| case,ground_truth | |
| "A 30-year-old woman presents with weight loss, heat intolerance, palpitations, and tremors. | |
| Physical examination reveals exophthalmos and diffuse goiter. | |
| Laboratory tests show low TSH and elevated T3/T4.",Graves Disease | |
| "A 27-year-old woman presents with anxiety, excessive sweating, increased appetite, and unintentional weight loss. | |
| Physical examination reveals a diffusely enlarged thyroid gland and mild exophthalmos. | |
| Laboratory studies show suppressed TSH and elevated free T4.",Graves Disease | |
| "A 35-year-old woman presents with palpitations, tremors, nervousness, and difficulty sleeping. | |
| Examination reveals warm skin, tachycardia, and a diffuse goiter. | |
| Laboratory tests demonstrate low TSH and elevated T3 levels.",Graves Disease | |
| "A 29-year-old woman presents with heat intolerance, weight loss, frequent bowel movements, and palpitations. | |
| Physical examination reveals lid lag, exophthalmos, and diffuse thyroid enlargement. | |
| Laboratory tests show elevated T3/T4 and suppressed TSH.",Graves Disease | |
| "A 32-year-old woman presents with fatigue despite increased energy levels, tremors, and rapid heartbeat. | |
| Examination reveals a bruit over a diffusely enlarged thyroid gland and mild exophthalmos. | |
| Laboratory studies show low TSH and markedly elevated free T4.",Graves Disease | |
| "A 62-year-old man presents with fatigue, recurrent infections, and easy bruising for the past two months. | |
| Complete blood count reveals anemia, thrombocytopenia, and leukocytosis. | |
| Peripheral blood smear shows numerous myeloblasts with Auer rods.",Acute Myeloid Leukemia (AML) | |
| "A 55-year-old woman presents with fever, fatigue, and bleeding gums. | |
| Laboratory studies reveal pancytopenia. | |
| Bone marrow biopsy demonstrates more than 20% myeloblasts.",Acute Myeloid Leukemia (AML) | |
| "A 68-year-old man presents with fatigue, shortness of breath, and recurrent respiratory infections. | |
| CBC shows severe anemia and elevated white blood cell count. | |
| Flow cytometry demonstrates CD13 and CD33 positivity.",Acute Myeloid Leukemia (AML) | |
| "A 47-year-old woman presents with petechiae, easy bruising, and persistent fatigue. | |
| Peripheral smear reveals circulating blast cells. | |
| Bone marrow examination shows hypercellularity with myeloblast predominance.",Acute Myeloid Leukemia (AML) | |
| "A 59-year-old man presents with weakness, fever, and unexplained weight loss. | |
| Laboratory tests reveal leukocytosis and thrombocytopenia. | |
| Peripheral smear demonstrates Auer rods within blast cells.",Acute Myeloid Leukemia (AML) | |
| "A 22-year-old man presents with abdominal pain that started around the umbilicus and later migrated to the right lower quadrant. | |
| He reports nausea and loss of appetite. | |
| Physical examination reveals tenderness at McBurney's point.",Acute Appendicitis | |
| "A 19-year-old woman presents with fever, vomiting, and right lower quadrant abdominal pain. | |
| Laboratory tests reveal leukocytosis with neutrophilia. | |
| Abdominal ultrasound demonstrates an enlarged non-compressible appendix.",Acute Appendicitis | |
| "A 35-year-old man presents with worsening abdominal pain, nausea, and low-grade fever. | |
| Physical examination reveals rebound tenderness in the right iliac fossa. | |
| CT scan shows periappendiceal fat stranding.",Acute Appendicitis | |
| "A 28-year-old woman presents with sharp right lower quadrant pain aggravated by movement. | |
| Laboratory testing shows elevated white blood cell count. | |
| CT abdomen reveals a dilated appendix with wall thickening.",Acute Appendicitis | |
| "A 31-year-old man presents with abdominal pain, vomiting, and fever. | |
| Physical examination demonstrates positive Rovsing sign and guarding. | |
| Imaging confirms inflammation of the appendix.",Acute Appendicitis | |
| "A 48-year-old man presents with severe epigastric pain radiating to the back. | |
| He reports nausea and multiple episodes of vomiting. | |
| Serum lipase is markedly elevated.",Acute Pancreatitis | |
| "A 55-year-old woman presents with sudden onset upper abdominal pain after a heavy meal. | |
| Laboratory tests reveal elevated amylase and lipase levels. | |
| Ultrasound demonstrates gallstones.",Acute Pancreatitis | |
| "A 50-year-old man with a history of alcohol abuse presents with severe abdominal pain and vomiting. | |
| Physical examination reveals epigastric tenderness. | |
| CT scan shows pancreatic edema.",Acute Pancreatitis | |
| "A 43-year-old woman presents with severe abdominal pain radiating to the back and fever. | |
| Serum lipase is elevated to more than three times the upper limit of normal. | |
| CT imaging reveals peripancreatic inflammation.",Acute Pancreatitis | |
| "A 60-year-old man presents with intense epigastric pain, nausea, and abdominal distension. | |
| Laboratory studies show elevated amylase and lipase. | |
| Abdominal CT confirms acute pancreatic inflammation.",Acute Pancreatitis | |
| "A 65-year-old woman presents with sudden onset shortness of breath and pleuritic chest pain. | |
| She recently underwent hip replacement surgery. | |
| CT pulmonary angiography reveals a filling defect in the pulmonary artery.",Pulmonary Embolism | |
| "A 58-year-old man presents with acute shortness of breath and hemoptysis. | |
| Oxygen saturation is 89% on room air. | |
| CT angiography demonstrates emboli in segmental pulmonary arteries.",Pulmonary Embolism | |
| "A 42-year-old woman presents with sudden chest pain and difficulty breathing after a long international flight. | |
| D-dimer levels are elevated. | |
| CT pulmonary angiography confirms pulmonary artery thrombosis.",Pulmonary Embolism | |
| "A 70-year-old man presents with sudden onset dyspnea and tachycardia. | |
| Physical examination reveals unilateral leg swelling. | |
| Imaging demonstrates emboli in the pulmonary vasculature.",Pulmonary Embolism | |
| "A 55-year-old woman presents with pleuritic chest pain, tachypnea, and dizziness. | |
| Arterial blood gas analysis reveals hypoxemia. | |
| CT pulmonary angiography identifies multiple pulmonary emboli.",Pulmonary Embolism | |
| "A 25-year-old man presents with chronic diarrhea, abdominal pain, and weight loss. | |
| Colonoscopy reveals skip lesions throughout the colon and terminal ileum.",Crohn Disease | |
| "A 30-year-old woman presents with recurrent abdominal cramps and non-bloody diarrhea. | |
| Colonoscopy shows patchy areas of inflammation separated by normal mucosa",Crohn Disease | |
| "A 28-year-old man presents with abdominal pain, fever, and unintended weight loss. | |
| MRI enterography reveals thickening of the terminal ileum and fistula formation.",Crohn Disease | |
| "A 35-year-old woman presents with chronic diarrhea and perianal pain. | |
| Examination reveals a perianal fistula. | |
| Colonoscopy demonstrates patchy intestinal inflammation.",Crohn Disease | |
| "A 22-year-old man presents with abdominal pain, diarrhea, and iron deficiency anemia. | |
| Colonoscopy reveals cobblestone mucosa and skip lesions.",Crohn Disease | |
| "A 72-year-old man develops sudden right-sided weakness and slurred speech. | |
| Brain MRI reveals an acute infarct in the left middle cerebral artery territory.",Acute Ischemic Stroke | |
| "A 68-year-old woman presents with sudden facial droop and inability to move her left arm. | |
| CT scan excludes intracranial hemorrhage.",Acute Ischemic Stroke | |
| "A 75-year-old man presents with abrupt loss of speech and right arm weakness. | |
| MRI demonstrates restricted diffusion in the left cerebral hemisphere.",Acute Ischemic Stroke | |
| "A 60-year-old woman presents with sudden vision loss in the right visual field and difficulty speaking. | |
| Brain imaging reveals an infarct in the left posterior cerebral circulation.",Acute Ischemic Stroke | |
| "A 70-year-old man with atrial fibrillation presents with sudden left-sided weakness and facial droop. | |
| MRI confirms an acute cerebral infarction.",Acute Ischemic Stroke | |
| "A 38-year-old woman presents with weight gain, muscle weakness, and easy bruising. | |
| Physical examination reveals moon facies and purple abdominal striae.",Cushing Syndrome | |
| "A 45-year-old woman presents with central obesity, hypertension, and fatigue. | |
| Laboratory tests reveal elevated cortisol levels.",Cushing Syndrome | |
| "A 50-year-old man presents with weight gain, diabetes, and proximal muscle weakness. | |
| Low-dose dexamethasone suppression testing fails to suppress cortisol.",Cushing Syndrome | |
| "A 42-year-old woman presents with facial rounding, abdominal obesity, and purple stretch marks. | |
| Laboratory evaluation shows elevated urinary free cortisol.",Cushing Syndrome | |
| "A 55-year-old man presents with hypertension, weight gain, and easy bruising. | |
| Physical examination reveals proximal muscle wasting and abdominal striae.",Cushing Syndrome | |
| "A 28-year-old woman presents with blurred vision in her right eye and pain with eye movement. | |
| MRI of the brain reveals multiple periventricular demyelinating plaques.",Multiple Sclerosis | |
| "A 32-year-old woman presents with numbness and tingling in both legs that developed over several days. | |
| MRI reveals demyelinating lesions in the spinal cord and brain.",Multiple Sclerosis | |
| "A 35-year-old woman presents with intermittent weakness of her left arm and episodes of double vision. | |
| Neurological examination reveals hyperreflexia.",Multiple Sclerosis | |
| "A 30-year-old woman presents with fatigue, difficulty walking, and urinary urgency. | |
| MRI demonstrates multiple white matter plaques.",Multiple Sclerosis | |
| "A 27-year-old woman presents with recurrent episodes of limb weakness and visual disturbances. | |
| CSF analysis reveals oligoclonal bands.",Multiple Sclerosis | |
| "A 25-year-old woman presents with fatigue, pallor, and yellowing of the eyes. | |
| Laboratory tests reveal low hemoglobin, elevated indirect bilirubin, and increased reticulocyte count. | |
| Direct Coombs test is positive.",Autoimmune Hemolytic Anemia | |
| "A 40-year-old woman presents with weakness, dark urine, and shortness of breath. | |
| Laboratory studies show anemia, elevated lactate dehydrogenase (LDH), and decreased haptoglobin levels. | |
| Direct antiglobulin test is positive.",Autoimmune Hemolytic Anemia | |
| "A 32-year-old man presents with fatigue, jaundice, and splenomegaly. | |
| Peripheral blood smear reveals spherocytes. | |
| Direct Coombs test is positive.",Autoimmune Hemolytic Anemia | |
| "A 55-year-old woman presents with progressive fatigue and recurrent episodes of jaundice. | |
| Laboratory tests show elevated indirect bilirubin, increased reticulocyte count, and low hemoglobin. | |
| Direct Coombs test is positive.",Autoimmune Hemolytic Anemia | |
| "A 28-year-old woman presents with weakness, palpitations, and scleral icterus. | |
| Laboratory evaluation demonstrates anemia, elevated LDH, low haptoglobin, and a positive Direct Coombs test.",Autoimmune Hemolytic Anemia | |
| "A 16-year-old boy presents with excessive thirst, frequent urination, weight loss, and vomiting. | |
| Blood glucose is 420 mg/dL. | |
| Urinalysis reveals ketones, and arterial blood gas shows metabolic acidosis.",Type 1 Diabetes Mellitus with Diabetic Ketoacidosis (DKA | |
| "A 14-year-old girl presents with abdominal pain, nausea, vomiting, and excessive thirst. | |
| Laboratory tests reveal blood glucose of 380 mg/dL, positive serum ketones, and low serum bicarbonate.",Type 1 Diabetes Mellitus with Diabetic Ketoacidosis (DKA | |
| "A 19-year-old man presents with fatigue, polyuria, polydipsia, and rapid breathing. | |
| Blood glucose is 510 mg/dL. | |
| Arterial blood gas reveals metabolic acidosis, and ketones are present in urine.",Type 1 Diabetes Mellitus with Diabetic Ketoacidosis (DKA | |
| "A 12-year-old boy presents with dehydration, confusion, and vomiting. | |
| Laboratory tests show glucose of 450 mg/dL, elevated serum ketones, and arterial pH of 7.15.",Type 1 Diabetes Mellitus with Diabetic Ketoacidosis (DKA | |
| "A 17-year-old girl presents with weight loss, excessive thirst, frequent urination, and fruity-smelling breath. | |
| Laboratory studies reveal blood glucose of 480 mg/dL, positive ketones, and metabolic acidosis.",Type 1 Diabetes Mellitus with Diabetic Ketoacidosis (DKA | |
| "A 24-year-old woman presents with fatigue, joint pain, and a butterfly-shaped rash across her cheeks. | |
| Laboratory testing reveals positive ANA and anti-dsDNA antibodies.",Systemic Lupus Erythematosus (SLE) | |
| "A 30-year-old woman presents with fatigue, photosensitivity, and oral ulcers. | |
| Urinalysis reveals proteinuria. | |
| Laboratory tests show positive ANA and low complement levels.",Systemic Lupus Erythematosus (SLE) | |
| "A 27-year-old woman presents with fever, fatigue, and pain in multiple joints. | |
| Physical examination reveals a malar rash. | |
| Laboratory studies show positive ANA and anti-Smith antibodies.",Systemic Lupus Erythematosus (SLE) | |
| "A 35-year-old woman presents with chest pain that worsens on deep inspiration and fatigue. | |
| Echocardiography demonstrates a small pericardial effusion. | |
| Laboratory testing reveals positive ANA and anti-dsDNA antibodies.",Systemic Lupus Erythematosus (SLE) | |
| "A 29-year-old woman presents with fatigue, hair loss, joint pain, and a facial rash. | |
| Laboratory tests reveal anemia, positive ANA, and positive anti-dsDNA antibodies.",Systemic Lupus Erythematosus (SLE) | |
| "A 15-year-old boy presents with recurrent wheezing, cough, and shortness of breath. | |
| Symptoms worsen during exercise and improve with inhaled bronchodilators. | |
| Spirometry demonstrates reversible airflow obstruction.",Asthma | |
| "A 22-year-old woman presents with episodic chest tightness, wheezing, and nighttime cough. | |
| Symptoms are triggered by exposure to dust. | |
| Pulmonary function testing shows improvement after bronchodilator administration.",Asthma | |
| "A 10-year-old boy presents with repeated episodes of wheezing and difficulty breathing. | |
| Symptoms occur mainly during pollen season. | |
| Spirometry reveals reversible airflow limitation.",Asthma | |
| "A 35-year-old woman presents with recurrent shortness of breath and chest tightness that worsen at night. | |
| Physical examination reveals diffuse expiratory wheezes. | |
| Symptoms improve after administration of albuterol.",Asthma | |
| "A 28-year-old man presents with intermittent cough, wheezing, and shortness of breath triggered by cold air. | |
| Spirometry demonstrates reduced FEV1 that improves significantly after bronchodilator therapy.",Asthma | |
| "A 35-year-old woman presents with recurrent episodes of severe headaches, palpitations, and excessive sweating. | |
| Blood pressure during episodes is 190/110 mmHg. | |
| Laboratory testing reveals elevated urinary metanephrines.",Pheochromocytoma | |
| "A 42-year-old man presents with episodic anxiety, sweating, and rapid heartbeat. | |
| Blood pressure fluctuates between normal values and severe hypertension. | |
| Plasma free metanephrines are markedly elevated.",Pheochromocytoma | |
| "A 50-year-old woman presents with recurrent pounding headaches and palpitations. | |
| CT scan reveals an adrenal mass. | |
| Urinary catecholamines are significantly elevated.",Pheochromocytoma | |
| "A 29-year-old woman presents with episodic tremors, sweating, and severe hypertension. | |
| Laboratory studies reveal elevated plasma metanephrine levels. | |
| MRI demonstrates a right adrenal tumor.",Pheochromocytoma | |
| "A 45-year-old man presents with intermittent headaches, palpitations, and panic attack-like episodes. | |
| Blood pressure is persistently elevated. | |
| Biochemical testing demonstrates increased urinary vanillylmandelic acid (VMA).",Pheochromocytoma | |
| "A 30-year-old woman presents with drooping of both eyelids and double vision that worsens throughout the day. | |
| Symptoms improve after resting. | |
| Acetylcholine receptor antibodies are positive.",Myasthenia Gravis | |
| "A 45-year-old woman presents with progressive difficulty chewing and swallowing toward the end of meals. | |
| Neurological examination is otherwise normal. | |
| Serologic testing reveals acetylcholine receptor antibodies.",Myasthenia Gravis | |
| "A 27-year-old woman presents with intermittent double vision and generalized muscle weakness. | |
| Symptoms worsen in the evening after prolonged activity. | |
| Electromyography demonstrates a decremental response on repetitive stimulation.",Myasthenia Gravis | |
| "A 55-year-old man presents with difficulty climbing stairs and lifting objects overhead. | |
| Physical examination reveals proximal muscle weakness that worsens with repeated movements. | |
| Acetylcholine receptor antibody testing is positive.",Myasthenia Gravis | |
| "A 38-year-old woman presents with ptosis, dysarthria, and generalized fatigue. | |
| CT scan of the chest reveals a thymoma. | |
| Serologic testing is positive for acetylcholine receptor antibodies.",Myasthenia Gravis | |
| "A 7-year-old boy presents with fatigue, fever, and easy bruising. | |
| Physical examination reveals hepatosplenomegaly and cervical lymphadenopathy. | |
| Bone marrow biopsy shows lymphoblasts accounting for more than 25% of nucleated cells.",Acute Lymphoblastic Leukemia (ALL) | |
| "A 10-year-old girl presents with recurrent infections, pallor, and bone pain. | |
| Complete blood count reveals anemia and thrombocytopenia. | |
| Peripheral smear demonstrates circulating lymphoblasts.",Acute Lymphoblastic Leukemia (ALL) | |
| "A 6-year-old boy presents with fatigue, fever, and petechiae. | |
| Laboratory tests reveal pancytopenia. | |
| Flow cytometry demonstrates TdT-positive lymphoblasts.",Acute Lymphoblastic Leukemia (ALL) | |
| "A 12-year-old boy presents with cough and shortness of breath. | |
| Chest X-ray reveals a mediastinal mass. | |
| Bone marrow examination shows lymphoblast proliferation.",Acute Lymphoblastic Leukemia (ALL) | |
| "An 8-year-old girl presents with fatigue, fever, and enlarged lymph nodes. | |
| Laboratory studies show leukocytosis with circulating lymphoblasts. | |
| Bone marrow biopsy confirms acute lymphoblastic leukemia.",Acute Lymphoblastic Leukemia (ALL) | |
| "A 52-year-old woman presents with recurrent kidney stones, constipation, and fatigue. | |
| Laboratory tests reveal elevated serum calcium and elevated parathyroid hormone levels.",Primary Hyperparathyroidism | |
| "A 60-year-old man presents with generalized bone pain and recurrent nephrolithiasis. | |
| Laboratory testing demonstrates hypercalcemia and elevated PTH. | |
| Neck ultrasound reveals a parathyroid adenoma.",Primary Hyperparathyroidism | |
| "A 48-year-old woman presents with depression, fatigue, and abdominal discomfort. | |
| Laboratory studies reveal serum calcium of 11.8 mg/dL and elevated PTH levels.",Primary Hyperparathyroidism | |
| "A 55-year-old woman presents with muscle weakness and recurrent fractures. | |
| DEXA scan demonstrates reduced bone mineral density. | |
| Laboratory tests reveal hypercalcemia and elevated parathyroid hormone.",Primary Hyperparathyroidism | |
| "A 63-year-old man presents with fatigue, constipation, and excessive thirst. | |
| Laboratory evaluation reveals elevated calcium, low phosphate, and elevated PTH levels.",Primary Hyperparathyroidism | |
| "A 62-year-old man with a history of diabetes presents with fatigue, swelling of the legs, and decreased urine output. | |
| Laboratory tests reveal elevated serum creatinine and reduced estimated glomerular filtration rate (eGFR).",Chronic Kidney Disease | |
| "A 55-year-old woman presents with weakness, nausea, and persistent hypertension. | |
| Laboratory studies show elevated blood urea nitrogen (BUN), elevated creatinine, and proteinuria.",Chronic Kidney Disease | |
| "A 68-year-old man presents with fatigue, pruritus, and ankle swelling. | |
| Laboratory tests reveal anemia and decreased eGFR.",Chronic Kidney Disease | |
| "A 59-year-old woman presents with generalized weakness and decreased appetite. | |
| Laboratory evaluation reveals hyperkalemia, elevated creatinine, and metabolic acidosis.",Chronic Kidney Disease | |
| "A 65-year-old man with longstanding hypertension presents with fatigue and lower extremity edema. | |
| Urinalysis reveals proteinuria. | |
| Serum creatinine is persistently elevated.",Chronic Kidney Disease | |
| "A 60-year-old woman presents with swelling and pain in her left calf after a long flight. | |
| Doppler ultrasound reveals thrombosis of the popliteal vein.",Deep Vein Thrombosis | |
| "A 48-year-old man presents with redness, warmth, and swelling of the right leg. | |
| Ultrasound demonstrates a thrombus in the femoral vein",Deep Vein Thrombosis | |
| "A 72-year-old woman develops calf pain three days after hip replacement surgery. | |
| Physical examination reveals unilateral leg edema. | |
| Venous Doppler confirms deep venous thrombosis.",Deep Vein Thrombosis | |
| "A 55-year-old man presents with sudden swelling and tenderness of the left lower limb. | |
| Laboratory testing reveals elevated D-dimer levels. | |
| Ultrasound identifies a thrombus in the deep venous system",Deep Vein Thrombosis | |
| "A 40-year-old woman taking oral contraceptive pills presents with unilateral leg pain and swelling. | |
| Venous ultrasound reveals a clot in the femoral vein.",Deep Vein Thrombosis | |
| "A 45-year-old man presents with chronic cough, night sweats, fever, and weight loss. | |
| Chest X-ray reveals cavitary lesions in the upper lobes. | |
| Sputum smear is positive for acid-fast bacilli.",Tuberculosis | |
| "A 38-year-old woman presents with persistent cough, low-grade fever, and weight loss. | |
| Chest imaging reveals upper lobe infiltrates. | |
| Sputum culture grows Mycobacterium tuberculosis.",Tuberculosis | |
| "A 52-year-old man presents with hemoptysis, night sweats, and fatigue. | |
| Chest X-ray shows cavitary lung lesions. | |
| Sputum testing is positive for acid-fast organisms.",Tuberculosis | |
| "A 29-year-old woman presents with chronic cough and unintended weight loss. | |
| CT scan demonstrates apical lung infiltrates. | |
| Interferon-gamma release assay is positive.",Tuberculosis | |
| "A 60-year-old man presents with fever, chronic productive cough, and night sweats. | |
| Chest radiography reveals upper lobe cavitation. | |
| Sputum microscopy identifies acid-fast bacilli.",Tuberculosis | |