id stringlengths 4 7 | text stringlengths 713 5.47k ⌀ | labels stringlengths 739 6.26k ⌀ | relations stringlengths 2 8.69k |
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227_72 | [['QUESTION', 'TYPE:', 'CARDIOLOGY'], ['CLINICAL', 'CASE:'], ['A', '45-year-old', 'woman', 'with', 'a', 'history', 'of', 'heart', 'murmur', 'detected', 'in', 'childhood.'], ['She', 'is', 'admitted', 'to', 'the', 'emergency', 'department', 'for', 'palpitations,', 'easy', 'fatigue', 'and', 'malleolar', 'edema.'], ['Physi... | [['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '... | [["If he has a pediatric murmur, I'm thinking congenital\n", 'So we rule out aortic and mitral stenosis\n', 'Support'], ['Hepatomegaly, malleolar edema and BRD, something that overloads the right heart\n', 'So we rule out aortic and mitral stenosis\n', 'Support'], ['So we rule out aortic and mitral stenosis\n', 'Aortic... |
168_86 | [['QUESTION', 'TYPE:', 'CARDIOLOGY', 'AND', 'CARDIOVASCULAR', 'SURGERY'], ['CLINICAL', 'CASE:'], ['What', 'examination', 'would', 'you', 'advise', 'in', 'the', 'first', 'place', 'for', 'an', '82-year-old', 'patient', 'with', 'exertional', 'angina', 'and', 'a', 'systolic', 'ejection', 'murmur', 'of', 'intensity', '3/6',... | [['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '... | [['Therefore, the first thing we will have to do will be to study the valve disease: we do not want to put the patient to run or overload him with dobuta and have a syncope, nor do we want to do a catheterization without having first performed another noninvasive test\n', 'A stress test\n', 'Attack'], ['Therefore, the ... |
329_84 | null | null | [] |
447_131 | [['QUESTION', 'TYPE:', 'NEPHROLOGY'], ['CLINICAL', 'CASE:'], ['A', '25-year-old', 'man', 'with', 'no', 'known', 'history', 'of', 'interest.'], ['He', 'has', 'been', 'presenting', 'with', 'foamy', 'and', 'loaded', 'urine', 'for', '2', 'months,', 'with', 'no', 'other', 'symptoms.'], ['Physical', 'examination', 'without',... | [['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '... | [['the levels of complement fractions C3 and C4 are low\n', 'Of the options given, only membranoproliferative glomerulonephritis presents with hypocomplementemia\n', 'Support'], ['Of the options given, only membranoproliferative glomerulonephritis presents with hypocomplementemia\n', 'option 4 correct\n', 'Support'], [... |
72_52 | [['QUESTION', 'TYPE:', 'ANESTHESIOLOGY,', 'CRITICAL', 'CARE', 'AND', 'EMERGENCIES'], ['CLINICAL', 'CASE:'], ['A', '72-year-old', 'man,', 'ex-smoker,', 'hypertensive', 'and', 'diabetic.'], ['History', 'of', 'stroke', 'with', 'residual', 'paresis', 'in', 'the', 'left', 'arm', '4', 'months', 'ago.'], ['He', 'comes', 'to',... | [['O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Pr... | [["It is evident from the patient's clinical picture that an urgent reperfusion strategy is indicated, which invalidates options 4 and 5\n", 'Hemodynamic stabilization and deferred revascularization procedure\n', 'Attack'], ["It is evident from the patient's clinical picture that an urgent reperfusion strategy is indic... |
505_85 | [['QUESTION', 'TYPE:', 'PSYCHIATRY'], ['CLINICAL', 'CASE:'], ['A', '79-year-old', 'patient', 'is', 'brought', 'to', 'the', 'ED', 'at', '7', 'pm', 'from', 'a', 'nursing', 'home,', 'but', 'we', 'do', 'not', 'have', 'the', 'referral', 'report', 'and', 'therefore', 'do', 'not', 'know', 'his', 'history.'], ['He', 'is', 'dis... | [['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-... | [['Altered state of consciousness\n', 'Fluctuation of the alert level\n', 'Support']] |
360_93 | [['QUESTION', 'TYPE:', 'HEMATOLOGY'], ['CLINICAL', 'CASE:'], ['46-year-old', 'woman', 'with', 'a', 'history', 'of', 'rheumatic', 'valve', 'disease,', 'requiring', 'mitral', 'valve', 'replacement', 'with', 'a', 'mechanical', 'prosthesis.'], ['The', 'initial', 'postoperative', 'evolution', 'is', 'favorable.'], ['However,... | [['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '... | [['Warfarin-induced skin necrosis is a rare and serious adverse effect of oral anticoagulant therapy, occurring in only 0.01 to 0.1% of patients and is especially related to coagulation protein C and S deficiency\n', 'Protein C deficiency\n', 'Support'], ['However, after starting treatment with acenocoumarol, she devel... |
459_173 | [['QUESTION', 'TYPE:', 'TRAUMATOLOGY', 'AND', 'ORTHOPEDICS'], ['CLINICAL', 'CASE:'], ['A', '36-year-old', 'man', 'with', 'no', 'past', 'history', 'of', 'interest', 'who,', 'after', 'a', 'high-energy', 'trauma', 'following', 'a', 'fall', 'from', 'a', 'motorcycle,', 'presents', 'with', 'a', 'Gustilo', 'grade', 'II', 'ope... | [['O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Pre... | [['I believe that the most correct is 2\n', 'Exhaustive debridement-wound lavage in the operating room with at least 10 liters of saline\n', 'Support'], ['Gustilo II fractures are mainly covered with Gram (+) by means of a 1st generation Cepha\n', 'I believe that the most correct is 2\n', 'Support'], ['it is not a ques... |
149_162 | [['QUESTION', 'TYPE:', 'PSYCHIATRY'], ['CLINICAL', 'CASE:'], ['A', '52-year-old', 'woman', 'comes', 'to', 'the', 'emergency', 'room', 'with', 'bilateral', 'paralysis', 'of', 'the', 'upper', 'extremities', 'that', 'had', 'started', 'abruptly', 'two', 'hours', 'earlier.'], ['In', 'the', 'interview', 'she', 'is', 'smiling... | [['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['... | [['The diagnosis.... can be excluded 2,3,4 because the clinical does not match: no delirium, no worry, no sadness\n', 'Delusional disorder\n', 'Attack'], ['The diagnosis.... can be excluded 2,3,4 because the clinical does not match: no delirium, no worry, no sadness\n', 'Hypochondriasis\n', 'Attack'], ['The diagnosis..... |
246_116 | [['QUESTION', 'TYPE:', 'INFECTIOUS', 'DISEASES'], ['CLINICAL', 'CASE:'], ['A', 'patient', 'with', 'a', 'history', 'of', 'excessive', 'alcohol', 'consumption', 'has', 'been', 'diagnosed', 'with', 'pulmonary', 'tuberculosis', 'due', 'to', 'cough,', 'fever,', 'expectoration,', 'and', 'sputum', 'culture', 'isolation', 'of'... | [['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'... | [['The option of adding a quinolone during the first two months of treatment (moxifloxacin or levofloxacin) is considered in cases of extensive pulmonary involvement\n', 'All the factors mentioned above make us lean more towards answer number 3\n', 'Support'], ['In this case, they do not tell us anything about extensiv... |
457_126 | [['QUESTION', 'TYPE:', 'OTORHINOLARYNGOLOGY', 'AND', 'MAXILLOFACIAL', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '47-year-old', 'man,', 'with', 'a', 'history', 'of', 'a', 'right', 'parotid', 'pleomorphic', 'adenoma,', 'treated', 'with', 'surgery', '(extrafacial', 'parotidectomy)', '6', 'months', 'ago,', 'who', 'comes', '... | [['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '... | [['The treatment is intradermal botulinum toxin injection\n', 'Intradermal botulinum toxin injection\n', 'Support'], ['during mastication, erythema and preauricular sweating occur\n', "This clinical picture is called Frey's syndrome and consists of an anomalous reinnervation of regional structures after parotidectomy d... |
165_229 | [['QUESTION', 'TYPE:', 'NEPHROLOGY'], ['CLINICAL', 'CASE:'], ['A', '58-year-old', 'woman,', 'weight', '130', 'kg,', 'height', '155', 'cm,', 'body', 'mass', 'index', '>', '30', 'with', 'mild', 'hypertension,', 'blood', 'glucose', '108', 'mg/dL', 'and', 'absence', 'of', 'edema', 'in', 'the', 'lower', 'limbs.'], ['Blood',... | [['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-... | [['The correct answer is: 2\n', 'Focal and segmental glomerulonephritis\n', 'Support'], ['Focal segmental glomerulonephritis\n', 'The correct answer is: 2\n', 'Support'], ['In urinalysis: sediment without alterations and in 24 h urine proteinuria of 6.3 g/24 h\n', 'We are in front of a patient with renal insufficiency ... |
157_73 | [['QUESTION', 'TYPE:', 'TRAUMATOLOGY', 'AND', 'ORTHOPEDICS'], ['CLINICAL', 'CASE:'], ['A', '75-year-old', 'patient', 'with', 'significant', 'gonarthrosis', 'with', '"Genu', 'Varo"', 'that', 'causes', 'marked', 'functional', 'impotence,', 'limited', 'mobility', 'and', 'continuous', 'pain', 'that', 'requires', 'continuou... | [['O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Pre... | [['A 75-year-old patient with significant gonarthrosis with "Genu Varo" that causes marked functional impotence, limited mobility and continuous pain that requires continuous antirheumatic, anti-inflammatory and analgesic medication\n', 'We are dealing with a patient who has exhausted the pharmacological route given th... |
382_231 | [['QUESTION', 'TYPE:', 'NEUROLOGY'], ['CLINICAL', 'CASE:'], ['A', '33-year-old', 'man,', 'independent', 'in', 'all', 'activities', 'of', 'daily', 'living,', 'with', 'a', 'history', 'of', 'well-controlled', 'hypertension,', 'antiplatelet', 'atrial', 'fibrillation', 'and', 'an', 'adenocarcinoma', 'of', 'the', 'prostate',... | [['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-... | [['He is brought to the emergency department for clinical aphasia and right hemiparesis of sudden onset, 45 minutes earlier\n', 'The patient suffers an abrupt neurological deficit probably related to a vascular event\n', 'Support'], ['The patient suffers an abrupt neurological deficit probably related to a vascular eve... |
496_71 | [['QUESTION', 'TYPE:', 'MEDICAL', 'ONCOLOGY'], ['CLINICAL', 'CASE:'], ['40-year-old', 'patient,', 'with', 'normal', 'physical', 'examination,', 'in', 'whom', 'a', 'mediastinal', 'mass', 'and', 'a', 'hepatic', 'nodule', 'have', 'been', 'evidenced', 'in', 'the', 'CT', 'scan,', 'and', 'in', 'the', 'CBC', 'a', 'serum', 'el... | [['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'... | [['Hepatocarcinoma can elevate (alone) alpha-fetus, seminoma LDH, lymphoma also LDH\n', 'Metastatic hepatocarcinoma\n', 'Support']] |
14_213 | [['QUESTION', 'TYPE:', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '41-year-old', 'man', 'comes', 'to', 'the', 'clinic', 'with', 'a', 'nodule', 'in', 'the', 'right', 'thyroid,', 'a', 'fine', 'needle', 'aspiration', 'is', 'performed.'], ['Cytological', 'analysis', 'will', 'allow', 'us:'], ['1-', 'Distinguish', 'between', '... | [['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O'], [... | [['FNA does not allow a histological study but a cytological one\n', 'questions 1, 2 are eliminated\n', 'Support'], ['I think the correct answer is 5\n', 'Identify the typical cytologic features of papillary carcinoma\n', 'Support'], ['FNA does not allow a histological study but a cytological one\n', 'Distinguish betwe... |
330_85 | [['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['A', '22-year-old', 'boy', 'with', 'hyposmia', 'presents', 'with', 'lack', 'of', 'development', 'of', 'secondary', 'sexual', 'characteristics', 'and', 'infertility.'], ['Bilateral', 'testicular', 'volume', 'of', '4', 'mL.'], ['Analytically,', 'FSH', '1.2'... | [['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ... | [["Kallman's syndrome or Morsier's syndrome is a congenital insufficiency associated with hypogonadotropic hypogonadism due to a deficit in GnRH hormone production\n", 'Repeated injections of GnRH are performed to restore fertility\n', 'Support'], ['Repeated injections of GnRH are performed to restore fertility\n', 'Gn... |
181_59 | [['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['A', 'type', '1', 'diabetic', 'who', 'comes', 'to', 'the', 'emergency', 'room', 'for', 'dyspnea', 'and', 'general', 'malaise.'], ['The', 'blood', 'test', 'showed', 'blood', 'glucose', '450', 'mg/dl,', 'Na', '142', 'mEq/l,', 'K', '4', 'mEq/l,', 'pH', '7.15... | [['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '... | [['Bicarbonate is indicated at pH < 7\n', 'Sodium bicarbonate 1M 100 cc iv in 30 minutes\n', 'Attack'], ['The blood test showed blood glucose 450 mg/dl, Na 142 mEq/l, K 4 mEq/l, pH 7.15, bicarbonate 12 mmol/l\n', 'Sodium bicarbonate 1M 100 cc iv in 30 minutes\n', 'Attack']] |
182_61 | [['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['A', '76-year-old', 'woman', 'consults', 'us', 'because', 'she', 'is', 'concerned', 'about', 'her', 'risk', 'of', 'stroke', 'since', 'her', 'mother', 'died', 'of', 'stroke', 'a', 'year', 'ago.'], ['She', 'is', 'diagnosed', 'with', 'arterial', 'hypertensio... | [['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-... | [['The most influential cardiovascular factor for stroke in women over 70 is blood pressure\n', 'Achieve optimal blood pressure control\n', 'Support']] |
21_111 | [['QUESTION', 'TYPE:', 'INFECTIOUS'], ['CLINICAL', 'CASE:'], ['A', '32-year-old', 'man,', 'ADVP', 'and', 'recently', 'released', 'from', 'prison,', 'has', 'a', 'protein', 'derivative', 'skin', 'test', '(PPD)', 'with', '10', 'mm', 'of', 'induration.'], ['One', 'year', 'ago,', 'the', 'PPD', 'was', 'negative,', 'he', 'is'... | [['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O',... | [['In the face of a PPD conversion within 2 years, and ruling out current TB disease, INH chemoprophylaxis is indicated, although I thought it was for 6 months and not 9\n', 'Isoniazid for 9 months\n', 'Support']] |
60_59 | [['QUESTION', 'TYPE:', 'ANESTHESIOLOGY', 'AND', 'CRITICAL', 'CARE'], ['CLINICAL', 'CASE:'], ['A', '40-year-old', 'male,', 'foreign', 'tourist,', 'is', 'referred', 'to', 'the', 'ED', 'for', 'low', 'level', 'of', 'consciousness,', 'temperature', 'of', '37.7°C', 'and', 'dyspnea.'], ['He', 'has', 'no', 'trauma.'], ['Severa... | [['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise',... | [['Actually, it can be all of them\n', 'PET SCAN\n', 'Support'], ['Actually, it can be all of them\n', 'EAP\n', 'Support'], ['Actually, it can be all of them\n', 'Lobar pneumonia\n', 'Support'], ['Actually, it can be all of them\n', 'Alveolar hypoventilation\n', 'Support'], ['Actually, it can be all of them\n', 'Bronch... |
455_155 | [['QUESTION', 'TYPE:', 'NEUROLOGY'], ['CLINICAL', 'CASE:'], ['In', 'a', '70-year-old', 'man,', 'hypertensive,', 'with', 'a', 'right', 'hemiplegia', 'of', 'sudden', 'onset', 'with', 'mild', 'dysarthria,', 'without', 'alterations', 'in', 'evocation', 'or', 'language', 'comprehension,', 'what', 'type', 'of', 'stroke', 'do... | [['O', 'O', 'O'], ['O', 'O'], ['O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'O', 'O', '... | [['The closest answer is 1\n', 'Left capsular lacunar lacunar infarction\n', 'Support'], ['If we are strict we would be talking about a pure motor lacunar infarction (with mild dysarthria)\n', 'Left capsular lacunar lacunar infarction\n', 'Support'], ['Since the other 3 options do not give us a clinical picture like th... |
1_35 | [['QUESTION', 'TYPE:', 'DIGESTIVE'], ['CLINICAL', 'CASE:'], ['A', '43-year-old', 'man', 'with', 'no', 'diseases', 'of', 'interest', 'comes', 'to', 'the', 'emergency', 'department', 'for', '4', 'melaenic', 'stools', 'in', 'the', 'last', '12', 'hours.'], ['He', 'refers', 'taking', 'NSAIDs', 'in', 'previous', 'days.'], ['... | [['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['... | [['endoscopic therapy is recommended, preferably with 2 techniques\n', 'the correct one would be 5\n', 'Support'], ['an unstable patient who has bled a lot, who has a Forrest IIa ulcer with a high risk of rebleeding\n', 'Answer 1 is not in accordance with what has been said\n', 'Support'], ['clots were found in the sto... |
66_106 | [['QUESTION', 'TYPE:', 'ANESTHESIOLOGY,', 'CRITICAL', 'CARE', 'AND', 'EMERGENCY', 'MEDICINE'], ['CLINICAL', 'CASE:'], ['Elderly', 'woman', 'brought', 'to', 'the', 'ER', 'by', 'her', 'neighbors', 'because', 'they', 'see', 'her', 'somewhat', 'groggy', 'and', 'with', 'stool', 'stains', 'on', 'her', 'clothes.'], ['BP', '10... | [['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-P... | [['in principle, unless the patient worsens and the pH is less than 7.10\n', 'we should not administer bicarbonate\n', 'Support'], ['We must take into account that, in this case, potassium is decreased\n', 'the most frequent cause (supported by the stains on the dress) would be diarrhea\n', 'Support'], ['although they ... |
521_76 | [['QUESTION', 'TYPE:', 'DERMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '7-year-old', 'girl', 'who', 'comes', 'for', 'consultation', 'because', 'her', 'parents', 'notice', 'her', 'red', 'face', 'since', 'the', 'previous', 'day', 'and', 'in', 'the', 'last', 'few', 'hours', 'they', 'have', 'noticed', 'red', 'spots', 'on', 'h... | [['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-... | [['It is typical that after an episode of high fever an erythema appears on both cheeks in the form of a "slap" that usually has a cranial-caudal extension in the following days\n', 'We are being told about erythema súdenita or fifth disease (also called megaloerythema), caused by parvovirus B19\n', 'Support'], ['We ar... |
20_110 | [['QUESTION', 'TYPE:', 'INFECTIOUS'], ['CLINICAL', 'CASE:'], ['A', '40-year-old', 'male', 'patient,', 'smoker', 'since', 'he', 'was', '18', 'years', 'old,', 'with', 'no', 'history', 'of', 'interest.'], ['He', 'consults', 'for', 'symptoms', 'of', '24', 'hours', 'of', 'evolution', 'of', 'chills,', 'thermometric', 'fever'... | [['O', 'O', 'O'], ['O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise',... | [] |
422_88 | [['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['What', 'is', 'the', 'treatment', 'of', 'choice', 'for', 'a', '38-year-old', 'man', 'diagnosed', 'with', "Cushing's", 'disease', 'in', 'relation', 'to', 'a', 'pituitary', 'macroadenoma', 'of', '22', 'mm', 'in', 'diameter?'], ['1-', 'Initially', 'try', 'me... | [['O', 'O', 'O'], ['O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'B-Claim', 'I... | [['Although the majority of ACTH-producing adenomas recur, surgery is always the first therapeutic option\n', 'Selective surgical resection of the adenoma\n', 'Support'], ['they are not curative\n', 'Initially try medical treatment and, if not effective, resort to surgery\n', 'Support'], ['they are not curative\n', 'Th... |
348_160 | [['QUESTION', 'TYPE:', 'GYNECOLOGY', 'AND', 'OBSTETRICS'], ['CLINICAL', 'CASE:'], ['45-year-old', 'woman,', 'mother', 'of', '3', 'children,', 'attends', 'an', 'early', 'diagnosis', 'consultation.'], ['The', 'cervicovaginal', 'cytology', 'is', 'compatible', 'with', 'a', 'high-grade', 'squamous', 'intraepithelial', 'lesi... | [['O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-P... | [['The cervicovaginal cytology is compatible with a high-grade squamous intraepithelial lesion\n', 'Colposcopy is indicated for all patients with altered cytology (intraepithelial lesion or suspicion of invasive cancer or HPV infection), as a second level of screening\n', 'Support'], ['Colposcopy is indicated for all p... |
411_52 | [['QUESTION', 'TYPE:', 'BIOSTATISTICS'], ['CLINICAL', 'CASE:'], ['A', 'couple', 'with', 'a', 'first', 'male', 'child', '(index', 'case)', 'with', 'cystic', 'fibrosis', '(mucoviscidosis)', 'come', 'for', 'genetic', 'counseling.'], ['Molecular', 'diagnosis', 'indicates', 'that', 'the', 'index', 'case', 'is', 'homozygous'... | [['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '... | [['they are not sick and have already had a homozygous child\n', 'Both parents are carriers of a mutation\n', 'Support'], ['the probability of receiving it from both is 50%x50%=25%\n', 'The probability that the next offspring will be affected is 25%\n', 'Support'], ['Both parents are carriers of a mutation\n', 'the nex... |
590_64 | [['QUESTION', 'TYPE:', 'OPHTHALMOLOGY'], ['CLINICAL', 'CASE:'], ['A', '68-year-old', 'woman', 'who', 'uses', '+4.00', 'diopter', 'glasses', 'for', 'distance', 'vision', 'in', 'both', 'eyes.'], ['She', 'consults', 'because', 'she', 'has', 'been', 'having', 'eye', 'pain', 'with', 'headache', 'and', 'blurred', 'vision', '... | [['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '... | [['We are presented with a 68-year-old female patient\n', 'At that age the crystalline lens, although it does not normally have a cataract that needs surgery, it usually has increased in thickness\n', 'Support'], ['At that age the crystalline lens, although it does not normally have a cataract that needs surgery, it us... |
86_51 | [['QUESTION', 'TYPE:', 'CARDIOLOGY', 'AND', 'VASCULAR', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '26-year-old', 'man', 'with', 'no', 'history', 'of', 'interest,', 'asymptomatic,', 'presents', 'on', 'examination', 'with', 'a', 'mesosystolic', 'murmur', 'in', 'the', 'aortic', 'focus', 'and', 'left', 'parasternal', 'borde... | [['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '... | [['a "portrait" of the typical findings that can be found in hypertrophic cardiomyopathy\n', 'Hypertrophic cardiomyopathy\n', 'Support'], ['A young male patient with an aortic systolic murmur that increases with the Valsalva maneuver and signs of left ventricular enlargement\n', 'a "portrait" of the typical findings th... |
498_129 | null | null | [] |
31_233 | [['QUESTION', 'TYPE:', 'NEUROLOGY', 'AND', 'THORACIC', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', 'patient', 'diagnosed', 'with', 'bronchial', 'asthma', 'who', 'is', 'being', 'treated', 'with', 'low-dose', 'inhaled', 'steroids', '(200', 'micrograms', 'of', 'budesonide', 'every', '12', 'hours)', 'and', 'rescue', 'medicati... | [['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '... | [['We rule out continuing with the same treatment since the patient is symptomatic\n', 'Maintain the same pharmacological regimen\n', 'Attack'], ['Asthma treatment algorithm\n', 'Switch to ocmbined therapy with low-dose inhaled corticosteroids and long-acting beta2-adrenergics\n', 'Support']] |
618_119 | [['QUESTION', 'TYPE:', 'TRAUMATOLOGY'], ['CLINICAL', 'CASE:'], ['13-year-old', 'female,', 'with', 'no', 'relevant', 'history,', 'with', 'menarche', '3', 'months', 'ago,', 'followed', 'since', 'the', 'age', 'of', '10', 'years', 'for', 'idiopathic', 'scoliosis', 'that', 'has', 'worsened.'], ['In', 'the', 'physical', 'exa... | [['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-... | [['In the physical examination she presents a hump of 7 degrees in the Adams test and in the scoliogram a T4-L1 thoracolumbar curve of 35 degrees of Cobb and a Risser 0\n', 'Treatment with a brace in Risser from 0 to 2 can be considered\n', 'Support'], ['Treatment with a brace in Risser from 0 to 2 can be considered\n'... |
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