id stringlengths 4 7 | text stringlengths 713 5.47k ⌀ | labels stringlengths 739 6.26k ⌀ | relations stringlengths 2 8.69k |
|---|---|---|---|
402_183 | [['QUESTION', 'TYPE:', 'PRIMARY', 'CARE', 'AND', 'SOCIAL', 'NETWORKS'], ['CLINICAL', 'CASE:'], ['Juan,', 'a', 'second', 'year', 'resident,', 'attends', 'Sofia,', 'a', '15', 'year', 'old', 'girl', 'in', 'the', 'emergency', 'room,', 'who', 'apparently', 'fainted', 'at', 'school', 'without', 'losing', 'consciousness.'], [... | [['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-Premis... | [['There is no doubt that the doctor-patient relationship today transcends the physical environment of the consultation room\n', 'Answer that it is important to maintain certain professional boundaries between patients and physicians and that, unfortunately, if you make the request you will not be able to accept it, so... |
237_144 | [['QUESTION', 'TYPE:', 'NEUROLOGY'], ['CLINICAL', 'CASE:'], ['After', 'a', 'traffic', 'accident', 'a', '38-year-old', 'patient', 'is', 'admitted', 'to', 'the', 'ICU', 'in', 'coma.'], ['After', 'several', 'days', 'the', 'patient', 'does', 'not', 'improve', 'neurologically', 'and', 'a', 'CT', 'scan', 'shows', 'hemorrhagi... | [['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', '... | [['Diffuse axonal injury produces an early and sustained deterioration of the level of consciousness (as mentioned in the case statement) without a lesion on CT scan to justify the picture\n', 'Severe diffuse axonal injury\n', 'Support'], ['After a traffic accident a 38-year-old patient is admitted to the ICU in coma\n... |
620_121 | null | null | [] |
396_136 | null | null | [] |
253_86 | [['QUESTION', 'TYPE:', 'DIGESTIVE', 'TRACT'], ['CLINICAL', 'CASE:'], ['A', '37-year-old', 'woman', 'with', 'extensive', 'ulcerative', 'colitis', 'presents', 'a', 'severe', 'flare-up', 'for', 'which', 'treatment', 'with', 'prednisone', 'at', 'a', 'dose', 'of', '1', 'mg/kg', 'is', 'started.'], ['After', 'one', 'week', '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-Premise'... | [['When a severe flare does not respond to iv corticosteroid therapy at full doses (1mg/kg body weight), it is necessary to switch to cyclosporine or infliximab\n', 'Intravenous cyclosporine 2mg/kg\n', 'Support'], ['Etanercept is not approved in Europe for inflammatory bowel disease (for the time being)\n', 'Treatment ... |
224_63 | [['QUESTION', 'TYPE:', 'CARDIOLOGY'], ['CLINICAL', 'CASE:'], ['A', '52-year-old', 'patient', 'who', 'has', 'been', 'complaining', 'of', 'dyspnea', 'on', 'medium', 'exertion', 'for', '6', 'months.'], ['He', 'has', 'not', 'presented', 'angina', 'or', 'syncope.'], ['Physical', 'examination', 'and', 'diagnostic', 'tests', ... | [['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'], ... | [['Something aortic\n', 'this is going to be aortic stenosis...\n', 'Support'], ['They give me a gradient, which without knowing the values seems somewhat high (55 mmHg!) and the area, which looks tiny to the naked eye\n', 'this is going to be aortic stenosis...\n', 'Support'], ["With the guidelines in hand, that's rig... |
430_115 | [['QUESTION', 'TYPE:', 'INFECTIOUS', 'DISEASES', 'AND', 'MICROBIOLOGY'], ['CLINICAL', 'CASE:'], ['A', '65-year-old', 'woman', 'who', 'underwent', 'hematopoietic', 'precursor', 'transplantation', '30', 'days', 'ago', 'and', 'has', 'severe', 'neutropenia.'], ['She', 'starts', 'with', 'cough', 'and', 'hemoptotic', 'expect... | [['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise',... | [['Patient on her 30th post-transplant day of hematopoietic precursor transplantation, in severe neutropenia who presents with cough with hemoptotic expectoration\n', 'This picture is usually seen in infection by Aspergillus spp\n', 'Support'], ['This picture is usually seen in infection by Aspergillus spp\n', 'Invasiv... |
588_63 | null | null | [] |
11_74 | [['QUESTION', 'TYPE:', 'SURGERY'], ['CLINICAL', 'CASE:'], ['Ten', 'days', 'after', 'performing', 'a', 'hemithyroidectomy', 'on', 'a', 'patient', 'with', 'a', '1.5', 'cm', 'thyroid', 'nodule', 'you', 'receive', 'the', 'following', 'anatomopathologic', 'report:', '"very', 'cellular', 'follicular', 'pattern', 'without', '... | [['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', 'O', 'O', 'O', 'O', 'O', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise',... | [['But if there are data of poor prognosis and the possibility of metastases - as in this case\n', 'it is best to complete the thyroidectomy and perform a radioactive iodine scan to rule out metastases or treat them if they are present\n', 'Support'], ['it is best to complete the thyroidectomy and perform a radioactive... |
535_121 | [['QUESTION', 'TYPE:', 'RHEUMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '27-year-old', 'black', 'woman', 'consults', 'for', 'the', 'appearance', 'of', 'edema', 'in', 'the', 'lower', 'limbs,', 'decreased', 'diuresis,', 'fever', 'and', 'a', 'malar', 'rash', 'in', 'butterfly', 'wings', 'of', '20', 'days', 'of', 'evolution.']... | [['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-... | [['Clinical case of SLE with renal involvement, in which positive double-stranded anti-DNA increases the risk of nephritis\n', 'Anti-two-stranded or native anti-DNA correlates with the risk of nephritis\n', 'Support'], ['As for the rest, anti-Sm are specific to SLE\n', 'The anti-Sm antibodies are not specific for this ... |
452_149 | [['QUESTION', 'TYPE:', 'NEUROLOGY'], ['CLINICAL', 'CASE:'], ['In', 'a', 'woman', 'with', 'an', 'epileptic', 'seizure', 'presenting', 'with', 'the', 'following', 'clinical', 'features:', 'epigastric', 'aura,', 'unpleasant', 'odor,', 'disconnection', 'from', 'the', 'environment,', 'motor', 'automatisms', '(sucking,', 'sw... | [['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'... | [['Clearly the answer is 4, with a very characteristic clinic of temporary seizures\n', 'Complex partial temporal lobe seizure\n', 'Support']] |
55_74 | [['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['Ten', 'days', 'after', 'performing', 'a', 'hemithyroidectomy', 'on', 'a', 'patient', 'with', 'a', '1.5', 'cm', 'thyroid', 'nodule', 'you', 'receive', 'the', 'following', 'definitive', 'report', 'from', 'the', 'pathologist:', '"very', 'cellular', 'follicu... | [['O', 'O', 'O'], ['O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-C... | [['Answer 4: simply by the way of expressing it, it should already have been ruled out\n', 'The report allows to rule out papillary carcinoma with total certainty in the remaining thyroid\n', 'Attack'], ['Answer 5: you already know that calcitonin is used in medullary carcinoma and not in differentiated carcinoma\n', '... |
281_33 | [['QUESTION', 'TYPE:', 'PATHOLOGICAL', 'ANATOMY'], ['CLINICAL', 'CASE:'], ['A', '67-year-old', 'woman', 'diagnosed', 'with', 'an', 'infiltrating', 'ductal', 'carcinoma', 'of', 'the', 'breast', 'and', 'no', 'family', 'history', 'of', 'neoplasia.'], ['What', 'additional', 'studies', 'should', 'be', 'performed', 'on', 'th... | [['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', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'... | [['The correct answer would be 2, HORMONE AND HER2 RECEPTOR STUDY\n', 'Study of hormone receptors and HER2\n', 'Support'], ['positive HER2 receptors imply greater aggressiveness of the tumor\n', 'The correct answer would be 2, HORMONE AND HER2 RECEPTOR STUDY\n', 'Support'], ['Answer 1 can be ruled out visu visu\n', 'Co... |
310_216 | [['QUESTION', 'TYPE:', 'OPHTHALMOLOGY'], ['CLINICAL', 'CASE:'], ['A', 'parent', 'comes', 'to', 'the', 'emergency', 'department', 'with', 'his', '2-year-old', 'son', 'because', 'he', 'reports', 'that', 'he', 'has', 'hit', 'his', 'right', 'eye', 'while', 'playing.'], ['Indeed,', 'a', 'hematoma', 'is', 'observed', 'on', '... | [['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-... | [['we have a blow to the right eye area, with a hematoma on the eyelid\n', 'Therefore, something other than the blow has caused hemorrhages in both retinas\n', 'Support'], ['The problem is that retinal hemorrhages appear not only in that eye (which in itself is rare, because an external blow to the eye in a child rarel... |
293_214 | [['QUESTION', 'TYPE:', 'DERMATOLOGY,', 'VENEREOLOGY', 'AND', 'PLASTIC', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', 'patient', 'comes', 'to', 'the', 'emergency', 'department', 'with', 'erythroderma', 'with', 'fever', 'and', 'general', 'malaise.'], ['On', 'examination,', 'the', 'nails', 'show', 'the', 'presence', 'of', 'na... | [['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Prem... | [['On examination, the nails show the presence of nail pitting and distal yellowish areas in an oil stain\n', 'although the description of nail lesions highly suggestive of psoriasis makes this diagnosis the most likely\n', 'Support'], ['although the description of nail lesions highly suggestive of psoriasis makes this... |
132_229 | [['QUESTION', 'TYPE:', 'NEUROLOGY', 'AND', 'NEUROSURGERY'], ['CLINICAL', 'CASE:'], ['A', '54-year-old', 'man,', 'with', 'a', 'personal', 'history', 'of', 'DM,', 'hypertension', 'and', 'mild', 'chronic', 'renal', 'insufficiency,', 'presented', 'with', 'somnolence', 'and', 'right', 'hemiparesis.'], ['Laboratory', 'tests:... | [['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'], ['B-P... | [['Schistocytes in smear\n', 'a patient with certain history who has: - Schistocytes in smear\n', 'Support'], ['Laboratory tests: creatinine 2.3 mg/dl, Hb 10.3 g/dl and platelets 20000 mm3, with normal coagulation\n', 'Bicytopenia: here the causes can be very, very varied\n', 'Support'], ['Elevation of LDH and Bilirubi... |
49_159 | null | null | [] |
120_192 | [['QUESTION', 'TYPE:', 'PREVENTIVE', 'MEDICINE', 'AND', 'EPIDEMIOLOGY'], ['CLINICAL', 'CASE:'], ['A', '40-year-old', 'orthopedic', 'surgeon', 'who', 'in', 'a', 'routine', 'serology', 'was', 'found', 'to', 'have', 'anti-HBs', 'levels', 'of', '30', 'IU/l.'], ['He', 'refers', 'complete', 'vaccination', 'according', 'to', ... | [['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'], ['B-Premise', 'I-Premise', 'I-Premise',... | [['As long as the serological levels of anti-HBs are above 10 IU/l it is not necessary to revaccinate\n', 'Do not revaccinate\n', 'Support'], ['A 40-year-old orthopedic surgeon who in a routine serology was found to have anti-HBs levels of 30 IU/l\n', 'Do not revaccinate\n', 'Support'], ['A 40-year-old orthopedic surge... |
304_174 | [['QUESTION', 'TYPE:', 'NEPHROLOGY'], ['CLINICAL', 'CASE:'], ['87-year-old', 'man', 'with', 'a', 'history', 'of', 'hypertension', 'and', 'gonarthrosis.'], ['Baseline', 'situation', 'with', 'full', 'functional', 'and', 'cognitive', 'autonomy', 'that', 'allows', 'him', 'to', 'continue', 'living', 'alone', 'in', 'the', 'c... | [['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', '... | [['In this case we are dealing with an elderly patient with chronic treatment with NSAIDs that produces arterial hypertension secondary to renal hypoperfusion\n', 'The most reasonable option would be to withdraw ibuprofen and replace it with an analgesic from a group other than NSAIDs (paracetamol, opiates), subsequent... |
214_228 | [['QUESTION', 'TYPE:', 'RHEUMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '19-year-old', 'man', 'consults', 'for', 'a', '24-hour', 'history', 'of', 'pain,', 'swelling', 'and', 'functional', 'impotence', 'of', 'the', 'right', 'knee', 'accompanied', 'by', 'a', 'fever', 'of', '38°C.'], ['Physical', 'examination', 'reveals', 'i... | [['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 absence of further information (more complete anamnesis on the current disease, risk factors, personal and family history, extra-articular symptoms or signs, etc.) it can be said that also 1 and 2 (and very exceptionally 5) could debut with a similar clinical and biological picture\n', 'Arthritis due to micro... |
249_120 | [['QUESTION', 'TYPE:', 'INFECTIOUS', 'DISEASES'], ['CLINICAL', 'CASE:'], ['A', '53-year-old', 'woman', 'consults', 'for', 'a', 'fever', 'of', '15', 'days', 'of', 'evolution,', 'without', 'symptoms', 'of', 'infectious', 'focality.'], ['On', 'examination,', 'a', 'painful', 'hepatomegaly', 'is', 'detected', 'at', '5', 'cm... | [['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premis... | [['All these data are suggestive of visceral Leishmaniasis\n', 'an OM biopsy should be performed to look for amastigotes and confirm the diagnosis\n', 'Support'], ['We are told about an HIV patient with irregular follow-up of antiretroviral treatment, presenting fever, hepatosplenomegaly, pancytopenia and polyclonal hy... |
53_146 | [['QUESTION', 'TYPE:', 'PSYCHIATRY'], ['CLINICAL', 'CASE:'], ['A', '31-year-old', 'man', 'with', 'no', 'psychiatric', 'history', 'comes', 'to', 'the', 'emergency', 'room', 'complaining...¨', 'symptoms', 'of', 'anxiety.'], ['Two', 'days', 'ago', 'he', 'experienced', 'another', 'episode', 'of', 'the', 'same', 'symptoms..... | [['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', '... | [['We first eliminate the most striking "acute" personality disorder.\n', 'Acute" dependent personality disorder.\n', 'Attack'], ['There are no "acute" characteristics in our personality.\n', 'We first eliminate the most striking "acute" personality disorder.\n', 'Support'], ['Depressive disorder? There is a time crite... |
48_158 | [['QUESTION', 'TYPE:', 'PEDIATRICS'], ['CLINICAL', 'CASE:'], ['A', '10-year-old', 'boy', 'is', 'brought', 'to', 'the', 'Emergency', 'Department', 'because', 'for', 'the', 'last', '2', 'hours', 'he', 'has', 'been', 'involuntarily', 'turning', 'his', 'neck', 'to', 'the', 'right', 'associated', 'with', 'marked', 'cervical... | [['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 1\n', 'Inject an intravenous anticholinergic\n', 'Support'], ['The anticholinergic can be administered intravenously and also intramuscularly if I am not mistaken\n', 'The correct answer is 1\n', 'Support'], ['The occurrence of dystonia as a side effect is common in children and is one of the m... |
490_106 | [['QUESTION', 'TYPE:', 'HEMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '65-year-old', 'woman', 'referred', 'to', 'the', 'emergency', 'department', 'for', 'fever', 'and', 'alterations', 'in', 'the', 'laboratory', 'tests:', 'hemoglobin', '11.4', 'g/dL,', 'leukocytes', '0.86', 'x103/μL,(neutrophils', '41.9%,', 'lymphocytes', ... | [['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 a definitive promyelocytic leukemia with t(15;17)\n', 'as it is well known by all of you the treatment is with arsenic trioxide + ATRA\n', 'Support'], ['as it is well known by all of you the treatment is with arsenic trioxide + ATRA\n', 'Start treatment with arsenic trioxide, ATRA and supportive therapy\n', 'S... |
416_76 | [['QUESTION', 'TYPE:', 'GENERAL', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '78-year-old', 'woman', 'with', 'dementia', 'and', 'institutionalized', 'is', 'brought', 'in', 'by', 'her', 'caregivers', 'for', 'significant', 'abdominal', 'pain', 'with', 'deterioration', 'of', 'general', 'condition', 'and', 'abdominal', 'dist... | [['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'... | [['Atrial Fibrillation\n', 'at the mir and at the ED door, any elderly person with AF and abdominal pain is emboligenic mesenteric ischemia until proven otherwise\n', 'Support'], ['at the mir and at the ED door, any elderly person with AF and abdominal pain is emboligenic mesenteric ischemia until proven otherwise\n', ... |
45_154 | null | null | [] |
336_31 | [['QUESTION', 'TYPE:', 'GYNECOLOGY', 'AND', 'OBSTETRICS'], ['CLINICAL', 'CASE:'], ['A', '20-year-old', 'woman', 'with', 'a', '15-cm', 'solid-cystic', 'ovarian', 'tumor', 'detected', 'by', 'ultrasound', 'after', 'presenting', 'with', 'nonspecific', 'abdominal', 'symptoms.'], ['In', 'the', 'histopathological', 'study', '... | [['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-P... | [['In the histopathological study of the corresponding specimen, teeth, hairs, areas of intestinal epithelium, areas of squamous epithelium (15%) and bronchial epithelium, as well as neuroectodermal and embryonal elements are found in several of the histological preparations\n', 'apart from cutaneous structures many ot... |
609_115 | [['QUESTION', 'TYPE:', 'TRAUMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '27-year-old', 'male,', 'a', 'regular', 'athlete,', 'refers', 'pain', 'in', 'the', 'right', 'leg', 'after', 'continuous', 'running.'], ['He', 'has', 'visited', 'a', 'physiotherapist', 'on', 'several', 'occasions', 'and', 'has', 'been', 'diagnosed', 'w... | [['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', '... | [['Several months have passed, she has not improved and refers intense pain after physical activity that subsides with rest in the hours following exercise\n', 'Exercise-induced compartment syndrome is an exercise-induced condition of the leg\n', 'Support'], ['Diagnosis is made by measuring compartment pressures at res... |
389_235 | null | null | [] |
201_76 | [['QUESTION', 'TYPE:', 'NEUROLOGY'], ['CLINICAL', 'CASE:'], ['A', 'patient', 'who', 'presents', 'with', 'problems', 'in', 'understanding', 'spoken', 'and', 'written', 'language,', 'inability', 'to', 'name', 'objects', 'and', 'repeat', 'words', 'that', 'are', 'said', 'to', 'him,', 'incomprehensible', 'fluent', 'speech',... | [['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-... | [['Transcortical have preserved repetition\n', 'Sensitive transcortical aphasia\n', 'Attack'], ["Broca's aphasia has preserved comprehension and absence of fluent speech\n", "Broca's aphasia\n", 'Attack'], ["Wernicke's aphasia is characterized by fluent speech (even in excess) with paraphasias and problems with compreh... |
345_159 | [['QUESTION', 'TYPE:', 'GYNECOLOGY', 'AND', 'OBSTETRICS'], ['CLINICAL', 'CASE:'], ['A', '69-year-old', 'woman', 'comes', 'to', 'your', 'office', 'reporting', 'genital', 'bleeding', 'of', 'several', "months'", 'evolution.'], ['She', 'denies', 'hormone', 'replacement', 'therapy', 'and', 'anticoagulation.'], ['She', 'prov... | [['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B... | [['In a case like this we must rule out endometrial neoplasia\n', 'an endometrial biopsy would be indicated, either by Cornier cannula if possible, or by hysteroscopy\n', 'Support'], ['We are being presented with a case of postmenopausal metrorrhagia\n', 'In a case like this we must rule out endometrial neoplasia\n', '... |
166_82 | [['QUESTION', 'TYPE:', 'CARDIOLOGY', 'AND', 'CARDIOVASCULAR', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '45-year-old', 'woman', 'presents', 'arterial', 'hypertension', '(190/120', 'mmHg)', 'accompanied', 'by', 'K', '2.5', 'mEq/l.'], ['An', 'abdominal', 'ultrasound', 'shows', 'stenosis', 'of', 'both', 'renal', 'arteries.... | [['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise',... | [['An abdominal ultrasound shows stenosis of both renal arteries\n', 'If the renal arteries are stenosed, blood has difficulty reaching the kidneys\n', 'Support'], ['If we administer an ACEI, we will provoke the relaxation of this arteriole and the fall of the glomerular filtration rate\n', 'Enalapril\n', 'Support'], [... |
481_171 | null | null | [] |
612_116 | [['QUESTION', 'TYPE:', 'TRAUMATOLOGY'], ['CLINICAL', 'CASE:'], ['95-year-old', 'woman', 'living', 'in', 'a', 'nursing', 'home,', 'independent', 'for', 'her', 'basic', 'activities', 'of', 'daily', 'living,', 'goes', 'out', 'to', 'the', 'garden', 'for', 'walks.'], ['She', 'has', 'a', 'history', 'of', 'hypertension,', 'dy... | [['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'], ['... | [['Given that this is a displaced subcapital hip fracture, the surgical treatment we should consider is hip joint replacement, given that the injury described presents a high probability of necrosis of the femoral head\n', 'Correct Answer 1\n', 'Support'], ['Given that this is a displaced subcapital hip fracture, the s... |
585_74 | [['QUESTION', 'TYPE:', 'OBSTETRICS', 'AND', 'GYNECOLOGY'], ['CLINICAL', 'CASE:'], ['34-week', 'primigravida', 'with', 'blood', 'pressure', 'of', '165/95', 'and', 'headache', 'of', 'two', 'days', 'of', 'evolution.'], ['Laboratory', 'tests:', 'hemoglobin', '10.5', 'g/dL,', 'platelets', '98,000/mm3,', 'AST', '356', 'IU/L'... | [['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-P... | [['Laboratory tests: hemoglobin 10.5 g/dL, platelets 98,000/mm3, AST 356 IU/L (0-31), ALT 234 IU/L (0-31), LDH 878 IU/L (125-243)\n', 'They are describing HELLP syndrome\n', 'Support'], ['34-week primigravida with blood pressure of 165/95 and headache of two days of evolution\n', 'They are describing HELLP syndrome\n',... |
3_37 | [['QUESTION', 'TYPE:', 'DIGESTIVE'], ['CLINICAL', 'CASE:'], ['A', '76-year-old', 'woman', 'with', 'no', 'history', 'other', 'than', 'hypertension', 'consults', 'for', 'painless', 'jaundice', 'and', 'pruritus', 'with', 'anorexia.'], ['Laboratory', 'tests', 'show', 'bilirubin', 'of', '12', 'mg/dl', '(9.5', 'direct).'], [... | [['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', '... | [['It is a pancreatic adenocarcinoma with metastasis, so the treatment should be palliative, so we remove options 1 and 5\n', 'Neoadjuvant chemo/radiotherapy, conditioning the option of radical surgery on initial response\n', 'Attack'], ['It is a pancreatic adenocarcinoma with metastasis, so the treatment should be pal... |
439_96 | [['QUESTION', 'TYPE:', 'GYNECOLOGY', 'AND', 'OBSTETRICS'], ['CLINICAL', 'CASE:'], ['A', '64-year-old', 'woman.'], ['Menopause', 'at', '54', 'years', 'of', 'age.'], ['Two', 'pregnancies', 'and', 'eutocic', 'deliveries.'], ['She', 'does', 'not', 'take', 'any', 'medication.'], ['She', 'comes', 'to', 'the', 'emergency', 'd... | [['O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise'... | [['Since the most frequent cause of vaginal bleeding in postmenopausal women is urogenital atrophy, the existence of an endometrial pathology cannot be ruled out\n', 'Transvaginal ultrasound and measurement of endometrial thickness. Depending on this, an endometrial biopsy should be taken or not\n', 'Support'], ['Accor... |
192_160 | [['QUESTION', 'TYPE:', 'PEDIATRICS'], ['CLINICAL', 'CASE:'], ['The', 'parents', 'of', 'a', '5-month-old', 'infant', 'come', 'because', 'their', 'child,', 'who', 'attends', 'day', 'care,', 'has', 'been', 'presenting', 'for', '3', 'days,', 'coinciding', 'with', 'an', 'upper', 'respiratory', 'tract', 'infection,', 'liquid... | [['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-... | [['On examination the infant is in good general condition, is well nourished and hydrated and his breathing is eupneic; his weight is 4,730g and has decreased by 70g with respect to the previous week\n', 'The baby is not dehydrated and is in good general condition\n', 'Support'], ['The abdomen is soft and depressible, ... |
261_100 | null | null | [] |
289_65 | [['QUESTION', 'TYPE:', 'GENERAL', 'SURGERY'], ['CLINICAL', 'CASE:'], ['Point', 'out', 'from', 'among', 'the', 'following', 'the', 'most', 'likely', 'complication', 'presented', 'by', 'a', 'patient', 'operated,', '20', 'years', 'ago,', 'of', 'gastric', 'ulcer', 'by', 'antrectomy', 'and', 'gastrojejunostomy', '(Billroth'... | [['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', 'I-Premise', 'I-... | [['the patient was operated 20 years ago for a Bilroth II\n', 'It is usually a late complication\n', 'Support'], ['If it were gastric adenocarcinoma, they would have spoken of constitutional syndrome, extradigestive manifestations (sister Maria Jose node, Krukenberg tumor, Virchow node)\n', 'Gastric adenocarcinoma\n', ... |
366_106 | [['QUESTION', 'TYPE:', 'PNEUMOLOGY', 'AND', 'THORACIC', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '32-year-old', 'man', 'from', 'Cameroon', 'consults', 'for', 'fever', 'cough', 'and', 'left', 'hemithorax', 'pain', 'of', '1', 'month', 'of', 'evolution.'], ['He', 'took', 'amoxicillin-clavulanic', 'acid', 'for', '1', 'week... | [['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'], ['B-Premise', 'I-Premise', 'I-Premise',... | [['a young patient from an area with a high rate of TB, a lymphocytic exudate pointing to TB, lymphoma or tumor\n', 'Suspicion is very high for tuberculous pleural effusion\n', 'Support'], ['Suspicion is very high for tuberculous pleural effusion\n', 'Measurement of pleural fluid adenosine deaminase\n', 'Support'], ['A... |
544_40 | [['QUESTION', 'TYPE:', 'ALLERGOLOGY'], ['CLINICAL', 'CASE:'], ['16-year-old', 'woman', 'diagnosed', 'with', 'allergic', 'rhinoconjunctivitis', 'due', 'to', 'sensitization', 'to', 'grass', 'pollens', 'since', 'she', 'was', '10', 'years', 'old,', 'who', 'does', 'not', 'fully', 'control', 'the', 'symptomatology', 'during'... | [['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 this patient the conventional treatment has not worked\n', 'it is possible to escalate to specific allergen immunotherapy\n', 'Support'], ['Currently the only effective treatment capable of modifying the natural course of respiratory allergy is specific allergen immunotherapy for a minimum of 3 consecutive years\... |
533_179 | [['QUESTION', 'TYPE:', 'ONCOLOGY'], ['CLINICAL', 'CASE:'], ['A', '32-year-old', 'woman', 'with', 'multiple', 'endocrine', 'neoplasia', 'syndrome', 'type', '2A', '(MEN-2A)', 'and', 'carrier', 'of', 'a', 'mutation', 'in', 'RET.'], ['In', 'a', 'neck', 'ultrasound', 'a', '6', 'mm', 'hypoechogenic', 'nodule', 'with', 'calci... | [['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '... | [['C cells, elevated calcitonin, inherited MEN-2nd\n', 'Typical medullary thyroid RET\n', 'Support'], ['Typical medullary thyroid RET\n', 'Multifocal medullary carcinoma\n', 'Support']] |
80_37 | [['QUESTION', 'TYPE:', 'DIGESTIVE', 'SYSTEM'], ['CLINICAL', 'CASE:'], ['A', '52-year-old', 'man', 'who', 'consults', 'for', 'a', 'second', 'opinion', 'on', 'the', 'need', 'to', 'perform', 'a', 'liver', 'biopsy', 'for', 'the', 'study', 'of', 'hypertransaminasemia', 'detected', 'two', 'years', 'ago', 'in', 'routine', 'co... | [['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 treatment of choice is phlebotomy\n', 'Initiate treatment with phlebotomies\n', 'Support'], ['This is a patient who already has a diagnosis of hemochromatosis, due to a positive genetic study and data of iron overload (IST >45% and elevated ferritin)\n', 'The treatment of choice is phlebotomy\n', 'Support'], ['B... |
394_225 | [['QUESTION', 'TYPE:', 'PSYCHIATRY'], ['CLINICAL', 'CASE:'], ['Mariano', 'is', 'a', '53-year-old', 'man', 'who', 'comes', 'to', 'your', 'office', 'reporting', 'that', 'he', 'has', 'been', 'feeling', 'very', 'unwell', 'for', 'several', 'years.'], ['He', 'relates', 'his', 'discomfort', 'to', 'a', 'behavior', 'that', 'he'... | [['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'], ['B-Premise', '... | [['therefore the correct answer is compulsion\n', 'Compulsion\n', 'Support'], ['In this question they ask for the name of the symptom, not the disease\n', 'therefore the correct answer is compulsion\n', 'Support'], ['This behavior, which she always does when she comes home from work, consists of turning the doorknob of... |
229_178 | [['QUESTION', 'TYPE:', 'PEDIATRICS'], ['CLINICAL', 'CASE:'], ['Previously', 'healthy', '10-month-old', 'infant', 'with', 'acute', 'gastroenteritis', 'of', 'one', "day's", 'evolution', 'and', 'signs', 'of', 'mild', 'dehydration,', 'without', 'blood', 'or', 'mucus', 'in', 'the', 'stool', 'and', 'without', 'oral', 'tolera... | [['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 infant presents with acute GEA without signs of alarm or severe dehydration\n', 'The first step would be to try oral tolerance with oral rehydration saline and continue with normal feeding if well tolerated\n', 'Support'], ['The first step would be to try oral tolerance with oral rehydration saline and continue ... |
198_73 | [['QUESTION', 'TYPE:', 'NEUROLOGY'], ['CLINICAL', 'CASE:'], ['A', '77-year-old', 'man', 'with', 'a', 'history', 'of', 'type', '2', 'Diabetes', 'Mellitus', 'was', 'diagnosed', '2', 'years', 'ago', 'with', 'mild', 'cognitive', 'impairment.'], ['At', 'that', 'time', 'a', 'Minimental', '(Folstein)', '28/30,', 'abbreviated'... | [['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', 'I-Premise', '... | [["This case describes an Alzheimer's disease with insidious onset of short-term memory problems\n", "Alzheimer's disease\n", 'Support'], ['The patient was accompanied by his wife, who reported a slow progressive evolution of memory impairment (e.g., sometimes confused with insulin doses)\n', "This case describes an Al... |
351_161 | [['QUESTION', 'TYPE:', 'GYNECOLOGY', 'AND', 'OBSTETRICS'], ['CLINICAL', 'CASE:'], ['A', '27-year-old', 'woman', 'referred', 'to', 'a', 'gynecology', 'office', 'for', 'evaluation,', 'reporting', 'dyspareunia', 'for', 'about', '8', 'months,', 'along', 'with', 'dyschezia', 'and', 'occasional', 'rectorrhagia', 'coinciding'... | [['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... | [['The clinical case presented is a woman of childbearing age (27 years) presenting dyspareunia + dysmenorrhea + infertility\n', 'which should lead us to think of endometriosis\n', 'Support'], ['but the diagnosis of certainty is given by direct observation (with or without associated biopsy) of ectopic endometrial tiss... |
69_124 | [['QUESTION', 'TYPE:', 'ANESTHESIOLOGY,', 'CRITICAL', 'CARE', 'AND', 'EMERGENCY', 'MEDICINE'], ['CLINICAL', 'CASE:'], ['The', 'daughter', 'of', 'an', '82-year-old', 'woman', 'consults', 'us', 'because', 'she', 'has', 'found', 'her', 'mother', 'more', 'confused', 'than', 'usual.'], ['The', 'patient', 'is', 'diagnosed', ... | [['O', '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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Pr... | [['which is seen in the heart rate\n', 'The most likely cause is a digitalis intoxication, which would produce this slowing of conduction\n', 'Support'], ['The most likely cause is a digitalis intoxication, which would produce this slowing of conduction\n', 'Digitalis intoxication\n', 'Support'], ['Probably secondary t... |
140_134 | [['QUESTION', 'TYPE:', 'PEDIATRICS'], ['CLINICAL', 'CASE:'], ['A', 'newborn', 'of', '37', 'weeks', 'gestational', 'age,', 'with', 'no', 'pathological', 'findings', 'in', 'the', 'prenatal', 'ultrasound,', 'presents', 'in', 'the', 'examination', 'performed', 'in', 'the', 'delivery', 'room', 'a', '"stop"', 'to', 'the', 'p... | [['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 3\n', 'Because of the risk of aspiration pneumonitis\n', 'Support'], ['The fact that there is intestinal aeration points to the existence of a fistula of the lower esophageal segment with the trachea or with a bronchus\n', 'Because of the risk of aspiration pneumonitis\n', 'Support'], ['Chest a... |
475_89 | [['QUESTION', 'TYPE:', 'CRITICAL', 'CARE'], ['CLINICAL', 'CASE:'], ['A', '46-year-old', 'man', 'with', 'bipolar', 'disorder', 'is', 'brought', 'to', 'the', 'emergency', 'department', 'after', 'an', 'over-ingestion', 'of', 'lithium', 'carbonate.'], ['Examination', 'reveals', 'severe', 'tremor,', 'ataxia,', 'dysarthria,'... | [['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premis... | [['Lithemia is 4.1 mEq/L (toxicity > 1.6 mEq/L)\n', 'We are dealing with a case of severe lithium intoxication (lithemia > 3.5 mEq/L is life threatening)\n', 'Support'], ['therefore, the therapeutic option of choice is to start hemodialysis urgently\n', 'Hemodialysis\n', 'Support'], ['Remember that activated charcoal i... |
85_50 | [['QUESTION', 'TYPE:', 'CARDIOLOGY', 'AND', 'VASCULAR', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', 'patient', 'with', 'a', 'history', 'of', 'febrile', 'illness', 'and', 'chest', 'pain', 'comes', 'to', 'the', 'hospital', 'with', 'dyspnea', 'and', 'tachypnea.'], ['On', 'physical', 'examination', 'his', 'blood', 'pressure',... | [['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'], ['O', 'O', 'O', 'B-Premise... | [['For all these reasons, the correct answer is 5\n', 'Pericardial effusion with cardiac tamponade\n', 'Support'], ['In cardiac tamponade, the deep sinus X is characteristic\n', 'For all these reasons, the correct answer is 5\n', 'Support'], ['In cardiac tamponade, inspiration, which causes an increase in blood flow to... |
527_31 | [['QUESTION', 'TYPE:', 'NEPHROLOGY'], ['CLINICAL', 'CASE:'], ['A', "patient's", 'arterial', 'blood', 'gas', 'result', 'is:', 'pH:', '7.40,', 'PaCO2', '60', 'mmHg;', 'bicarbonate', '36', 'mM/L.'], ['What', 'is', 'the', 'presenting', 'disturbance:'], ['1-', 'None,', 'pH', 'is', 'normal.'], ['2-', 'Respiratory', 'acidosis... | [['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'], ['O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim'... | [["A patient's arterial blood gas result is: pH: 7.40, PaCO2 60 mmHg; bicarbonate 36 mM/L\n", 'Blood gases can be misleading\n', 'Support'], ['since a normal pH may suggest that there is no disturbance of acid-base balance\n', 'Blood gases can be misleading\n', 'Support'], ['instead it is masking a double disturbance i... |
407_81 | [['QUESTION', 'TYPE:', 'ONCOLOGY', '(ECTOPIC)'], ['CLINICAL', 'CASE:'], ['A', '30-year-old', 'woman', 'comes', 'to', 'the', 'clinic', 'reporting', 'anxiety,', 'weight', 'loss', 'of', 'about', '6', 'kgs', 'and', 'a', 'feeling', 'of', '"nervousness"', 'in', 'the', 'last', 'three', 'months.'], ['Physical', 'examination', ... | [['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'... | [['Patients with this disorder voluntarily or accidentally ingest excessive amounts of thyroid hormone, resulting in hyperthyroidism in the absence of goiter\n', 'Factitious thyrotoxicosis\n', 'Support'], ['Physical examination showed tachycardia, hyperreflexia and absence of goiter\n', 'Patients with this disorder vol... |
15_126 | [['QUESTION', 'TYPE:', 'PALLIATIVE', 'CARE'], ['CLINICAL', 'CASE:'], ['For', 'the', 'third', 'time', 'in', 'the', 'last', '6', 'months', 'an', '84-year-old', 'man', 'with', 'advanced', 'dementia', 'is', 'admitted', 'to', 'a', 'hospital', 'for', 'aspiration', 'pneumonia.'], ['He', 'has', 'lost', '9.5', 'kg', 'in', 'the'... | [['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'... | [['his wife is the representative decision maker regarding his medical care and that he does not want extraordinary measures to prolong his life including artificial nutrition\n', 'Discharge home with palliative care from the health area\n', 'Support'], ['We may appoint a representative to act as an interlocutor with t... |
322_85 | [['QUESTION', 'TYPE:', 'UROLOGY'], ['CLINICAL', 'CASE:'], ['A', '22-year-old', 'boy', 'with', 'hyposmia', 'presents', 'lack', 'of', 'development', 'of', 'secondary', 'sexual', 'characteristics', 'and', 'infertility.'], ['Bilateral', 'testicular', 'volume', 'of', '4', 'mL.'], ['Analytically,', 'EST-I', '1.2', 'U/L', '(v... | [['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'], ['B-Premise',... | [['Triptorelin is a GnRH agonist, which by continuous action reduces FSH and LH, and is used in sex hormone-dependent cancers, as well as precocious puberty\n', 'Monthly intramuscular administration of triptorelin\n', 'Attack'], ['A 22-year-old boy with hyposmia presents lack of development of secondary sexual characte... |
610_116 | null | null | [] |
391_222 | [['QUESTION', 'TYPE:', 'PSYCHIATRY'], ['CLINICAL', 'CASE:'], ['A', '26-year-old', 'single', 'man', 'is', 'brought', 'in', 'by', 'his', 'family', 'because', 'he', 'has', 'been', 'refusing', 'to', 'leave', 'his', 'home', 'for', '3', 'months.'], ['The', 'reason', 'given', 'by', 'the', 'patient', 'is', 'the', 'belief', 'th... | [['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'], ['... | [['As a psychiatry resident, I wish the MIR questions in my specialty were a bit more thought-provoking and in-depth, although I know that the seconds you will have saved by marking the fourth one directly are very valuable\n', 'Body dysmorphic disorder\n', 'Support'], ['It describes a patient worried about a non-exist... |
324_55 | [['QUESTION', 'TYPE:', 'CRITICAL,', 'PALLIATIVE', 'AND', 'EMERGENCY', 'CARE'], ['CLINICAL', 'CASE:'], ['A', '70-year-old', 'female', 'patient', 'is', 'admitted', 'to', 'the', 'ICU', 'after', 'suffering', 'anterior', 'AMI', 'treated', 'by', 'coronary', 'angioplasty', 'and', 'stent', 'placement', 'in', 'the', 'anterior',... | [['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-Premis... | [['Mortality is not so low\n', 'Mortality with medical treatment is 20%\n', 'Attack'], ['hence the correct answer is 3\n', 'In case of free wall rupture, there is no palpable frémito\n', 'Support'], ['the oximetric jump occurs in the case of septum rupture, as well as fremitus\n', 'In case of free wall rupture, there i... |
240_150 | [['QUESTION', 'TYPE:', 'NEUROLOGY'], ['CLINICAL', 'CASE:'], ['A', '76-year-old', 'man', 'consults', 'for', 'cognitive', 'impairment,', 'slowness', 'and', 'clumsiness', 'of', 'movements,', 'of', 'eight', 'months', 'of', 'evolution.'], ['The', 'family', 'reports', 'that', 'the', 'patient', 'had', 'visual', 'hallucination... | [['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', '... | [['it presents the case with the typical symptoms of dementia due to Lewy bodies, being the guiding symptom visual hallucinations\n', 'The correct answer is 2\n', 'Support'], ['The correct answer is 2\n', 'Dementia due to Lewy bodies\n', 'Support'], ['Progressive cognitive impairment, parkinsonian motor signs (inferred... |
68_123 | [['QUESTION', 'TYPE:', 'ANESTHESIOLOGY,', 'CRITICAL', 'CARE', 'AND', 'EMERGENCY', 'MEDICINE'], ['CLINICAL', 'CASE:'], ['A', '64-year-old', 'man', 'with', 'a', 'history', 'of', 'hypertension', 'and', 'ischemic', 'heart', 'disease', 'comes', 'to', 'the', 'emergency', 'department', 'for', 'oppressive', 'chest', 'pain', 'w... | [['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... | [['If the ECG shows ischemic changes, we will obviously treat the patient in the emergency room and notify the cardiologist\n', 'We will do an ECG in less than 10 minutes\n', 'Support'], ['If not, you will be treated as if it were angina and observed, with serial enzymes and treatment in the observation area\n', 'We wi... |
206_125 | [['QUESTION', 'TYPE:', 'UROLOGY'], ['CLINICAL', 'CASE:'], ['Faced', 'with', 'a', '49-year-old', 'man,', 'asymptomatic,', 'with', 'a', 'family', 'history', 'of', 'a', 'father', 'who', 'died', 'of', 'prostate', 'cancer,', 'who', 'in', 'a', 'routine', 'company', 'control', 'is', 'identified', 'a', 'PSA', '(Prostate', 'Spe... | [['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 patient has a PSA >4 and a palpation with increased consistency\n', 'the need for a transrectal ultrasound-guided biopsy to diagnose whether it is Benign Prostatic Hyperplasia or Prostate Cancer\n', 'Support'], ['the need for a transrectal ultrasound-guided biopsy to diagnose whether it is Benign Prostatic Hyper... |
570_153 | [['QUESTION', 'TYPE:', 'NEPHROLOGY'], ['CLINICAL', 'CASE:'], ['A', '19-year-old', 'male', 'with', 'no', 'past', 'history', 'of', 'interest', 'comes', 'to', 'the', 'emergency', 'department', 'because', 'after', 'a', 'respiratory', 'infection', 'he', 'presents', 'with', 'asthenia,', 'malaise,', 'oliguria', 'and', 'headac... | [['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-... | [['Urine system: proteinuria 300 mg/dl, sediment 15 red blood cells per field\n', 'The patient presents with thrombotic microangiopathy (TMA) with acute renal failure\n', 'Support'], ['The patient presents with thrombotic microangiopathy (TMA) with acute renal failure\n', 'This points to HUS, TTP, drug-induced TMA, or ... |
506_87 | [['QUESTION', 'TYPE:', 'PSYCHIATRY'], ['CLINICAL', 'CASE:'], ['Faced', 'with', 'sudden-onset', 'obsessive-compulsive', 'disorder', '(OCD)', 'in', 'a', '9-year-old', 'boy', 'who', 'also', 'presents', 'with', 'tics', 'and', 'chorea', 'as', 'neurological', 'manifestations,', 'infection', 'by:'], ['1-', 'Streptococcus', 'v... | [['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', 'O'], ['O', 'O', 'O'], ['O', 'B-Claim', ... | [['It never ceases to amaze us the strange ways of biology and that the axiom "the longest is the right one" is fulfilled in this case\n', 'Beta-hemolytic streptococcus, group A\n', 'Support']] |
619_121 | null | null | [] |
161_118 | [['QUESTION', 'TYPE:', 'NEPHROLOGY'], ['CLINICAL', 'CASE:'], ['A', '60-year-old', 'woman', 'diagnosed', 'with', 'chronic', 'bronchopathy,', 'diabetes', 'mellitus,', 'hypertension', 'and', 'treated', 'for', '4', 'months', 'with', 'Omeprazole,', 'Metformin,', 'Salbutamol,', 'Ipratropium', 'Bromide', 'and', 'Enalapril', '... | [['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', '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'... | [['The correct answer is: 4\n', 'Antihypertensive\n', 'Support'], ['The correct answer is: 4\n', 'Antihypertensive\n', 'Support'], ["In particular, hydrochlorothiazide, as a thiazide, is primarily responsible for this patient's hypokalemia\n", 'Antihypertensive\n', 'Support'], ['treated for 4 months with Omeprazole, Me... |
269_141 | null | null | [] |
18_138 | [['QUESTION', 'TYPE:', 'DERMATOLOGY'], ['CLINICAL', 'CASE:'], ['If', 'a', 'patient', 'reports', 'having', 'for', 'months', 'now', 'enlargement', 'of', 'the', 'tongue,', 'with', 'no', 'other', 'alterations', 'of', 'the', 'tongue', 'causing', 'constant', 'biting,', 'which', 'disease', 'would', 'you', 'think', 'of', 'the'... | [['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', 'O'... | [['Sometimes amyloid deposits appear on the tongue which can produce macroglossia\n', 'Amyloidosis\n', 'Support'], ['If a patient reports having for months now enlargement of the tongue, with no other alterations of the tongue causing constant biting\n', 'Sometimes amyloid deposits appear on the tongue which can produc... |
250_78 | [['QUESTION', 'TYPE:', 'DIGESTIVE', 'SYSTEM'], ['CLINICAL', 'CASE:'], ['A', '55-year-old', 'man,', 'father', 'of', 'a', 'celiac', 'child,', 'with', 'iron-deficiency', 'anemia', 'and', 'a', 'recent', 'increase', 'in', 'the', 'stool', 'rhythm,', 'has', 'been', 'tested', 'negative', 'for', 'HLA-DQ2', 'and', 'HLA-DQ8', 'al... | [['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'... | [['Middle-aged male with iron deficiency anemia and increased number of stools\n', 'a colonoscopy should be done to rule out colorectal cancer!!!\n', 'Support'], ['a colonoscopy should be done to rule out colorectal cancer!!!\n', 'Colonoscopy\n', 'Support'], ['If the HLA is negative it is very unlikely to be celiac dis... |
5_44 | [['QUESTION', 'TYPE:', 'DIGESTIVE'], ['CLINICAL', 'CASE:'], ['A', '66-year-old', 'man', 'reports', 'daily', 'heartburn', 'since', 'youth,', 'which', 'he', 'treats', 'with', 'alkalis.'], ['An', 'upper', 'endoscopy', 'shows', 'mild', 'erosive', 'esophagitis', 'and', 'displaced', 'squamous', 'columnar', 'junction', 'appro... | [['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '... | [["In any case, Barrett's esophagus should follow endoscopic surveillance and lifelong PPI treatment or antireflux surgery to prevent progression\n", 'The correct answer is 4\n', 'Support'], ["This patient presents Barrett's esophagus with low grade dysplasia\n", "In any case, Barrett's esophagus should follow endoscop... |
359_91 | [['QUESTION', 'TYPE:', 'HEMATOLOGY'], ['CLINICAL', 'CASE:'], ['The', 'determination', 'in', 'a', '70-year-old', 'woman', 'of', 'hematocrit', '32%,', 'Hb', '9.6', 'g/dL,', 'MCV', '85', 'fL', '(70-99),', 'Fe', '25', 'ug/dL', '(37-145)', 'and', 'ferritin', '350', 'ng/mL', '(15-150),', 'is', 'more', 'suggestive', 'of:'], [... | [['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-... | [['Older woman with normocitic anemia and clear ferrokinetic pattern of chronic disorder (hyposideremia but hyperferritinemia)\n', 'The only one that fits, and it fits perfectly, is number 3; they only needed to give us a high ESR\n', 'Support'], ['The only one that fits, and it fits perfectly, is number 3; they only n... |
108_219 | [['QUESTION', 'TYPE:', 'GENETICS', 'AND', 'IMMUNOLOGY'], ['CLINICAL', 'CASE:'], ['A', 'man', 'has', 'a', 'partial', 'deletion', 'in', 'the', 'dystrophin', 'gene', '(chromosome', 'Xp21)', 'which', 'causes', 'the', 'semiology', 'of', 'Becker', 'muscular', 'dystrophy.'], ['He', 'goes', 'to', 'the', 'genetic', 'consultatio... | [['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', 'I-P... | [['It is the male who presents the disease, which we are told is X-linked, so there are only two options left: 2 and 3\n', 'Their daughters will not inherit the disease, but all their future sons will be carriers and can transmit the mutation to 50%\n', 'Support'], ['It is the male who presents the disease, which we ar... |
255_94 | [['QUESTION', 'TYPE:', 'DIGESTIVE', 'SYSTEM'], ['CLINICAL', 'CASE:'], ['A', '65-year-old', 'woman', 'with', 'a', 'history', 'of', 'joint', 'pain', 'and', 'under', 'treatment', 'with', 'anti-inflammatory', 'drugs', 'is', 'referred', 'for', 'anemia.'], ['In', 'the', 'complementary', 'studies', 'she', 'presented', 'red', ... | [['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'], ['O', 'O', 'O', 'O', 'B-Premise', 'I... | [['We have yet to see jejunum and ileum\n', 'we will have to perform a capsule endoscopy\n', 'Support'], ['we will have to perform a capsule endoscopy\n', 'Endoscopic capsule\n', 'Support'], ['It is a study of iron deficiency anemia with normal gastroscopy and colonoscopy, having ruled out possible celiac disease\n', '... |
303_111 | [['QUESTION', 'TYPE:', 'NEPHROLOGY'], ['CLINICAL', 'CASE:'], ['In', 'a', 'patient', 'with', 'rheumatoid', 'arthritis', 'on', 'methotrexate,', 'prednisone', 'and', 'indomethacin', 'who', 'acutely', 'presents', 'with', 'edema', 'and', 'increased', 'plasma', 'creatinine', 'with', 'poorly', 'expressive', 'urine', 'sediment... | [['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'... | [['Amyloidosis presents with proteinuria usually in the nephrotic range, and has a more chronic course\n', 'Renal amyloidosis\n', 'Attack'], ['a patient with rheumatoid arthritis on methotrexate, prednisone and indomethacin who acutely presents with edema and increased plasma creatinine with poorly expressive urine sed... |
539_3 | null | null | [] |
408_190 | [['QUESTION', 'TYPE:', 'PRIMARY', 'CARE'], ['CLINICAL', 'CASE:'], ['A', '45-year-old', 'woman', 'diagnosed', 'with', 'stage', 'IV', 'breast', 'cancer', 'with', 'multiple', 'bone', 'metastases', 'on', 'hormonal', 'treatment', 'and', 'iv', 'bisphosphonates.'], ['She', 'comes', 'to', 'your', 'office', 'referring', 'intens... | [['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'], ['B-Premise', 'I-Premise', 'I-Premis... | [['A 45-year-old woman diagnosed with stage IV breast cancer with multiple bone metastases on hormonal treatment and iv bisphosphonates\n', 'if the patient has bone metastases and may suffer fractures we can control inflammatory pain with ibuprofen\n', 'Support'], ['if the patient has bone metastases and may suffer fra... |
29_60 | [['QUESTION', 'TYPE:', 'NEUROLOGY', 'AND', 'THORACIC', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '71-year-old', 'patient,', 'smoker', 'of', '2', 'packs', 'of', 'cigarettes/day', 'for', '50', 'years,', 'with', 'good', 'quality', 'of', 'life', 'and', 'no', 'other', 'pathologic', 'history', 'of', 'interest,', 'consults', '... | [['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', '... | [['especially considering that it is only 71 years old, but especially because the patient\'s "quality of life" is good (and I put "quality of life" because it is a term used erroneously, it is supposed to mean that he maintains a good functional level)\n', '2: Age should not be a limiting factor\n', 'Support'], ['1 an... |
10_37 | [['QUESTION', 'TYPE:', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '76-year-old', 'woman', 'with', 'no', 'history', 'other', 'than', 'hypertension', 'consults', 'for', 'painless', 'jaundice', 'and', 'pruritus', 'with', 'anorexia.'], ['Laboratory', 'tests', 'show', 'a', 'bilirubin', 'level', 'of', '12', 'mg/dl', '(with', '... | [['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', '... | [['although both lesions are resectable\n', 'I think the correct answer is 4\n', 'Attack'], ['Surgical bypass has more complications than placing a self-expanding metallic prosthesis that has a median patency of 6 months which is similar to the median survival of a patient with hepatic metastases of pancreatic adenocar... |
284_57 | null | null | [] |
188_230 | [['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['A', '57-year-old', 'patient', 'had', 'an', 'acute', 'myocardial', 'infarction', 'and', 'has', 'a', 'blood', 'test', 'with', 'cholesterol', '312', 'mg/dl,', 'LDL', '241', 'mg/dl,', 'HDL', '29', 'and', 'normal', 'TG.'], ['He', 'smoked', '30', 'cig/day,', '... | [['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 treatment for hypercholesterolemia is statins so we rule out answers 2 and 4\n', 'Rule out hypothyroidism or other systemic disease, recommend a healthy lifestyle and treat with fibrates to normalize cholestero\n', 'Attack'], ['The statin in a patient with cardiovascular disease (such as an AMI) is a lifelong tr... |
349_160 | [['QUESTION', 'TYPE:', 'GYNECOLOGY', 'AND', 'OBSTETRICS'], ['CLINICAL', 'CASE:'], ['A', '45-year-old', 'woman,', 'mother', 'of', '3', 'children,', 'attends', 'an', 'early', 'diagnosis', 'consultation.'], ['Cervicovaginal', 'cytology', 'is', 'compatible', 'with', 'a', 'high-grade', 'squamous', 'intraepithelial', 'lesion... | [['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-P... | [['The correct answer is 2\n', 'Colposcopy with possible biopsy\n', 'Support'], ['Cervicovaginal cytology is compatible with a high-grade squamous intraepithelial lesion\n', "According to the 2014 SEGO Oncoguide on cervical cancer prevention, when a cytology shows a high-grade squamous intraepithelial lesion, the actio... |
290_50 | [['QUESTION', 'TYPE:', 'DERMATOLOGY,', 'VENEREOLOGY', 'AND', 'PLASTIC', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '58-year-old', 'man', 'referred', 'a', '3-week', 'history', 'of', 'progressive,', 'mildly', 'painful', 'skin', 'lesions', 'on', 'his', 'left', 'arm.'], ['It', 'had', 'started', 'as', 'an', 'erythematous', 'l... | [['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Prem... | [['A 58-year-old man referred a 3-week history of progressive, mildly painful skin lesions on his left arm\n', 'The lesions with sporotrichoid or lymphocutaneous pattern described may correspond to sporotrichosis or aquarium granuloma\n', 'Support'], ['It had started as an erythematous lesion on his left thumb\n', 'The... |
305_174 | [['QUESTION', 'TYPE:', 'NEPHROLOGY'], ['CLINICAL', 'CASE:'], ['An', '87-year-old', 'man', 'with', 'a', 'history', 'of', 'hypertension', 'and', 'gonarthrosis.'], ['Baseline', 'situation', 'with', 'full', 'functional', 'and', 'cognitive', 'autonomy', 'that', 'allows', 'him', 'to', 'continue', 'living', 'alone', 'in', 'th... | [['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'], ['B-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 preferable thing to do in this patient, before increasing the medication, is to change the ibuprofen for paracetamol, which does not have this effect, and to re-evaluate it later\n', 'I would change ibuprofen to paracetamol to avoid the possible influence of paracetamol on the effect of hypotensives\n... |
104_91 | null | null | [] |
38_232 | [['QUESTION', 'TYPE:', 'OPHTHALMOLOGY'], ['CLINICAL', 'CASE:'], ['A', '52-year-old', 'woman', 'consults', 'for', 'having', 'noticed', 'during', 'the', 'previous', 'week', 'a', 'yellowish', 'discoloration', 'of', 'the', 'conjunctivae.'], ['She', 'does', 'not', 'refer', 'to', 'risky', 'sexual', 'behavior', 'or', 'epidemi... | [['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', '... | [["A middle-aged woman with Sjögren's-like symptoms (absence of lacrimation, dry mouth), with hyperbilirubinemia, jaundice and hepatomegaly, makes us think of primary biliary cirrhosis\n", 'To diagnose it we will use antimitochondrial antibodies (AMA IgG)\n', 'Support'], ["A middle-aged woman with Sjögren's-like sympto... |
376_130 | [['QUESTION', 'TYPE:', 'NEUROLOGY'], ['CLINICAL', 'CASE:'], ['A', '39-year-old', 'man', 'who', 'in', 'the', 'last', '3', 'months', 'has', 'had', 'two', 'episodes', 'of', 'wide', 'and', 'involuntary', 'jumping', 'movements', 'of', 'the', 'left', 'limbs,', 'which', 'in', 'about', 'two', 'minutes', 'lead', 'to', 'loss', '... | [['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-... | [['They refer to a partial seizure that is followed by loss of level of consciousness\n', 'strictly speaking it would be a symptomatic complex partial seizure, not a secondarily generalized partial seizure (which occurs when tonic-clonic movements extend to the rest of the extremities)\n', 'Support'], ['strictly speaki... |
163_122 | [['QUESTION', 'TYPE:', 'NEPHROLOGY'], ['CLINICAL', 'CASE:'], ['A', '66-year-old', 'man', 'with', 'a', 'history', 'of', 'ankylosing', 'spondylitis', 'of', 'long', 'evolution.'], ['He', 'presents', 'proteinuria', 'of', '6', 'grams', 'per', 'day', 'with', 'hypoalbuminemia', 'and', 'edema.'], ['In', 'the', 'urinary', 'sedi... | [['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', '... | [['The correct answer is: 3\n', 'Subcutaneous fat biopsy\n', 'Support'], ['The correct answer is: 3\n', 'Subcutaneous fat biopsy\n', 'Support'], ['The appearance of urinary abnormalities or renal impairment of parenchymal cause are indications for renal biopsy, even with proteinuria ranges lower than those accepted in ... |
148_158 | [['QUESTION', 'TYPE:', 'PSYCHIATRY'], ['CLINICAL', 'CASE:'], ['A', '23-year-old', 'woman', 'comes', 'to', 'the', 'emergency', 'department', 'because', 'she', 'is', 'very', 'nervous', 'after', 'an', 'argument', 'with', 'her', 'partner.'], ['Her', 'medical', 'history', 'shows', 'several', 'similar', 'complaints', 'in', '... | [['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'], ['B-Premise', 'I-Premise', 'I-Premise', '... | [['A 23-year-old woman comes to the emergency department because she is very nervous after an argument with her partner\n', 'The woman is 23 years old and is pissed off\n', 'Support'], ['The diagnosis is 1\n', 'Borderline personality disorder\n', 'Support'], ['The issue is that she cannot stand rejection and has self-i... |
178_94 | [['QUESTION', 'TYPE:', 'HEMATOLOGY'], ['CLINICAL', 'CASE:'], ['18-month-old', 'boy,', 'with', 'complete', 'vaccination', 'schedule', 'to', 'date,', 'who', 'consults', 'the', 'Emergency', 'Department', 'for', 'swelling', 'of', 'the', 'right', 'knee', 'after', 'playing', 'in', 'the', 'park,', 'without', 'obvious', 'traum... | [['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-... | [['18-month-old boy, with complete vaccination schedule to date, who consults the Emergency Department for swelling of the right knee after playing in the park, without obvious trauma\n', 'a small child who suffers a hemarthrosis without clear trauma\n', 'Support'], ['The ultrasound examination is compatible with hemar... |
100_85 | [['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['A', '24-year-old', 'man', 'reports', 'progressive', 'asthenia', 'for', 'at', 'least', '6', 'months,', 'hoarse', 'voice,', 'slow', 'speech,', 'drowsiness', 'and', 'swelling', 'of', 'the', 'hands,', 'feet', 'and', 'face.'], ['Examination:', 'pulse', 'at', ... | [['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-... | [['Treatment is with thyroxine\n', 'Treat with L-Tyroxine and determine antithyroid antibodies\n', 'Support'], ['If there is no nodule, neither echo nor FNA is indicated\n', 'Perform a thyroid ultrasound before starting treatment\n', 'Attack'], ['If there is no nodule, neither echo nor FNA is indicated\n', 'Perform thy... |
398_140 | [['QUESTION', 'TYPE:', 'TRAUMATOLOGY', 'AND', 'ORTHOPEDICS'], ['CLINICAL', 'CASE:'], ['You', 'evaluate', 'a', '66-year-old', 'patient', 'with', 'groin', 'pain', 'accentuated', 'by', 'prolonged', 'standing', 'a', 'few', 'days', 'a', 'month.'], ['A', 'plain', 'radiograph', 'of', 'the', 'hips', 'shows', 'narrowing', 'of',... | [['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-P... | [['Although the diagnosis is clearly osteoarthritis, it does not lead directly to a surgical indication\n', 'I make the diagnosis of coxarthrosis and send to the traumatologist to place a hip prosthesis\n', 'Attack'], ['The first step is to try conservative treatment\n', 'I make the diagnosis of coxarthrosis and send t... |
28_58 | null | null | [] |
587_76 | null | null | [] |
554_50 | [['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['A', '58-year-old', 'man', 'comes', 'for', 'a', 'scheduled', 'check-up', 'for', 'type', '2', 'diabetes', 'mellitus', 'diagnosed', '6', 'years', 'ago.'], ['He', 'has', 'a', 'personal', 'history', 'of', 'hypertension,', 'dyslipidemia,', 'ischemic', 'heart',... | [['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', '... | [['Patient with obesity, hypertension and increased HbA1C\n', 'In recent studies, Empaglifozin, a highly selective inhibitor of SGLT210, significantly reduces AT, HbA1C and BMI\n', 'Support'], ['In recent studies, Empaglifozin, a highly selective inhibitor of SGLT210, significantly reduces AT, HbA1C and BMI\n', 'Empagl... |
251_81 | [['QUESTION', 'TYPE:', 'DIGESTIVE', 'SYSTEM'], ['CLINICAL', 'CASE:'], ['A', '50-year-old', 'woman', 'comes', 'to', 'the', 'emergency', 'department', 'with', 'asthenia,', 'anorexia,', 'weight', 'loss,', 'jaundice,', 'fever', 'and', 'abdominal', 'pain.'], ['She', 'has', 'no', 'recent', 'history', 'of', 'blood', 'transfus... | [['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premis... | [['Patient with harmful alcohol consumption (60g and female), high fever, hepatic encephalopathy (disorientation, asterixis), very high direct bilirubin, jaundice, painful hepatomegaly, coagulopathy (elevated prothrombin time) and mild elevation of transaminases (less than 5 times the upper limit of normal)\n', 'sugges... |
128_79 | [['QUESTION', 'TYPE:', 'NEUROLOGY', 'AND', 'NEUROSURGERY'], ['CLINICAL', 'CASE:'], ['A', '42-year-old', 'married', 'woman', 'with', '2', 'school-age', 'children', 'consults', 'her', 'family', 'physician', 'for', 'a', 'severe', 'headache', 'of', 'about', '7', "days'", 'evolution.'], ['Although', 'she', 'has', 'been', 'h... | [['O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-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', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-P... | [['Both the initially occipital location, the 2-year evolution time, and the sensation of weight lead to answer 4, a tension headache\n', 'Tension\n', 'Support'], ['The pain is like a weight that starts in the occipital area, spreads to both temporal regions and is barely relieved by taking 650 mg paracetamol tablets, ... |
0_34 | [['QUESTION', 'TYPE:', 'DIGESTIVE'], ['CLINICAL', 'CASE:'], ['A', '27-year-old', 'woman', 'under', 'study', 'in', 'the', 'dermatology', 'department', 'for', 'recurrent', 'episodes', 'of', 'oral', 'aphthous', 'ulcers.'], ['She', 'was', 'referred', 'to', 'the', 'gastrointestinal', 'department', 'for', 'a', 'blood', 'test... | [['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'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'B-Premise', 'I-Premise', 'I-Premise', ... | [['The rest of the symptoms fall perfectly within the picture\n', 'In this question, they give an important piece of information when it comes to suspecting a diagnosis, which is the antitransglutaminase antibodies\n', 'Support'], ['A 27-year-old woman under study in the dermatology department for recurrent episodes of... |
256_162 | [['QUESTION', 'TYPE:', 'DIGESTIVE', 'SYSTEM'], ['CLINICAL', 'CASE:'], ['An', '80-year-old', 'woman', 'consults', 'for', 'presenting,', 'since', '1', 'month', 'ago,', 'a', 'progressive', 'increase', 'in', 'abdominal', 'perimeter.'], ['During', 'the', 'previous', '4-5', 'months', 'she', 'noted', 'asthenia,', 'anorexia', ... | [['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premis... | [['The characteristics of the fluid described are milky\n', 'chylous ascitic fluid\n', 'Support'], ['chylous ascitic fluid\n', "Chylous ascites due to non-Hodgkin's lymphoma\n", 'Support'], ['Taking into account the age of the patient and the constitutional syndrome described\n', "it is most likely to be a non-Hodgkin'... |
604_113 | [['QUESTION', 'TYPE:', 'TRAUMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '35-year-old', 'man,', 'a', 'letter', 'carrier,', 'with', 'no', 'history', 'of', 'interest,', 'who', 'comes', 'to', 'the', 'emergency', 'department', 'for', 'acute', 'cervical', 'pain', 'of', '24', 'hours', 'of', 'evolution,', 'without', 'previous', '... | [['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-... | [['Conservative treatment with a success rate of 75%-90%\n', 'Conservative treatment with nonsteroidal anti-inflammatory drugs, local heat and relative rest\n', 'Support']] |
362_96 | null | null | [] |
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