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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 3 new columns ({'response', 'prerequisit', 'zoo'}) and 6 missing columns ({'Examination and Results', 'Others', 'Patient Symptoms', 'Treatment', 'Diagnosis', 'Patient Personal Background'}).
This happened while the json dataset builder was generating data using
hf://datasets/JesseLiu/Trouble_Makers/raw_response.jsonl (at revision 09556a893cbc9eef786b522ea1a9f5c42d268045)
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 "/src/services/worker/.venv/lib/python3.9/site-packages/datasets/builder.py", line 1870, in _prepare_split_single
writer.write_table(table)
File "/src/services/worker/.venv/lib/python3.9/site-packages/datasets/arrow_writer.py", line 622, in write_table
pa_table = table_cast(pa_table, self._schema)
File "/src/services/worker/.venv/lib/python3.9/site-packages/datasets/table.py", line 2292, in table_cast
return cast_table_to_schema(table, schema)
File "/src/services/worker/.venv/lib/python3.9/site-packages/datasets/table.py", line 2240, in cast_table_to_schema
raise CastError(
datasets.table.CastError: Couldn't cast
prerequisit: string
zoo: list<item: string>
child 0, item: string
response: string
to
{'Patient Symptoms': Sequence(feature=Value(dtype='string', id=None), length=-1, id=None), 'Diagnosis': Sequence(feature=Value(dtype='string', id=None), length=-1, id=None), 'Patient Personal Background': Sequence(feature=Value(dtype='string', id=None), length=-1, id=None), 'Examination and Results': Sequence(feature=Value(dtype='string', id=None), length=-1, id=None), 'Treatment': Sequence(feature=Value(dtype='string', id=None), length=-1, id=None), 'Others': Sequence(feature=Value(dtype='string', id=None), length=-1, id=None)}
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 1417, 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 1049, in convert_to_parquet
builder.download_and_prepare(
File "/src/services/worker/.venv/lib/python3.9/site-packages/datasets/builder.py", line 924, in download_and_prepare
self._download_and_prepare(
File "/src/services/worker/.venv/lib/python3.9/site-packages/datasets/builder.py", line 1000, in _download_and_prepare
self._prepare_split(split_generator, **prepare_split_kwargs)
File "/src/services/worker/.venv/lib/python3.9/site-packages/datasets/builder.py", line 1741, in _prepare_split
for job_id, done, content in self._prepare_split_single(
File "/src/services/worker/.venv/lib/python3.9/site-packages/datasets/builder.py", line 1872, 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 3 new columns ({'response', 'prerequisit', 'zoo'}) and 6 missing columns ({'Examination and Results', 'Others', 'Patient Symptoms', 'Treatment', 'Diagnosis', 'Patient Personal Background'}).
This happened while the json dataset builder was generating data using
hf://datasets/JesseLiu/Trouble_Makers/raw_response.jsonl (at revision 09556a893cbc9eef786b522ea1a9f5c42d268045)
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.
Patient Symptoms
sequence | Diagnosis
null | Patient Personal Background
sequence | Examination and Results
sequence | Treatment
sequence | Others
sequence |
|---|---|---|---|---|---|
null | null | null | null | [
"The tendon is repaired without complication."
] | [
"During the case, the resident inadvertently cuts a flexor tendon.",
"The attending tells the resident that the patient will do fine, and there is no need to report this minor complication that will not harm the patient, as he does not want to make the patient worry unnecessarily.",
"He tells the resident to leave this complication out of the operative report."
] |
null | null | null | [
"Pure tone audiometry shows a sensorineural hearing loss of 45 dB."
] | [
"He received this first course of neoadjuvant chemotherapy 1 week ago."
] | null |
null | null | [
"He has type 2 diabetes mellitus and osteoarthritis of the hips.",
"Prior to admission, his medications were insulin and naproxen."
] | [
"His temperature is 38°C (100.4°F), pulse is 93/min, and blood pressure is 125/85 mm Hg.",
"Examination shows mottled, reticulated purplish discoloration of the feet.",
"Laboratory studies show:\nHemoglobin count 14 g/dL\nLeukocyte count 16,400/mm3\nSegmented neutrophils 56%\nEosinophils 11%\nLymphocytes 31%\nMonocytes 2%\nPlatelet count 260,000/mm3\nErythrocyte sedimentation rate 68 mm/h\nSerum\nUrea nitrogen 25 mg/dL\nCreatinine 4.2 mg/dL\nRenal biopsy shows intravascular spindle-shaped vacuoles."
] | [
"He was also started on aspirin, clopidogrel, and metoprolol after the coronary intervention."
] | null |
[
"Pelvic examination shows mucopurulent discharge from the cervical os and left adnexal tenderness."
] | null | null | [
"Her temperature is 39.1°C (102.3°F), pulse is 126/min, respirations are 28/min, and blood pressure is 80/50 mm Hg.",
"There is blood oozing around the site of a peripheral intravenous line.",
"Laboratory studies show:\nPlatelet count 14,200/mm3\nFibrinogen 83 mg/mL (N = 200–430 mg/dL)\nD-dimer 965 ng/mL (N < 500 ng/mL)\nWhen phenol is applied to a sample of the patient's blood at 90°C, a phosphorylated N-acetylglucosamine dimer with 6 fatty acids attached to a polysaccharide side chain is identified."
] | null | null |
[
"He has also been sneezing multiple times a day during this period.",
"He had a similar episode 1 year ago around springtime."
] | null | [
"He has iron deficiency anemia and ankylosing spondylitis.",
"Current medications include ferrous sulfate, artificial tear drops, and indomethacin.",
"His vital signs are within normal limits."
] | [
"Visual acuity is 20/20 without correction.",
"Physical examination shows bilateral conjunctival injection with watery discharge.",
"The pupils are 3 mm, equal, and reactive to light.",
"Examination of the anterior chamber of the eye is unremarkable."
] | null | [
"He works as an elementary school teacher."
] |
[
"The pain radiates to the epigastric area.",
"The patient is diaphoretic and in marked distress."
] | null | [
"He has a 5-year history of untreated hypertension.",
"He has smoked 1 pack of cigarettes daily for the past 5 years and started abusing cocaine 2 weeks before his emergency room visit."
] | null | null | null |
[
"Physical examination shows abdominal tenderness and right flank tenderness."
] | null | [
"He has a history of diabetes and peripheral artery disease."
] | [
"His blood pressure is 160/90 mm Hg.",
"An ultrasound shows dilation of the right ureter and renal pelvis."
] | null | null |
[
"He appears pale and diaphoretic."
] | null | [
"He has hypertension and asthma.",
"Current medications include atorvastatin, lisinopril, and an albuterol inhaler."
] | [
"His pulse is 114/min and blood pressure is 130/88 mm Hg.",
"An ECG shows ST-segment depressions in leads II, III, and aVF.",
"Laboratory studies show an increased serum troponin T concentration.",
"At the time of discharge, echocardiography shows a left ventricular ejection fraction of 58%."
] | [
"The patient is treated for acute coronary syndrome and undergoes percutaneous transluminal coronary angioplasty."
] | null |
null | null | [
"She has been utilizing oral contraceptive pills (OCPs) for the past 8 years, but asks to switch to an intrauterine device (IUD)."
] | [
"Her vital signs are: blood pressure 118/78 mm Hg, pulse 73/min and respiratory rate 16/min.",
"She is afebrile.",
"Physical examination is within normal limits."
] | null | null |
null | null | [
"She has no history of serious illness and takes no medications."
] | [
"She appears well.",
"A photograph of the nails is shown."
] | null | null |
null | null | [
"She says she has not experienced vaginal discharge, bleeding, or fluid leakage, and is currently taking no medications.",
"She has had little prenatal care and uses condoms inconsistently.",
"Her sexually transmitted infections status is unknown."
] | [
"On physical examination, her blood pressure is 110/70 mm Hg, heart rate is 86/min, and temperature is 37.6°C (99.7°F).",
"A confirmatory test is then performed in the mother to confirm the diagnosis of HIV."
] | [
"As part of the patient’s workup, she undergoes a series of rapid screening tests that result in the administration of zidovudine during delivery.",
"The infant is also given zidovudine to reduce the risk of transmission."
] | null |
[
"During this period, he also has excessive night sweats and shortness of breath on exertion.",
"Over the past 3 months, he has had a 5.6-kg (12-lb) weight loss."
] | null | [
"He had a myocardial infarction 3 years ago.",
"He has hypertension, diabetes mellitus, and chronic bronchitis.",
"He has smoked half a pack of cigarettes for the past 45 years.",
"Vital signs are within normal limits."
] | [
"The spleen is palpated 6 cm below the left costal margin.",
"Laboratory studies show:\nHemoglobin 6.4 g/dL\nMean corpuscular volume 85 μm3\nLeukocyte count 5,200/mm3\nPlatelet count 96,000/mm3\nA blood smear is shown.",
"Bone marrow aspiration shows extensive fibrosis and a few scattered plasma cells.",
"A JAK 2 assay is positive."
] | null | null |
[
"He has had intermittent tingling sensations on both cheeks over this time period."
] | null | [
"He has no history of serious medical illness and takes no medications."
] | [
"Audiometry shows bilateral sensorineural hearing loss.",
"Genetic evaluation shows a mutation of a tumor suppressor gene on chromosome 22 that encodes merlin."
] | null | null |
[
"He currently has no complaints and claims to be “as fit as a fiddle.” The physical examination findings are unremarkable, except for a mid-systolic murmur heard in the 2nd left intercostal space that radiates to the carotids on auscultation."
] | null | null | [
"The physician instructs the patient to stand from a supine position with the stethoscope still placed on his chest."
] | null | [
"He currently has no complaints and claims to be “as fit as a fiddle.” The physical examination findings are unremarkable, except for a mid-systolic murmur heard in the 2nd left intercostal space that radiates to the carotids on auscultation."
] |
null | null | null | null | null | [
"After a detailed study of the virus and its life cycle, he proposes a theory: Initially, a host cell is co-infected with 2 viruses from the same virus family.",
"Within the host cell, concomitant production of various genome segments from both viruses occurs.",
"Ultimately, the different genome segments from the viruses are packaged into a unique and novel virus particle.",
"The newly formed virus particle is both stable and viable and is a new strain from the virus family that caused the outbreak of infection."
] |
[
"She also complains of a dull pain in her back with nausea and vomiting several times.",
"Her pain has no relation with food."
] | null | [
"Her past medical history is significant for recurrent abdominal pain due to cholelithiasis.",
"Her father died at the age of 60 with some form of abdominal cancer."
] | [
"Her temperature is 37°C (98.6°F), respirations are 15/min, pulse is 67/min, and blood pressure is 122/98 mm Hg.",
"Physical exam is unremarkable.",
"However, a CT scan of the abdomen shows a calcified mass near her gallbladder."
] | null | null |
[
"He is currently on a β-agonist inhaler because of exacerbation of his symptoms.",
"He has observed that his symptoms are more prominent in springtime, especially when the new flowers are blooming.",
"His mother has a backyard garden and whenever he goes out to play there, he experiences chest tightness with associated shortness of breath."
] | null | [
"He was diagnosed with asthma when he was 3 years old and has since been on treatment for the condition."
] | null | [
"He is currently on a β-agonist inhaler because of exacerbation of his symptoms.",
"He has been advised to take more precaution during this seasonal change and to stay away from pollen.",
"He is also being considered for an experimental therapy, which attenuates the activity of certain mediators which cause his asthmatic attack."
] | [
"The targeted mediator favors the class switching of antibodies.",
"A reduction in this mechanism will eventually reduce the exaggerated response observed during his asthmatic attacks, even when exposed to an allergen."
] |
[
"Diagnostic evaluation fails to discover an exact etiology of the boy's symptoms and the episode is classified as a brief resolved unexplained event (BRUE)."
] | null | null | null | null | [
"The risk profile for BRUE in infants remains largely unknown.",
"The pediatrician who saw the boy in the emergency department is trying to identify risk factors for BRUE.",
"She is aware of several confounders, including age, socioeconomic background, and family history of medical illness.",
"She recruits 75 infants under 1 year of age with BRUE and 75 infants without BRUE of the same age, socioeconomic background, and family history of medical illness.",
"She then compares the two groups with regard to history of feeding problems and history of recent upper respiratory infection."
] |
[
"The pain is sharp, severe, increases when lying down, and improves with leaning forward.",
"The pain also radiates to his shoulders and neck."
] | null | [
"The patient has no past medical history.",
"He has smoked 10 cigarettes per day for the past 7 years and occasionally drinks alcohol."
] | [
"He presents with vital signs: blood pressure 110/70 mm Hg, regular radial pulse of 95/min, and temperature 37.3°C (99.1°F).",
"On physical exam, a scratching sound of to-and-from character is audible over the left sternal border at end-expiration with the patient leaning forward.",
"His chest X-ray is normal and ECG is shown in the picture."
] | null | null |
[
"He was found on the floor in front of his apartment.",
"He is somnolent but responsive when aroused.",
"On physical examination, an alcoholic smell and slurred speech are noted.",
"His pupils are normal."
] | null | null | [
"His pulse is 64/min, respiratory rate is 15/min, and blood pressure is 120/75 mm Hg.",
"Neurological exam shows diminished deep tendon reflexes bilaterally and an ataxic gait.",
"Blood alcohol concentration is 0.04%.",
"An ECG shows no abnormalities."
] | null | null |
[
"She recently observed an enlargement of her axillary lymph nodes, which she examines on a weekly basis."
] | null | [
"She has a remote history of breast cancer in her 60s that was treated with radiation and chemotherapy.",
"She also reports a history of extensive travel to Africa and a 30-pack-year history of smoking."
] | [
"On physical exam, several axillary lymph nodes are palpable with a large non-tender palpable mass in her right axilla measuring 10 x 8 cm.",
"Fine-needle aspiration demonstrates what the pathologist describes as \"a centroblastic and immunoblastic cell presence, suspicious for non-Hodgkin’s lymphoma (NHL)–diffuse large B cell variant\"."
] | null | null |
[
"In addition, she seems to have less energy compared to other babies and appears listless throughout the day."
] | null | [
"She was born by cesarean section to a G1P1 woman with no prior medical history and had a normal APGAR score at birth."
] | [
"Physical exam reveals a high-pitched holosystolic murmur that is best heard at the lower left sternal border."
] | null | [
"Her parents say that she has never been observed to turn blue."
] |
[
"During this period, the patient has had headaches, muscle aches, joint pain, fever, and chills."
] | null | [
"The patient has asthma that is treated with an albuterol inhaler.",
"The patient has smoked one pack of cigarettes daily for the past 10 years."
] | [
"Her temperature is 38°C (100.4°F).",
"Physical examination shows slight wheezes throughout both lung fields.",
"Laboratory studies and urinalysis are positive for polysaccharide antigen.",
"Bronchoalveolar lavage using silver/PAS-staining shows macrophages filled with a dimorphic fungus with septate hyphae."
] | null | [
"Ten days ago, she was hiking with her family in Mississippi.",
"Her mother has a lung disease treated with methotrexate."
] |
[
"One week into the hospitalization, he develops a fever and purulent cough."
] | null | null | [
"His vitals include: heart rate 88/min, respiratory rate 20/min, temperature 38.4°C (101.1°F), and blood pressure 110/85 mm Hg.",
"On physical examination, he has basal crackles on the right side of the chest.",
"Chest radiography shows a new consolidation on the same side."
] | null | null |
[
"He appears uncomfortable."
] | null | [
"He has asthma and eczema.",
"He uses a glucocorticoid inhaler and an albuterol inhaler but has missed his medications for the past week while on vacation."
] | [
"His temperature is 36°C (96.8°F), pulse is 120/min, respirations are 40/min, and blood pressure is 100/80.",
"Expiratory and inspiratory wheezing is heard throughout both lung fields.",
"There are moderate intercostal and subcostal retractions and a decreased inspiratory to expiratory ratio.",
"His temperature is 36°C (96.8°F), pulse is 150/min, respirations are 22/min, and blood pressure is 100/70."
] | [
"Nebulized albuterol and ipratropium treatments and intravenous methylprednisolone are given in the emergency department for a presumed asthma exacerbation.",
"Magnesium sulfate is administered."
] | [
"One hour later, the child is limp and lethargic."
] |
null | null | null | [
"The patient's neutrophils are examined in the laboratory and they fail to react during the nitroblue tetrazolium test."
] | null | null |
[
"His mother reports that his cough has worsened over the last few hours.",
"He has a frequent barking cough and a hoarse voice when he speaks."
] | null | null | [
"The patient's blood pressure is 118/78 mm Hg, pulse is 90/min, respiratory rate is 35/min, and temperature is 38.3°C (101.1°F).",
"On physical examination, the boy is sitting and leaning forward in apparent respiratory distress with suprasternal and intercostal retractions.",
"Auscultation reveals inspiratory stridor without wheezing."
] | null | null |
null | null | [
"She is very surprised as she has been taking oral contraceptives regularly.",
"Her current anti-TB regimen includes rifampin, isoniazid, pyrazinamide, and ethambutol."
] | [
"After performing a complete physical examination and a screening test for pregnancy, her gynecologist informs her that she is pregnant."
] | [
"Her current anti-TB regimen includes rifampin, isoniazid, pyrazinamide, and ethambutol."
] | null |
[
"His mother noted bloody stools and decreased oral intake of food and water over the last 24 hours.",
"The next day, he complains of lower extremity weakness and tingling."
] | null | [
"He is normally in daycare; however, he has been home for the past 3 days."
] | [
"On physical exam his temperature is 102.2°F (39°C), blood pressure is 140/90 mmHg, pulse is 120/min, respirations are 22/min and O2 saturation is 99% on room air.",
"He has dry mucous membranes.",
"On abdominal exam you note diffuse tenderness to palpation without rebound or guarding.",
"There are no masses, hepatosplenomegaly, and bowel sounds are hyperactive.",
"Ultrasound of the right lower quadrant is negative for appendicitis.",
"Stool is guaiac positive.",
"On repeat exam, lower extremity strength is 3/5 with diminished patellar deep tendon reflexes."
] | [
"He receives 15mg/kg acetaminophen and fluids are started."
] | null |
null | null | [
"He was born at 38 weeks' gestation by cesarean section because of breech presentation.",
"The pregnancy was complicated by oligohydramnios."
] | [
"Examination shows concavity of the medial border of the left foot with a skin crease just below the ball of the great toe.",
"The lateral border of the left foot is convex.",
"The heel is in neutral position.",
"Tickling the lateral border of the foot leads to correction of the deformity.",
"The remainder of the examination shows no abnormalities.",
"X-ray of the left foot shows an increased angle between the 1st and 2nd metatarsal bones."
] | null | null |
[
"Physical examination shows a distended abdomen and right upper quadrant tenderness with normal bowel sounds."
] | null | null | [
"She is 163 cm (5 ft 4 in) tall and weighs 91 kg (200 lb); her BMI is 34 kg/m2.",
"Her temperature is 38.5°C (101.3°F).",
"Laboratory studies show:\nLeukocyte count 14,000/mm3\nSerum\nTotal bilirubin 1.1 mg/dL\nAST 32 U/L\nALT 40 U/L\nAlkaline phosphatase 68 U/L\nAbdominal ultrasonography is performed, but the results are inconclusive.",
"Cholescintigraphy shows the intrahepatic bile ducts, hepatic ducts, common bile duct, and proximal small bowel."
] | null | null |
null | null | null | [
"A cardiac catheterization is performed and measurements of the left ventricular volume and pressure at different points in the cardiac cycle are obtained.",
"The patient's pressure-volume loop (gray) is shown with a normal pressure-volume loop (black) for comparison."
] | null | null |
[
"She also has a 1-month history of progressive fatigue."
] | null | [
"Five weeks ago, she was hospitalized and received intravenous antibiotics for treatment of bacterial meningitis while visiting relatives in Guatemala."
] | [
"Her temperature is 39.4°C (102.9°F), pulse is 130/min, and blood pressure is 105/70 mm Hg.",
"Examination shows pallor and scattered petechiae and ecchymoses.",
"Laboratory studies show a hemoglobin concentration of 9.0 g/dL, a leukocyte count of 1,100/mm3 with 30% segmented neutrophils, and a platelet count of 20,000/mm3 ."
] | null | [
"Blood cultures grow coagulase-negative staphylococci."
] |
[
"He has had a 3.2-kg (7-lb) weight loss during this time.",
"Physical examination shows bilateral pitting pedal edema."
] | null | null | [
"An endoscopy shows prominent rugae in the gastric fundus.",
"Biopsy shows parietal cell atrophy."
] | null | null |
[
"He was brought in by staff from the homeless shelter when they found him unresponsive."
] | null | [
"The patient is a known IV drug abuser but otherwise has an unknown past medical history.",
"He currently attends a methadone clinic."
] | [
"His temperature is 99.5°F (37.5°C), blood pressure is 97/48 mmHg, pulse is 140/min, respirations are 29/min, and oxygen saturation is 98% on room air.",
"Serum:\nNa+: 139 mEq/L\nCl-: 100 mEq/L\nK+: 6.3 mEq/L\nHCO3-: 17 mEq/L\nGlucose: 589 mg/dL\n\nThe patient is given treatment.",
"His laboratory values are seen below."
] | [
"After treatment, his temperature is 99.5°F (37.5°C), blood pressure is 117/78 mmHg, pulse is 100/min, respirations are 23/min, and oxygen saturation is 98% on room air."
] | [
"Initial laboratory values are shown below."
] |
[
"His left knee was swollen a few weeks ago, but now with both joints affected, he has difficulty walking and feels frustrated.",
"He also has back pain which makes it extremely difficult to move around and be active during the day.",
"He says his pain significantly improves with rest.",
"He also suffers from dandruff for which he uses special shampoos."
] | null | null | [
"Physical examination is notable for pitting of his nails."
] | null | null |
[
"The weakness is more noticeable when climbing stairs and combing hair.",
"The weakness improves after brief exercise.",
"She also has bladder incontinence for the past 4 weeks and was given an anticholinesterase agent with no improvement."
] | null | null | null | [
"She also has bladder incontinence for the past 4 weeks and was given an anticholinesterase agent with no improvement."
] | null |
null | null | null | [
"His weight is in the 10th percentile.",
"Laboratory results for the HIV are negative by PCR."
] | null | null |
null | null | null | null | null | [
"The novel drug was previously tested in a small population and is now undergoing a larger phase 3 trial in preparation for FDA approval."
] |
[
"Noticeably the patient remains unable to complete tasks involving verbal repetition."
] | null | null | [
"Subsequent neurologic exam finds that the patient is fluent while speaking and is able to comprehend both one and two step instructions."
] | [
"After acute treatment with tissue plasminogen activator (tPA), the patient is able to recover most of his speech."
] | null |
[
"Her main concern at the moment is her acne and unwanted facial hair on her upper lip, for which she often visits a local spa."
] | null | [
"She says she has always been \"large\" and was constantly targeted by her classmates and coworkers for being so.",
"She has tried numerous diet plans, exercise regimens, and cosmetic products with little to no effect.",
"She has a family history of type 2 diabetes mellitus and a menstrual cycle that occurs every 45 days."
] | [
"Recently, she underwent a glucose tolerance test that showed a plasma glucose level of 160 mg/dL (8.9 mmol/L) after 2 hours of a 75 g dose of oral glucose.",
"Her pulse is 72/min and the blood pressure is 138/80 mm Hg.",
"On physical examination, her height is 160 cm (5 ft 3 in) and her weight is 85 kg (187 lb), and she has severe inflammatory acne over the cheeks and forehead and dark coarse hairs on the back."
] | null | null |
[
"Не also сomрlаіnѕ of реrѕіѕtеnt раіn in his legs whісh is not relieved by over-the-counter analgesics."
] | null | [
"Past medical history is significant for type 2 dіаbеtes mellitus for 2 уеаrѕ, inconsistently managed with mеtformіn аnd glіmеріrіdе."
] | [
"Оn physical ехаmіnаtіon, thеrе іѕ dесrеаѕеd ѕеnѕаtіon to pain in both lower lіmbs, but deep tеndon rеflехеѕ аrе іntасt.",
"Ніѕ vіtаl ѕіgnѕ include: blood рrеѕѕurе 122/84 mm Нg, tеmреrаturе 36.7°C (98.1°F), and rеѕріrаtorу rаtе 10/mіn.",
"His ankle-brachial pressure index (ABPI) on the right side is 1.1."
] | null | null |
[
"The patient has urinated multiple times since birth but has not yet passed meconium.",
"His abdomen is firm and distended with hypoactive bowel sounds."
] | null | [
"He was born at 38 weeks gestation to a 36-year-old gravida 3 via vaginal delivery.",
"The pregnancy was complicated by gestational diabetes.",
"The patient’s mother received routine prenatal care and declined first trimester screening.",
"She subsequently underwent a quadruple screen at 15 weeks gestation that demonstrated decreased maternal serum alpha-fetoprotein (AFP), increased beta-hCG, decreased unconjugated estriol, and increased inhibin A.",
"Her last ultrasound prior to onset of labor demonstrated an amniotic fluid index (AFI) of 28 cm.",
"The patient’s two older siblings are both healthy.",
"The patient’s temperature is 97.8°F (36.6°C), blood pressure is 58/37 mmHg, pulse is 166/min, and respirations are 38/min."
] | [
"On physical exam, the patient is in moderate distress.",
"His abdomen is firm and distended with hypoactive bowel sounds."
] | null | null |
null | null | null | null | null | null |
[
"She now soaks one super absorbent tampon every two hours for five days each cycle.",
"Her cycles have also become irregular, with intermenstrual bleeding for the last two months.",
"She now experiences significant dysmenorrhea, requiring 400 mg ibuprofen every four hours for the majority of each menses.",
"In addition, she reports new onset mild dyspareunia with intercourse and a “heavy feeling” in her pelvis.",
"She has also noticed increased urinary frequency but denies bowel changes."
] | null | [
"The patient has a past medical history of obesity and type II diabetes on metformin.",
"Her last child was born four years ago, and she has had five spontaneous vaginal deliveries."
] | [
"At this office visit, temperature is 98.5°F (36.9°C), blood pressure is 137/84 mmHg, pulse is 87/min, and respirations are 14/min."
] | null | null |
[
"On exam, the man is behaving erratically.",
"He appears confused and has a slurred speech.",
"On gait exam, the patient is ataxic and cannot stand without support for more than a few seconds."
] | null | [
"The officer state that the man has been arrested multiple times for public alcohol intoxication, but recently became homeless."
] | [
"His vitals are all within normal limits.",
"Labs return with the following values: Na 140, K 4, Cl 106, BUN 8, Cr 2.",
"His ABG has pH 7.3, PaCO2 13mm, PaO2 130mm, HCO3 7.",
"Blood salicylate levels return as normal."
] | null | [
"His urinalysis is shown in Figure 1."
] |
null | null | null | null | null | [
"The study enrolled a total of 3,000 subjects, 1,500 in each study arm.",
"Follow-up was conducted at 45 days post-MI.",
"The following are the results of the trial:\nEndpoints Medication 1 Medication 2 P-Value\nPrimary: death from cardiac causes 134 210 0.03\nSecondary: hyperkalemia 57 70 0.4\nWhat is the number needed to treat (NNT) for the primary endpoint of death from cardiac causes?"
] |
[
"He reports that he started exercising regularly 2 months ago and that his right calf cramps when he uses the incline feature on the treadmill, forcing him to take frequent breaks.",
"The pain completely disappears after resting for a few minutes.",
"There is no pain in the back."
] | null | [
"He has an 8-year history of type 2 diabetes mellitus.",
"He has smoked two packs of cigarettes daily for 34 years.",
"His only medication is metformin."
] | [
"His pulse is 82/min, and blood pressure is 170/92 mm Hg.",
"Straight leg raise test elicits pallor and tingling pain in the right foot.",
"His muscle strength is normal.",
"Femoral pulses are palpable; right pedal pulses are absent."
] | null | null |
[
"On admission, fetal heartbeats cannot be detected by fetal doppler monitor."
] | null | [
"She has no history of serious medical illness.",
"She has had an uncomplicated pregnancy.",
"Her last ultrasound at 22 weeks' gestation was normal."
] | [
"Ultrasound shows decreased amniotic fluid levels and no evidence of fetal movement, respiration, or heart activity.",
"Physical examination shows no signs of life.",
"The placenta is unremarkable."
] | null | [
"The patient gives birth to a 2296 g (5 lb 1 oz) male infant.",
"There are no visible malformations."
] |
[
"Despite therapy, his shortness of breath continues to worsen and his oxygen saturation decreases to the point where ICU transfer and intubation are required."
] | null | null | [
"Respiratory viral panel returns positive for influenza A and the patient is started on a standard five day course of oseltamivir.",
"Chest radiograph shows bilateral infiltrates."
] | [
"Respiratory viral panel returns positive for influenza A and the patient is started on a standard five day course of oseltamivir."
] | [
"After several weeks of supportive therapy, the patient improves with lung function returning to near normal."
] |
null | null | null | null | null | null |
null | null | [
"He has had no recent changes to his medication regimen, which includes hydrochlorothiazide, lisinopril, and amlodipine."
] | [
"His temperature is 98.0°F (36.7°C), blood pressure is 174/111 mmHg, pulse is 70/min, respirations are 12/min, and oxygen saturation is 98% on room air.",
"The patient's cardiopulmonary and abdominal exams are unremarkable.",
"Laboratory values are ordered as seen below."
] | null | null |
[
"Examination shows jaundice of the skin and scleral icterus."
] | null | null | [
"Urinalysis shows an elevated concentration of bilirubin and a low concentration of urobilinogen."
] | null | null |
[
"Two weeks later, the patient develops vomiting, mild crampy abdominal pain, and watery, nonbloody diarrhea."
] | null | null | null | [
"Treatment with galantamine is initiated."
] | null |
[
"These symptoms started slowly about 2 weeks ago and have become more pronounced, but they do not seem to bother the patient."
] | null | [
"He resides in an inpatient psychiatric facility where he has been successfully treated with haloperidol for the past several months."
] | [
"His physical exam and vitals are within normal limits."
] | null | null |
[
"He denies having any rash anywhere else on his body."
] | null | [
"He says this started during summer workouts leading up to this season."
] | [
"The blood pressure is 123/78 mm Hg, pulse is 67/min, respiratory rate is 15/min, and temperature is 38.1°C (98.7°F).",
"Physical examination reveals an erythematous, well-demarcated patch with peripheral scale on the left thigh, pubic region, and perineum.",
"There is no apparent scrotal involvement with the rash."
] | null | null |
null | null | null | null | [
"Risperidone therapy is initiated."
] | null |
[
"She also says she has been nauseous for the past 3 hours and has vomited twice.",
"The patient mentions she has had heavy menstrual bleeding for the past few days."
] | null | null | [
"Her blood pressure is 95/80 mm Hg and her temperature is 40.0°C (104.0°F).",
"On physical examination, the patient appears diaphoretic.",
"A pelvic examination reveals a tampon in her vagina."
] | null | null |
[
"One week ago, he experienced abdominal pain, vomiting, and bloody diarrhea that have since subsided.",
"His temperature is 38.4°C (101.1°F), pulse is 130/min, respirations are 35/min, and blood pressure is 95/50 mm Hg.",
"Examination shows scleral icterus."
] | null | [
"The patient's father states that they returned early from a 6-week roadtrip in Mexico because of these symptoms.",
"His immunizations are up-to-date.",
"He appears pale."
] | [
"His temperature is 38.4°C (101.1°F), pulse is 130/min, respirations are 35/min, and blood pressure is 95/50 mm Hg.",
"The abdomen is soft and nontender; there is no rebound or guarding.",
"Bowel sounds are hyperactive.",
"Laboratory studies show:\nHemoglobin 8.5 g/dL\nMean corpuscular volume 94 μm3\nLeukocyte count 18,000/mm3\nPlatelet count 45,000/mm3\nProthrombin time 12 sec\nPartial thromboplastin time 34 sec\nSerum\nUrea nitrogen 28 mg/dL\nCreatinine 1.6 mg/dL\nBilirubin\nTotal 2.5 mg/dL\nDirect 0.1 mg/dL\nLactate dehydrogenase 1658 U/L\nA blood smear shows schistocytes."
] | [
"His parents have been giving him oral rehydration solution."
] | [
"The remainder of the examination shows no abnormalities."
] |
[
"More recently, she has been inducing emesis more often and even looked into diuretics as she feels that she is gaining more and more weight compared to her ‘skinny friends’."
] | null | [
"She has been visiting the same dentist since childhood and for the past 2 years has had at least 2 visits for dental caries.",
"She eventually admitted to him that she regularly induces vomiting by putting her fingers down her throat.",
"She says she has been doing this for the last few years and purging at least once a week."
] | [
"Her BMI is at the 50th percentile for her age and sex."
] | null | null |
[
"Her symptoms began one week ago, when she had several days of low-grade fever and constipation.",
"Her temperature is 39.3°C (102.8°F)."
] | null | [
"She returned from Indonesia 2 weeks ago, where she spent the summer with her grandparents."
] | [
"Examination shows diffuse abdominal tenderness and mild hepatosplenomegaly.",
"There is a faint salmon-colored maculopapular rash on her trunk and abdomen."
] | null | null |
[
"At a party shortly afterward she experiences facial flushing, nausea, tachycardia, dyspnea, headache, and abdominal cramps after consuming alcohol."
] | null | null | null | null | null |
[
"She complains of increased fatigability, but is otherwise well."
] | null | [
"She takes folic acid, iron, and vitamin D supplementation."
] | [
"Her vital signs are as follows: blood pressure, 110/70 mm Hg; heart rate, 86/min; respiratory rate, 13/min; and temperature, 36.6℃ (97.9℉).",
"The physical examination is unremarkable."
] | null | null |
[
"During the physical, the patient mentions some discomfort in his abdomen and pelvis and during a records review it is noted that he has not passed urine in the PACU, step-down unit, or since arriving on the med-surg floor."
] | null | null | [
"On the med-surg floor, his temperature is 36.8°C (98.2°F), the heart rate is 98/min, the respiratory rate is 15/min, the blood pressure is 100/75 mm Hg, the oxygen saturation is 90%.",
"His heart has a regular rate and rhythm and his lungs are clear to auscultation bilaterally.",
"His incision site is clean, dry, and intact with an appropriate level of swelling and erythema.",
"A bladder scan is inconclusive due to body habitus."
] | [
"He had undergone a successful hernia surgery 14 hours ago.",
"Before the surgery, he was pre-treated with atropine, scopolamine, and morphine and recovered well in the PACU after the surgery."
] | [
"There were no complications in the step-down unit and the patient continued to recover.",
"On physical exam, he is a well-developed, obese man."
] |
[
"He reports that he noticed a white film on his tongue and the sides of his mouth 2 days ago while brushing his teeth.",
"The film was easily brushed off.",
"He also complains of a bitter metallic taste in his mouth but otherwise denies pain, burning, dysphagia, or hoarseness."
] | null | [
"He is a competitive swimmer and has had 8 sexual partners in the past year.",
"He intermittently uses barrier protection."
] | [
"On exam, he is well-appearing and in no acute distress.",
"His oral examination demonstrates patches of white pseudomembranes that can be wiped away to reveal erythematous mucosa."
] | null | [
"He is otherwise healthy and takes no medications."
] |
[
"The pain is described as a dull, constant ache that is worse at night."
] | null | [
"He could not recall any precipitating event except for an amateur weight-lifting competition that he participated in 2 months ago.",
"Past medical history is significant for non-small cell lung cancer that was diagnosed and successfully treated."
] | [
"Physical exam was unremarkable except for some point tenderness along the lumbosacral area."
] | null | [
"A PET scan 1 year ago demonstrated no recurrence."
] |
[
"He has not had bowel movements in the past 24 hours.",
"He appears ill. His temperature is 37.8°C (100°F) and pulse is 122/min."
] | null | null | [
"Examination shows a distended abdomen.",
"There is tenderness to palpation in the lower abdomen; guarding and rebound tenderness are present.",
"Bowel sounds are decreased.",
"An x-ray of the abdomen shows dilated loops of bowel."
] | [
"The surgeon recommends an emergency laparotomy."
] | [
"He has been accompanied by his 14-year-old brother.",
"The parents are away visiting friends and cannot be reached."
] |
[
"He appears irritable."
] | null | [
"He was born at 38 weeks' gestation via normal vaginal delivery.",
"He has been latching on and breastfeeding well since birth.",
"His mother has a history of Graves' disease and underwent near-total thyroidectomy in the second trimester of her pregnancy after her symptoms could not be controlled with antithyroid drugs.",
"She is currently receiving L-thyroxine therapy."
] | [
"He weighed 3005 g (6 lb, 10 oz) at birth and currently weighs 2835 g (6 lb, 4 oz).",
"The patient's temperature is 38.9°C (102°F), pulse is 176/min, and respirations are 42/min.",
"Examination shows a diaphoretic infant with a paucity of subcutaneous fat.",
"There is swelling of the neck at the midline."
] | null | null |
[
"She is accompanied by her partner, who reports that she had been complaining of black and tarry stools for the past several days."
] | null | null | [
"Vital signs are temperature 37 degrees celsius, heart rate 141 beats per minute, blood pressure 90/60, respiratory rate 20, and oxygen saturation 99% on room air.",
"On physical examination, she has splenomegaly and a positive fluid wave.",
"The remainder of her examination is within normal limits.",
"Subsequent emergent upper endoscopy reveals bleeding from the submucosal veins in the lower 1/3 of the esophagus, but no gastric bleed."
] | [
"The patient is stabilized with intravenous fluids, and her blood pressure improves.",
"In the endoscopy suite she also receives IV octreotide."
] | null |
null | null | [
"He feels well and currently drinks 5 glasses of wine each night.",
"Medications include atenolol and lisinopril."
] | [
"On physical exam, temperature is 98.1 deg F (36.7 deg C), blood pressure is 151/82 mmHg, pulse is 71/min, and respirations are 14/min.",
"He has spider angiomata on his chest; no asterixis, jaundice, ascites, or peripheral edema is noted.",
"Screening ultrasound reveals a new liver nodule, and follow up CT demonstrates a 2 cm right hepatic lobe lesion with enhancement in the arterial phase.",
"No hypodense attenuation is seen on the venous or delayed phase."
] | null | null |
[
"The patient’s wife says that he has been sleeping much more than usual for the past 5 days.",
"On physical examination, the patient is altered and not responsive to commands.",
"Oriented x 0."
] | null | [
"His past medical history is significant for alcoholic liver cirrhosis."
] | [
"His bowel and bladder habit have not changed.",
"His vital signs include: pulse 76/min, respiratory rate 15/min, temperature 38.0°C (100.4°F) and blood pressure 122/75 mm Hg.",
"The abdomen is significantly distended.",
"Shifting dullness is present and a positive fluid wave can be elicited.",
"Hyperreflexia and asterixis are noted.",
"Laboratory findings are significant for the following:\nLaboratory test\nSodium 140 mEq/L\nPotassium 3.5 mEq/L\nChloride 97 mEq/L\nGlucose 90 mg/dL\nAmmonia 100 µg/dL (ref: 19-60 µg/dL)\nArterial blood gas\npH 7.4\npCO2 40 mm Hg\npO2 90 mm Hg\nHCO3 26 mEq/L\nAn abdominal ultrasound shows surface nodularity compatible with cirrhosis but no other changes aside from ascites.",
"An upper GI endoscopy is performed which shows gastric varices with no signs of active bleeding.",
"An MRI of the brain is insignificant."
] | null | null |
[
"The patient was the front seat unrestrained driver in a head on collision.",
"The patient is currently complaining of chest pain.",
"Physical exam is notable for an uncomfortable young man with bruising over his chest wall."
] | null | null | [
"The patient’s echocardiogram (ECG) is notable only for sinus tachycardia.",
"His temperature is 99.5°F (37.5°C), blood pressure is 107/58 mmHg, pulse is 120/min, respirations are 17/min, and oxygen saturation is 98% on room air.",
"Initial workup demonstrates that the patient’s pulmonary capillary wedge pressure and troponins are elevated."
] | [
"The patient is given 2 liters of Ringer lactate solution and morphine."
] | null |
[
"He reports that his symptoms began approximately 1 week ago and he has noticed episodes of diarrhea."
] | null | [
"He recently started melatonin and magnesium supplementation in hopes of improving his sleep.",
"Medical history is significant for alcohol use disorder that required multiple hospital admissions for management of acute pancreatitis and cirrhosis.",
"He states that he occasionally injects heroin intravenously."
] | [
"Temperature is 100°F (37.8°C), blood pressure is 105/70 mmHg, pulse is 92/min, and respirations are 17/min.",
"Physical examination is significant for scleral icterus, hepatomegaly, ascites, and diffuse abdominal tenderness.",
"Laboratory testing is significant for leukocytosis and metabolic acidosis.",
"Ascitic fluid analysis demonstrates a polymorphonuclear cell count of 280 cells/mm^3, serum-ascites albumin gradient of 1.3 g/dL, and a culture positive for Escherichia coli sensitive to cefotaxime and ceftriaxone.",
"Physical examination is unchanged.",
"Laboratory testing is significant for a serum sodium of 131 mEq/L and creatinine of 1.8 mg/dL (it was 0.9 mg/dL on admission).",
"Urine studies are significant for a low urine sodium level, without evidence of blood or protein."
] | [
"A paracentesis is performed and he is admitted into the hospital to receive intravenous cefotaxime and albumin."
] | [
"On hospital day 2, the nurse reports that the patient is oliguric in the setting of constant fluid intake.",
"Since the hospital admission, he has not been started on any new medications."
] |
[
"She noticed a 6.8 kg (15 lb) unintentional weight loss over the preceding several months.",
"She also reports feuding with her boyfriend over the temperature of their shared apartment, as she always feels warmer than he does.",
"She also exhibits a fine tremor in her hands when her arms are outstretched."
] | null | [
"She has not changed her diet or exercise habits."
] | [
"The vital signs include: heart rate 110/min and blood pressure 146/78 mm Hg.",
"The physical exam is notable for warm and slightly moist skin.",
"The urine pregnancy test is negative."
] | null | null |
[
"He first noticed the symptoms after returning from a business trip last week in the Bahamas.",
"The rash initially started as a single lesion on his upper back but since then has extended to his shoulders."
] | null | [
"He works as an office manager and has no known exposure to melanocytotoxic chemicals.",
"He has been sexually active with three female partners over the past year and uses condoms inconsistently.",
"He is 183 cm (6 ft) tall and weighs 80 kg (176 lb); BMI is 23.9 kg/m2.",
"One month ago, his hemoglobin A1C was 7.8%."
] | [
"His temperature is 37.2°C (99°F), pulse is 78/min, and blood pressure is 130/84 mm Hg."
] | null | [
"While he was there, he visited a couple of beaches and went hiking with some coworkers.",
"A photograph of the rash is shown."
] |
[
"She is only able to verbalize two word sentences and has generalized developmental delay."
] | null | null | [
"When she was born it was noticed that she had a high pitched mewing cry and subsequent physical exam revealed microcephaly, prominent epicanthal folds, and a holosystolic murmur best heard in the left 5th intercostal space near the sternum."
] | null | null |
[
"She has had no fever, abdominal pain, or diarrhea."
] | null | [
"Menopause occurred at 52 years of age.",
"She has hypertension, hypercholesterolemia, and diabetes.",
"Medications include atorvastatin, hydrochlorothiazide, metformin, and aspirin.",
"She is sexually active with her husband."
] | [
"Her temperature is 37°C (98.6°F), pulse is 95/min, respirations are 12/min, and blood pressure is 155/65 mm Hg.",
"Pelvic exam demonstrates a 4 x 3 cm firm, immobile erythematous mass on the right inner vaginal wall."
] | null | [
"Her last Pap smear 1 year ago was normal."
] |
[
"There is swelling and tenderness over the first, second, and third metacarpophalangeal joints of both hands."
] | null | [
"He has had diabetes mellitus for 2 years which is not well controlled with medications."
] | [
"His hand radiograph is shown.",
"Lab studies show a transferrin saturation of 88% and serum ferritin of 1,200 ng/mL."
] | null | null |
[
"He then develops progressive respiratory failure and is admitted to the neonatal ICU."
] | null | null | [
"A single loud S2 heart sound is appreciated as well as a machine-like murmur at the left upper sternal border.",
"Radiography shows an enlarged \"egg-shaped\" heart."
] | [
"The newborn is then taken for a atrial septostomy to alleviate the condition pending definitive surgical correction."
] | null |
[
"The patient is unconscious and cannot provide any further history.",
"On physical examination, the patient is diaphoretic and unresponsive.",
"Extremities are pale and cool."
] | null | null | [
"Vitals show a temperature of 37-0°C (98.6°F), blood pressure of 85/55 mm Hg, pulse of 115/min, respirations of 19/min, and oxygen saturation of 92% on room air.",
"There is a 3-inch long penetrating wound between the 3rd and 4th intercostal space on the left side of the chest, which is bleeding profusely.",
"Transthoracic echocardiography reveals a full thickness penetrating injury to the right ventricular free wall.",
"There are no apparent injuries to any coronary arteries or major branches."
] | [
"The patient is intubated and aggressive fluid resuscitation is initiated, including a blood transfusion."
] | null |
null | null | null | null | null | null |
null | null | [
"He has well-controlled hypertension and diabetes but has otherwise been healthy.",
"He does not smoke but drinks socially with his friends."
] | [
"Physical exam reveals enlarged nodules that are not tender to palpation.",
"A biopsy is obtained showing a characteristic change in chromosome 18."
] | null | null |
null | null | [
"She is concerned about cancer because her uncle died of metastatic melanoma 1 year ago.",
"She has no history of serious illness and does not take any medication.",
"She has been working in a law firm for the past 20 years and travels to the Carribean regularly with her husband."
] | [
"Examination of her skin shows no abnormal moles or warts."
] | null | null |
[
"The daughter reports that her mother has recently been having difficulty combing her hair in the mornings."
] | null | [
"The patient’s past medical history is positive for diverticulosis.",
"She takes no medication."
] | [
"Her blood pressure is 120/70 mm Hg, heart rate is 75/min, respiratory rate is 14/min, and temperature is 37.6°C (99.7°F).",
"On physical examination, the patient’s neck is stiff and she also has bilateral shoulder tenderness; muscle strength is intact."
] | null | [
"The patient’s family history is significant for an ischemic stroke in her father."
] |
[
"The patient also reports episodic pelvic and back pain accompanied by painful diarrhea for 5 years.",
"She has about one such episode on average per month for 4–6 days.",
"She has taken ibuprofen for the pain, which has provided some relief."
] | null | [
"She is sexually active with her husband and does not use contraception."
] | [
"Analysis of her husband's semen has shown normal sperm counts during this time.",
"Vital signs are within normal limits.",
"Pelvic and bimanual examinations are normal; rectal examination is unremarkable.",
"A hysterosalpingogram 6 months prior showed normal results."
] | [
"Menses have occurred at regular 29-day intervals since menarche at the age of 14 years and last for 7 days."
] | null |
[
"She states that her husband developed a fever and began feeling weak 3 days ago, but has refused medical help.",
"He has been unable to go to work because of his symptoms."
] | null | [
"The patient has been previously hospitalized for a tricuspid valve replacement surgery 1 year ago and takes aspirin daily.",
"The medical history is also relevant for myocardial infarction 3 years ago and hypertension for the past 10 years, for which he takes lisinopril."
] | [
"His blood pressure is 140/80 mm Hg, the pulse is 82/min, the respirations are 18/minute, and the temperature is 37.2°C (98.9°F).",
"On examination, several hemorrhages are noted on the nail beds of several fingers."
] | null | null |
[
"She also reports frequent episodes of crampy pelvic pain that starts one day before menses and lasts for 7 days.",
"Her symptoms are not relieved with pain medication."
] | null | [
"She is sexually active with her husband.",
"She uses a combined oral contraceptive pill."
] | [
"Her vital signs are within normal limits.",
"Physical examination shows rectovaginal tenderness.",
"Cervical and urethral swabs are negative.",
"Transvaginal ultrasonography shows no abnormalities."
] | null | [
"Menses occur at regular 28-day intervals and last 5 days.",
"Her last menstrual period was 2 weeks ago."
] |
null | null | [
"The patient has no active complaints and says he feels healthy; however, he does not exercise regularly and lives a sedentary lifestyle.",
"He is employed as an administrative position at a local college, and is seated at a desk most of the day.",
"His father had a heart attack at age 54 and his mother is still alive with no health concerns.",
"He does not smoke, only drinks socially, and does not use drugs.",
"Today, his blood pressure is 130/90 mm Hg, pulse is 84/min, and respiratory rate is 14/min."
] | [
"Physical examination reveals an obese male with no significant findings."
] | null | [
"He is concerned about his health after a colleague recently had a heart attack."
] |
[
"On arrival, she is lethargic and incoherent.",
"She has severe facial lacerations and is in respiratory distress."
] | null | null | [
"Her pulse is 130/min, respirations are 29/min, and blood pressure is 90/58 mm Hg.",
"Pulse oximetry on room air shows an oxygen saturation of 70%.",
"Examination shows multiple facial lacerations.",
"There is dullness to percussion and decreased breath sounds over the left lung base.",
"Abdominal examination shows diffuse tenderness with no guarding or rebound.",
"Bowel sounds are normal.",
"Her hemoglobin concentration is 12.1 g/dL.",
"An x-ray of the chest shows a fractured left second rib, depression of the left mainstem bronchus, deviation of the nasogastric tube to the right, and a widened mediastinum."
] | null | [
"The remainder of the examination shows no abnormalities."
] |
[
"She finds it difficult initiating sleep, occasionally has palpitations, and feels fatigued."
] | null | [
"She denies having similar symptoms in the past or starting any new medications or illicit drugs.",
"She is currently 10 weeks pregnant and is closely followed by her obstetrician."
] | [
"Her temperature is 98.6°F (37°C), blood pressure is 125/70 mmHg, pulse is 105/min, and respirations are 18/min.",
"On physical exam, the patient is mildly diaphoretic.",
"The skin is warm and the thyroid gland is diffusely enlarged with thyroid bruits.",
"Laboratory studies are significant for a thyroid-stimulating hormone level of 0.01 µU/mL (normal is 0.5-5.0 µU/mL) and an elevated free thyroxine (FT4) that is inappropriate for her pregnancy."
] | null | null |
[
"Abdominal examination shows diffuse tenderness with no guarding or rebound."
] | null | [
"She immigrated to the US from Uganda 6 weeks ago."
] | [
"The liver is firm and palpable 3 cm below the right costal margin, and the spleen is palpable just below the left costal margin.",
"Her leukocyte count is 12,800/mm3 (12% eosinophils).",
"Stool culture shows several oval-shaped eggs with lateral spines.",
"Microscopic examination of a liver biopsy specimen shows granulomatous inflammation with periportal fibrosis."
] | null | null |
[
"She has central cyanosis without signs of respiratory distress or signs of heart failure."
] | null | null | [
"An echocardiogram reveals severe pulmonary outflow obstruction, right ventricular hypertrophy, a ventricular septal defect, and an overriding of the aorta."
] | [
"An elective primary surgical repair is planned at 4 months of age."
] | null |
[
"She is unarousable during the day, but then is awake and impulsive during the night, requiring frequent reorientation.",
"She is distressed and oriented to person but not to place or time."
] | null | [
"Her husband says that she usually drinks one to two glasses of wine weekly.",
"Her only current medication is oxycodone for pain."
] | [
"Her vital signs are within normal limits.",
"Neurologic examination shows inattentiveness but no focal deficits.",
"Urine dipstick is normal."
] | [
"Her only current medication is oxycodone for pain."
] | null |
[
"Her caretakers state that the patient’s gait suddenly became ataxic, and she became less responsive than her normal non-verbal baseline."
] | null | null | [
"Her temperature is 98.5°F (36.9°C), blood pressure is 125/68 mmHg, pulse is 90/min, respirations are 15/min, and oxygen saturation is 99% on room air.",
"Physical exam is notable for an unremarkable HEENT exam with normal facial features and no signs of airway compromise.",
"Neurological exam is remarkable for new onset spasticity.",
"The patient has 3+ reflexes and a positive Babinski sign.",
"Musculoskeletal exam is only notable for symmetric swelling and deformities of the patient’s hands bilaterally.",
"Additionally, there is a \"clunk\" when posterior force is applied to the head while anterior force is applied to the cervical spine."
] | null | null |
[
"On arrival, he has rapid, shallow breathing and appears anxious."
] | null | null | [
"His pulse is 135/min, respirations are 30/min and shallow, and palpable systolic blood pressure is 80 mm Hg.",
"Examination shows no active external bleeding.",
"There is a 2.5-cm single stab wound to the left chest at the 4th intercostal space at the midclavicular line.",
"Cardiovascular examination shows muffled heart sounds and jugular venous distention.",
"Breath sounds are normal."
] | [
"He is intubated and mechanically ventilated.",
"Infusion of 0.9% saline is begun."
] | null |
[
"He is asymptomatic at his office visit and denies any new complaints."
] | null | [
"He has a 10-year history of hypertension that remains poorly controlled on maximum doses of lisinopril, hydrochlorothiazide, and amlodipine.",
"His past medical history is otherwise unremarkable.",
"He has no smoking history, drinks alcohol occasionally, and denies any illicit drug use.",
"His father required a kidney transplant in his forties."
] | [
"The physical exam is notable for palpable flank masses bilaterally.",
"Laboratory studies show a creatinine of 2.5."
] | null | [
"The physician orders a renal ultrasound, and the results are shown."
] |
[
"She says that the chest pain is worse when she breathes or coughs.",
"Furthermore, on the way to the hospital she noticed that there were specks of blood on a tissue that she coughed into."
] | null | [
"She has no previous medical history and does not recall anything that could have provoked these symptoms."
] | [
"On presentation her temperature is 99°F (37.2°C), blood pressure is 107/65 mmHg, pulse is 102/min, respirations are 21/min, and O2 saturation is 91% on room air.",
"Further testing shows a large filling defect in the pulmonary vessels, and the patient is started on an appropriate treatment intravenously."
] | [
"After drug administration, the effects of the drug are monitored using a standard blood test."
] | [
"Surprisingly, the test results come back within normal parameters."
] |
null | null | null | [
"A urethral smear shows gram negative diplococci within white blood cells.",
"The organism grows well when cultured on Thayer-Martin agar."
] | [
"The patient is prescribed a course of ceftriaxone and the infection resolves without further complication."
] | [
"One year later, the patient returns with the same infection."
] |
[
"He reported significant neck pain to emergency responders, but otherwise denies weakness, numbness or tingling in his extremities."
] | null | null | [
"His vitals on presentation to the ED are HR 90, BP 140/80, RR 20, SpO2 98%."
] | null | null |
[
"He is concerned about abnormal discharge from both nipples over the past 3 months.",
"The fluid is white, and he wonders if it could be milk.",
"On further review of systems, he endorses a diminished sexual drive."
] | null | null | null | null | null |
End of preview.
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