signs stable; no acute distress."],"auxiliary_examination":{"Imaging examination":{"Preoperative transthoracic echocardiography":"Severe aortic stenosis; aortic valv... | [
"Aortic Stenosis",
"Complete Atrioventricular Block",
"Anaphylactic Shock"
] | 1. Aortic Stenosis: history: severe aortic stenosis; symptoms: none specified in the text; signs: severe AS observed during echocardiography; auxiliary_examination: echocardiography showed aortic valve peak flow velocity of 4.73 m/s. || 2. Complete Atrioventricular Block: history: patient experienced complete AV block ... | null |
pmc-8652043-1 | A 35-year-old gentleman came to our institution in February 2021 for evaluation of persistent fever and non-resolving pneumonia. He had a polymerase chain reaction (PCR)-confirmed SARS-CoV-2 infection in October 2020, with classical radiological findings. He was managed conservatively under home quarantine. Two weeks l... | Male, 35 years old | Persistent fever and non-resolving pneumonia | Probable vaccine-related/autoimmune optic neuritis in 2017; received 13 doses of rituximab; developed rituximab-induced hypogammaglobulinaemia in 2019. | Initially diagnosed with a polymerase chain reaction (PCR)-confirmed SARS-CoV-2 infection in October 2020. Experienced recurrent high spiking fever and pneumonia, treated with amoxicillin-clavulanate and later linezolid. During hospitalization, bronchoscopy revealed Streptococcus pneumoniae. Diagnosed with organizing p... | "Vital signs: temperature elevated due to fever; respiratory examination showed signs of pneumonia." | {
"Imaging examination": "{\"Computed tomography thorax\":\"Showed resolution of left lower lobe consolidation but had new-onset bilateral ground-glass opacities (GGOs).\"}",
"Laboratory examination": "{\"SARS-CoV-2 RT-PCR\":\"Positive in April 2021.\",\"Antibody testing\":\"Anti-N: 9.6 and anti-S-RBD: 41.4 in June... | Respiratory Medicine Dept. | [
"Organizing pneumonia",
"COVID-19 re-infection",
"Pneumonia due to Pseudomonas aeruginosa"
] | 1. Organizing pneumonia: history: History of prior probable pneumonia and B-cell depletion suggests increased vulnerability; symptoms: Persistent fever and respiratory symptoms; signs: Imaging showed bilateral ground-glass opacities; auxiliary_examination: Bronchoscopic biopsy suggestive of organizing pneumonia. 2. COV... | 1. Tuberculosis: Persistent fever and respiratory symptoms with potential exposure; 2. Lymphoma: Possible due to history of immunosuppression and respiratory symptoms; 3. ANCA associated vasculitis: Given persistent fever and pulmonary symptoms; 4. Lung malignancy: Needs consideration due to potential B-cell malignanci... | Initiation of high-dose corticosteroids for organizing pneumonia, along with antibiotics for Pseudomonas infection and supportive symptomatic care. | {"first_course_record":{"chief_complaint":["Persistent fever and non-resolving pneumonia."],"physical_examination":["The patient shows signs of respiratory distress."],"auxiliary_examination":{"Imaging examination":{"Chest X-ray":"Left-sided lung consolidation."},"Laboratory examination":{"SARS-CoV-2 PCR":"Positive - c... | [
"Organizing pneumonia",
"COVID-19 re-infection",
"Hypogammaglobulinaemia"
] | 1. Organizing pneumonia: history: Recurrence of pneumonia and inadequate clinical improvement post-treatment; symptoms: Persistent fever and lung consolidation; signs: Bronchoscopy showed suggestive histopathology; auxiliary_examination: Negative TB PCR, negative cultures, bronchoscopic biopsy suggesting organizing pne... | null |
pmc-8668146-1 | A 95-year-old lady with a past medical history of heart failure with reduced ejection fraction (HFrEF) and biventricular implantable cardioverter-defibrillator (ICD), hypertension, and asthma presented to the emergency department for evaluation of nausea, vomiting, and a two-month history of intermittent diarrhea, whic... | Female, 95 years old | Nausea, vomiting, and a two-month history of intermittent diarrhea | Heart failure with reduced ejection fraction, hypertension, asthma, biventricular implantable cardioverter-defibrillator | The patient presented with nausea, vomiting, and worsening diarrhea for a few days. Diarrhea was associated with severe abdominal cramps. No recent antibiotic use was reported. | "Abdomen soft but tender on deep palpation, audible bowel sounds, no organomegaly or CVA tenderness." | {
"Imaging examination": "{\"CT abdomen\":\"Long segment of the colon with a loop within loop appearance consistent with intussusception\"}",
"Laboratory examination": "{\"Potassium level\":\"Hypokalemia (3.3 mEq\\/L)\",\"Lipase\":\"Within normal limits (32 U\\/L)\",\"AST\":\"19 U\\/L\",\"ALT\":\"10 U\\/L\",\"Total... | Gastrointestinal Surgical Dept. | [
"Intussusception",
"Acute kidney injury"
] | 1. Intussusception: history: 95-year-old female presenting with nausea, vomiting, and diarrhea; symptoms: abdominal cramps, worsening diarrhea; signs: tender abdomen on deep palpation; auxiliary_examination: CT abdomen showing intussusception. 2. Acute kidney injury: history: developing after surgery; symptoms: oliguri... | 1. Colorectal cancer: may present with abdominal pain and changes in bowel habits; could be a cause of intussusception. 2. Gastroenteritis: could present with similar symptoms of nausea, vomiting, and diarrhea but would typically show signs of infectious etiology which weren't noted here. | Surgical intervention for intussusception with right hemicolectomy and subsequent monitoring postoperatively. | {"first_course_record":{"chief_complaint":["Nausea, vomiting, and a two-month history of intermittent diarrhea that has worsened for a few days."],"physical_examination":["The abdomen was soft but tender on deep palpation, with audible bowel sounds. No organomegaly or costovertebral angle tenderness was appreciated."],... | [
"Intussusception",
"Tubulovillous adenoma with high-grade dysplasia",
"Acute kidney injury"
] | 1. Intussusception: history: Two-month history of intermittent diarrhea with abdominal cramps; symptoms: Nausea, vomiting, and worsening diarrhea; signs: Tender abdomen on deep palpation; auxiliary_examination: CT abdomen showing loop within loop appearance in the colon. || 2. Tubulovillous adenoma with high-grade dysp... | null |
pmc-8684331-1 | Chief complaint
Our patient is a 65-year-old male who reported severe and progressive abdominal pain of three days’ duration.
History of present illness
The patient was admitted for stomach pain and lack of bowel movements for three days. The patient’s abdominal pain became progressively worse over the two days prior t... | Male, 65 | Severe and progressive abdominal pain | Significant for an open ventral hernia repair with mesh approximately four years prior and multiple instances of small bowel obstruction since, with the most recent resolving non-operatively 10 months prior. | The patient was admitted for stomach pain and lack of bowel movements for three days, with progressively worsening sharp pain localized to the left side of his abdomen. Nausea was reported, but no vomiting. Abdominal X-rays revealed small bowel dilation; CT scan showed small bowel obstruction. | "Abdominal tenderness to palpation on the left side with rebound, severe tenderness at the umbilicus with a palpable mass. Unable to tolerate nasogastric tube placement." | {
"Imaging examination": "{\"Abdominal X-rays\":\"Showed small bowel dilation and adynamic air-fluid levels.\",\"CT scan\":\"Showed decompressed distal and terminal ileum consistent with SBO, with soft tissue thickening that could possibly be the cause of obstruction.\"}",
"Laboratory examination": "{}",
"Patholo... | Gastrointestinal Surgical Dept. | [
"Small Bowel Obstruction (SBO)",
"Adhesions due to previous surgery"
] | 1. Small Bowel Obstruction (SBO): history: Patient has a long history of small bowel obstructions and a recent admission for similar symptoms; symptoms: Severe progressive abdominal pain, localized to the left side, with nausea; signs: Abdominal tenderness to palpation on the left side, severe tenderness at the umbilic... | 1. Ileus: Characterized by a lack of peristalsis, leading to abdominal distension and pain but with no mechanical obstruction; 2. Perforated viscera: May present with similar symptoms but typically accompanied by signs of peritonitis and clinical deterioration; 3. Recurrent hernia: Potential due to previous surgical hi... | Exploratory laparotomy, release of small bowel obstruction, removal of abdominal wall mesh, and placement of Jackson-Pratt drain | {"first_course_record":{"chief_complaint":["The patient reported severe and progressive abdominal pain of three days\u2019 duration."],"physical_examination":["Abdominal tenderness to palpation on the left side with rebound, severe tenderness at the umbilicus with a palpable mass."],"auxiliary_examination":{"Imaging ex... | [
"Small Bowel Obstruction",
"Adhesions"
] | 1. Small Bowel Obstruction: history: Severe and progressive abdominal pain, history of SBO, long history of tenderness and mass at the site of past hernia repair; symptoms: Sharp, localized abdominal pain worse with movement, nausea; signs: Abdominal tenderness on examination, rebound tenderness, palpable mass; auxilia... | null |
pmc-8684637-1 | A 72-year-old man presented to emergency room with 8-h fatigue and 4-h mild exertional dyspnea, palpitation, and blurred vision. He was a nonsmoker and denied previous history of cardiovascular disease. Physical examination showed sinus tachycardia (117 bpm) and normal blood pressure (120/70 mmHg). The position and ran... | Male, 72 years old | Fatigue, dyspnea, palpitation, and blurred vision | No previous history of cardiovascular disease | The patient presented with 8 hours of fatigue and 4 hours of mild exertional dyspnea, palpitations, and blurred vision. A diagnosis of acute inferior myocardial infarction was established. Treatment included dual anti-platelet therapy, coronary angiography, and percutaneous balloon angioplasty. He developed severe dysp... | "Heart rate 120 bpm, blood pressure 90\/60 mmHg, normal apical impulse, no heart murmurs, crackles throughout both lungs" | {
"Imaging examination": "{\"Transthoracic echocardiography\":\"Left-to-right shunt in the posterior portion of the interventricular septum with a size of 11.4 mm\"}",
"Laboratory examination": "{\"ECG\":\"ST-segment elevated by 2\\u20133 mm in leads II, III, and aVF with Q-waves\",\"Cardiac troponin T\":\"3.33 ng\... | Cardiovascular Medicine Dept. | [
"Acute Inferior Myocardial Infarction",
"Ventricular Septal Rupture"
] | 1. Acute Inferior Myocardial Infarction: history: 72-year-old man with no previous history of cardiovascular disease and presented with exertional dyspnea and palpitations. symptoms: fatigue, mild exertional dyspnea, palpitation, and blurred vision. signs: sinus tachycardia at 117 bpm, normal blood pressure. auxiliary_... | 1. Acute Respiratory Distress Syndrome: related to severe dyspnea and crackles in both lungs. 2. Pulmonary Embolism: presents with sudden onset dyspnea and hypotension. 3. Aortic Dissection: can mimic acute myocardial infarction with similar symptoms and signs but would show different imaging results. | Initiate Dual anti-platelet therapy (aspirin 300 mg and clopidogrel 300 mg). Implement IABP for hemodynamic support. Continue with furosemide, rhBNP, and anticoagulation therapy. Plan for percutaneous closure of the ventricular septal rupture. | {"first_course_record":{"chief_complaint":["The patient presents with 8-hour fatigue and 4-hour mild exertional dyspnea, palpitation, and blurred vision."],"physical_examination":["Sinus tachycardia (117 bpm) and normal blood pressure (120\/70 mmHg). No heart murmurs or crackles on lung auscultation."],"auxiliary_exami... | [
"Acute inferior myocardial infarction",
"Ventricular septal rupture",
"Heart failure"
] | 1. Acute inferior myocardial infarction: history: 72-year-old man presented with fatigue, exertional dyspnea; symptoms: mild exertional dyspnea, palpitation, blurred vision; signs: sinus tachycardia, no heart murmurs; auxiliary_examination: ST-segment elevation and elevated cardiac troponin T. || 2. Ventricular septal ... | null |
pmc-8686221-1 | A 69-year-old Han man complained of chest distress and shortness of breath after stress for four months. He was diagnosed with hypertension for four months, and he felt that these symptoms were accompanied by high blood pressure. The maximum blood pressure measured was 200/110 mmHg. Benidipine hydrochloride (4 mg twice... | Male, 69 years | Chest distress and shortness of breath after stress | 10 years of diabetes mellitus and hyperlipidemia. | Patient experienced chest distress and shortness of breath for four months associated with hypertension diagnosed four months ago. The maximum recorded blood pressure was 200/110 mmHg. He also reported dull pain in the left waist. During hospitalization, he was diagnosed with resistant hypertension, chronic renal disea... | "Blood pressure 130\/75 mmHg, creatinine 96 \u00b5mol\/L, eGFR 69.21 mL\/(min \u00d7 1.73 m2)." | {
"Imaging examination": "{\"Abdominal enhanced CT\":\"Suspected left renal infarction, left renal artery nearly occluded.\",\"Invasive angiography\":\"95% stenosis of the proximal segment of the left renal artery.\"}",
"Laboratory examination": "{\"Serum creatinine\":\"122 \\u00b5mol\\/L\",\"eGFR\":\"51.80 mL\\/mi... | Nephrology Dept. | [
"Resistant hypertension",
"Left renal artery stenosis",
"Chronic renal disease"
] | 1. Resistant hypertension: history: Diagnosed with hypertension for four months; symptoms: chest distress and shortness of breath; signs: maximum blood pressure of 200/110 mmHg; auxiliary_examination: multiple antihypertensive medications applied without adequate blood pressure control. 2. Left renal artery stenosis: h... | 1. Atherosclerotic renal artery stenosis: can present with similar symptoms of hypertension and renal dysfunction. 2. Diabetic nephropathy: a possibility given the patient's long history of diabetes. 3. Congestive heart failure: may cause similar respiratory symptoms and worsened by hypertension. | Post-procedure management with atorvastatin, ezetimibe, aspirin, clopidogrel, Sacubitril Valsartan Sodium, and metoprolol to optimize blood pressure control and protect renal function, along with lifestyle modifications for hypertension and diabetes management. | {"first_course_record":{"chief_complaint":["The patient complains of chest distress and shortness of breath after stress for four months."],"physical_examination":["Blood pressure measured at 200\/110 mmHg. Patient presents with mild shortness of breath."],"auxiliary_examination":{"Imaging examination":{"Abdominal enha... | [
"Resistant Hypertension",
"Chronic Renal Disease",
"Renal Artery Stenosis",
"Left Renal Infarction",
"Diabetes Mellitus",
"Hyperlipidemia"
] | 1. Resistant Hypertension: history: Diagnosed with hypertension for four months; symptoms: Chest distress and shortness of breath after stress; signs: Blood pressure 200/110 mmHg; auxiliary_examination: Treatment with antihypertensive medications shows controlled blood pressure. || 2. Chronic Renal Disease: history: El... | null |
pmc-8710040-1 | A 25-month-old boy with fever and maculopapular rashes was admitted to Mofid Children's Hospital. His parents explained that fever began three days ago and rashes developed after one day. The rashes started with mild itching in the feet, spreading to the thighs and the genital area on the second day. Despite taking ant... | Male, 25 months | Fever and maculopapular rashes | Only ranitidine used in the past three weeks; mother's history of upper respiratory infection three weeks ago. | The patient had fever for three days, with rashes developing on the second day involving mild itching, spreading to thighs and genital area. Mucosal involvement of mouth, lips, and conjunctiva, leading to ulcer and bulla formation. Diagnosis of SJS/TEN, later identified as MIS-C due to laboratory findings. | "Temperature: 39.5\u00b0C, blood pressure: 82\/10 mmHg, respiratory rate: 28, pulse rate: 86." | {
"Imaging examination": "{\"Chest CT scan\":\"Unremarkable\"}",
"Laboratory examination": "{\"WBC count\":\"3200\\/\\u03bcl (PMN: 58%, Lymph: 41%)\",\"Hemoglobin\":\"12.3 gr\\/dl\",\"Platelet count\":\"29000\\/\\u03bcl\",\"ESR\":\"36 mm\\/hr\",\"CRP\":\"58 mg\\/l\",\"Ferritin\":\"517 \\u03bcg\\/L\",\"Fibrinogen\":... | Pediatrics Dept. | [
"Stevens-Johnson Syndrome (SJS)",
"Toxic Epidermal Necrolysis (TEN)",
"Multisystem Inflammatory Syndrome in Children (MIS-C)"
] | 1. Stevens-Johnson Syndrome (SJS): history: Recent medication use (ranitidine); symptoms: Fever, rash, malaise, poor feeding, mucosal involvement; signs: Maculopapular rashes, ulcer and bulla formation, vital signs indicating fever; auxiliary_examination: Laboratory tests showing elevated ferritin and fibrinogen levels... | 1. Viral Exanthem: Symptoms often include fever and rash, but without significant mucosal involvement. 2. Bacterial Infection (e.g., Scarlet Fever): Presents with fever and rash but typically involves different lab findings and signs of respiratory infection. 3. Kawasaki Disease: Presents with fever and rash, but often... | Initial treatment included supportive care, steroids, intravenous immune globulin (IVIG), and atazanavir due to the diagnosis of MIS-C. | {"first_course_record":{"chief_complaint":["The patient has a high fever of 39.5\u00b0C, malaise, poor feeding, and maculopapular rashes with ulcer and bulla formation."],"physical_examination":["Vital signs: Blood pressure 82\/10 mmHg, respiratory rate 28, pulse rate 86. Skin examination shows blistered lesions, and m... | [
"Stevens-Johnson Syndrome (SJS)/Toxic Epidermal Necrolysis (TEN)",
"Multisystem Inflammatory Syndrome in Children (MIS-C)",
"Maculopapular Rash"
] | 1. Stevens-Johnson Syndrome (SJS)/Toxic Epidermal Necrolysis (TEN): history: recent use of ranitidine; symptoms: fever, malaise, poor feeding, mucosal involvement, maculopapular rashes with ulcer and bulla formation; signs: blistered skin lesions; auxiliary_examination: clinical presentation and history. || 2. Multisys... | null |
pmc-6002982-1 | An 18-year-old female was admitted to Peking Union Medical College Hospital in November 2016 with the chief complaints of abnormal limb movements and slurred speech for two years, which worsened 20 days ago. Initially, her movements were slower, her hands were clumsy, and she could not speak clearly. In the past 20 day... | Female, 18 years old | Abnormal limb movements and slurred speech | No significant history of other diseases. Patient had xerostomia, keratoconjunctivitis sicca, and frequent oral ulcers. Family history revealed behavioral changes and abnormal movements since age five. No significant symptoms reported in family members. | The patient has experienced abnormal limb movements and slurred speech for two years, worsening over the past 20 days. Initially, she had slower movements and clumsiness in her hands, with unclear speech. She later developed dysdipsia, unsteady gait, dyskinesia, and increased involuntary movements leading to multiple f... | "The patient had normal comprehension, low-grade fever (37.5-38.0 \u00b0C), hepatomegaly, splenomegaly, dystonia, lack of coordination, slight tremor, dysarthria, dysphagia, and positive right side Babinski sign." | {
"Imaging examination": "{\"MRI\":\"Abnormal signals in bilateral basal ganglia and thalamus, low signal on T1-weighted image, high signals on T2-weighted and FLAIR images.\",\"CT\":\"Diffuse lesions in the liver and hepatosplenomegaly.\"}",
"Laboratory examination": "{\"WBC count\":\"2.87*10^9\\/L (decreased)\",\... | Neurology Dept. | [
"Wilson's Disease",
"Systemic Lupus Erythematosus",
"Secondary Sjögren Syndrome"
] | 1. Wilson's Disease: history: The patient has a family history of behavioral changes and involuntary movements; symptoms: Abnormal limb movements, slurred speech, dyskinesia, dysarthria; signs: Kayser–Fleischer ring present in both eyes; auxiliary_examination: MRI showed abnormal signals in basal ganglia and thalamus; ... | 1. Rheumatoid Arthritis: Can cause joint symptoms and systemic effects but less likely given neurological and specific antibody findings. 2. Multiple Sclerosis: Can present with similar neurological symptoms but less likely due to normal MRI findings of demyelination. 3. Neurodegeneration: Such as Huntington's disease ... | Administer iv sodium dimercaptopropane sulfonate (DMPS), full dose zinc sulfate for Wilson's Disease, methylprednisolone (80 mg iv for 7 days, then 40 mg po for 3 weeks) for SLE, and hydroxychloroquine po for SLE. Begin anticoagulant therapy (low molecular weight heparin, followed by aspirin) due to positive aPL antibo... | {"first_course_record":{"chief_complaint":["The patient has abnormal limb movements and slurred speech for two years, worsening 20 days ago."],"physical_examination":["Low-grade fever, hepatomegaly, splenomegaly, dystonia, lack of coordination, slight tremor, dysarthria, dysphagia, and positive right side Babinski sign... | [
"Wilson's disease",
"Systemic lupus erythematosus",
"Secondary Sjögren syndrome",
"Antiphospholipid syndrome"
] | 1. Wilson's disease: history: Family history of behavioral changes and involuntary movements; symptoms: abnormal limb movements, dysarthria, dysphagia, hepatomegaly, splenomegaly, frequent falls; signs: Kayser–Fleischer ring in both eyes, positive right side Babinski sign; auxiliary_examination: MRI showing abnormal si... | null |
pmc-6003786-1 | A 35-year-old male presented to the Emergency Department of Civil Hospital Karachi with a 10-day history of high-grade fever, shortness of breath, palpitations, and joint pain. The patient had poor appetite and fatigue. He denied any history of trauma, allergies, any other medical conditions, or weight loss. A review o... | Male, 35 years old | High-grade fever, shortness of breath, palpitations, and joint pain | Intravenous drug abuse, no major surgeries, no other significant history | 10-day history of high-grade fever, poor appetite, fatigue, and multiple joint pains. Previously diagnosed with ostium secundum (22.18 mm, left to right shunt) via transoesophageal echocardiography. Suspected infective endocarditis (IE) due to high-grade fever. | "Dehydrated, blood pressure 100\/70 mm Hg, heart rate 100 bpm, respiratory rate 20 breaths\/min, temperature 102\u00b0F. Enlarged spleen 2 cm below the costal margin. Cardiovascular exam normal, clear lungs, non-tender abdomen." | {
"Imaging examination": "{}",
"Laboratory examination": "{\"Complete Blood Count (CBC)\":\"Hb level = 12.6 g\\/dL, TLC = 15,000\\/\\u03bcL\",\"Malarial parasite test\":\"Insignificant\",\"Dengue test\":\"Insignificant\",\"HIV serology\":\"Normal findings\",\"Hepatitis serology\":\"Normal findings\",\"Blood culture... | Cardiovascular Medicine Dept. | [
"Infective Endocarditis",
"Methicillin-resistant Staphylococcus aureus (MRSA) Infection"
] | 1. Infective Endocarditis: history: IV drug abuse and previously diagnosed ostium secundum with left to right shunt; symptoms: high-grade fever, chills, rigors, palpitations, joint pain; signs: enlarged spleen, fever; auxiliary_examination: blood culture positive for MRSA. 2. Methicillin-resistant Staphylococcus aureus... | 1. Septicemia: Characterized by fever, chills, and elevated white blood cell count; could be due to a systemic infection. 2. Viral Exanthema: Presents with fever and joint pain, typically associated with viral infections but less likely given the blood culture results. | IV vancomycin, 1 gm once daily, and IV gentamicin, 80 mg twice a day for 6 weeks. | {"first_course_record":{"chief_complaint":["The patient presented with a 10-day history of high-grade fever, shortness of breath, palpitations, joint pain, poor appetite, and fatigue."],"physical_examination":["The patient was dehydrated, blood pressure 100\/70 mm Hg, heart rate 100 beats\/minute, respiratory rate 20 b... | [
"Infective Endocarditis",
"Atrial Septal Defect"
] | 1. Infective Endocarditis: history: intravenous drug abuse; symptoms: high-grade fever, shortness of breath, palpitations, joint pain; signs: dehydration, splenomegaly; auxiliary_examination: positive blood cultures for MRSA. || 2. Atrial Septal Defect: history: previously diagnosed ostium secundum of 22.18 mm with lef... | null |
pmc-6004287-1 | A 56-year-old Chinese Han female presented to Shanghai Dermatology Hospital in 2016 with symptoms of erythematous plaques and pain over her left upper limb for 2 days and foreign object sensation in the throat when swallowing for 3 days. The patient had a 6-year history of leprosy. She was diagnosed with BB in 2011 and... | Female, 56 | Erythematous plaques and pain over the left upper limb, foreign object sensation in the throat when swallowing | 6-year history of leprosy, diagnosed with BB in 2011, received multidrug therapy (MDT) for 1 year, clinical cure in 2012 | Symptoms began with erythematous plaques and pain over the left upper limb for 2 days and foreign object sensation in the throat for 3 days. Initially treated with 20 mg/day of methylprednisolone. Symptoms worsened with neck muscle tension, difficulty opening mouth, and plaque spread over the left upper limb. Diagnosed... | "Temperature: 37.8 \u00b0C, Normal blood pressure and pulse, exhibits shortness of breath, wry smile, trismus, difficulty speaking, persistent stiffness in neck and limbs, opisthotonus, and spasms." | {
"Imaging examination": "{}",
"Laboratory examination": "{\"White cell count\":\"12,000\\/mm3 (reference value: 3690\\u20139160\\/mm3)\",\"Neutrophils\":\"81% (reference value: 50\\u201370%)\",\"Liver and renal function tests\":\"Normal\",\"Slit skin smears\":\"Presence of acid-fast bacilli ranging from negative t... | Neurology Dept. | [
"Tetanus",
"Borderline lepromatous leprosy (BT)",
"T1R leprosy reaction (T1LR)"
] | 1. Tetanus: history: Patient has a history of leprosy; symptoms: Erythematous plaques, pain over the left upper limb, foreign body sensation in the throat, trismus, difficulty speaking, shortness of breath; signs: Muscle stiffness, opisthotonus, wry smile; auxiliary_examination: Laboratory tests indicated leukocytosis ... | 1. Rabies: Associated with muscle rigidity and spasms; history of animal bites could be a clue. 2. Multiple Sclerosis: Could present with muscle stiffness and spasms, but lacks the specific erythematous plaques and history of leprosy. 3. Spinal cord injury: Causes stiffness and spasms, but not with the same clinical pr... | Administer tetanus antitoxin 100,000 IU in 500-ml 5% glucose-saline intravenous infusion daily; Penicillin 200,000 U IM four times a day; Hydrocortisone 200 mg in 250-ml 5% glucose intravenous infusion daily; Diazepam 10 mg/day IM; Phenergan 50 mg/day IM; wound care with daily debridement and hydrogen peroxide rinse. | {"first_course_record":{"chief_complaint":["Erythematous plaques and pain over the left upper limb for 2 days, and foreign object sensation in the throat when swallowing for 3 days."],"physical_examination":["Normal blood pressure and pulse, temperature at 37.8 \u00b0C, with shortness of breath, wry smile, trismus, and... | [
"tetanus",
"borderline leprosy",
"T1 leprosy reaction"
] | 1. Tetanus: history: history of muscle tension and difficulty in mouth opening; symptoms: shortness of breath, wry smile, trismus; signs: opisthotonus, paroxysmal spasms; auxiliary_examination: presence of symptoms in conjunction with tetanus antitoxin treatment. || 2. Borderline leprosy: history: 6-year history of lep... | null |
End of preview.
ClinicalMC
Welcome to explore our work "ClinicalMC: A Benchmark for Multi-Course Clinical Decision-Making with Large Language Models".
For more information about the paper and dataset, please visit our GitHub repository: https://github.com/hzyuezh/ClinicalMPD.
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