id stringlengths 4 7 | text stringlengths 713 5.47k ⌀ | labels stringlengths 739 6.26k ⌀ | relations stringlengths 2 8.69k |
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503_80 | [['QUESTION', 'TYPE:', 'PEDIATRICS'], ['CLINICAL', 'CASE:'], ['An', '8-year-old', 'boy', 'consults', 'for', 'the', 'appearance', 'of', 'pubic', 'hair', 'at', 'the', 'base', 'of', 'the', 'penis', 'for', 'the', 'last', '12', 'months.'], ['The', 'testicle', 'has', 'not', 'increased', 'in', 'volume', 'and', 'the', 'penis',... | [['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', '... | [['In the male, the onset of puberty is considered normal from the age of 9 years\n', 'therefore in this case it is a premature puberty\n', 'Support'], ['the testicular size has not increased\n', 'we can rule out options 1 and 2\n', 'Support'], ['we can rule out options 1 and 2\n', 'Central precocious puberty\n', 'Atta... |
300_106 | [['QUESTION', 'TYPE:', 'INFECTIOUS', 'DISEASES'], ['CLINICAL', 'CASE:'], ['A', '32-year-old', 'man', 'from', 'Cameroon', 'consults', 'for', 'fever', 'cough', 'and', 'left', 'hemithorax', 'pain', 'of', '1', "month's", 'evolution.'], ['He', 'took', 'amoxicillin-clavulanic', 'acid', 'for', '1', 'week', 'without', 'improve... | [['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... | [['the presence of a pneumonia of long evolution that does not improve with antibiotic treatment, with an effusion with abundant leukocytes and lymphocytic predominance, in which the presence of neoplasia is ruled out, with values higher than 70 UI/L\n', 'The determination of ADA, in the presence of a pneumonia of long... |
434_119 | [['QUESTION', 'TYPE:', 'INFECTIOUS', 'DISEASES', 'AND', 'MICROBIOLOGY'], ['CLINICAL', 'CASE:'], ['A', '38-year-old', 'woman', 'of', 'veterinary', 'profession,', 'in', 'charge', 'of', 'monitoring', 'wild', 'animals', 'and', 'assisting', 'in', 'the', 'delivery', 'of', 'domestic', 'livestock.'], ['She', 'starts', 'with', ... | [['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise',... | [['Coxiella infection is not transmitted by ticks\n', 'The way of transmission of this entity is by ticks\n', 'Attack'], ['The contact can be with high probability at the time of delivery of an infected farm animal, in which the bacterium is disseminated in aerosols\n', 'Coxiella infection is not transmitted by ticks\n... |
563_175 | [['QUESTION', 'TYPE:', 'PREVENTIVE', 'MEDICINE'], ['CLINICAL', 'CASE:'], ['A', '62-year-old', 'patient', 'who', 'consults', 'because', 'of', 'close', 'contact', 'in', 'recent', 'weeks', 'with', 'a', 'person', 'with', 'active', 'tuberculosis.'], ['Mantoux', 'test', 'is', 'positive', '(12', 'mm).'], ['His', 'history', 'i... | [['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... | [['Health care providers should prescribe the shorter treatments, which are more convenient, whenever possible\n', 'The shortest combination would be Isoniazid + Rifapentine for three months or Rifampicin for four months\n', 'Support'], ['The shortest combination would be Isoniazid + Rifapentine for three months or Rif... |
89_57 | [['QUESTION', 'TYPE:', 'CARDIOLOGY', 'AND', 'VASCULAR', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '64-year-old', 'man', 'consults', 'for', 'right', 'calf', 'pain', 'when', 'climbing', 'hills', 'and', 'stairs', 'and', 'when', 'walking', 'on', 'level', 'ground', 'for', 'a', 'prolonged', 'period', 'of', 'time.'], ['He', 'r... | [['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '... | [['we can objectively assess the severity of the disease with the use of bloodless techniques\n', 'The most important is the ankle-brachial index\n', 'Support'], ['The most important is the ankle-brachial index\n', 'answer 2 is correct\n', 'Support'], ['answer 2 is correct\n', 'Ankle-brachial index\n', 'Support'], ['Al... |
586_75 | [['QUESTION', 'TYPE:', 'OBSTETRICS', 'AND', 'GYNECOLOGY'], ['CLINICAL', 'CASE:'], ['A', '30-year-old', 'woman', 'requesting', 'a', 'contraceptive', 'method.'], ['She', 'has', 'a', 'history', 'of', 'an', 'emergency', 'cesarean', 'section', '7', 'months', 'ago,', 'giving', 'birth', 'to', 'a', '3,550', 'g', 'baby', 'girl.... | [['O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-P... | [['She is exclusively breastfeeding\n', 'Given her circumstances and taking into account that she is exclusively breastfeeding, the best thing to do would be to prescribe only gestagens\n', 'Support'], ['She has a history of an emergency cesarean section 7 months ago, giving birth to a 3,550 g baby girl\n', 'Given her ... |
461_148 | [['QUESTION', 'TYPE:', 'OPHTHALMOLOGY', '(ECTOPIC)'], ['CLINICAL', 'CASE:'], ['A', '59-year-old', 'woman', 'with', 'recent', 'onset', 'of', 'epileptic', 'seizures', 'comes', 'to', 'the', 'emergency', 'department.'], ['On', 'examination', 'she', 'presents', 'left', 'pyramidal', 'signs', 'and', 'papillary', 'edema.'], ['... | [['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-Premis... | [['It is a headache in the context of papilledema\n', 'In this case the papilledema is due to increased intracranial pressure due to a tumor\n', 'Support'], ['A brain MRI shows a right hemispheric mass with edema, midline deviation and signs of tentorial herniation\n', 'In this case the papilledema is due to increased ... |
547_125 | [['QUESTION', 'TYPE:', 'CARDIOLOGY'], ['CLINICAL', 'CASE:'], ['A', '23-year-old', 'male', 'diagnosed', 'with', 'Wolff-Parkinson-White', 'syndrome', 'who', 'comes', 'to', 'the', 'emergency', 'department', 'for', 'palpitations.'], ['The', 'ECG', 'shows', 'an', 'irregular', 'wide', 'QRS', 'tachycardia,', 'with', 'a', 'hea... | [['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', '... | [['digoxin and non-dihydropyridine calcium channel blockers (e.g., verapamil, diltiazem) are contraindicated\n', 'Digoxin\n', 'Attack'], ['digoxin and non-dihydropyridine calcium channel blockers (e.g., verapamil, diltiazem) are contraindicated\n', 'Verapamil\n', 'Attack'], ['Procainamide\n', 'Procainamide\n', 'Support... |
193_161 | [['QUESTION', 'TYPE:', 'PEDIATRICS'], ['CLINICAL', 'CASE:'], ['In', 'a', '3-month-old', 'infant', 'all', 'the', 'clinical', 'manifestations', 'outlined', 'below', 'would', 'make', 'it', 'necessary', 'to', 'rule', 'out', 'cystic', 'fibrosis,', 'EXCEPT:'], ['1-', 'Delayed', 'meconium', 'evacuation.'], ['2-', 'Salty', 'ta... | [['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', 'B-Claim', 'I-Claim', 'I-Claim... | [['Dehydration may be due to diarrhea of other etiologies\n', 'Hypernatremic dehydration\n', 'Support'], ['We have to understand that the growth of Pseudomona aeruginosa is in the culture of bronchial secretions\n', 'Because clearly the indication to perform a sweat chlorine (to rule out FQP) are the HIPOnatremic dehyd... |
431_116 | [['QUESTION', 'TYPE:', 'INFECTIOUS', 'DISEASES', 'AND', 'MICROBIOLOGY'], ['CLINICAL', 'CASE:'], ['A', '38-year-old', 'man', 'comes', 'to', 'the', 'emergency', 'department', 'with', 'fever', 'above', '39ºC', 'and', 'deterioration', 'of', 'consciousness', 'after', 'a', 'trip', 'to', 'Equatorial', 'Guinea', 'without', 'an... | [['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '... | [['The laboratory reports the visualization of Plasmodium falciparum in the blood with a parasitemia level of 6%\n', 'In severe cases of Plasmodium infection, the greatest risk of mortality occurs in the first 24 hours of clinical presentation\n', 'Support'], ['In severe cases of Plasmodium infection, the greatest risk... |
569_152 | [['QUESTION', 'TYPE:', 'NEPHROLOGY'], ['CLINICAL', 'CASE:'], ['24-year-old', 'male', 'presenting', 'with', 'dysmorphic', 'microhematuria,', 'proteinuria', 'of', '3', 'g/24', 'h,', 'eGFR', '(CKD-EPI)', '85', 'ml/min', 'and', 'sensorineural', 'hearing', 'loss.'], ['He', 'reports', 'that', 'his', 'maternal', 'grandmother'... | [['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', '... | [['Microhematuria, proteinuria and sensorineural hearing loss in a young male with a family history of women with hematuria\n', 'Alport syndrome\n', 'Support'], ['Alport syndrome\n', 'Alport syndrome\n', 'Support']] |
501_76 | [['QUESTION', 'TYPE:', 'PEDIATRICS'], ['CLINICAL', 'CASE:'], ['A', '5-year-old', 'boy', 'diagnosed', 'with', 'chronic', 'renal', 'failure.'], ['He', 'comes', 'to', 'the', 'emergency', 'department', 'with', 'vomiting,', 'malaise,', 'and', 'palpitations.'], ['An', 'electrocardiogram', 'was', 'performed', 'with', 'T-wave'... | [['O', 'O', 'O'], ['O', 'O'], ['B-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'], ['B-Premise', 'I-Premise', 'I-Premise',... | [['Calcium gluconate has no effect on blood potassium levels\n', 'therefore options 1, 2 and 3 are ruled out\n', 'Support'], ['therefore options 1, 2 and 3 are ruled out\n', 'Encourage the displacement of potassium from the plasma space to the intracellular space\n', 'Attack'], ['therefore options 1, 2 and 3 are ruled ... |
242_111 | [['QUESTION', 'TYPE:', 'INFECTIOUS', 'DISEASES'], ['CLINICAL', 'CASE:'], ['A', '50-year-old', 'man', 'with', 'chronic', 'bronchitis', 'is', 'admitted', 'for', 'pneumonia', 'with', 'positive', 'blood', 'culture', 'for', 'Streptococcus', 'pneumoniae,', 'with', 'an', 'MIC', 'to', 'penicillin', 'of', '0.0125', 'mg/l.'], ['... | [['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 patient is a man with pneumonia with isolated germ in blood culture and antibiogram\n', 'According to the data provided, it is a pneumococcus sensitive to penicillin (MIC < 0.125)\n', 'Support'], ['According to the data provided, it is a pneumococcus sensitive to penicillin (MIC < 0.125)\n', 'treatment is starte... |
487_68 | [['QUESTION', 'TYPE:', 'GENETICS'], ['CLINICAL', 'CASE:'], ['What', 'genetic', 'and', 'reproductive', 'counseling', 'would', 'you', 'indicate', 'to', 'a', '30-year-old', 'woman', 'who', 'consults', 'because', 'she', 'is', 'a', 'carrier', 'of', 'a', 'premutation', 'in', 'the', 'FMR1', 'gene,', 'responsible', 'for', 'Fra... | [['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-Premise', 'I-Premise... | [['Triplet expansion diseases, such as this one, can have the anticipation phenomenon whereby females with premutations (between 55-200 repeats) can have children with full mutations (more than 200 repeats of the triplet) and more obvious, more severe and/or earlier clinical, in both males and females (Fragile X syndro... |
364_176 | [['QUESTION', 'TYPE:', 'HEMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '78-year-old', 'woman', 'with', 'a', 'history', 'of', 'type', '2', 'diabetes', 'treated', 'with', 'oral', 'antidiabetics,', 'hypertension', 'treated', 'with', 'beta-blockers', 'and', 'ACE', 'inhibitors,', 'and', 'NYHA', 'grade', '1', 'congestive', 'hear... | [['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-... | [['given the lack of survival benefit with early initiation of treatment, the NCCN guidelines recommend waiting and seeing, unless GELF criteria are met to initiate treatment: GELF criteria (Follicular Lymphoma Study Group)\n', 'There may be debate about whether to start Rituximab with another cytostatic drug or in mon... |
90_32 | [['QUESTION', 'TYPE:', 'GENERAL', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '35-year-old', 'woman', 'is', 'diagnosed', 'with', 'colon', 'cancer', 'located', 'in', 'the', 'hepatic', 'angle.'], ['She', 'has', 'a', 'family', 'history', 'of', 'colon', 'cancer', 'in', 'her', 'mother,', 'an', 'aunt', 'at', 'the', 'age', 'of',... | [['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premis... | [['If a conventional right hemicolectomy type surgery is performed, the chances of recurrence are higher than 30%\n', 'Right hemicolectomy\n', 'Attack'], ['The age and right location data lead us to answer 4: total colectomy with ileorectal anastomosis\n', 'Total colectomy with ileorectal anatomosis\n', 'Support']] |
528_134 | [['QUESTION', 'TYPE:', 'NEPHROLOGY'], ['CLINICAL', 'CASE:'], ['53-year-old', 'woman', 'with', 'a', 'personal', 'history', 'of', 'obesity', 'and', 'migraine.'], ['Her', 'blood', 'pressure', 'has', 'been', 'taken', 'repeatedly', 'at', 'the', "doctor's", 'and', "nurse's", 'office,', 'presenting', 'figures', 'below', '140/... | [['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', '... | [['normal figures in consultation and elevated on AMPA or ABPM\n', 'The patient described is the definition of masked HT\n', 'Support'], ['He comes in showing blood pressure recordings taken at home over several weeks with values above 140/90 mmHg\n', 'normal figures in consultation and elevated on AMPA or ABPM\n', 'Su... |
583_70 | [['QUESTION', 'TYPE:', 'OBSTETRICS', 'AND', 'GYNECOLOGY'], ['CLINICAL', 'CASE:'], ['A', '43-year-old', 'woman', 'with', 'a', 'levonorgestrel', 'intrauterine', 'device', 'who', 'consults', 'for', 'lack', 'of', 'rest', 'at', 'night', 'with', 'the', 'appearance', 'of', 'heat', 'and', 'palpitations.'], ['In', 'the', 'analy... | [['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... | [['FSH >20; estradiol <5\n', 'The hormonal profile we are told is in menopausal range\n', 'Support'], ['the patient has systemic vasomotor symptoms\n', 'The hormonal profile we are told is in menopausal range\n', 'Support'], ['The hormonal profile we are told is in menopausal range\n', 'Therefore, it would be more appr... |
195_163 | [['QUESTION', 'TYPE:', 'PEDIATRICS'], ['CLINICAL', 'CASE:'], ['A', '15-month-old', 'boy,', 'who', 'during', 'dinner,', 'after', 'eating', 'a', 'bite', 'of', 'tortilla,', 'suddenly', 'presented', 'with', 'facial', 'reddening', 'predominantly', 'perioral,', 'habonous', 'lesions', 'on', 'the', 'trunk', 'and', 'extremities... | [['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 of choice is intramuscular adrenaline, and effectively, without wasting too much time\n', 'The first thing is INTRAMUSCULAR adrenaline NOW\n', 'Support'], ['A 15-month-old boy, who during dinner, after eating a bite of tortilla, suddenly presented with facial reddening predominantly perioral, habonous ... |
84_49 | [['QUESTION', 'TYPE:', 'CARDIOLOGY', 'AND', 'VASCULAR', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '75-year-old', 'man,', 'hypertensive', 'and', 'dyslipidemic', 'with', 'a', 'history', 'of', 'heart', 'failure', 'due', 'to', 'left', 'ventricular', 'systolic', 'dysfunction', '(EF', '<', '30%).'], ['He', 'comes', 'to', 'our... | [['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'], ... | [['in this case we will use bisoprolol\n', 'Bisoprolol\n', 'Support'], ['In a patient with multiple CVRF with concomitant heart and renal failure (presumably of multiple etiology: renal hypoperfusion, arteriosclerosis...)\n', 'we must be very careful when using diuretics and ACEI/ARA-II\n', 'Support'], ['we can worsen ... |
427_95 | [['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['A', '45-year-old', 'woman', 'comes', 'to', 'the', 'emergency', 'department', 'with', 'confusional', 'symptoms', 'accompanied', 'by', 'dysphonia.'], ['On', 'examination', 'she', 'has', 'a', 'palpable', 'neck', 'mass', 'and', 'a', 'blood', 'test', 'shows',... | [['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', '... | [['On examination she has a palpable neck mass and a blood test shows plasma calcium levels of 15 mg/dL\n', 'normal up to 10.2 mg/dL\n', 'Support'], ['therefore, the option of medullary thyroid cancer is ruled out\n', 'Medullary thyroid carcinoma\n', 'Attack'], ['it does not affect the level of calcemia\n', 'therefore,... |
462_151 | [['QUESTION', 'TYPE:', 'OPHTHALMOLOGY', '(ECTOPIC)'], ['CLINICAL', 'CASE:'], ['A', '13-year-old', 'boy', 'presents', 'with', 'subacute', 'headache', 'and', 'diplopia.'], ['Neurologic', 'examination', 'shows', 'vertical', 'gaze', 'palsy', 'and', 'MRI', 'shows', 'a', 'contrast-enhancing', 'lesion', 'in', 'the', 'pineal',... | [['O', '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-Premis... | [['In this case the MRI already places the origin of the symptoms in the pineal gland\n', 'The most frequent tumor in this region is the germ cell tumor (answer 3)\n', 'Support'], ['The most frequent tumor in this region is the germ cell tumor (answer 3)\n', 'Germ cell tumor\n', 'Support']] |
557_168 | [['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['58-year-old', 'male,', 'obese,', 'asymptomatic,', 'moderate', 'drinker,', 'who', 'presents', 'a', 'first', 'baseline', 'blood', 'glucose', 'of', '153', 'mg/d', 'with', 'negative', 'glycosuria.'], ['In', 'the', 'following', 'weeks', 'he', 'has', 'had', 't... | [['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', '... | [['Diagnostic Criteria for DM according to ISPAD 2018 *Classic symptoms of diabetes with blood glucose > 200mgr/dl or: * Fasting glycemia ≥ 126mgr/dl (fasting at least 8h) or * Glycemia at 2h SOG ≥ 200mgr/dl (on 2 occasions) or * HbA1C ≥ 6.5%\n', 'Already meets diagnostic criteria for diabetes mellitus\n', 'Support']] |
35_68 | [['QUESTION', 'TYPE:', 'NEUROLOGY', 'AND', 'NEUROSURGERY'], ['CLINICAL', 'CASE:'], ['A', '56-year-old', 'patient', 'with', 'no', 'personal', 'or', 'family', 'history', 'of', 'interest', 'is', 'studied', 'because', 'he', 'has', 'been', 'having', 'difficulty', 'walking', 'with', 'his', 'right', 'leg', 'for', 'six', 'mont... | [['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... | [['It does not explain pyramidalism\n', 'Answer 1 incorrect\n', 'Support'], ['We would lack data to think of a Brown Sequard hemimedullary syndrome\n', 'Answer 3 incorrect\n', 'Support'], ['It could explain the difficulty in dorsiflexion and plantar flexion of the foot, but not the pyramidalism\n', 'Incorrect answer 4\... |
271_170 | [['QUESTION', 'TYPE:', 'ANESTHESIOLOGY', 'AND', 'CRITICAL', 'CARE'], ['CLINICAL', 'CASE:'], ['An', '80-year-old', 'man', 'comes', 'to', 'your', 'office', 'for', 'evaluation', 'of', 'a', 'scheduled', 'cholecystectomy', 'by', 'laparoscopy.'], ['He', 'has', 'a', 'history', 'of', 'arterial', 'hypertension', 'under', 'treat... | [['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',... | [['The answer is obviously 4\n', 'Perform electrocardiogram\n', 'Support'], ['Had there been a fifth option it would have been that nothing needs to be done, which might have generated some doubt in the student, but since the question does not exist it is a piece of candy\n', 'The answer is obviously 4\n', 'Support'], ... |
306_207 | [['QUESTION', 'TYPE:', 'OPHTHALMOLOGY'], ['CLINICAL', 'CASE:'], ['A', '34-year-old', 'patient', 'playing', 'tennis', 'is', 'hit', 'by', 'a', 'tennis', 'ball', 'in', 'the', 'left', 'orbit.'], ['On', 'examination', 'he', 'presents', 'significant', 'palpebral', 'hematoma,', 'hyposphagmia,', 'diplopia', 'to', 'the', 'upper... | [['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', '... | [['Fracture of the roof is much less frequent\n', 'Fracture of the superior wall of the orbit with entrapment of the superior rectus muscle\n', 'Attack'], ['entrapment of the superior rectus would cause limitation for infraduction\n', 'Fracture of the superior wall of the orbit with entrapment of the superior rectus mu... |
328_83 | [['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['A', '49-year-old', 'man', 'who', 'consults', 'for', 'severe', 'polyuria', 'and', 'polydipsia', 'and', 'unintentional', 'weight', 'loss', 'of', '10', 'kg', 'and', 'is', 'diagnosed', 'with', 'diabetes', 'mellitus', 'due', 'to', 'a', 'plasma', 'blood', 'glu... | [['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-... | [['Discontinue sulfonylurea because of Risk of hypoglycemia\n', 'Discontinue sulfonylurea\n', 'Support']] |
223_62 | [['QUESTION', 'TYPE:', 'CARDIOLOGY'], ['CLINICAL', 'CASE:'], ['In', 'a', '60-year-old', 'diabetic', 'patient', 'with', 'stable', 'angina', 'secondary', 'to', 'ischemic', 'heart', 'disease', 'due', 'to', 'subtotal', 'obstruction', 'in', 'the', 'middle', 'third', 'of', 'the', 'anterior', 'descending', 'coronary', 'artery... | [['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'... | [['2 is absurd: sitting down to avoid angina?\n', 'Expectorant with rigorous rest, since decreasing myocardial oxygen demand should decrease angina\n', 'Attack'], ['although I miss statins, ACE inhibitors and antiplatelet agents, and I have too many vasodilators (nitrates are class IIb, if my memory serves me correctly... |
468_122 | [['QUESTION', 'TYPE:', 'ORTHOPEDIC', 'SURGERY', 'AND', 'TRAUMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '70-year-old', 'man', 'consults', 'for', 'non-radiating', 'lumbar', 'pain', 'of', '1', "week's", 'duration,', 'of', 'progressive', 'intensity,', 'accompanied', 'by', 'marked', 'limitation', 'of', 'spinal', 'mobility', '... | [['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '... | [['the febrile fever and the limitation of mobility of the spine with the acute course give the key\n', 'We suspect spondylodiscitis\n', 'Support'], ['We suspect spondylodiscitis\n', 'the indicated test is the MRI\n', 'Support'], ['the indicated test is the MRI\n', 'Pyogenic spondylodiscitis with magnetic resonance ima... |
96_170 | [['QUESTION', 'TYPE:', 'DERMATOLOGY,', 'VENEREOLOGY', 'AND', 'PLASTIC', 'SURGERY'], ['CLINICAL', 'CASE:'], ['60-year-old', 'male', 'patient', 'who', 'refers', '10', 'days', 'ago', 'the', 'appearance', 'of', 'blistering', 'lesions', 'on', 'dorsum', 'of', 'hands', 'after', 'sun', 'exposure.'], ['The', 'picture', 'is', 'a... | [['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'], ['B-Prem... | [['Clinically, it is characterized by marked skin fragility with the appearance of erosions, vesicles and blisters after minimal trauma\n', 'Porphyria cutanea tarda (PCT) is the most common porphyria and can present with three major clinical forms: familial, sporadic and toxic\n', 'Support'], ['The picture is accompani... |
603_112 | [['QUESTION', 'TYPE:', 'TRAUMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '61-year-old', 'woman,', 'administrative,', 'with', 'a', 'history', 'of', 'overweight,', 'hypertension,', 'dyslipidemia', 'and', 'metabolic', 'syndrome,', 'who', 'consults', 'for', 'pain', 'in', 'both', 'buttocks,', 'left', 'trochanteric', 'region,', ... | [['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-... | [['A 61-year-old woman, administrative, with a history of overweight, hypertension, dyslipidemia and metabolic syndrome, who consults for pain in both buttocks, left trochanteric region, lateral aspect of the left thigh up to the knee and left leg up to the middle third\n', 'The most common symptomatology of a patient ... |
574_100 | [['QUESTION', 'TYPE:', 'NEUROLOGY'], ['CLINICAL', 'CASE:'], ['An', '80-year-old', 'woman', 'with', 'a', 'history', 'of', 'arterial', 'hypertension', 'and', 'diabetes', 'mellitus', 'who', 'suddenly', 'presents', 'with', 'language', 'impairment.'], ['On', 'arrival', 'at', 'the', 'hospital,', 'an', 'unknown', 'atrial', 'f... | [['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', '... | [['It is a semiology question that helps us to remember the types of aphasia\n', 'The following aspects should be taken into account: language emission (fluent, non-fluent, non-emission), comprehension (yes or no), repetition (yes or no) and nomination\n', 'Support'], ['On arrival at the hospital, an unknown atrial fib... |
67_111 | [['QUESTION', 'TYPE:', 'ANESTHESIOLOGY,', 'CRITICAL', 'CARE', 'AND', 'EMERGENCY', 'MEDICINE'], ['CLINICAL', 'CASE:'], ['A', '45-year-old', 'male', 'patient', 'with', 'a', 'history', 'of', 'uric', 'lithiasis', 'and', 'repeated', 'expulsive', 'nephritic', 'colic', 'for', 'the', 'past', '25', 'years', 'comes', 'to', 'the'... | [['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... | [['The urine is normal (without hematuria, caused by the lithiasis as it progresses)\n', 'In principle, what you tell us does not fit with a nephritic colic\n', 'Support'], ['the Creat is normal (it can rise up to 1.9 in nephritic colic)\n', 'In principle, what you tell us does not fit with a nephritic colic\n', 'Suppo... |
77_31 | [['QUESTION', 'TYPE:', 'DIGESTIVE', 'SYSTEM'], ['CLINICAL', 'CASE:'], ['A', '17-year-old', 'boy', 'with', "Crohn's", 'disease', 'with', 'colonic', 'involvement', 'of', '2', 'years', 'of', 'evolution,', 'in', 'maintenance', 'treatment', 'with', 'azathioprine,', 'consults', 'for', 'the', 'appearance', 'since', '5', 'days... | [['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'... | [['Treatment of the disease and its control usually improves the cutaneous lesions\n', 'Adjustment of the treatment of the disease\n', 'Support'], ['The lesions should not be biopsied\n', 'Biopsy skin areas away from the injured areas and prescribe opioid analgesics at the beginning\n', 'Attack'], ['The lesions should ... |
440_97 | null | null | [] |
203_47 | [['QUESTION', 'TYPE:', 'GENERAL', 'SURGERY'], ['CLINICAL', 'CASE:'], ['55-year-old', 'woman,', 'operated', 'on', 'for', 'appendicitis', '24', 'years', 'ago,', 'who', 'comes', 'in', 'because', 'while', 'previously', 'well,', 'she', 'has', 'started', 'with', 'repeated', 'vomiting', 'after', 'breakfast,', 'about', '12', '... | [['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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... | [['most of these situations resolve spontaneously with conservative treatment\n', 'The correct answer is 5 and not 1\n', 'Support'], ['The correct answer is 5 and not 1\n', 'Initial management should be conservative, with serum therapy, nasogastric aspiration and periodic clinical, analytical and radiographic monitorin... |
158_133 | [['QUESTION', 'TYPE:', 'TRAUMATOLOGY', 'AND', 'ORTHOPEDICS'], ['CLINICAL', 'CASE:'], ['Obese', '12-year-old', 'boy', '(87', 'kg).'], ['He', 'has', 'been', 'complaining', 'of', 'mechanical', 'pain', 'in', 'the', 'right', 'thigh', 'and', 'knee', 'for', '4', 'months.'], ['Clinical', 'examination', 'reveals', 'a', '1', 'cm... | [['O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-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', 'I-Premise', 'I-Premise', 'I-Premise'], ['B... | [['Obese 12-year-old boy (87 kg)\n', 'We are presented with an adolescent patient who is overweight with pain in the thigh and knee, a length discrepancy of 1 cm and the limb in external rotation\n', 'Support'], ['He has been complaining of mechanical pain in the right thigh and knee for 4 months\n', 'We are presented ... |
46_155 | [['QUESTION', 'TYPE:', 'PEDIATRICS'], ['CLINICAL', 'CASE:'], ['A', '1-year-old', 'boy', 'whose', 'mother', 'has', 'just', 'been', 'diagnosed', 'with', 'bacilliferous', 'pulmonary', 'tuberculosis,', 'having', 'started', 'correct', 'treatment.'], ['The', 'child', 'is', 'asymptomatic', 'with', 'a', 'normal', 'examination,... | [['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', '... | [['The correct answer is 5\n', 'Chemoprophylaxis with INH, 8-12 weeks. Repeat PT. If negative, stop treatment. If positive, perform chest X-ray to decide whether or not there is disease\n', 'Support'], ['If the result of the repeat PT is still negative, the child should not be tested again\n', 'Chemoprophylaxis with IN... |
593_146 | null | null | [] |
395_136 | null | null | [] |
424_91 | [['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['A', '27-year-old', 'woman', 'consults', 'for', 'secondary', 'amenorrhea', 'of', 'one', 'year', 'of', 'evolution.'], ['She', 'has', 'no', 'iatrogenic', 'history.'], ['Analytically,', 'the', 'estradiol', 'concentration', 'is', 'below', 'normal', 'and', '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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise',... | [['values above 20ngr/ml are considered hyperprolectinemia\n', 'Prolactin values are normal\n', 'Support'], ['Analytically, the estradiol concentration is below normal and the prolactin value is 12 ng/mL\n', 'Prolactin values are normal\n', 'Support'], ['For its diagnosis we will ask for a basal FSH\n', 'Basal FSH\n', ... |
169_87 | [['QUESTION', 'TYPE:', 'CARDIOLOGY', 'AND', 'CARDIOVASCULAR', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '70-year-old', 'woman,', 'hypertensive', 'and', 'diabetic,', 'who', 'has', 'worked', 'as', 'a', 'sales', 'clerk', 'all', 'her', 'life.'], ['She', 'consults', 'for', 'an', 'internal', 'malleolar', 'lesion', 'in', 'the'... | [['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise',... | [['At least for me, as a family physician, I usually start with the least invasive and most cost-effective tests, and in the case described, an ischemic problem in the lower limbs is the ankle-brachial index\n', 'Ankle-brachial index\n', 'Support']] |
95_170 | [['QUESTION', 'TYPE:', 'DERMATOLOGY,', 'VENEREOLOGY', 'AND', 'PLASTIC', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '60-year-old', 'male', 'patient', 'who', 'reported', '10', 'days', 'ago', 'the', 'appearance', 'of', 'blistering', 'lesions', 'on', 'the', 'dorsum', 'of', 'the', 'hands', 'after', 'sun', 'exposure.'], ['The'... | [['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... | [['The fact of being a photoinduced picture, the histology and the age make the diagnosis of PCT more probable (3)\n', 'Porphyria cutanea tarda\n', 'Support'], ['The rest of the answers do not fit with the clinical picture or the histology\n', 'Scalded skin syndrome\n', 'Attack'], ['The rest of the answers do not fit w... |
537_1 | null | null | [] |
363_97 | [['QUESTION', 'TYPE:', 'HEMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '35-year-old', 'patient', 'who,', 'due', 'to', 'hematemesis', 'due', 'to', 'ulcus,', 'receives', 'a', 'transfusion', 'of', '2', 'packed', 'red', 'blood', 'cells.'], ['5-10', 'minutes', 'after', 'starting', 'the', 'transfusion,', 'she', 'begins', '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', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', '... | [['Acute hemolytic transfusion reactions can occur within minutes\n', 'Hemolytic transfusion reaction\n', 'Support'], ['5-10 minutes after starting the transfusion, she begins with fever, chills, hypotension and pain in the lumbar region\n', 'Clinically they are characterized by chills, fever, urticaria, tachycardia, n... |
339_33 | [['QUESTION', 'TYPE:', 'GYNECOLOGY', 'AND', 'OBSTETRICS'], ['CLINICAL', 'CASE:'], ['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', ... | [['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'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', '... | [['she does not have a family history of neoplasia\n', 'The study of relatives and the BCRA gene is not indicated\n', 'Support'], ['The study of relatives and the BCRA gene is not indicated\n', 'BRCA 1-2 study and study of first-degree relatives\n', 'Attack'], ['All breast carcinomas should be accompanied by the study ... |
144_142 | [['QUESTION', 'TYPE:', 'PEDIATRICS'], ['CLINICAL', 'CASE:'], ['A', '13-year-old', 'girl', 'consults', 'us', 'for', 'weight', 'loss,', 'asthenia,', 'secondary', 'amenorrhea', 'and', 'constipation.'], ['Examination', 'revealed', 'a', 'temperature', 'of', '35ºC,', 'weight', 'below', 'the', '3rd', 'percentile,', 'bradycard... | [['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', '... | [['The correct answer is 1\n', 'Suspect anorexia nervosa and inquire about intake, body image, etc\n', 'Support'], ['The symptoms and signs described are the biological findings associated with anorexia nervosa\n', 'Suspect anorexia nervosa and inquire about intake, body image, etc\n', 'Support'], ['A 13-year-old girl ... |
356_166 | [['QUESTION', 'TYPE:', 'GYNECOLOGY', 'AND', 'OBSTETRICS'], ['CLINICAL', 'CASE:'], ['A', 'pregnant', 'woman,', '10', 'weeks', 'pregnant,', 'comes', 'to', 'the', 'emergency', 'room', 'with', 'a', 'blood', 'pressure', 'of', '160/105', 'mmHg.'], ['She', 'is', 'in', 'good', 'general', 'condition,', 'with', 'only', 'mild', '... | [['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... | [['This is hypertension that is detected before pregnancy or before the 20th week of pregnancy and/or persists at 12 weeks postpartum\n', 'Chronic hypertension\n', 'Support'], ['A pregnant woman, 10 weeks pregnant, comes to the emergency room with a blood pressure of 160/105 mmHg\n', 'This is hypertension that is detec... |
495_64 | [['QUESTION', 'TYPE:', 'MEDICAL', 'ONCOLOGY'], ['CLINICAL', 'CASE:'], ['65-year-old', 'woman', 'with', 'no', 'comorbidities,', 'undergoing', 'left', 'breast-conserving', 'surgery', 'with', 'selective', 'sentinel', 'lymph', 'node', 'biopsy.'], ['The', 'pathological', 'anatomy', 'of', 'the', 'specimen', 'shows', 'an', 'i... | [['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', 'I-Premis... | [['That is why today, anthracyclines (does not suffer from heart) and taxanes before RT\n', 'Chemotherapy based on anthracyclines and taxanes, and radiotherapy\n', 'Support'], ['High grade, and no hormone receptors or her2 (the dreaded triple negative)\n', 'That is why today, anthracyclines (does not suffer from heart)... |
355_166 | [['QUESTION', 'TYPE:', 'GYNECOLOGY', 'AND', 'OBSTETRICS'], ['CLINICAL', 'CASE:'], ['A', 'pregnant', 'woman,', '10', 'weeks', 'pregnant,', 'comes', 'to', 'the', 'emergency', 'room', 'with', 'a', 'blood', 'pressure', 'of', '160/105', 'mmHg.'], ['She', 'is', 'in', 'good', 'general', 'condition,', 'with', 'only', 'mild', '... | [['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... | [['The SEGO in its 2006 protocol "Hypertensive disorders of pregnancy" refers that this is chronic hypertension, although diagnosed in pregnancy\n', 'Chronic hypertension\n', 'Support'], ['This is because it has been diagnosed at 10 weeks of gestation\n', 'The SEGO in its 2006 protocol "Hypertensive disorders of pregna... |
94_31 | [['QUESTION', 'TYPE:', 'DERMATOLOGY,', 'VENEREOLOGY', 'AND', 'PLASTIC', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '17-year-old', 'boy', 'with', "Crohn's", 'disease', 'with', 'colonic', 'involvement', 'of', '2', 'years', 'of', 'evolution,', 'in', 'maintenance', 'treatment', 'with', 'azathioprine,', 'consults', 'for', 'th... | [['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... | [['the usefulness of antidepressants in this picture has not been described\n', 'answer nº1 would not be correct\n', 'Support'], ['answer nº1 would not be correct\n', 'Recommend relative rest and warm cloths on both legs and add antidepressant treatment\n', 'Attack'], ["About 10% of cases of erythema nodosum are associ... |
39_134 | [['QUESTION', 'TYPE:', 'OTORHINOLARYNGOLOGY', 'AND', 'MAXILLOFACIAL', 'SURGERY'], ['CLINICAL', 'CASE:'], ['60-year-old', 'woman,', 'diagnosed', 'with', 'breast', 'cancer', 'treated', 'with', 'surgery', 'and', 'radiotherapy', '10', 'years', 'ago.'], ['Currently', 'with', 'metastases', 'in', 'the', 'dorsal', 'spine', 'an... | [['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-Premise',... | [['there would be infectious signs\n', '1 cannot be\n', 'Support'], ['the radiotherapy that the patient received would be oriented on the breast and not on the mandible\n', '3 seems unlikely to me\n', 'Support'], ['bisphosphonates create mandibular necrosis\n', 'Answer 2 is possible\n', 'Support'], ['it is not a case o... |
252_83 | [['QUESTION', 'TYPE:', 'DIGESTIVE', 'SYSTEM'], ['CLINICAL', 'CASE:'], ['What', 'disease', 'would', 'we', 'suspect', 'in', 'a', 'young', 'patient', 'with', 'a', 'frequent', 'history', 'of', 'dysphagia', 'to', 'solids', 'and', 'liquids', 'with', 'repeated', 'food', 'impactions,', 'without', 'symptoms', 'of', 'heartburn',... | [['O', 'O', 'O', 'O'], ['O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Prem... | [['a young patient with a frequent history of dysphagia to solids and liquids with repeated food impactions, without symptoms of heartburn and in whom oral endoscopy shows multiple concentric esophageal rings with normal mucosa (trachealized appearance)\n', 'The endoscopic appearance of trachealized esophagus is very t... |
57_77 | [['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['In', 'a', '42-year-old', 'obese', 'woman,', 'cortisol', 'levels', 'in', 'blood,', 'urine', 'and', 'saliva', 'are', 'determined', 'and', 'in', 'all', 'the', 'determinations', 'they', 'are', 'elevated.'], ['After', 'performing', 'the', 'nocturnal', 'suppre... | [['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 answer is CT\n', 'An adrenal CT scan\n', 'Support'], ['before doing the CT scan, ACTH should be measured and, once ACTH is suppressed, the CT scan should be done\n', 'Anyway, I think that the clinical case is poorly stated\n', 'Support']] |
595_88 | null | null | [] |
98_171 | [['QUESTION', 'TYPE:', 'DERMATOLOGY,', 'VENEREOLOGY', 'AND', 'PLASTIC', 'SURGERY'], ['CLINICAL', 'CASE:'], ['The', 'patient', 'presents', 'since', '2', 'weeks', 'ago', 'a', 'pruritic', 'eruption', 'consisting', 'of', 'multiple', 'polygonal', 'erythematous-violaceous', 'papules,', 'with', 'flattened', 'surface,', 'prefe... | [['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... | [['Lichen planus is a very common dermatosis of unknown etiology characterized by the appearance of pruritic polygonal papules, with a purplish color and shiny surface, preferentially located in the distal areas of the extremities\n', 'Lichen planus\n', 'Support'], ['The patient presents since 2 weeks ago a pruritic er... |
118_117 | [['QUESTION', 'TYPE:', 'INFECTOLOGY'], ['CLINICAL', 'CASE:'], ['A', '14-year-old', 'asymptomatic', 'boy', 'whose', 'father', 'has', 'just', 'been', 'diagnosed', 'with', 'pulmonary', 'TB', 'undergoes', 'a', 'Mantoux', 'test,', 'with', 'a', 'negative', 'result.'], ['What', 'is', 'the', 'appropriate', 'course', 'of', 'act... | [['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O',... | [['In young contacts, chemoprophylaxis should be started even if the mantoux test is negative and repeated after 2-3 months to decide whether to continue treatment for 6 months (if it turns positive) or to stop it\n', 'Start chemoprophylaxis and repeat skin test after 3 months\n', 'Support'], ['A 14-year-old asymptomat... |
388_233 | null | null | [] |
421_78 | [['QUESTION', 'TYPE:', 'GENERAL', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '52-year-old', 'man', 'was', 'referred', 'to', 'the', 'gastroenterology', 'department', 'for', 'hematochezia,', 'tenesmus', 'and', 'reduction', 'of', 'stool', 'diameter.'], ['A', 'series', 'of', 'tests', 'were', 'performed', 'and', 'a', 'diagnos... | [['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... | [['Among these, less importance is given to the size of the lesion than to its degree of invasion of the intestinal wall or other adjacent structures, a criterion that must be taken into account for staging by TNM or Astler-Coller classification, which guide the indication of adjuvant treatment after the surgical appro... |
500_45 | [['QUESTION', 'TYPE:', 'PEDIATRICS'], ['CLINICAL', 'CASE:'], ['15-year-old', 'female', 'presenting', 'with', 'delayed', 'menarche', 'and', 'short', 'stature.'], ['She', 'does', 'not', 'have', 'intellectual', 'disability.'], ['Which', 'of', 'the', 'following', 'genetic', 'tests', 'would', 'be', 'routinely', 'used', 'for... | [['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'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-... | [['15-year-old female presenting with delayed menarche and short stature\n', 'In a woman with delayed puberty and short stature we should always think about and rule out Turner syndrome, whose diagnosis is made by karyotyping (45X0)\n', 'Support'], ['In a woman with delayed puberty and short stature we should always th... |
611_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'], ['... | [['We are told of a case of a 95-year-old patient with a displaced intracapsular (subcapital) hip fracture\n', 'In this case, the surgical options may be the use of cannulated screws or hip arthroplasty\n', 'Support'], ['Cannulated screws are reserved for cases of non-displaced fractures\n', 'In this case, the surgical... |
542_38 | [['QUESTION', 'TYPE:', 'ALLERGOLOGY'], ['CLINICAL', 'CASE:'], ['A', '25-year-old', 'woman', 'with', 'a', 'history', 'of', 'allergic', 'bronchial', 'asthma', 'due', 'to', 'sensitization', 'to', 'grass', 'pollens', 'and', 'atopic', 'dermatitis.'], ['She', 'suddenly', 'presents', 'hypotension,', 'tachycardia,', 'urticaria... | [['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', '... | [['She suddenly presents hypotension, tachycardia, urticaria and bronchospasm after ingesting peanuts and is transferred to the emergency department\n', 'The patient is suffering from anaphylactic shock secondary to peanut ingestion\n', 'Support'], ['The patient is suffering from anaphylactic shock secondary to peanut ... |
79_36 | [['QUESTION', 'TYPE:', 'DIGESTIVE', 'SYSTEM'], ['CLINICAL', 'CASE:'], ['Which', 'of', 'the', 'following', 'clinical', 'data,', 'recorded', 'during', 'the', 'clinical', 'history', 'taking', 'of', 'a', 'patient', 'with', 'diarrhea', 'of', 'more', 'than', '4', 'weeks', 'of', 'evolution,', 'can', 'be', 'found', 'in', 'peop... | [['O', 'O', 'O', 'O'], ['O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'O', 'O', 'O', 'O', 'O', 'B-Premise', 'I-Premise', 'I-Premise'], ['O', 'B-Cl... | [['Although mucus is usually more frightening in the consultation, it falls within the Rome II criteria for the diagnosis of Irritable Bowel Syndrome\n', 'Expulsion of mucus in more than 25% of defecations\n', 'Support'], ['All the rest are typical signs of organicity\n', 'Weight loss with or without rectorrhagia\n', '... |
524_54 | [['QUESTION', 'TYPE:', 'STATISTICS'], ['CLINICAL', 'CASE:'], ['An', '86-year-old', 'woman', 'in', 'whom', 'nonvalvular', 'atrial', 'fibrillation', 'has', 'been', 'detected.'], ['She', 'has', 'a', 'CHADS2', 'score', 'of', '3', 'points.'], ['In', 'the', 'literature,', 'similar', 'patients', 'on', 'warfarin', 'therapy', '... | [['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Cl... | [['On average, if 100 patients like this woman are treated with warfarin, the number of strokes is reduced by 3 (from 5.2 untreated to 3.2 treated)\n', 'Therefore, if you treat 33.3 patients like this woman with warfarin, you reduce the number of strokes by 1\n', 'Support'], ['Therefore, if you treat 33.3 patients like... |
319_141 | [['QUESTION', 'TYPE:', 'RHEUMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '20-year-old', 'boy', 'consults', 'for', 'lumbosacral', 'pain', 'of', 'inflammatory', 'rhythm', 'of', '4', 'months', 'of', 'evolution.'], ['Also', 'bilateral', 'thalalgia', 'and', 'morning', 'stiffness', 'for', '1', 'hour.'], ['In', 'the', 'last', '2'... | [['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '... | [['In the last 2 months, onset of diarrhea with loss of 4 kg of weight\n', 'The clinical picture is typical of spondyloarthritis, and together with the digestive symptoms it is probably associated with inflammatory bowel disease\n', 'Support']] |
400_147 | [['QUESTION', 'TYPE:', 'TRAUMATOLOGY', 'AND', 'ORTHOPEDICS'], ['CLINICAL', 'CASE:'], ['A', '13-year-old', 'boy', 'presents', 'dorsal', 'pain', 'of', 'several', 'months', 'of', 'evolution,', 'only', 'on', 'standing', 'and', 'walking,', 'what', 'diagnosis', 'should', 'we', 'consider?'], ['1-', "Scheuermann's", 'disease.'... | [['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', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim',... | [['There is no data in the statement to suggest any of the other etiologies\n', "Scheuermann's disease\n", 'Attack'], ['There is no data in the statement to suggest any of the other etiologies\n', 'Thoracic scoliosis\n', 'Attack'], ['There is no data in the statement to suggest any of the other etiologies\n', 'Malignan... |
196_164 | [['QUESTION', 'TYPE:', 'PEDIATRICS'], ['CLINICAL', 'CASE:'], ['A', '4-year-old', 'boy', 'consulted', 'for', 'the', 'appearance', 'over', 'the', 'last', 'three', 'days', 'of', 'skin', 'lesions', 'on', 'the', 'legs', 'and', 'buttocks.'], ['His', 'parents', 'reported', 'that', 'his', 'pediatrician', 'had', 'diagnosed', 'a... | [['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', '... | [['You are describing a Schönlein-Henoch purpura which is a vasculitic phenomenon, so the lesions are not due to plateletopenia\n', 'Plateletopenia\n', 'Attack'], ["Scrotal edema (sometimes even torsion of Morgani's capsid of the testis) is not exceptional in males with S. Schönlein-Henoch\n", 'Scrotal edema\n', 'Suppo... |
509_150 | [['QUESTION', 'TYPE:', 'DIGESTIVE'], ['CLINICAL', 'CASE:'], ['83-year-old', 'male', 'who', 'consults', 'for', 'a', 'recurrent', 'picture', 'of', 'abdominal', 'pain', 'in', 'the', 'left', 'iliac', 'fossa,', 'accompanied', 'by', 'diarrhea', 'of', 'up', 'to', '6', 'stools', 'per', 'day', 'without', 'pathological', 'produc... | [['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-... | [['83-year-old male who consults for a recurrent picture of abdominal pain in the left iliac fossa, accompanied by diarrhea of up to 6 stools per day without pathological products, of 10-15 days of evolution\n', 'They refer to a concept that has emerged relatively recently and is not present in all clinical guidelines ... |
549_128 | null | null | [] |
221_48 | [['QUESTION', 'TYPE:', 'ANATOMIC', 'PATHOLOGY'], ['CLINICAL', 'CASE:'], ['A', '20-year-old', 'man', 'with', 'ataxia,', 'headaches', 'and', 'solid-cystic', 'mass', 'in', 'the', 'right', 'cerebellar', 'hemisphere', 'underwent', 'surgery', 'and', 'a', 'lesion', 'was', 'resected,', 'histologically', 'showing', 'cells', 'wi... | [['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 statement concisely summarizes the description of pilocytic astrocytoma\n', 'Pilocytic astrocytoma\n', 'Support'], ['The Rosenthal fibers may confuse us as they are not very specific, and make us think, for example, of pleomorphic xanthoastrocytoma in which they can also be found\n', 'The statement concisely sum... |
606_113 | [['QUESTION', 'TYPE:', 'TRAUMATOLOGY'], ['CLINICAL', 'CASE:'], ['35-year-old', 'male,', 'letter', 'carrier,', 'with', 'no', 'history', 'of', 'interest,', 'who', 'comes', 'to', 'the', 'emergency', 'department', 'for', 'acute', 'cervical', 'pain', 'of', '24', 'hours', 'of', 'evolution,', 'without', 'previous', 'trauma,',... | [['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-... | [['Correct answer 1\n', 'Conservative treatment with non-steroidal anti-inflammatory drugs, local heat and relative rest\n', 'Support'], ['75% of patients with radiculopathy improve with non-surgical treatment, this being the treatment of choice in the initial stages\n', 'Urgent call to the neurosurgeon for surgical ev... |
436_223 | null | null | [] |
220_126 | null | null | [] |
483_174 | [['QUESTION', 'TYPE:', 'CRITICAL', 'CARE'], ['CLINICAL', 'CASE:'], ['A', '22-year-old', 'woman', 'presents', 'with', 'sudden', 'cardiac', 'arrest', 'with', 'a', 'rhythm', 'that', 'is', 'considered', 'amenable', 'to', 'defibrillation.'], ['Chest', 'compressions', 'and', 'ventilations', 'are', 'being', 'performed,', 'a',... | [['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... | [['Although, be careful, that is what the guidelines say\n', 'Controversial question, since amiodarone (the dose is correct, 300mg), is administered after the third shock, and not after the first defibrillation\n', 'Attack'], ['I am sure that more than one of us has administered amiodarone as soon as we have had venous... |
113_93 | [['QUESTION', 'TYPE:', 'HEMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '35-year-old', 'healthy', 'woman', 'consults', 'for', 'asthenia.'], ['The', 'CBC', 'shows', 'microcytic', 'and', 'hypochromic', 'anemia', '(hemoglobin', '7', 'g/dL,', 'mean', 'corpuscular', 'volume', '68', 'fl,', 'mean', 'corpuscular', 'hemoglobin', '24... | [['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '... | [['A 35-year-old healthy woman consults for asthenia\n', 'With the data we are given\n', 'Support'], ['With the data we are given\n', 'the first thing that comes to mind is that it is an arregenerative anemia, since the bone marrow has not responded with an exaltation of erythropoiesis; in this way we have already elim... |
59_51 | [['QUESTION', 'TYPE:', 'ANESTHESIOLOGY', 'AND', 'CRITICAL', 'CARE'], ['CLINICAL', 'CASE:'], ['A', '47-year-old', 'male', 'patient', 'who', 'consults', 'the', 'emergency', 'department', 'for', 'sudden', 'loss', 'of', 'consciousness', 'Which', 'of', 'the', 'following', 'has', 'a', 'higher', 'diagnostic', 'yield?'], ['1-'... | [['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', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim'],... | [['that encompasses all the causes of sudden loss of consciousness and that allows us to somehow filter the diagnosis\n', 'Clinical history\n', 'Support'], ['that encompasses all the causes of sudden loss of consciousness and that allows us to somehow filter the diagnosis\n', 'Obviously, it is the only answer\n', 'Supp... |
412_54 | [['QUESTION', 'TYPE:', 'BIOSTATISTICS'], ['CLINICAL', 'CASE:'], ['Elizabeth', 'has', 'three', 'sons', 'and', 'one', 'daughter', '(Mary),', 'all', 'of', 'whom', 'are', 'healthy.'], ['A', 'brother', 'and', 'a', 'maternal', 'uncle', 'of', 'Isabel', 'died', 'of', 'Duchenne', 'disease:', 'an', 'X-linked', 'recessive', 'dise... | [['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', '... | [["one of Isabel's brothers has suffered from the disease but not her father\n", "Isabel's mother continues to carry it\n", 'Support'], ['The maternal grandmother carried the mutation in one copy of the gene on an X chromosome\n', "Isabel's mother continues to carry it\n", 'Support'], ['her children are all healthy\n',... |
347_159 | [['QUESTION', 'TYPE:', 'GYNECOLOGY', 'AND', 'OBSTETRICS'], ['CLINICAL', 'CASE:'], ['69-year-old', 'woman', 'who', 'comes', 'to', 'your', 'office', 'referring', 'genital', 'bleeding', 'of', 'several', 'months', 'of', 'evolution.'], ['She', 'denies', 'hormone', 'replacement', 'therapy', 'and', 'anticoagulation.'], ['She'... | [['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', 'I-P... | [['Endometrial biopsy\n', 'Endometrial biopsy\n', 'Support'], ['Peri- or menopause\n', 'Endometrial biopsy\n', 'Support'], ['Due to the high prevalence of organic pathology during this period it is necessary to systematically perform endometrial biopsy (Cornier or Hysteroscopy)\n', 'Endometrial biopsy\n', 'Support'], [... |
325_56 | [['QUESTION', 'TYPE:', 'CRITICAL,', 'PALLIATIVE', 'AND', 'EMERGENCY', 'CARE'], ['CLINICAL', 'CASE:'], ['A', '54-year-old', 'patient', 'is', 'admitted', 'for', 'thermometric', 'fever', 'of', '38°C', 'in', 'the', 'previous', 'five', 'days', 'and', 'dyspnea', 'at', 'rest', '(NYHA', 'lV)', 'that', 'appeared', '6', 'hours',... | [['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... | [['Examination in the emergency room was compatible with heart failure and the ECG showed complete atrioventricular block with an escape ventricular rate of 45 bpm\n', 'the indications for cardiac surgery include the appearance of heart failure or new conduction disorders, and in this case it presents both\n', 'Support... |
335_175 | [['QUESTION', 'TYPE:', 'PHARMACOLOGY'], ['CLINICAL', 'CASE:'], ['An', '88-year-old', 'man', 'comes', 'for', 'consultation', 'because', 'he', 'has', 'fallen', '3', 'times', 'in', 'the', 'last', '6', 'months.'], ['None', 'of', 'the', 'falls', 'was', 'accompanied', 'by', 'dizziness', 'or', 'syncope.'], ['One', 'fall', 'oc... | [['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', '... | [['both hydrochlorothiazide and lisinopril can also produce falls in the elderly, but they would generally be accompanied by dizziness\n', 'Hydrochlorothiazide\n', 'Attack'], ['both hydrochlorothiazide and lisinopril can also produce falls in the elderly, but they would generally be accompanied by dizziness\n', 'Lisino... |
19_109 | [['QUESTION', 'TYPE:', 'INFECTIOUS', 'DISEASES'], ['CLINICAL', 'CASE:'], ['A', '32-year-old', 'woman', 'has', 'traveled', 'to', 'Cuba', 'from', 'where', 'she', 'arrived', 'three', 'days', 'ago.'], ['The', 'day', 'after', 'her', 'return,', 'she', 'goes', 'to', 'her', 'family', 'doctor', 'for', 'high', 'fever,', 'intense... | [['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-Premis... | [['although the clinical picture is suggestive, it does not present lymphocytosis\n', 'The 1 should not be\n', 'Support'], ['although the clinical picture is suggestive, it does not present lymphocytosis\n', 'Infectious mononucleosis\n', 'Attack'], ['What points to dengue, in addition to the clinical signs, is the plat... |
401_147 | [['QUESTION', 'TYPE:', 'TRAUMATOLOGY', 'AND', 'ORTHOPEDICS'], ['CLINICAL', 'CASE:'], ['A', '13-year-old', 'boy', 'presents', 'dorsal', 'pain', 'of', 'several', 'months', 'of', 'evolution,', 'only', 'when', 'standing', 'and', 'walking,', 'what', 'diagnosis', 'should', 'we', 'consider?'], ['1-', "Scheuermann's", 'disease... | [['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', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim',... | [['the patient presents with a specific examination that would give us the diagnosis\n', 'As for Scheuermann and scoliosis, we should be given some physical data\n', 'Support'], ['A malignant tumor would also hurt at rest\n', 'Malignant tumor of the vertebral body\n', 'Support'], ['As for Scheuermann and scoliosis, we ... |
607_115 | null | null | [] |
453_150 | [['QUESTION', 'TYPE:', 'NEUROLOGY'], ['CLINICAL', 'CASE:'], ['A', '25-year-old', 'man', 'consults', 'for', 'tremor.'], ['Examination', 'reveals', 'dysarthria', 'and', 'dystonia.'], ['He', 'has', 'a', 'family', 'history', 'of', 'psychiatric', 'illness', 'and', 'movement', 'disorders.'], ['Which', 'diagnostic', 'test', '... | [['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise']... | [['If they are talking about a young man 20-30 years old, with tremor and dystonia, whether or not he has a family history, and especially if one of the options tells me about copper in urine\n', "they are telling me to think of Wilson's disease\n", 'Support'], ['So the correct answer is 4\n', 'Copper in urine of 24\n'... |
529_166 | [['QUESTION', 'TYPE:', 'NEPHROLOGY'], ['CLINICAL', 'CASE:'], ['An', '18-year-old', 'patient', 'consulted', 'for', 'edema.'], ['A', 'complete', 'blood', 'test', 'showed', 'proteinuria', 'of', '8', 'g/day', 'without', 'microhematuria,', 'hypoalbuminemia', 'and', 'hypercholesterolemia', 'with', 'normal', 'renal', 'functio... | [['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', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '... | [['After one month, the clinical picture has completely disappeared\n', 'We describe a young patient with criteria of nephrotic syndrome with excellent response to corticosteroids\n', 'Support'], ['A complete blood test showed proteinuria of 8 g/day without microhematuria, hypoalbuminemia and hypercholesterolemia with ... |
258_96 | [['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['A', '62-year-old', 'man', 'with', 'type', '2', 'diabetes', 'mellitus', 'of', '10', 'years', 'of', 'evolution', 'is', 'treated', 'with', 'metformin', 'and', 'sitagliptin.'], ['He', 'does', 'little', 'physical', 'exercise', 'and', 'follows', 'an', 'adequat... | [['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', '... | [['To associate a basal insulin dose to the treatment\n', 'To associate a basal insulin dose to the treatment\n', 'Support'], ['Patient poorly controlled with metformin and sitagliptin with discrete cardinal symptoms (weight loss, asthenia)\n', 'To associate a basal insulin dose to the treatment\n', 'Support'], ['Patie... |
375_128 | [['QUESTION', 'TYPE:', 'NEUROLOGY'], ['CLINICAL', 'CASE:'], ['A', '45-year-old', 'patient', 'under', 'study', 'for', 'possible', 'meningitis,', 'with', 'fever,', 'headache', 'and', 'vomiting', 'of', '2', 'days', 'of', 'evolution.'], ['A', 'brain', 'MRI', 'and', 'lumbar', 'puncture', 'were', 'performed.'], ['Twenty', 'h... | [['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '... | [['A 45-year-old patient under study for possible meningitis, with fever, headache and vomiting of 2 days of evolution\n', 'we have not been told what the initial headache was like\n', 'Support'], ['we have not been told what the initial headache was like\n', 'he first cannot be\n', 'Support'], ['The picture they descr... |
352_161 | [['QUESTION', 'TYPE:', 'GYNECOLOGY', 'AND', 'OBSTETRICS'], ['CLINICAL', 'CASE:'], ['A', '27-year-old', 'woman', 'referred', 'to', 'the', 'gynecology', 'office', 'for', 'evaluation', 'referring', '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 correct answer is 2\n', 'Diagnostic laparoscopy\n', 'Support'], ['A 27-year-old woman referred to the gynecology office for evaluation referring dyspareunia for about 8 months, along with dyschezia and occasional rectorrhagia coinciding with menstruation for 3-4 months\n', 'We are facing a suspicion of endometri... |
575_102 | [['QUESTION', 'TYPE:', 'NEUROLOGY'], ['CLINICAL', 'CASE:'], ['A', '29-year-old', 'woman', 'with', 'a', 'history', 'of', 'febrile', 'seizures', 'and', 'a', 'heavy', 'smoker.'], ['She', 'consults', 'for', 'frequent,', 'stereotyped', 'episodes', 'that', 'begin', 'with', 'an', 'ascending', 'epigastric', 'sensation', 'and',... | [['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', '... | [['The clinical case makes a textbook description of a medial temporal seizure\n', 'Complex focal temporal lobe seizures\n', 'Support'], ['The aura of ascending epigastric sensation and olfactory alteration and the subsequent description of the seizure with alteration of the level of consciousness (disconnection from t... |
278_31 | [['QUESTION', 'TYPE:', 'PATHOLOGICAL', 'ANATOMY'], ['CLINICAL', 'CASE:'], ['A', '20-year-old', 'woman', 'with', 'a', '15', 'cm', 'solid-cystic', 'ovarian', 'tumor', 'detected', 'by', 'ultrasound', 'after', 'presenting', 'with', 'non-specific', 'abdominal', 'symptoms.'], ['In', 'the', 'anatomopathological', 'study', 'of... | [['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premis... | [['we can safely rule out tumor lesions, leaving doubts between answers 2 and 3\n', 'Teratocarcinoma\n', 'Attack'], ['we can safely rule out tumor lesions, leaving doubts between answers 2 and 3\n', 'Dysgerminoma\n', 'Attack'], ['In this case, we would have to opt for IMMATURE TERATOMA, mentioning the presence of embry... |
225_64 | [['QUESTION', 'TYPE:', 'CARDIOLOGY'], ['CLINICAL', 'CASE:'], ['An', '82-year-old', 'patient', 'presents', 'with', 'sudden', 'and', 'frequent', 'dizziness,', 'without', 'prodromes,', 'of', 'short', 'duration', 'and', 'which', 'subsides', 'spontaneously,', 'without', 'ever', 'presenting', 'syncope.'], ['Physical', 'exami... | [['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'], ['... | [['it is not a complete AVB\n', 'Option 1 is ruled out\n', 'Support'], ['Option 1 is ruled out\n', 'The patient has a third-degree AVB and requires pacemaker implantation\n', 'Attack'], ['Option 2 cannot be answered either: to exclude, what is said to exclude...\n', 'The absence of periods of asystole >3 seconds exclud... |
370_125 | [['QUESTION', 'TYPE:', 'PULMONOLOGY', 'AND', 'THORACIC', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', 'former', 'smoker', 'patient,', 'previously', 'diagnosed', 'with', 'COPD', 'comes', 'in', 'for', 'a', 'checkup.'], ['The', 'physical', 'examination', 'reveals', 'digital', 'hypokratism', 'of', 'recent', 'onset.'], ['What',... | [['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',... | [['A former smoker patient, previously diagnosed with COPD comes in for a checkup\n', 'In a digital hypokratitis of recent onset in a smoking patient, the first option to rule out is bronchopulmonary carcinoma\n', 'Support'], ['The physical examination reveals digital hypokratism of recent onset\n', 'In a digital hypok... |
332_88 | null | null | [] |
78_33 | [['QUESTION', 'TYPE:', 'DIGESTIVE', 'SYSTEM'], ['CLINICAL', 'CASE:'], ['A', '55-year-old', 'postmenopausal', 'woman', 'consults', 'for', 'asthenia', 'and', 'dyspnea', 'on', 'exertion.'], ['In', 'the', 'anamnesis', 'she', 'reported', 'slight', 'epigastralgia', 'and', 'occasional', 'heartburn.'], ['No', 'metrorrhagia.'],... | [['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Prem... | [['We have a case of chronic iron deficiency anemia, without obvious bleeding\n', 'The existence of clinical symptoms suggestive of pathology of the upper digestive tract has led us to begin the study with upper endoscopy,\n', 'Support'], ['The first cause of iron deficiency anemia is occult bleeding of digestive origi... |
397_140 | [['QUESTION', 'TYPE:', 'TRAUMATOLOGY', 'AND', 'ORTHOPEDICS'], ['CLINICAL', 'CASE:'], ['You', 'assess', 'a', '66-year-old', 'patient', 'with', 'accentuated', 'groin', 'pain', 'with', '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... | [['Weak opioids are not the initial treatment of choice\n', 'Start treatment with weak opioids that have shown evidence of halting disease progression\n', 'Attack'], ['conservative options are exhausted before opting for surgical treatment\n', 'I make the diagnosis of coxarthrosis and send to the traumatologist to plac... |
275_74 | [['QUESTION', 'TYPE:', 'DIGESTIVE', 'SYSTEM'], ['CLINICAL', 'CASE:'], ['A', '67-year-old', 'man,', 'diagnosed', 'with', 'cirrhosis', 'of', 'the', 'liver', 'and', 'an', 'active', 'drinker,', 'is', 'admitted', 'for', 'progressive', 'abdominal', 'distension', 'with', 'diffuse', 'malaise,', 'of', 'two', 'weeks', 'of', 'evo... | [['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'... | [['in this case there are 1,380, which is 60% of 2,300\n', 'This is spontaneous bacterial peritonitis (SBP), defined by the presence of > 250 polymorphonuclears/mL in the ascitic fluid\n', 'Support'], ['This is spontaneous bacterial peritonitis (SBP), defined by the presence of > 250 polymorphonuclears/mL in the asciti... |
418_77 | [['QUESTION', 'TYPE:', 'GENERAL', 'SURGERY'], ['CLINICAL', 'CASE:'], ['An', '80-year-old', 'woman', 'comes', 'to', 'the', 'emergency', 'room', 'with', 'abdominal', 'pain', 'starting', 'in', 'the', 'epigastrium', 'and', 'radiating', 'later', 'to', 'the', 'left', 'iliac', 'fossa.'], ['An', 'abdominal', 'CT', 'scan', 'is'... | [['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 correct answer is 1\n', 'Admission to the ward with absolute diet and broad-spectrum antibiotic treatment\n', 'Support'], ['the abscess is not larger than 5-6 cm\n', 'it does not meet the criteria to require drainage by guided puncture\n', 'Support'], ['it is not a question of solving an obstructive condition\n'... |
200_75 | null | null | [] |
469_137 | [['QUESTION', 'TYPE:', 'ORTHOPEDIC', 'SURGERY', 'AND', 'TRAUMATOLOGY'], ['CLINICAL', 'CASE:'], ['93-year-old', 'woman', 'with', 'a', 'history', 'of', 'COPD,', 'AHT,', 'dyslipidemia,', 'atrial', 'fibrillation', 'and', 'ischemic', 'heart', 'disease.'], ['She', 'lives', 'alone.'], ['She', 'has', 'ventricular', 'ejection',... | [['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'], ['B-Premise', 'I-Premise', 'I-Premise... | [['There is no data to suggest that he has any unstable comorbidity at the present time\n', 'surgery in less than 48 hours and orthogeriatric management is of interest\n', 'Support'], ['surgery in less than 48 hours and orthogeriatric management is of interest\n', 'Closed reduction and fixation of the fracture within 4... |
378_132 | [['QUESTION', 'TYPE:', 'NEUROLOGY'], ['CLINICAL', 'CASE:'], ['A', '72-year-old', 'patient', 'presents', 'with', 'progressive', 'memory', 'loss', 'and', 'word', 'finding', 'difficulty', 'of', 'one', "year's", 'duration.'], ['What', 'is', 'the', 'most', 'useful', 'examination', 'to', 'characterize', 'the', 'type', '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'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O']... | [['The first option would be the correct one\n', 'Neuropsychological evaluation\n', 'Support'], ["it allows us to measure in a standardized way each of the cognitive domains, which will allow us to frame the patient's deficits in a specific syndrome and to monitor the deterioration with repeated scans over time\n", 'Th... |
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