diff --git "a/en/validation_en_ordered.json" "b/en/validation_en_ordered.json"
--- "a/en/validation_en_ordered.json"
+++ "b/en/validation_en_ordered.json"
@@ -1 +1,27427 @@
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"I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim"], ["O", "O"], ["O", "O", "O"], ["B-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "B-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "B-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim"], ["B-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim"]]}]
\ No newline at end of file
+[
+    {
+        "id": "274_73",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DIGESTIVE",
+                "SYSTEM"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "52-year-old",
+                "man",
+                "with",
+                "no",
+                "concomitant",
+                "diseases",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "for",
+                "melena",
+                "of",
+                "24",
+                "hours",
+                "evolution",
+                "without",
+                "hemodynamic",
+                "repercussions."
+            ],
+            [
+                "He",
+                "denies",
+                "taking",
+                "nonsteroidal",
+                "anti-inflammatory",
+                "drugs."
+            ],
+            [
+                "The",
+                "hematocrit",
+                "is",
+                "33%",
+                "and",
+                "the",
+                "rest",
+                "of",
+                "the",
+                "laboratory",
+                "tests",
+                "are",
+                "normal."
+            ],
+            [
+                "The",
+                "upper",
+                "gastrointestinal",
+                "endoscopy",
+                "performed",
+                "urgently",
+                "6",
+                "hours",
+                "after",
+                "admission",
+                "shows",
+                "a",
+                "normal",
+                "stomach,",
+                "without",
+                "blood",
+                "or",
+                "hematic",
+                "debris",
+                "and",
+                "an",
+                "excavated",
+                "ulcer",
+                "of",
+                "8",
+                "mm",
+                "in",
+                "diameter",
+                "in",
+                "the",
+                "anterior",
+                "face",
+                "of",
+                "the",
+                "duodenal",
+                "bulb",
+                "with",
+                "\"visible",
+                "vessel\"",
+                "at",
+                "its",
+                "base",
+                "and",
+                "without",
+                "active",
+                "bleeding."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "statements",
+                "is",
+                "true?"
+            ],
+            [
+                "1-",
+                "In",
+                "the",
+                "initial",
+                "endoscopy",
+                "it",
+                "is",
+                "indicated",
+                "to",
+                "apply",
+                "an",
+                "endoscopic",
+                "therapy",
+                "and",
+                "subsequently",
+                "to",
+                "establish",
+                "endovenous",
+                "treatment",
+                "with",
+                "high",
+                "doses",
+                "of",
+                "a",
+                "proton",
+                "pump",
+                "inhibitor.",
+                "This",
+                "strategy",
+                "has",
+                "been",
+                "shown",
+                "to",
+                "reduce",
+                "the",
+                "risk",
+                "of",
+                "hemorrhagic",
+                "recurrence",
+                "and",
+                "mortality."
+            ],
+            [
+                "2-",
+                "In",
+                "the",
+                "initial",
+                "endoscopy,",
+                "given",
+                "the",
+                "absence",
+                "of",
+                "active",
+                "bleeding,",
+                "endoscopic",
+                "therapy",
+                "is",
+                "not",
+                "indicated.",
+                "Subsequently,",
+                "to",
+                "reduce",
+                "the",
+                "risk",
+                "of",
+                "hemorrhagic",
+                "recurrence,",
+                "intravenous",
+                "treatment",
+                "with",
+                "high",
+                "doses",
+                "of",
+                "a",
+                "proton",
+                "pump",
+                "inhibitor",
+                "should",
+                "be",
+                "started."
+            ],
+            [
+                "3-",
+                "n",
+                "initial",
+                "endoscopy,",
+                "endoscopic",
+                "therapy",
+                "is",
+                "indicated.",
+                "Subsequent",
+                "treatment",
+                "with",
+                "high",
+                "doses",
+                "of",
+                "a",
+                "proton",
+                "pump",
+                "inhibitor",
+                "has",
+                "not",
+                "been",
+                "shown",
+                "to",
+                "be",
+                "of",
+                "any",
+                "additional",
+                "benefit."
+            ],
+            [
+                "4-",
+                "Since",
+                "this",
+                "is",
+                "a",
+                "complicated",
+                "ulcer",
+                "(hemorrhage)",
+                "the",
+                "best",
+                "therapeutic",
+                "option,",
+                "once",
+                "the",
+                "hemorrhagic",
+                "episode",
+                "is",
+                "resolved,",
+                "is",
+                "a",
+                "vagotomy",
+                "and",
+                "pyloroplasty."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "This",
+                "is",
+                "a",
+                "grade",
+                "IIa",
+                "ulcer",
+                "(Forrest",
+                "classification),",
+                "with",
+                "a",
+                "high",
+                "risk",
+                "of",
+                "recurrence."
+            ],
+            [
+                "Therefore,",
+                "endoscopic",
+                "treatment",
+                "and",
+                "hospitalization",
+                "with",
+                "intravenous",
+                "treatment",
+                "with",
+                "PPIs",
+                "(in",
+                "our",
+                "setting",
+                "it",
+                "is",
+                "usually",
+                "omeprazole)",
+                "for",
+                "at",
+                "least",
+                "72",
+                "hours",
+                "is",
+                "clearly",
+                "indicated."
+            ],
+            [
+                "Surgery",
+                "is",
+                "indicated",
+                "in",
+                "massive",
+                "bleeding",
+                "or",
+                "bleeding",
+                "refractory",
+                "to",
+                "medical",
+                "treatment."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "233_104",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "HEMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "In",
+                "a",
+                "29-year-old",
+                "woman",
+                "the",
+                "following",
+                "parameters",
+                "are",
+                "found",
+                "in",
+                "the",
+                "course",
+                "of",
+                "a",
+                "routine",
+                "blood",
+                "test:",
+                "Hb",
+                "11.5",
+                "g/dL,",
+                "MCV",
+                "70",
+                "fl,",
+                "MCH",
+                "28",
+                "pg,",
+                "Ferritin",
+                "10",
+                "ng/mL,",
+                "leukocytes",
+                "5,200/mm3,",
+                "platelets",
+                "335,000/mm3."
+            ],
+            [
+                "Physical",
+                "examination",
+                "is",
+                "normal."
+            ],
+            [
+                "The",
+                "most",
+                "indicated",
+                "examination",
+                "in",
+                "this",
+                "situation",
+                "is:"
+            ],
+            [
+                "1-",
+                "Gynecological",
+                "examination."
+            ],
+            [
+                "2-",
+                "Fecal",
+                "occult",
+                "blood",
+                "test."
+            ],
+            [
+                "3-",
+                "Radiological",
+                "study",
+                "of",
+                "the",
+                "digestive",
+                "tract."
+            ],
+            [
+                "4-",
+                "Hemoglobin",
+                "electrophoresis."
+            ],
+            [
+                "5-",
+                "Cooms",
+                "test."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "The",
+                "most",
+                "frequent",
+                "cause",
+                "of",
+                "microcytic",
+                "iron",
+                "deficiency",
+                "anemia",
+                "in",
+                "young",
+                "women",
+                "is",
+                "chronic",
+                "gynecologic",
+                "leaks."
+            ]
+        ],
+        "labels": [
+            [
+                "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-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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "315_136",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "235_107",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "HEMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "71-year-old",
+                "man",
+                "presenting",
+                "with",
+                "severe",
+                "pancytopenia",
+                "without",
+                "presence",
+                "of",
+                "immature",
+                "cells",
+                "and",
+                "with",
+                "a",
+                "bone",
+                "marrow",
+                "study",
+                "suggestive",
+                "of",
+                "severe",
+                "aplastic",
+                "anemia."
+            ],
+            [
+                "What",
+                "would",
+                "be",
+                "the",
+                "fundamental",
+                "therapeutic",
+                "approach?"
+            ],
+            [
+                "1-",
+                "Treatment",
+                "with",
+                "methylprednisolone",
+                "at",
+                "a",
+                "dose",
+                "of",
+                "1",
+                "g/kg/day",
+                "for",
+                "5",
+                "days."
+            ],
+            [
+                "2-",
+                "Study",
+                "of",
+                "siblings",
+                "and",
+                "if",
+                "any",
+                "of",
+                "them",
+                "is",
+                "HLA",
+                "compatible,",
+                "allogeneic",
+                "transplantation",
+                "of",
+                "hematopoietic",
+                "progenitors."
+            ],
+            [
+                "3-",
+                "Immunosuppressive",
+                "therapy",
+                "with",
+                "cyclosporine",
+                "and",
+                "antithymocyte",
+                "immunoglobulin."
+            ],
+            [
+                "4-",
+                "Hemotherapy",
+                "support."
+            ],
+            [
+                "5-",
+                "Chemotherapy",
+                "and",
+                "if",
+                "response",
+                "autologous",
+                "transplantation",
+                "of",
+                "hematopoietic",
+                "progenitors."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Severe",
+                "aplastic",
+                "anemia",
+                "and",
+                "not",
+                "a",
+                "candidate",
+                "for",
+                "allogeneic",
+                "transplant",
+                "because",
+                "of",
+                "his",
+                "age."
+            ],
+            [
+                "Antisuppressants",
+                "seem",
+                "to",
+                "be",
+                "the",
+                "most",
+                "suitable."
+            ]
+        ],
+        "labels": [
+            [
+                "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-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "429_114",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "540_4",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "266_138",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PNEUMOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "In",
+                "a",
+                "patient",
+                "with",
+                "mild",
+                "chronic",
+                "obstructive",
+                "pulmonary",
+                "disease",
+                "(COPD)",
+                "in",
+                "stable",
+                "phase,",
+                "polyglobulia",
+                "and",
+                "respiratory",
+                "insufficiency",
+                "are",
+                "evident."
+            ],
+            [
+                "In",
+                "the",
+                "chest",
+                "X-ray",
+                "there",
+                "are",
+                "no",
+                "notable",
+                "alterations."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "procedures",
+                "would",
+                "you",
+                "consider",
+                "performing",
+                "first",
+                "to",
+                "rule",
+                "out",
+                "the",
+                "coexistence",
+                "of",
+                "other",
+                "diseases",
+                "that",
+                "may",
+                "justify",
+                "the",
+                "findings",
+                "described?"
+            ],
+            [
+                "1-",
+                "Respiratory",
+                "polygraphy."
+            ],
+            [
+                "2-",
+                "Echocardiogram."
+            ],
+            [
+                "3-",
+                "Thoracic",
+                "computed",
+                "tomography."
+            ],
+            [
+                "4-",
+                "Pulmonary",
+                "scintigraphy."
+            ],
+            [
+                "5-",
+                "Bone",
+                "marrow",
+                "puncture."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "The",
+                "approach",
+                "is",
+                "questionable",
+                "due",
+                "to",
+                "lack",
+                "of",
+                "sufficient",
+                "data."
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "could",
+                "be",
+                "respiratory",
+                "polygraphy,",
+                "especially",
+                "in",
+                "the",
+                "case",
+                "of",
+                "an",
+                "obese",
+                "patient,",
+                "which",
+                "we",
+                "do",
+                "not",
+                "know,",
+                "but",
+                "it",
+                "could",
+                "also",
+                "be",
+                "correct",
+                "2",
+                "(echocardiogram)",
+                "in",
+                "the",
+                "case",
+                "of",
+                "suspicion",
+                "of",
+                "associated",
+                "cardiopathy,",
+                "less",
+                "frequent",
+                "but",
+                "also",
+                "possible."
+            ],
+            [
+                "The",
+                "association",
+                "of",
+                "COPD",
+                "with",
+                "OSAHS",
+                "is",
+                "a",
+                "frequent",
+                "cause",
+                "of",
+                "COPD",
+                "deterioration,",
+                "greater",
+                "than",
+                "that",
+                "which",
+                "would",
+                "correspond",
+                "to",
+                "functional",
+                "impairment."
+            ]
+        ],
+        "labels": [
+            [
+                "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",
+                "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",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "13_150",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "one-and-a-half-year-old",
+                "boy",
+                "presents",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "with",
+                "abdominal",
+                "pain",
+                "and",
+                "jaundice."
+            ],
+            [
+                "On",
+                "examination,",
+                "an",
+                "abdominal",
+                "mass",
+                "is",
+                "palpated."
+            ],
+            [
+                "An",
+                "ultrasound",
+                "shows",
+                "the",
+                "presence",
+                "of",
+                "a",
+                "common",
+                "bile",
+                "duct",
+                "cyst."
+            ],
+            [
+                "What",
+                "therapeutic",
+                "approach",
+                "should",
+                "we",
+                "adopt?"
+            ],
+            [
+                "1-",
+                "A",
+                "percutaneous",
+                "puncture",
+                "will",
+                "be",
+                "performed",
+                "for",
+                "peritoneal",
+                "lavage",
+                "to",
+                "check",
+                "that",
+                "the",
+                "cyst",
+                "contains",
+                "bile",
+                "in",
+                "order",
+                "to",
+                "leave",
+                "a",
+                "drainage",
+                "to",
+                "improve",
+                "abdominal",
+                "pain."
+            ],
+            [
+                "2-",
+                "Radical",
+                "resection",
+                "of",
+                "the",
+                "entire",
+                "bile",
+                "duct",
+                "is",
+                "indicated",
+                "to",
+                "replace",
+                "it",
+                "with",
+                "a",
+                "loop",
+                "of",
+                "bowel."
+            ],
+            [
+                "3-",
+                "An",
+                "exploratory",
+                "laparotomy",
+                "and",
+                "drainage",
+                "of",
+                "the",
+                "cyst",
+                "will",
+                "be",
+                "indicated",
+                "and",
+                "when",
+                "the",
+                "dilatation",
+                "subsides",
+                "the",
+                "drainage",
+                "will",
+                "be",
+                "removed."
+            ],
+            [
+                "4-",
+                "A",
+                "cholangioresonance",
+                "will",
+                "be",
+                "performed",
+                "to",
+                "delimit",
+                "the",
+                "cyst",
+                "and",
+                "a",
+                "laparotomy",
+                "will",
+                "be",
+                "indicated",
+                "for",
+                "resection",
+                "of",
+                "the",
+                "cyst",
+                "and",
+                "anastomosis",
+                "of",
+                "the",
+                "biliary",
+                "tract."
+            ],
+            [
+                "5-",
+                "HIDA",
+                "scintigraphy",
+                "is",
+                "necessary",
+                "to",
+                "delimit",
+                "the",
+                "cyst",
+                "and",
+                "to",
+                "be",
+                "able",
+                "to",
+                "perform",
+                "percutaneous",
+                "drainage",
+                "safely."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "I",
+                "believe",
+                "that",
+                "the",
+                "correct",
+                "answer",
+                "is",
+                "4",
+                "the",
+                "common",
+                "bile",
+                "duct",
+                "cyst",
+                "is",
+                "a",
+                "rare",
+                "pathology",
+                "but",
+                "its",
+                "treatment",
+                "is",
+                "surgical",
+                "and",
+                "consists",
+                "of",
+                "resection",
+                "of",
+                "the",
+                "cyst",
+                "and",
+                "hepaticojejunosotomy."
+            ],
+            [
+                "Cholangioresonance",
+                "is",
+                "necessary",
+                "to",
+                "choose",
+                "the",
+                "appropriate",
+                "technique",
+                "for",
+                "the",
+                "four",
+                "existing",
+                "classes",
+                "of",
+                "common",
+                "bile",
+                "duct",
+                "cyst",
+                "(Todani",
+                "classification)."
+            ]
+        ],
+        "labels": [
+            [
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "299_104",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTIOUS",
+                "DISEASES"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "46-year-old",
+                "male",
+                "parenteral",
+                "drug",
+                "user",
+                "came",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "with",
+                "fever",
+                "with",
+                "chills,",
+                "mental",
+                "confusion,",
+                "diffuse",
+                "myalgias",
+                "and",
+                "intense",
+                "pain",
+                "in",
+                "the",
+                "left",
+                "hand",
+                "of",
+                "24",
+                "hours",
+                "of",
+                "evolution",
+                "without",
+                "clear",
+                "local",
+                "phlogosis",
+                "signs."
+            ],
+            [
+                "She",
+                "does",
+                "not",
+                "refer",
+                "any",
+                "traumatic",
+                "history."
+            ],
+            [
+                "Examination",
+                "revealed:",
+                "temperature",
+                "38.9\u00b0C,",
+                "120",
+                "beats",
+                "per",
+                "minute,",
+                "respiratory",
+                "rate",
+                "30/min,",
+                "blood",
+                "pressure",
+                "90/54",
+                "mm",
+                "Hg."
+            ],
+            [
+                "Laboratory",
+                "tests",
+                "showed",
+                "leukocytosis",
+                "with",
+                "left",
+                "deviation",
+                "(25,000",
+                "leukocytes/mm3,",
+                "80%",
+                "neutrophils);",
+                "increased",
+                "creatinine",
+                "(1.6",
+                "mg/dL)",
+                "and",
+                "CK",
+                "(138",
+                "U/L)."
+            ],
+            [
+                "Among",
+                "the",
+                "following,",
+                "which",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis:"
+            ],
+            [
+                "1-",
+                "Streptococcal",
+                "necrotizing",
+                "fasciitis."
+            ],
+            [
+                "2-",
+                "Gangrene",
+                "due",
+                "to",
+                "Clostridium",
+                "spp."
+            ],
+            [
+                "3-",
+                "Mycobacterial",
+                "cellulitis."
+            ],
+            [
+                "4-",
+                "Erysipelas."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "I",
+                "have",
+                "my",
+                "doubts",
+                "between",
+                "1",
+                "and",
+                "2;",
+                "exceptionally",
+                "C.",
+                "botulinum",
+                "can",
+                "infect",
+                "traumatic",
+                "or",
+                "puncture",
+                "wounds",
+                "in",
+                "IVDUs",
+                "using",
+                "brown",
+                "heroin",
+                "or",
+                "cause",
+                "sinusitis",
+                "in",
+                "cocaine",
+                "addicts."
+            ],
+            [
+                "On",
+                "the",
+                "other",
+                "hand,",
+                "the",
+                "case",
+                "may",
+                "refer",
+                "to",
+                "a",
+                "severe",
+                "sepsis",
+                "with",
+                "poor",
+                "initial",
+                "manifestation",
+                "at",
+                "first",
+                "sight,",
+                "with",
+                "incipient",
+                "rhabdomyolysis",
+                "and",
+                "muscle",
+                "pain,",
+                "in",
+                "this",
+                "case",
+                "it",
+                "may",
+                "be",
+                "a",
+                "necrotizing",
+                "fasciitis,",
+                "where",
+                "the",
+                "most",
+                "frequently",
+                "implicated",
+                "germ",
+                "is",
+                "S.",
+                "pyogenes."
+            ]
+        ],
+        "labels": [
+            [
+                "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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "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",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "16_131",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DERMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "62-year-old",
+                "man",
+                "with",
+                "a",
+                "history",
+                "of",
+                "significant",
+                "alcohol",
+                "abuse,",
+                "carrier",
+                "of",
+                "hepatitis",
+                "C",
+                "virus,",
+                "treated",
+                "with",
+                "Ibuprofen",
+                "for",
+                "tendinitis",
+                "of",
+                "the",
+                "right",
+                "shoulder,",
+                "goes",
+                "to",
+                "his",
+                "dermatologist",
+                "because",
+                "after",
+                "spending",
+                "two",
+                "weeks",
+                "on",
+                "vacation",
+                "at",
+                "the",
+                "beach",
+                "he",
+                "notices",
+                "the",
+                "appearance",
+                "of",
+                "tense",
+                "blisters",
+                "on",
+                "the",
+                "dorsum",
+                "of",
+                "his",
+                "hands."
+            ],
+            [
+                "On",
+                "examination,",
+                "in",
+                "addition",
+                "to",
+                "localization",
+                "and",
+                "slight",
+                "malar",
+                "hypertrichosis."
+            ],
+            [
+                "The",
+                "most",
+                "likely",
+                "diagnosis",
+                "is:"
+            ],
+            [
+                "1-",
+                "Epidermolysis",
+                "bullosa",
+                "acquisita."
+            ],
+            [
+                "2-",
+                "Porphyria",
+                "cutanea",
+                "tarda."
+            ],
+            [
+                "3-",
+                "Phototoxic",
+                "reaction."
+            ],
+            [
+                "4-",
+                "Contact",
+                "dermatitis."
+            ],
+            [
+                "5-",
+                "Acute",
+                "intermittent",
+                "porphyria."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Porphyria",
+                "Cutanea",
+                "Tarda:",
+                "60%",
+                "of",
+                "patients",
+                "with",
+                "PCT",
+                "are",
+                "male,",
+                "many",
+                "of",
+                "them",
+                "drink",
+                "alcohol",
+                "in",
+                "excess,",
+                "women",
+                "who",
+                "develop",
+                "it",
+                "are",
+                "usually",
+                "treated",
+                "with",
+                "drugs",
+                "containing",
+                "estrogens."
+            ],
+            [
+                "Most",
+                "are",
+                "males",
+                "with",
+                "signs",
+                "of",
+                "iron",
+                "overload,",
+                "this",
+                "overload",
+                "reduces",
+                "the",
+                "activity",
+                "of",
+                "the",
+                "enzyme",
+                "uroporphyrinogen",
+                "decarboxylase,",
+                "which",
+                "leads",
+                "to",
+                "the",
+                "elevation",
+                "of",
+                "uroporphyrins."
+            ],
+            [
+                "HCV",
+                "and",
+                "HIV",
+                "infections",
+                "have",
+                "been",
+                "implicated",
+                "in",
+                "the",
+                "precipitation",
+                "of",
+                "acquired",
+                "PCT."
+            ],
+            [
+                "There",
+                "is",
+                "a",
+                "hereditary",
+                "form",
+                "with",
+                "AD",
+                "pattern."
+            ],
+            [
+                "Patients",
+                "with",
+                "PCT",
+                "present",
+                "with",
+                "blistering",
+                "of",
+                "photoexposed",
+                "skin,",
+                "most",
+                "frequently",
+                "on",
+                "the",
+                "dorsum",
+                "of",
+                "the",
+                "hands",
+                "and",
+                "scalp."
+            ],
+            [
+                "In",
+                "addition",
+                "to",
+                "fragility,",
+                "they",
+                "may",
+                "develop",
+                "hypertrichosis,",
+                "hyperpigmentation,",
+                "cicatricial",
+                "alopecia",
+                "and",
+                "sclerodermal",
+                "induration."
+            ]
+        ],
+        "labels": [
+            [
+                "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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "121_114",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "MICROBIOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "47-year-old",
+                "woman."
+            ],
+            [
+                "Native",
+                "of",
+                "Cochabamba",
+                "(Bolivia),",
+                "she",
+                "has",
+                "been",
+                "living",
+                "in",
+                "Spain",
+                "for",
+                "8",
+                "years."
+            ],
+            [
+                "In",
+                "mid",
+                "2009",
+                "she",
+                "began",
+                "to",
+                "experience",
+                "palpitations,",
+                "dyspnea",
+                "and",
+                "progressive",
+                "edema",
+                "in",
+                "the",
+                "lower",
+                "extremities."
+            ],
+            [
+                "She",
+                "was",
+                "diagnosed",
+                "with",
+                "heart",
+                "failure",
+                "secondary",
+                "to",
+                "cardiomyopathy",
+                "due",
+                "to",
+                "Chagas",
+                "disease."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "etiological",
+                "agent",
+                "of",
+                "this",
+                "disease",
+                "endemic",
+                "in",
+                "several",
+                "Latin",
+                "American",
+                "countries?"
+            ],
+            [
+                "1-",
+                "Toxoplasma",
+                "gondii."
+            ],
+            [
+                "2-",
+                "Trypanosoma",
+                "brucei."
+            ],
+            [
+                "3-",
+                "Lehismania",
+                "donovani."
+            ],
+            [
+                "4-",
+                "Giardia",
+                "lamblia."
+            ],
+            [
+                "5-",
+                "Trypanosoma",
+                "cruzi."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "the",
+                "fifth",
+                "one."
+            ],
+            [
+                "The",
+                "cause",
+                "of",
+                "Chagas",
+                "disease",
+                "is",
+                "Trypanosoma",
+                "cruzi."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "241_229",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "29-year-old",
+                "obese",
+                "woman,",
+                "with",
+                "no",
+                "past",
+                "history",
+                "of",
+                "interest,",
+                "consults",
+                "for",
+                "a",
+                "month",
+                "of",
+                "intense,",
+                "bilateral,",
+                "pulsating",
+                "headache,",
+                "accompanied",
+                "by",
+                "horizontal",
+                "diplopia",
+                "and",
+                "episodes",
+                "of",
+                "monocular",
+                "amaurosis",
+                "lasting",
+                "seconds."
+            ],
+            [
+                "Examination",
+                "is",
+                "normal,",
+                "except",
+                "for",
+                "the",
+                "presence",
+                "of",
+                "bilateral",
+                "papilledema."
+            ],
+            [
+                "Which",
+                "of",
+                "these",
+                "tests",
+                "do",
+                "you",
+                "think",
+                "will",
+                "allow",
+                "you",
+                "to",
+                "fully",
+                "confirm",
+                "the",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Ultrasound",
+                "of",
+                "supra-aortic",
+                "trunks."
+            ],
+            [
+                "2-",
+                "Cranial",
+                "magnetic",
+                "resonance",
+                "imaging."
+            ],
+            [
+                "3-",
+                "Electroencephalogram."
+            ],
+            [
+                "4-",
+                "Lumbar",
+                "puncture."
+            ],
+            [
+                "5-",
+                "Visual",
+                "evoked",
+                "potentials."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Again",
+                "we",
+                "are",
+                "presented",
+                "with",
+                "a",
+                "case",
+                "to",
+                "make",
+                "a",
+                "diagnosis",
+                "and",
+                "then,",
+                "in",
+                "this",
+                "case,",
+                "perform",
+                "a",
+                "confirmatory",
+                "test."
+            ],
+            [
+                "Now",
+                "the",
+                "guiding",
+                "symptom",
+                "is",
+                "bilateral",
+                "papilledema",
+                "which",
+                "is",
+                "indicative",
+                "of",
+                "intracranial",
+                "hypertension."
+            ],
+            [
+                "Although",
+                "he",
+                "does",
+                "not",
+                "comment",
+                "that",
+                "a",
+                "space-occupying",
+                "lesion",
+                "has",
+                "been",
+                "ruled",
+                "out,",
+                "given",
+                "the",
+                "normal",
+                "neurological",
+                "examination",
+                "and",
+                "the",
+                "other",
+                "symptoms,",
+                "it",
+                "is",
+                "deduced",
+                "that",
+                "it",
+                "is",
+                "idiopathic",
+                "intracranial",
+                "hypertension",
+                "or",
+                "pseudotumor",
+                "cerebri."
+            ],
+            [
+                "Other",
+                "data",
+                "suggestive",
+                "of",
+                "this",
+                "entity",
+                "include:",
+                "women",
+                "of",
+                "reproductive",
+                "age,",
+                "obesity,",
+                "and",
+                "diplopia",
+                "(due",
+                "to",
+                "involvement",
+                "of",
+                "the",
+                "VI",
+                "cranial",
+                "nerve)."
+            ],
+            [
+                "It",
+                "is",
+                "characteristic",
+                "that",
+                "the",
+                "headache",
+                "and",
+                "visual",
+                "blurriness",
+                "suddenly",
+                "worsen",
+                "in",
+                "the",
+                "mornings",
+                "when",
+                "getting",
+                "up",
+                "or",
+                "changing",
+                "posture,",
+                "producing",
+                "transitory",
+                "blindness",
+                "(Neurology,",
+                "Zarranz)."
+            ],
+            [
+                "The",
+                "lumbar",
+                "puncture",
+                "invariably",
+                "shows",
+                "an",
+                "increase",
+                "in",
+                "cerebrospinal",
+                "fluid",
+                "pressure,",
+                "so",
+                "the",
+                "correct",
+                "answer",
+                "is",
+                "4."
+            ]
+        ],
+        "labels": [
+            [
+                "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-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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "576_103",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "30-year-old",
+                "male",
+                "who",
+                "consults",
+                "for",
+                "unilateral",
+                "periocular",
+                "headaches",
+                "that",
+                "rapidly",
+                "progress",
+                "to",
+                "become",
+                "very",
+                "intense."
+            ],
+            [
+                "The",
+                "pain",
+                "attacks",
+                "last",
+                "30-60",
+                "minutes,",
+                "occur",
+                "2-3",
+                "times",
+                "a",
+                "day,",
+                "and",
+                "are",
+                "accompanied",
+                "by",
+                "tearing",
+                "in",
+                "the",
+                "painful",
+                "eye",
+                "and",
+                "unilateral",
+                "rhinorrhea."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "appropriate",
+                "preventive",
+                "treatment?"
+            ],
+            [
+                "1-",
+                "Oral",
+                "prednisone",
+                "with",
+                "withdrawal",
+                "in",
+                "2-3",
+                "months."
+            ],
+            [
+                "2-",
+                "Oral",
+                "prednisone",
+                "with",
+                "withdrawal",
+                "in",
+                "one",
+                "month,",
+                "associated",
+                "with",
+                "oral",
+                "verapamil",
+                "at",
+                "a",
+                "dose",
+                "of",
+                "80-180",
+                "mg",
+                "every",
+                "8",
+                "hours."
+            ],
+            [
+                "3-",
+                "Carbamazepine",
+                "at",
+                "doses",
+                "of",
+                "600-1200",
+                "mg",
+                "per",
+                "day."
+            ],
+            [
+                "4-",
+                "Indomethacin",
+                "at",
+                "a",
+                "dose",
+                "of",
+                "50",
+                "mg",
+                "every",
+                "8",
+                "hours",
+                "for",
+                "one",
+                "month."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "They",
+                "describe",
+                "a",
+                "characteristic",
+                "case",
+                "of",
+                "cluster",
+                "headache."
+            ],
+            [
+                "It",
+                "is",
+                "more",
+                "frequent",
+                "in",
+                "males,",
+                "the",
+                "pain",
+                "is",
+                "characteristically",
+                "unilateral",
+                "periocular",
+                "of",
+                "great",
+                "intensity,",
+                "of",
+                "variable",
+                "duration,",
+                "usually",
+                "minutes,",
+                "and",
+                "it",
+                "associates",
+                "trigeminoautonomic",
+                "signs",
+                "such",
+                "as",
+                "rhinorrhea",
+                "and",
+                "unilateral",
+                "conjunctival",
+                "injection."
+            ],
+            [
+                "The",
+                "preventive",
+                "treatment",
+                "par",
+                "excellence",
+                "is",
+                "verapamil",
+                "associated",
+                "with",
+                "a",
+                "descending",
+                "corticosteroid",
+                "regimen,",
+                "as",
+                "described",
+                "in",
+                "answer",
+                "2."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "504_87",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "Given",
+                "sudden-onset",
+                "obsessive-compulsive",
+                "disorder",
+                "(OCD)",
+                "in",
+                "a",
+                "9-year-old",
+                "boy",
+                "who",
+                "also",
+                "has",
+                "tics",
+                "and",
+                "chorea",
+                "as",
+                "neurologic",
+                "manifestations,",
+                "an",
+                "infection",
+                "by",
+                "should",
+                "be",
+                "ruled",
+                "out:"
+            ],
+            [
+                "1-",
+                "Streptococcus",
+                "viridans."
+            ],
+            [
+                "2-",
+                "Alpha-hemolytic",
+                "streptococcus."
+            ],
+            [
+                "3-",
+                "Beta-hemolytic",
+                "streptococcus,",
+                "group",
+                "A."
+            ],
+            [
+                "4-",
+                "Enterococcus."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "We",
+                "are",
+                "presented",
+                "with",
+                "a",
+                "case",
+                "of",
+                "PANDAS",
+                "syndrome,",
+                "a",
+                "rare",
+                "complication",
+                "of",
+                "an",
+                "infection",
+                "caused",
+                "by",
+                "group",
+                "A",
+                "beta-hemolytic",
+                "streptococcus."
+            ]
+        ],
+        "labels": [
+            [
+                "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",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "367_119",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PNEUMOLOGY",
+                "AND",
+                "THORACIC",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "38-year-old",
+                "nonsmoking",
+                "woman",
+                "previously",
+                "diagnosed",
+                "with",
+                "atopic",
+                "rhinitis",
+                "presents",
+                "with",
+                "a",
+                "two-month",
+                "history",
+                "of",
+                "intermittent",
+                "cough",
+                "and",
+                "wheezing,",
+                "predominantly",
+                "at",
+                "night."
+            ],
+            [
+                "Chest",
+                "X-ray",
+                "was",
+                "normal."
+            ],
+            [
+                "Spirometry",
+                "within",
+                "the",
+                "normal",
+                "range",
+                "with",
+                "negative",
+                "bronchodilator",
+                "test."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "tests",
+                "would",
+                "you",
+                "request",
+                "next?"
+            ],
+            [
+                "1-",
+                "Paranasal",
+                "sinus",
+                "Rx."
+            ],
+            [
+                "2-",
+                "Thoracic",
+                "CT."
+            ],
+            [
+                "3-",
+                "Methacholine",
+                "test."
+            ],
+            [
+                "4-",
+                "Prick",
+                "test."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "A",
+                "normal",
+                "spirometry",
+                "and",
+                "a",
+                "negative",
+                "bronchodilator",
+                "test",
+                "does",
+                "not",
+                "exclude",
+                "asthma,",
+                "and",
+                "the",
+                "patient's",
+                "clinical",
+                "picture",
+                "is",
+                "highly",
+                "suggestive",
+                "of",
+                "asthma,",
+                "so",
+                "a",
+                "methacholine",
+                "test",
+                "would",
+                "confirm",
+                "the",
+                "diagnosis,",
+                "at",
+                "least",
+                "of",
+                "bronchial",
+                "hyperresponsiveness."
+            ]
+        ],
+        "labels": [
+            [
+                "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",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "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",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "444_104",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "171_226",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CARDIOLOGY",
+                "AND",
+                "CARDIOVASCULAR",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "26-year-old",
+                "male",
+                "patient,",
+                "competitive",
+                "athlete,",
+                "is",
+                "studied",
+                "because",
+                "his",
+                "brother",
+                "has",
+                "had",
+                "a",
+                "sudden",
+                "death."
+            ],
+            [
+                "Complementary",
+                "tests",
+                "detect",
+                "the",
+                "existence",
+                "of",
+                "obstructive",
+                "hypertrophic",
+                "cardiomyopathy."
+            ],
+            [
+                "Mark",
+                "the",
+                "FALSE",
+                "option",
+                "regarding",
+                "this",
+                "pathology:"
+            ],
+            [
+                "1-",
+                "Treatment",
+                "with",
+                "beta-blockers",
+                "helps",
+                "to",
+                "reduce",
+                "symptoms."
+            ],
+            [
+                "2-",
+                "Abandonment",
+                "of",
+                "competitive",
+                "sport",
+                "should",
+                "be",
+                "recommended."
+            ],
+            [
+                "3-",
+                "Digoxin",
+                "is",
+                "useful",
+                "to",
+                "reduce",
+                "the",
+                "subaortic",
+                "gradient."
+            ],
+            [
+                "4-",
+                "Diuretics",
+                "should",
+                "be",
+                "avoided",
+                "or",
+                "used",
+                "with",
+                "great",
+                "care."
+            ],
+            [
+                "5-",
+                "Given",
+                "the",
+                "hereditary",
+                "nature",
+                "of",
+                "the",
+                "pathology,",
+                "a",
+                "screening",
+                "study",
+                "should",
+                "be",
+                "performed",
+                "in",
+                "the",
+                "rest",
+                "of",
+                "the",
+                "direct",
+                "relatives."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Our",
+                "myocardium",
+                "is",
+                "thicker",
+                "than",
+                "it",
+                "should",
+                "be,",
+                "predominantly",
+                "in",
+                "the",
+                "septum,",
+                "and",
+                "it",
+                "is",
+                "so",
+                "thick",
+                "that",
+                "it",
+                "obstructs",
+                "the",
+                "LV",
+                "outflow,",
+                "producing",
+                "a",
+                "\"functional\"",
+                "stenosis",
+                "with",
+                "a",
+                "pressure",
+                "gradient."
+            ],
+            [
+                "Our",
+                "objective",
+                "will",
+                "be,",
+                "first",
+                "of",
+                "all,",
+                "to",
+                "\"relax\"",
+                "the",
+                "myocardium:",
+                "for",
+                "this",
+                "purpose,",
+                "a",
+                "beta-blocker",
+                "is",
+                "recommended,",
+                "whereas",
+                "digoxin,",
+                "as",
+                "a",
+                "good",
+                "positive",
+                "inotrope,",
+                "increases",
+                "the",
+                "gradient",
+                "and",
+                "is",
+                "contraindicated."
+            ],
+            [
+                "Sport",
+                "is",
+                "not",
+                "highly",
+                "recommended,",
+                "given",
+                "the",
+                "increased",
+                "risk",
+                "of",
+                "sudden",
+                "death",
+                "associated",
+                "with",
+                "this",
+                "pathology."
+            ],
+            [
+                "And",
+                "if",
+                "we",
+                "have",
+                "a",
+                "fat",
+                "septum,",
+                "which",
+                "protrudes",
+                "into",
+                "the",
+                "LV",
+                "cavity,",
+                "it",
+                "is",
+                "not",
+                "advisable",
+                "to",
+                "perform",
+                "volume",
+                "depletion,",
+                "since",
+                "we",
+                "would",
+                "also",
+                "be",
+                "increasing",
+                "the",
+                "gradient."
+            ],
+            [
+                "Regarding",
+                "number",
+                "5,",
+                "it",
+                "is",
+                "true:",
+                "it",
+                "is",
+                "convenient",
+                "to",
+                "perform",
+                "a",
+                "careful",
+                "exploration",
+                "and",
+                "an",
+                "ECG",
+                "in",
+                "the",
+                "relatives",
+                "of",
+                "patients",
+                "with",
+                "hypertrophy."
+            ]
+        ],
+        "labels": [
+            [
+                "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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "555_51",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "55-year-old",
+                "woman",
+                "with",
+                "type",
+                "1",
+                "diabetes",
+                "diagnosed",
+                "at",
+                "age",
+                "15",
+                "years",
+                "who",
+                "refers",
+                "nausea",
+                "and",
+                "abdominal",
+                "distention,",
+                "especially",
+                "after",
+                "meals."
+            ],
+            [
+                "Evaluation",
+                "is",
+                "consistent",
+                "with",
+                "diabetic",
+                "gastroparesis."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "medications",
+                "would",
+                "be",
+                "the",
+                "most",
+                "appropriate",
+                "treatment",
+                "to",
+                "improve",
+                "her",
+                "symptoms:"
+            ],
+            [
+                "1-",
+                "Lansoprazole."
+            ],
+            [
+                "2-",
+                "Ondansetron."
+            ],
+            [
+                "3-",
+                "Loperamide."
+            ],
+            [
+                "4-",
+                "Metoclopramide."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "It",
+                "was",
+                "approved",
+                "as",
+                "a",
+                "treatment",
+                "for",
+                "gastroparesis",
+                "by",
+                "the",
+                "US",
+                "Food",
+                "and",
+                "Drug",
+                "Administration",
+                "(FDA)",
+                "in",
+                "1979",
+                "and",
+                "remains",
+                "the",
+                "first-line",
+                "drug."
+            ],
+            [
+                "It",
+                "acts",
+                "as",
+                "a",
+                "prokinetic",
+                "by",
+                "its",
+                "antagonistic",
+                "effect",
+                "on",
+                "dopamine",
+                "2",
+                "(D2)",
+                "receptors",
+                "promoting",
+                "gastric",
+                "emptying",
+                "and,",
+                "in",
+                "addition,",
+                "binds",
+                "to",
+                "the",
+                "5-hydroxytryptamine",
+                "4",
+                "receptor",
+                "(serotonin",
+                "5-HT4)",
+                "to",
+                "stimulate",
+                "cholinergic",
+                "nerve",
+                "pathways",
+                "in",
+                "the",
+                "stomach."
+            ],
+            [
+                "Physiologically,",
+                "it",
+                "accelerates",
+                "intestinal",
+                "transit",
+                "by",
+                "increasing",
+                "the",
+                "tone",
+                "and",
+                "amplitude",
+                "of",
+                "gastric",
+                "contractions,",
+                "increases",
+                "lower",
+                "esophageal",
+                "sphincter",
+                "pressure",
+                "and",
+                "improves",
+                "antropyloroduodenal",
+                "coordination."
+            ],
+            [
+                "In",
+                "addition,",
+                "this",
+                "antiemetic",
+                "agent",
+                "provides",
+                "relief",
+                "through",
+                "antagonism",
+                "of",
+                "central",
+                "and",
+                "peripheral",
+                "dopamine",
+                "receptors."
+            ]
+        ],
+        "labels": [
+            [
+                "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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "320_142",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "RHEUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "40-year-old",
+                "man,",
+                "with",
+                "no",
+                "history",
+                "of",
+                "interest,",
+                "presents",
+                "with",
+                "acute",
+                "arthritis",
+                "of",
+                "the",
+                "right",
+                "knee",
+                "of",
+                "5",
+                "days",
+                "of",
+                "evolution",
+                "as",
+                "well",
+                "as",
+                "fever",
+                "up",
+                "to",
+                "37.7\u00b0C."
+            ],
+            [
+                "He",
+                "has",
+                "no",
+                "history",
+                "of",
+                "trauma."
+            ],
+            [
+                "He",
+                "presented",
+                "with",
+                "joint",
+                "effusion,",
+                "warmth",
+                "on",
+                "palpation",
+                "and",
+                "functional",
+                "limitation",
+                "due",
+                "to",
+                "pain."
+            ],
+            [
+                "Diagnostic",
+                "arthrocentesis",
+                "was",
+                "performed",
+                "and",
+                "showed",
+                "30000",
+                "cels/microliter",
+                "with",
+                "predominance",
+                "of",
+                "neutrophils."
+            ],
+            [
+                "Polarized",
+                "light",
+                "examination",
+                "revealed",
+                "rhomboidal",
+                "and",
+                "cylindrical",
+                "crystals",
+                "with",
+                "weakly",
+                "positive",
+                "birefringence."
+            ],
+            [
+                "On",
+                "plain",
+                "radiograph",
+                "of",
+                "the",
+                "knee,",
+                "radiodense",
+                "deposits",
+                "are",
+                "found",
+                "in",
+                "the",
+                "external",
+                "meniscus",
+                "of",
+                "the",
+                "knee."
+            ],
+            [
+                "Mark",
+                "the",
+                "FALSE",
+                "answer:"
+            ],
+            [
+                "1-",
+                "Initial",
+                "treatment",
+                "will",
+                "consist",
+                "of",
+                "non-steroidal",
+                "anti-inflammatory",
+                "drugs,",
+                "as",
+                "well",
+                "as",
+                "aspiration",
+                "of",
+                "synovial",
+                "fluid."
+            ],
+            [
+                "2-",
+                "It",
+                "is",
+                "advisable",
+                "to",
+                "perform",
+                "a",
+                "synovial",
+                "fluid",
+                "culture",
+                "to",
+                "rule",
+                "out",
+                "infectious",
+                "synovitis."
+            ],
+            [
+                "3-",
+                "Once",
+                "the",
+                "acute",
+                "flare-up",
+                "has",
+                "passed,",
+                "treatment",
+                "with",
+                "allopurinol",
+                "should",
+                "be",
+                "started",
+                "to",
+                "reduce",
+                "the",
+                "incidence",
+                "of",
+                "new",
+                "arthritis",
+                "flare-ups",
+                "in",
+                "the",
+                "future."
+            ],
+            [
+                "4-",
+                "The",
+                "most",
+                "likely",
+                "diagnosis",
+                "is",
+                "acute",
+                "arthritis",
+                "due",
+                "to",
+                "calcium",
+                "pyrophosphate",
+                "crystal",
+                "deposition",
+                "(pseudogout)."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "It",
+                "is",
+                "a",
+                "chondrocalcinosis."
+            ],
+            [
+                "There",
+                "is",
+                "no",
+                "treatment",
+                "for",
+                "this",
+                "disease,",
+                "only",
+                "treatment",
+                "for",
+                "flare-ups",
+                "(colchicine,",
+                "NSAIDs",
+                "or",
+                "corticosteroids),",
+                "although",
+                "sometimes",
+                "if",
+                "the",
+                "flare-ups",
+                "are",
+                "habitual",
+                "the",
+                "colchicine",
+                "is",
+                "maintained."
+            ],
+            [
+                "Allopurinol",
+                "has",
+                "not",
+                "shown",
+                "any",
+                "efficacy",
+                "in",
+                "this",
+                "microcrystal",
+                "arthropathy,",
+                "but",
+                "it",
+                "has",
+                "shown",
+                "efficacy",
+                "in",
+                "gout."
+            ]
+        ],
+        "labels": [
+            [
+                "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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "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",
+                "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"
+            ],
+            [
+                "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",
+                "B-Marker",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "617_119",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "TRAUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "13-year-old",
+                "female,",
+                "with",
+                "no",
+                "relevant",
+                "history,",
+                "with",
+                "menarche",
+                "3",
+                "months",
+                "ago,",
+                "followed",
+                "since",
+                "the",
+                "age",
+                "of",
+                "10",
+                "years",
+                "for",
+                "idiopathic",
+                "scoliosis",
+                "that",
+                "has",
+                "worsened."
+            ],
+            [
+                "In",
+                "the",
+                "physical",
+                "examination",
+                "she",
+                "presents",
+                "a",
+                "hump",
+                "of",
+                "7",
+                "degrees",
+                "in",
+                "the",
+                "Adams",
+                "test",
+                "and",
+                "in",
+                "the",
+                "scoliogram",
+                "a",
+                "T4-L1",
+                "thoracolumbar",
+                "curve",
+                "of",
+                "35",
+                "degrees",
+                "of",
+                "Cobb",
+                "and",
+                "a",
+                "Risser",
+                "0:"
+            ],
+            [
+                "1-",
+                "Recommend",
+                "swimming",
+                "and",
+                "revision",
+                "in",
+                "three",
+                "months."
+            ],
+            [
+                "2-",
+                "Prescribe",
+                "a",
+                "brace",
+                "type",
+                "orthosis."
+            ],
+            [
+                "3-",
+                "Refer",
+                "to",
+                "physiotherapy",
+                "for",
+                "spine",
+                "elastification."
+            ],
+            [
+                "4-",
+                "Revise",
+                "in",
+                "6",
+                "months",
+                "with",
+                "a",
+                "new",
+                "X-ray."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "We",
+                "are",
+                "presented",
+                "with",
+                "the",
+                "case",
+                "of",
+                "a",
+                "13",
+                "year",
+                "old",
+                "patient,",
+                "with",
+                "menarche",
+                "3",
+                "months",
+                "ago,",
+                "a",
+                "T4-L1",
+                "thoracolumbar",
+                "curve",
+                "of",
+                "35\u00ba",
+                "and",
+                "a",
+                "Risser",
+                "0."
+            ],
+            [
+                "As",
+                "a",
+                "general",
+                "rule",
+                "we",
+                "could",
+                "say",
+                "that",
+                "below",
+                "50\u00ba",
+                "the",
+                "treatment",
+                "is",
+                "usually",
+                "conservative,",
+                "with",
+                "two",
+                "options:",
+                "observation",
+                "or",
+                "use",
+                "of",
+                "a",
+                "brace",
+                "to",
+                "slow",
+                "down",
+                "the",
+                "evolution."
+            ],
+            [
+                "In",
+                "this",
+                "case,",
+                "taking",
+                "into",
+                "account",
+                "the",
+                "remaining",
+                "growth",
+                "(menarche",
+                "3",
+                "months",
+                "ago",
+                "and",
+                "Risser",
+                "0)",
+                "the",
+                "most",
+                "indicated",
+                "would",
+                "be",
+                "to",
+                "use",
+                "a",
+                "brace",
+                "(Answer",
+                "2",
+                "correct)."
+            ]
+        ],
+        "labels": [
+            [
+                "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-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "146_231",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "7-month-old",
+                "infant",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "referred",
+                "by",
+                "his",
+                "pediatrician",
+                "for",
+                "suspected",
+                "Kawasaki",
+                "disease."
+            ],
+            [
+                "He",
+                "reports",
+                "a",
+                "fever",
+                "of",
+                "up",
+                "to",
+                "39.5\u00baC",
+                "of",
+                "5",
+                "days",
+                "evolution",
+                "that",
+                "does",
+                "not",
+                "subside",
+                "despite",
+                "treatment",
+                "with",
+                "amoxicillin",
+                "prescribed",
+                "72",
+                "hours",
+                "ago",
+                "for",
+                "suspected",
+                "acute",
+                "pharyngotonsillitis."
+            ],
+            [
+                "During",
+                "the",
+                "last",
+                "24",
+                "hours",
+                "he",
+                "has",
+                "had",
+                "erythematous",
+                "and",
+                "pruritic",
+                "exanthema",
+                "of",
+                "cephalocaudal",
+                "evolution",
+                "and",
+                "during",
+                "the",
+                "last",
+                "few",
+                "days",
+                "his",
+                "parents",
+                "have",
+                "noticed",
+                "a",
+                "cough",
+                "and",
+                "intense",
+                "conjunctivitis."
+            ],
+            [
+                "No",
+                "rhinorrhea",
+                "was",
+                "reported."
+            ],
+            [
+                "Clinical",
+                "examination",
+                "showed",
+                "subcrepitant",
+                "in",
+                "both",
+                "lung",
+                "bases",
+                "without",
+                "tachypnea",
+                "or",
+                "signs",
+                "of",
+                "respiratory",
+                "distress."
+            ],
+            [
+                "On",
+                "oropharyngeal",
+                "examination",
+                "there",
+                "are",
+                "whitish",
+                "spots",
+                "in",
+                "the",
+                "jugal",
+                "mucosa."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "probable",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Kawasaki",
+                "disease."
+            ],
+            [
+                "2-",
+                "Scarlet",
+                "fever."
+            ],
+            [
+                "3-",
+                "Allergic",
+                "reaction",
+                "to",
+                "amoxicillin."
+            ],
+            [
+                "4-",
+                "Infectious",
+                "mononucleosis."
+            ],
+            [
+                "5-",
+                "Measles."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "5."
+            ],
+            [
+                "The",
+                "clue",
+                "is",
+                "in",
+                "the",
+                "whitish",
+                "lesions",
+                "of",
+                "the",
+                "jugal",
+                "mucosa",
+                "corresponding",
+                "to",
+                "Koplik's",
+                "spots,",
+                "which",
+                "are",
+                "pathognomonic",
+                "of",
+                "measles,",
+                "although",
+                "as",
+                "an",
+                "observation",
+                "I",
+                "would",
+                "say",
+                "that",
+                "they",
+                "usually",
+                "appear",
+                "in",
+                "the",
+                "prodromal",
+                "phase",
+                "of",
+                "the",
+                "disease",
+                "and",
+                "are",
+                "often",
+                "no",
+                "longer",
+                "seen",
+                "when",
+                "the",
+                "exanthema",
+                "appears."
+            ],
+            [
+                "In",
+                "this",
+                "case",
+                "you",
+                "are",
+                "describing",
+                "measles",
+                "complicated",
+                "by",
+                "pneumonia."
+            ],
+            [
+                "Very",
+                "timely",
+                "question",
+                "at",
+                "the",
+                "present",
+                "time."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "467_92",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ORTHOPEDIC",
+                "SURGERY",
+                "AND",
+                "TRAUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "woman",
+                "presenting",
+                "with",
+                "difficulty",
+                "walking",
+                "after",
+                "gynecologic",
+                "surgery."
+            ],
+            [
+                "She",
+                "has",
+                "mild",
+                "thigh",
+                "pain",
+                "and",
+                "leg",
+                "failure",
+                "on",
+                "support."
+            ],
+            [
+                "On",
+                "examination",
+                "she",
+                "has",
+                "weakness",
+                "in",
+                "hip",
+                "flexion",
+                "and",
+                "knee",
+                "extension,",
+                "and",
+                "dysesthesias",
+                "in",
+                "the",
+                "anterior",
+                "aspect",
+                "of",
+                "the",
+                "thigh."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "probable",
+                "diagnosis",
+                "of",
+                "suspicion:"
+            ],
+            [
+                "1-",
+                "Femoral",
+                "nerve",
+                "neuropathy."
+            ],
+            [
+                "2-",
+                "Meralgia",
+                "paresthetica",
+                "of",
+                "the",
+                "femoral",
+                "cutaneous",
+                "nerve."
+            ],
+            [
+                "3-",
+                "Obturator",
+                "nerve",
+                "neuropathy."
+            ],
+            [
+                "4-",
+                "Neuropathy",
+                "of",
+                "the",
+                "sciatic",
+                "nerve."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "The",
+                "femoral",
+                "nerve",
+                "(although",
+                "rare)",
+                "may",
+                "be",
+                "damaged",
+                "in",
+                "a",
+                "cesarean",
+                "section,",
+                "hysterectomy",
+                "or",
+                "lower",
+                "abdominal",
+                "operation."
+            ],
+            [
+                "This",
+                "nerve",
+                "injury",
+                "produces",
+                "hypoesthesia",
+                "and",
+                "weakness",
+                "along",
+                "its",
+                "distribution."
+            ],
+            [
+                "Femoroneuropathy",
+                "is",
+                "manifested",
+                "by",
+                "paralysis",
+                "(25%",
+                "of",
+                "cases)",
+                "of",
+                "the",
+                "quadriceps",
+                "muscles,",
+                "abolition",
+                "of",
+                "patellar",
+                "reflexes",
+                "and",
+                "hypoesthesia",
+                "of",
+                "the",
+                "anterior",
+                "and",
+                "inner",
+                "thigh."
+            ],
+            [
+                "Therefore,",
+                "answer",
+                "1",
+                "is",
+                "correct."
+            ],
+            [
+                "The",
+                "femoral",
+                "cutaneous",
+                "or",
+                "lateral",
+                "femoral",
+                "cutaneous",
+                "nerve",
+                "(L2,L3)",
+                "is",
+                "only",
+                "sensitive",
+                "and",
+                "is",
+                "responsible",
+                "for",
+                "the",
+                "sensitivity",
+                "of",
+                "the",
+                "skin",
+                "of",
+                "the",
+                "lateral",
+                "and",
+                "anterior",
+                "aspect",
+                "of",
+                "the",
+                "thigh",
+                "up",
+                "to",
+                "the",
+                "knee,",
+                "so",
+                "it",
+                "would",
+                "not",
+                "explain",
+                "the",
+                "motor",
+                "problem",
+                "of",
+                "gait",
+                "and",
+                "2",
+                "is",
+                "false."
+            ],
+            [
+                "The",
+                "obturator",
+                "nerve",
+                "(L2-L4)",
+                "is",
+                "a",
+                "mixed",
+                "nerve."
+            ],
+            [
+                "At",
+                "the",
+                "motor",
+                "level,",
+                "it",
+                "invests",
+                "the",
+                "obturator",
+                "externus,",
+                "pectineus,",
+                "short",
+                "approximator,",
+                "the",
+                "approximators",
+                "(adductors)",
+                "and",
+                "gracilis."
+            ],
+            [
+                "At",
+                "the",
+                "sensory",
+                "level",
+                "the",
+                "capsule",
+                "of",
+                "the",
+                "coxofemoral",
+                "joint,",
+                "medial",
+                "aspect",
+                "of",
+                "the",
+                "thigh",
+                "above",
+                "the",
+                "knee."
+            ],
+            [
+                "Therefore",
+                "neither",
+                "affects",
+                "the",
+                "sensitivity",
+                "of",
+                "the",
+                "anterior",
+                "aspect",
+                "of",
+                "the",
+                "thigh",
+                "nor",
+                "the",
+                "extension",
+                "of",
+                "the",
+                "knee",
+                "so",
+                "that",
+                "3",
+                "is",
+                "false."
+            ],
+            [
+                "A",
+                "lesion",
+                "of",
+                "the",
+                "sciatic",
+                "nerve",
+                "at",
+                "motor",
+                "level",
+                "affects",
+                "to",
+                "the",
+                "flexion",
+                "of",
+                "the",
+                "knee",
+                "not",
+                "to",
+                "its",
+                "extension",
+                "and",
+                "at",
+                "distal",
+                "level",
+                "to",
+                "this",
+                "one",
+                "(they",
+                "do",
+                "not",
+                "count",
+                "anything",
+                "of",
+                "distal",
+                "clinic)",
+                "and",
+                "at",
+                "sensitive",
+                "level",
+                "also",
+                "it",
+                "is",
+                "distal",
+                "in",
+                "the",
+                "external",
+                "face",
+                "of",
+                "the",
+                "leg",
+                "and",
+                "in",
+                "the",
+                "foot",
+                "reason",
+                "why",
+                "4",
+                "also",
+                "is",
+                "false."
+            ]
+        ],
+        "labels": [
+            [
+                "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"
+            ],
+            [
+                "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",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "423_89",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "449_151",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROSURGERY"
+            ],
+            [
+                "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",
+                "region",
+                "obstructing",
+                "the",
+                "aqueduct",
+                "of",
+                "Sylvius."
+            ],
+            [
+                "The",
+                "most",
+                "likely",
+                "diagnosis",
+                "is:"
+            ],
+            [
+                "1-",
+                "Glioblastoma."
+            ],
+            [
+                "2-",
+                "Medulloblastoma."
+            ],
+            [
+                "3-",
+                "Germ",
+                "cell",
+                "tumor."
+            ],
+            [
+                "4-",
+                "Meningioma."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Germinal",
+                "tumors",
+                "are",
+                "the",
+                "most",
+                "frequent",
+                "in",
+                "children",
+                "in",
+                "the",
+                "pineal",
+                "region."
+            ],
+            [
+                "They",
+                "usually",
+                "capitate",
+                "homogeneously",
+                "and",
+                "cause",
+                "triventricular",
+                "hydrocephalus",
+                "and",
+                "Parinaud."
+            ],
+            [
+                "Glioblastomas",
+                "usually",
+                "occur",
+                "in",
+                "adults",
+                "at",
+                "the",
+                "lobar",
+                "level,",
+                "medulloblastomas",
+                "are",
+                "the",
+                "most",
+                "frequent",
+                "malignant",
+                "tumors",
+                "at",
+                "the",
+                "posterior",
+                "fossa",
+                "level",
+                "in",
+                "children",
+                "(vermis",
+                "and",
+                "roof",
+                "of",
+                "the",
+                "IV",
+                "ventricle)",
+                "but",
+                "rare",
+                "at",
+                "the",
+                "pineal",
+                "level",
+                "and",
+                "meningiomas",
+                "are",
+                "rare",
+                "in",
+                "children",
+                "and",
+                "also",
+                "in",
+                "the",
+                "pineal",
+                "region."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "433_118",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTIOUS",
+                "DISEASES",
+                "AND",
+                "MICROBIOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "Luis",
+                "is",
+                "a",
+                "25-year-old",
+                "young",
+                "man",
+                "who",
+                "underwent",
+                "splenectomy",
+                "after",
+                "a",
+                "bicycle",
+                "accident",
+                "1",
+                "year",
+                "ago."
+            ],
+            [
+                "He",
+                "has",
+                "a",
+                "dog",
+                "that",
+                "bit",
+                "him",
+                "24",
+                "hours",
+                "ago",
+                "and",
+                "has",
+                "caused",
+                "a",
+                "small",
+                "wound",
+                "on",
+                "his",
+                "right",
+                "hand."
+            ],
+            [
+                "She",
+                "comes",
+                "to",
+                "her",
+                "health",
+                "center",
+                "(located",
+                "3",
+                "hours",
+                "from",
+                "the",
+                "nearest",
+                "hospital)",
+                "with",
+                "fever",
+                "of",
+                "39\u00b0C,",
+                "pain",
+                "in",
+                "the",
+                "wound",
+                "and",
+                "general",
+                "malaise."
+            ],
+            [
+                "On",
+                "examination,",
+                "BP",
+                "100/60",
+                "mm",
+                "Hg,",
+                "HR",
+                "110",
+                "beats",
+                "per",
+                "minute,",
+                "slight",
+                "swelling",
+                "in",
+                "the",
+                "wound",
+                "without",
+                "pus."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "actions",
+                "is",
+                "most",
+                "indicated",
+                "at",
+                "this",
+                "time?"
+            ],
+            [
+                "1-",
+                "Send",
+                "to",
+                "hospital",
+                "for",
+                "rabies",
+                "and",
+                "tetanus",
+                "vaccination",
+                "and",
+                "keep",
+                "under",
+                "observation."
+            ],
+            [
+                "2-",
+                "Clean",
+                "the",
+                "wound",
+                "and",
+                "administer",
+                "intramuscular",
+                "nonspecific",
+                "gamma",
+                "globulin."
+            ],
+            [
+                "3-",
+                "Give",
+                "400",
+                "mg",
+                "of",
+                "oral",
+                "moxifloxacin",
+                "and",
+                "send",
+                "to",
+                "hospital."
+            ],
+            [
+                "4-",
+                "Give",
+                "clindamycin",
+                "600",
+                "mg",
+                "orally",
+                "every",
+                "8",
+                "hours",
+                "and",
+                "observation."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "This",
+                "question",
+                "has",
+                "been",
+                "complicated",
+                "for",
+                "us."
+            ],
+            [
+                "The",
+                "question",
+                "does",
+                "not",
+                "have",
+                "all",
+                "the",
+                "necessary",
+                "information,",
+                "but",
+                "using",
+                "what",
+                "we",
+                "have",
+                "we",
+                "can",
+                "try",
+                "to",
+                "answer."
+            ],
+            [
+                "The",
+                "dog",
+                "is",
+                "domestic,",
+                "known",
+                "and",
+                "can",
+                "be",
+                "monitored,",
+                "so",
+                "we",
+                "would",
+                "have",
+                "to",
+                "wait",
+                "for",
+                "the",
+                "observation",
+                "period",
+                "to",
+                "pass",
+                "and",
+                "prophylaxis",
+                "is",
+                "not",
+                "recommended."
+            ],
+            [
+                "At",
+                "this",
+                "point",
+                "we",
+                "will",
+                "only",
+                "have",
+                "to",
+                "worry",
+                "about",
+                "the",
+                "possible",
+                "bacteremia",
+                "that",
+                "may",
+                "be",
+                "occurring",
+                "in",
+                "a",
+                "patient",
+                "with",
+                "the",
+                "possibility",
+                "of",
+                "high",
+                "risk",
+                "due",
+                "to",
+                "asplenia."
+            ],
+            [
+                "The",
+                "treatment",
+                "of",
+                "choice",
+                "in",
+                "dog",
+                "bite",
+                "is",
+                "amoxicillin/clavulanic",
+                "acid",
+                "but",
+                "it",
+                "is",
+                "not",
+                "available,",
+                "so",
+                "we",
+                "can",
+                "use",
+                "another",
+                "treatment",
+                "such",
+                "as",
+                "clindamycin",
+                "plus",
+                "cephalosporin",
+                "or",
+                "clindamycin",
+                "+",
+                "moxifloxacin",
+                "but",
+                "it",
+                "is",
+                "not",
+                "contemplated",
+                "among",
+                "the",
+                "alternatives."
+            ],
+            [
+                "In",
+                "a",
+                "first",
+                "attempt",
+                "we",
+                "answered",
+                "4,",
+                "but",
+                "the",
+                "correct",
+                "answer",
+                "is",
+                "3,",
+                "because",
+                "of",
+                "the",
+                "second",
+                "part",
+                "of",
+                "the",
+                "question;",
+                "it",
+                "is",
+                "a",
+                "high",
+                "risk",
+                "patient",
+                "with",
+                "incipient",
+                "signs",
+                "of",
+                "sepsis",
+                "so",
+                "he",
+                "should",
+                "be",
+                "sent",
+                "to",
+                "the",
+                "hospital,",
+                "here",
+                "the",
+                "key",
+                "more",
+                "than",
+                "the",
+                "antibiotic",
+                "is",
+                "in",
+                "the",
+                "position",
+                "to",
+                "take,",
+                "in",
+                "the",
+                "second",
+                "part",
+                "of",
+                "each",
+                "answer."
+            ],
+            [
+                "It",
+                "could",
+                "be",
+                "challenged",
+                "since",
+                "they",
+                "do",
+                "not",
+                "say",
+                "in",
+                "which",
+                "community",
+                "the",
+                "bite",
+                "occurred",
+                "(if",
+                "it",
+                "was",
+                "in",
+                "Ceuta",
+                "or",
+                "Melilla",
+                "the",
+                "protocol",
+                "may",
+                "vary)."
+            ]
+        ],
+        "labels": [
+            [
+                "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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "337_31",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "20-year-old",
+                "woman",
+                "with",
+                "ovarian",
+                "tumor",
+                "of",
+                "15",
+                "cm,",
+                "solid-cystic,",
+                "detected",
+                "by",
+                "ultrasound",
+                "after",
+                "presenting",
+                "with",
+                "unspecific",
+                "abdominal",
+                "symptoms."
+            ],
+            [
+                "In",
+                "the",
+                "histopathological",
+                "study",
+                "of",
+                "the",
+                "corresponding",
+                "specimen,",
+                "teeth,",
+                "hairs,",
+                "areas",
+                "of",
+                "intestinal",
+                "epithelium,",
+                "areas",
+                "of",
+                "squamous",
+                "epithelium",
+                "(15%)",
+                "and",
+                "bronchial",
+                "epithelium,",
+                "as",
+                "well",
+                "as",
+                "neuroectodermal",
+                "and",
+                "embryonic",
+                "elements",
+                "are",
+                "found",
+                "in",
+                "several",
+                "of",
+                "the",
+                "histological",
+                "preparations."
+            ],
+            [
+                "In",
+                "reference",
+                "to",
+                "this",
+                "case,",
+                "point",
+                "out",
+                "the",
+                "correct",
+                "diagnosis:"
+            ],
+            [
+                "1-",
+                "Teratocarcinoma."
+            ],
+            [
+                "2-",
+                "Immature",
+                "teratoma."
+            ],
+            [
+                "3-",
+                "Mature",
+                "cystic",
+                "teratoma."
+            ],
+            [
+                "4-",
+                "Dysgerminoma."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "The",
+                "answer",
+                "is",
+                "3,",
+                "mature",
+                "cystic",
+                "teratoma."
+            ],
+            [
+                "This",
+                "is",
+                "due",
+                "to",
+                "the",
+                "characteristics",
+                "of",
+                "the",
+                "tumor:",
+                "mature",
+                "teratomas",
+                "are",
+                "constituted",
+                "by",
+                "adult",
+                "tissues,",
+                "coming",
+                "from",
+                "the",
+                "three",
+                "embryonic",
+                "leaves,",
+                "with",
+                "a",
+                "clear",
+                "predominance",
+                "of",
+                "ectodermal",
+                "elements",
+                "(epidermis,",
+                "pilosebaceous",
+                "structures",
+                "and",
+                "neural",
+                "tissue)."
+            ],
+            [
+                "Mature",
+                "teratoma",
+                "is",
+                "a",
+                "tumor",
+                "of",
+                "ovarian",
+                "germ",
+                "cells."
+            ]
+        ],
+        "labels": [
+            [
+                "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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "296_17",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTIOUS",
+                "DISEASES"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "47-year-old",
+                "man,",
+                "active",
+                "smoker,",
+                "with",
+                "a",
+                "history",
+                "of",
+                "drug",
+                "abuse",
+                "by",
+                "parenteral",
+                "route",
+                "comes",
+                "to",
+                "the",
+                "ED",
+                "for",
+                "a",
+                "2-hour",
+                "evolution",
+                "of",
+                "acute",
+                "onset",
+                "pleuritic",
+                "left",
+                "costal",
+                "pain",
+                "and",
+                "progressive",
+                "dyspnea",
+                "until",
+                "becoming",
+                "resting."
+            ],
+            [
+                "In",
+                "the",
+                "previous",
+                "2",
+                "weeks",
+                "he",
+                "had",
+                "presented",
+                "febrile",
+                "fever,",
+                "general",
+                "malaise",
+                "and",
+                "dry",
+                "cough."
+            ],
+            [
+                "On",
+                "examination,",
+                "the",
+                "patient",
+                "is",
+                "tachypneic",
+                "at",
+                "36",
+                "rpm,",
+                "with",
+                "supraclavicular",
+                "pull,",
+                "oxygen",
+                "saturation",
+                "by",
+                "pulse",
+                "oximetry",
+                "of",
+                "81%,",
+                "cyanosis,",
+                "sweating,",
+                "tachycardia",
+                "at",
+                "135",
+                "beats",
+                "per",
+                "minute",
+                "and",
+                "BP",
+                "of",
+                "75/47",
+                "mm",
+                "Hg."
+            ],
+            [
+                "The",
+                "trachea",
+                "is",
+                "deviated",
+                "to",
+                "the",
+                "right",
+                "side",
+                "and",
+                "auscultation",
+                "shows",
+                "complete",
+                "absence",
+                "of",
+                "vesicular",
+                "murmur",
+                "in",
+                "the",
+                "left",
+                "hemithorax."
+            ],
+            [
+                "HIV",
+                "serology",
+                "is",
+                "positive",
+                "and",
+                "shows",
+                "an",
+                "ADC",
+                "lymphocyte",
+                "count",
+                "of",
+                "176",
+                "cells/ml."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Subpleural",
+                "emphysematous",
+                "bulla",
+                "rupture."
+            ],
+            [
+                "2-",
+                "Community-acquired",
+                "necrotizing",
+                "bacterial",
+                "pneumonia."
+            ],
+            [
+                "3-",
+                "Pulmonary",
+                "tuberculosis."
+            ],
+            [
+                "4-",
+                "Pneumocystis",
+                "jiroveci",
+                "pneumonia."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Patient",
+                "with",
+                "risk",
+                "factor",
+                "for",
+                "HIV",
+                "acquisition,",
+                "who",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "for",
+                "a",
+                "subacute",
+                "onset",
+                "of",
+                "2",
+                "weeks",
+                "of",
+                "evolution",
+                "(fever,",
+                "malaise",
+                "and",
+                "dry",
+                "cough)",
+                "that",
+                "worsens",
+                "abruptly",
+                "(pleuritic",
+                "pain)",
+                "and",
+                "progressively",
+                "(dyspnea)."
+            ],
+            [
+                "Physical",
+                "examination",
+                "suggests",
+                "a",
+                "pneumothorax",
+                "(tachypnea,",
+                "tugging,",
+                "low",
+                "saturation,",
+                "cyanosis,",
+                "diaphoresis,",
+                "tachycardia,",
+                "deviated",
+                "trachea",
+                "and",
+                "absence",
+                "of",
+                "vesicular",
+                "murmur)."
+            ],
+            [
+                "He",
+                "has",
+                "a",
+                "positive",
+                "HIV",
+                "serology",
+                "and",
+                "a",
+                "CD4",
+                "less",
+                "than",
+                "200",
+                "cells/mL."
+            ],
+            [
+                "The",
+                "radiograph",
+                "shows",
+                "hyperclarity",
+                "in",
+                "the",
+                "left",
+                "lung",
+                "field",
+                "with",
+                "absence",
+                "of",
+                "vessels",
+                "between",
+                "the",
+                "lung",
+                "border",
+                "and",
+                "the",
+                "chest",
+                "wall",
+                "on",
+                "the",
+                "left",
+                "side,",
+                "displacement",
+                "of",
+                "the",
+                "mediastinum",
+                "and",
+                "trachea",
+                "to",
+                "the",
+                "right",
+                "side,",
+                "and",
+                "a",
+                "stump",
+                "in",
+                "the",
+                "left",
+                "pulmonary",
+                "hilum",
+                "corresponding",
+                "to",
+                "the",
+                "collapsed",
+                "lung."
+            ],
+            [
+                "The",
+                "suspicion",
+                "of",
+                "HIV",
+                "is",
+                "high",
+                "and",
+                "although",
+                "it",
+                "is",
+                "pending",
+                "confirmation,",
+                "in",
+                "the",
+                "emergency",
+                "it",
+                "is",
+                "valid",
+                "to",
+                "assume",
+                "this",
+                "option."
+            ],
+            [
+                "That",
+                "said,",
+                "I",
+                "am",
+                "looking",
+                "for",
+                "pathologies",
+                "that",
+                "are",
+                "associated",
+                "with",
+                "this",
+                "picture,",
+                "the",
+                "rupture",
+                "of",
+                "a",
+                "bulla",
+                "although",
+                "it",
+                "is",
+                "related",
+                "to",
+                "the",
+                "appearance",
+                "of",
+                "abrupt",
+                "symptoms",
+                "does",
+                "not",
+                "go",
+                "hand",
+                "in",
+                "hand",
+                "with",
+                "the",
+                "other",
+                "symptoms",
+                "(you",
+                "have",
+                "to",
+                "look",
+                "for",
+                "something",
+                "that",
+                "explains",
+                "everything",
+                "or",
+                "almost",
+                "everything),",
+                "pneumonia",
+                "although",
+                "it",
+                "is",
+                "true",
+                "that",
+                "it",
+                "can",
+                "be",
+                "related",
+                "to",
+                "many",
+                "of",
+                "the",
+                "symptoms",
+                "does",
+                "not",
+                "correlate",
+                "with",
+                "the",
+                "image,",
+                "Pulmonary",
+                "TB",
+                "could",
+                "be",
+                "manifested",
+                "with",
+                "all",
+                "of",
+                "the",
+                "above",
+                "and",
+                "cause",
+                "a",
+                "pneumothorax,",
+                "but",
+                "here",
+                "in",
+                "a",
+                "patient",
+                "with",
+                "a",
+                "respiratory",
+                "picture",
+                "with",
+                "more",
+                "than",
+                "7",
+                "days",
+                "of",
+                "evolution",
+                "that",
+                "is",
+                "complicated",
+                "abruptly,",
+                "in",
+                "a",
+                "patient",
+                "with",
+                "a",
+                "high",
+                "suspicion",
+                "of",
+                "HIV",
+                "infection",
+                "the",
+                "clearest",
+                "option",
+                "goes",
+                "for",
+                "pneumonia",
+                "due",
+                "to",
+                "P.",
+                "jirovecii",
+                "pneumonia."
+            ],
+            [
+                "In",
+                "patients",
+                "with",
+                "Pneumocystis,",
+                "10%,",
+                "pneumatoceles",
+                "appear",
+                "which",
+                "can",
+                "sometimes",
+                "open",
+                "into",
+                "the",
+                "pleural",
+                "space",
+                "producing",
+                "a",
+                "spontaneous",
+                "pneumothorax."
+            ],
+            [
+                "As",
+                "a",
+                "reminder,",
+                "the",
+                "most",
+                "frequent",
+                "germs",
+                "in",
+                "pulmonary",
+                "involvement",
+                "in",
+                "patients",
+                "with",
+                "HIV/AIDS",
+                "infection",
+                "are",
+                "P.",
+                "jiroveci",
+                "(alone",
+                "or",
+                "associated",
+                "with",
+                "tuberculosis",
+                "or",
+                "other",
+                "mycobacteria),",
+                "S.",
+                "pneumoniae,",
+                "H.",
+                "influenzae,",
+                "S.",
+                "aureus,",
+                "cytomegalovirus,",
+                "Legionella,",
+                "staphylococci",
+                "and",
+                "gram-negative",
+                "bacilli",
+                "(Pseudomonas)."
+            ],
+            [
+                "Patients",
+                "with",
+                "P.",
+                "jirovecii",
+                "pneumonia",
+                "have,",
+                "in",
+                "90%",
+                "of",
+                "cases,",
+                "a",
+                "CD4",
+                "count",
+                "<",
+                "250",
+                "cells/mL."
+            ],
+            [
+                "Other",
+                "agents",
+                "that",
+                "can",
+                "cause",
+                "pulmonary",
+                "involvement",
+                "less",
+                "frequently",
+                "are",
+                "Rhodococcus",
+                "equi,",
+                "Nocardia,",
+                "Aspergillus,",
+                "Cryptococcus,",
+                "Toxoplasma",
+                "and",
+                "Leishmania."
+            ],
+            [
+                "Although",
+                "the",
+                "frequency",
+                "of",
+                "the",
+                "different",
+                "opportunistic",
+                "infections",
+                "has",
+                "varied",
+                "as",
+                "a",
+                "consequence",
+                "of",
+                "the",
+                "administration",
+                "of",
+                "highly",
+                "effective",
+                "antiretroviral",
+                "treatments,",
+                "our",
+                "patient",
+                "would",
+                "be",
+                "in",
+                "a",
+                "setting",
+                "where",
+                "he",
+                "has",
+                "not",
+                "yet",
+                "received",
+                "HAART."
+            ]
+        ],
+        "labels": [
+            [
+                "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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise"
+            ],
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+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
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+                "I-Premise"
+            ],
+            [
+                "B-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+            ],
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise"
+            ],
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+                "B-Premise",
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+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "B-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "O",
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+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "76_87",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ANESTHESIOLOGY,",
+                "CRITICAL",
+                "CARE",
+                "AND",
+                "EMERGENCIES"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "76-year-old",
+                "woman",
+                "with",
+                "obesity",
+                "and",
+                "type",
+                "2",
+                "diabetes",
+                "mellitus",
+                "on",
+                "metformin."
+            ],
+            [
+                "She",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "room",
+                "because",
+                "for",
+                "3",
+                "days",
+                "she",
+                "presents",
+                "fever",
+                "of",
+                "38\u00baC,",
+                "polyuria,",
+                "dysuria,",
+                "intense",
+                "thirst",
+                "and",
+                "progressive",
+                "decrease",
+                "in",
+                "the",
+                "level",
+                "of",
+                "consciousness."
+            ],
+            [
+                "Physical",
+                "examination",
+                "showed",
+                "signs",
+                "of",
+                "dehydration,",
+                "BP",
+                "95/54",
+                "mm",
+                "Hg",
+                "and",
+                "no",
+                "signs",
+                "of",
+                "neurological",
+                "localization."
+            ],
+            [
+                "The",
+                "CBC",
+                "shows",
+                "leukocytosis,",
+                "creatinine",
+                "of",
+                "1.8",
+                "mg/dL",
+                "and",
+                "blood",
+                "glucose",
+                "of",
+                "855",
+                "mg/dL."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Hyperglycemic",
+                "hyperosmolar",
+                "non-ketotic",
+                "hyperglycemic",
+                "coma."
+            ],
+            [
+                "2-",
+                "Cardiac",
+                "failure."
+            ],
+            [
+                "3-",
+                "Subdural",
+                "hematoma."
+            ],
+            [
+                "4-",
+                "Obstructive",
+                "renal",
+                "failure."
+            ],
+            [
+                "5-",
+                "Diabetic",
+                "ketoacidosis",
+                "with",
+                "coma."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "The",
+                "question",
+                "relates",
+                "the",
+                "case",
+                "of",
+                "a",
+                "type",
+                "2",
+                "diabetic",
+                "patient",
+                "with",
+                "hyperglycemia",
+                "and",
+                "decreased",
+                "level",
+                "of",
+                "consciousness",
+                "without",
+                "neurological",
+                "focality",
+                "in",
+                "the",
+                "context",
+                "of",
+                "a",
+                "urinary",
+                "tract",
+                "infection",
+                "and",
+                "who",
+                "has",
+                "developed",
+                "acute",
+                "renal",
+                "failure",
+                "of",
+                "probable",
+                "prerenal",
+                "origin."
+            ],
+            [
+                "Option",
+                "2",
+                "is",
+                "immediately",
+                "ruled",
+                "out",
+                "because",
+                "the",
+                "clinical",
+                "picture",
+                "is",
+                "not",
+                "one",
+                "of",
+                "heart",
+                "failure."
+            ],
+            [
+                "Option",
+                "3",
+                "is",
+                "also",
+                "discarded",
+                "because",
+                "it",
+                "does",
+                "not",
+                "fit",
+                "with",
+                "the",
+                "clinical",
+                "picture",
+                "and",
+                "in",
+                "addition",
+                "HSD",
+                "would",
+                "give",
+                "neurological",
+                "symptoms",
+                "with",
+                "locality."
+            ],
+            [
+                "Option",
+                "4",
+                "is",
+                "discarded",
+                "because",
+                "obstructive",
+                "renal",
+                "failure",
+                "does",
+                "not",
+                "give",
+                "polyuria,",
+                "dysuria",
+                "or",
+                "the",
+                "rest",
+                "of",
+                "the",
+                "clinical",
+                "picture."
+            ],
+            [
+                "Option",
+                "5",
+                "is",
+                "less",
+                "likely",
+                "because",
+                "diabetic",
+                "ketoacidosis",
+                "is",
+                "more",
+                "typical",
+                "of",
+                "type",
+                "1",
+                "DM."
+            ],
+            [
+                "Therefore",
+                "the",
+                "correct",
+                "option",
+                "is",
+                "1."
+            ]
+        ],
+        "labels": [
+            [
+                "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"
+            ],
+            [
+                "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-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-Premise",
+                "I-Premise",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "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-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "159_111",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "UROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "45-year-old",
+                "male",
+                "patient",
+                "with",
+                "a",
+                "history",
+                "of",
+                "uric",
+                "lithiasis",
+                "with",
+                "repeated",
+                "expulsive",
+                "nephritic",
+                "colic",
+                "for",
+                "25",
+                "years,",
+                "comes",
+                "to",
+                "the",
+                "ED",
+                "referring",
+                "palpitations",
+                "and",
+                "intense",
+                "right",
+                "lumbar",
+                "pain",
+                "since",
+                "2",
+                "hours",
+                "before."
+            ],
+            [
+                "Urinalysis",
+                "showed",
+                "a",
+                "pH",
+                "of",
+                "5.5",
+                "and",
+                "leukocyturia",
+                "without",
+                "proteinuria."
+            ],
+            [
+                "The",
+                "ECG",
+                "confirms",
+                "a",
+                "previously",
+                "unknown",
+                "atrial",
+                "fibrillation."
+            ],
+            [
+                "Blood",
+                "biochemistry",
+                "shows",
+                "a",
+                "creatinine",
+                "of",
+                "0.9mg/dl,",
+                "a",
+                "calcium",
+                "of",
+                "11mg/dl",
+                "and",
+                "an",
+                "LDH",
+                "of",
+                "950",
+                "U/l."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "useful",
+                "diagnostic",
+                "maneuver",
+                "to",
+                "perform?"
+            ],
+            [
+                "1-",
+                "Simple",
+                "abdominal",
+                "X-ray."
+            ],
+            [
+                "2-",
+                "IVU."
+            ],
+            [
+                "3-",
+                "CT",
+                "with",
+                "contrast."
+            ],
+            [
+                "4-",
+                "Abdominal",
+                "echography."
+            ],
+            [
+                "5-",
+                "Doppler",
+                "echocardiography."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "In",
+                "this",
+                "question",
+                "I",
+                "have",
+                "more",
+                "doubts",
+                "as",
+                "to",
+                "which",
+                "is",
+                "the",
+                "correct",
+                "answer,",
+                "since",
+                "we",
+                "must",
+                "interpret",
+                "which",
+                "is",
+                "the",
+                "most",
+                "useful",
+                "test,",
+                "with",
+                "which",
+                "we",
+                "can",
+                "obtain",
+                "more",
+                "performance."
+            ],
+            [
+                "However,",
+                "this",
+                "situation",
+                "also",
+                "depends",
+                "on",
+                "the",
+                "radiology",
+                "services",
+                "of",
+                "each",
+                "center",
+                "and",
+                "their",
+                "preferences."
+            ],
+            [
+                "I",
+                "will",
+                "focus",
+                "on",
+                "the",
+                "urological",
+                "part,",
+                "leaving",
+                "aside",
+                "the",
+                "rest",
+                "of",
+                "the",
+                "symptomatology."
+            ],
+            [
+                "-",
+                "Abdominal",
+                "X-ray",
+                "is",
+                "the",
+                "first",
+                "imaging",
+                "study",
+                "to",
+                "be",
+                "performed",
+                "because",
+                "it",
+                "is",
+                "fast,",
+                "simple",
+                "and",
+                "practically",
+                "innocuous",
+                "(except",
+                "in",
+                "children",
+                "and",
+                "pregnant",
+                "women)."
+            ],
+            [
+                "90%",
+                "of",
+                "the",
+                "stones",
+                "are",
+                "radiopaque",
+                "and",
+                "therefore",
+                "visible,",
+                "but",
+                "the",
+                "sensitivity",
+                "of",
+                "this",
+                "test,",
+                "used",
+                "in",
+                "isolation,",
+                "decreases",
+                "to",
+                "45-59%."
+            ],
+            [
+                "It",
+                "is",
+                "a",
+                "mandatory",
+                "test",
+                "in",
+                "any",
+                "suspicion",
+                "of",
+                "colic",
+                "pain."
+            ],
+            [
+                "However,",
+                "it",
+                "has",
+                "a",
+                "lower",
+                "yield",
+                "than",
+                "the",
+                "others."
+            ],
+            [
+                "Although",
+                "the",
+                "urological",
+                "history",
+                "speaks",
+                "of",
+                "uric",
+                "lithiasis",
+                "(radiotransparent),",
+                "with",
+                "an",
+                "acid",
+                "pH",
+                "that",
+                "reaffirms",
+                "the",
+                "diagnosis",
+                "of",
+                "uric",
+                "origin,",
+                "we",
+                "can",
+                "never",
+                "rule",
+                "out",
+                "calcium",
+                "oxalate",
+                "lithiasis",
+                "that",
+                "can",
+                "appear",
+                "synchronously."
+            ],
+            [
+                "-",
+                "IVUS",
+                "seems",
+                "to",
+                "me",
+                "to",
+                "be",
+                "one",
+                "of",
+                "the",
+                "best",
+                "performing",
+                "options."
+            ],
+            [
+                "It",
+                "will",
+                "give",
+                "us",
+                "diagnostic",
+                "clarity",
+                "of",
+                "obstruction,",
+                "its",
+                "magnitude",
+                "and",
+                "its",
+                "renal",
+                "repercussions."
+            ],
+            [
+                "It",
+                "has",
+                "long",
+                "been",
+                "considered",
+                "the",
+                "examination",
+                "of",
+                "choice",
+                "for",
+                "the",
+                "study",
+                "of",
+                "patients",
+                "with",
+                "renal",
+                "lithiasis."
+            ],
+            [
+                "It",
+                "is",
+                "a",
+                "test",
+                "with",
+                "high",
+                "sensitivity",
+                "and",
+                "specificity",
+                "(87-90%",
+                "and",
+                "94-100%,",
+                "respectively),",
+                "relatively",
+                "innocuous,",
+                "and",
+                "available",
+                "in",
+                "all",
+                "hospitals."
+            ],
+            [
+                "It",
+                "informs",
+                "us",
+                "of",
+                "the",
+                "number,",
+                "size,",
+                "shape",
+                "and",
+                "location",
+                "of",
+                "the",
+                "stone,",
+                "as",
+                "well",
+                "as",
+                "the",
+                "functional",
+                "status",
+                "of",
+                "the",
+                "affected",
+                "kidney."
+            ],
+            [
+                "-",
+                "Contrast-enhanced",
+                "CT",
+                "seems",
+                "to",
+                "me",
+                "to",
+                "be",
+                "the",
+                "most",
+                "efficient",
+                "option."
+            ],
+            [
+                "It",
+                "serves",
+                "to",
+                "discover",
+                "lithiasis",
+                "that",
+                "other",
+                "tests",
+                "cannot",
+                "find",
+                "and",
+                "gives",
+                "us",
+                "a",
+                "global",
+                "image",
+                "of",
+                "the",
+                "rest",
+                "of",
+                "the",
+                "structures."
+            ],
+            [
+                "Great",
+                "performance",
+                "but",
+                "also",
+                "more",
+                "expensive,",
+                "more",
+                "time,",
+                "more",
+                "radiation."
+            ],
+            [
+                "It",
+                "has",
+                "been",
+                "confirmed",
+                "as",
+                "a",
+                "high",
+                "sensitivity",
+                "and",
+                "specificity",
+                "scan,",
+                "surpassing",
+                "previous",
+                "tests",
+                "(94-100%",
+                "and",
+                "92-100%,",
+                "respectively,",
+                "for",
+                "the",
+                "detection",
+                "of",
+                "ureteral",
+                "calculi)",
+                "and",
+                "with",
+                "its",
+                "numerous",
+                "advantages",
+                "it",
+                "has",
+                "become",
+                "the",
+                "reference",
+                "test",
+                "and",
+                "is",
+                "expected",
+                "to",
+                "replace",
+                "IVUS",
+                "and",
+                "ultrasound",
+                "worldwide."
+            ],
+            [
+                "It",
+                "performs",
+                "a",
+                "helical",
+                "scan",
+                "with",
+                "5",
+                "mm",
+                "slices",
+                "allowing",
+                "the",
+                "detection",
+                "of",
+                "stones",
+                "up",
+                "to",
+                "2",
+                "mm."
+            ],
+            [
+                "With",
+                "the",
+                "administration",
+                "of",
+                "contrast,",
+                "it",
+                "allows",
+                "the",
+                "evaluation",
+                "of",
+                "renal",
+                "function."
+            ],
+            [
+                "-",
+                "Ultrasound",
+                "is",
+                "a",
+                "fast,",
+                "cheap",
+                "and",
+                "innocuous",
+                "test,",
+                "but",
+                "very",
+                "radiologist-dependent."
+            ],
+            [
+                "It",
+                "gives",
+                "great",
+                "renal",
+                "information",
+                "on",
+                "obstructive",
+                "repercussions,",
+                "but",
+                "less",
+                "quality",
+                "in",
+                "terms",
+                "of",
+                "finding",
+                "a",
+                "lithiasis."
+            ],
+            [
+                "Ultrasonography",
+                "only",
+                "detects",
+                "calculi",
+                "larger",
+                "than",
+                "4",
+                "mm,",
+                "located",
+                "in",
+                "the",
+                "pyelo-ureteral",
+                "junction",
+                "or",
+                "the",
+                "uretero-vesical",
+                "junction,",
+                "while",
+                "the",
+                "lumbar",
+                "and",
+                "pelvic",
+                "ureter",
+                "is",
+                "not",
+                "very",
+                "accessible",
+                "due",
+                "to",
+                "the",
+                "interposition",
+                "of",
+                "the",
+                "intestinal",
+                "loops."
+            ],
+            [
+                "Therefore,",
+                "ultrasound",
+                "performed",
+                "in",
+                "isolation",
+                "is",
+                "not",
+                "very",
+                "sensitive",
+                "(20-45%)",
+                "for",
+                "the",
+                "detection",
+                "of",
+                "calculi,",
+                "but",
+                "associated",
+                "with",
+                "simple",
+                "abdominal",
+                "radiography",
+                "increases",
+                "its",
+                "sensitivity",
+                "and",
+                "specificity."
+            ],
+            [
+                "-",
+                "Doppler",
+                "echocardiography",
+                "has",
+                "no",
+                "use",
+                "in",
+                "urological",
+                "diagnosis."
+            ],
+            [
+                "My",
+                "answer",
+                "would",
+                "be",
+                "CT",
+                "with",
+                "ev",
+                "contrast",
+                "and",
+                "excretory",
+                "phase",
+                "(answer",
+                "(c)),",
+                "in",
+                "terms",
+                "of",
+                "performance,",
+                "sensitivity",
+                "and",
+                "specificity."
+            ],
+            [
+                "There",
+                "are",
+                "radiology",
+                "services",
+                "more",
+                "skilled",
+                "or",
+                "predisposed",
+                "to",
+                "one",
+                "or",
+                "the",
+                "other."
+            ],
+            [
+                "Without",
+                "forgetting",
+                "that",
+                "abdominal",
+                "X-ray",
+                "should",
+                "always",
+                "be",
+                "done",
+                "in",
+                "the",
+                "suspicion",
+                "of",
+                "colic."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "I-Premise"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "52_144",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PSYCHIATRY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "36-year-old",
+                "patient",
+                "from",
+                "another",
+                "culture",
+                "who",
+                "has",
+                "been",
+                "living",
+                "in",
+                "Spain",
+                "for",
+                "the",
+                "last",
+                "4",
+                "years",
+                "presents",
+                "at",
+                "a",
+                "National",
+                "Health",
+                "Service",
+                "office."
+            ],
+            [
+                "He",
+                "reports",
+                "presenting",
+                "with",
+                "anxious",
+                "symptoms",
+                "and",
+                "depressive",
+                "mood",
+                "for",
+                "the",
+                "last",
+                "10",
+                "months."
+            ],
+            [
+                "This",
+                "condition",
+                "moderately",
+                "interferes",
+                "with",
+                "her",
+                "daily",
+                "activities."
+            ],
+            [
+                "She",
+                "has",
+                "no",
+                "previous",
+                "psychiatric",
+                "history."
+            ],
+            [
+                "This",
+                "situation",
+                "is",
+                "the",
+                "result",
+                "of",
+                "the",
+                "death,",
+                "in",
+                "a",
+                "car",
+                "accident,",
+                "of",
+                "an",
+                "older",
+                "brother",
+                "with",
+                "whom",
+                "he",
+                "was",
+                "very",
+                "close."
+            ],
+            [
+                "Indicate",
+                "which",
+                "of",
+                "the",
+                "following",
+                "diagnoses",
+                "is",
+                "appropriate:"
+            ],
+            [
+                "1-",
+                "Major",
+                "depression."
+            ],
+            [
+                "2-",
+                "Bipolar",
+                "II",
+                "disorder."
+            ],
+            [
+                "3-",
+                "Adjustment",
+                "disorder."
+            ],
+            [
+                "4-",
+                "Dysthymia."
+            ],
+            [
+                "5-",
+                "Cyclothymia."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "The",
+                "relative",
+                "mildness",
+                "of",
+                "the",
+                "symptoms,",
+                "which",
+                "do",
+                "not",
+                "seriously",
+                "interfere",
+                "with",
+                "daily",
+                "activities,",
+                "excludes",
+                "in",
+                "principle",
+                "the",
+                "diagnosis",
+                "of",
+                "major",
+                "depression."
+            ],
+            [
+                "There",
+                "is",
+                "no",
+                "evidence",
+                "of",
+                "hypomanic",
+                "phases",
+                "to",
+                "justify",
+                "a",
+                "bipolar",
+                "II",
+                "disorder."
+            ],
+            [
+                "Dysthymia",
+                "requires",
+                "a",
+                "duration",
+                "of",
+                "at",
+                "least",
+                "two",
+                "years."
+            ],
+            [
+                "Cyclothymia",
+                "is",
+                "a",
+                "very",
+                "rare",
+                "diagnosis",
+                "nowadays",
+                "(because,",
+                "as",
+                "Castilla",
+                "del",
+                "Pino",
+                "said",
+                "in",
+                "an",
+                "interview,",
+                "what",
+                "used",
+                "to",
+                "be",
+                "cyclothymics",
+                "are",
+                "now",
+                "called",
+                "bipolar,",
+                "contributing",
+                "to",
+                "one",
+                "of",
+                "the",
+                "multiple",
+                "psychiatric",
+                "epidemics",
+                "of",
+                "our",
+                "time),",
+                "which",
+                "consists",
+                "of",
+                "oscillations",
+                "between",
+                "the",
+                "depressive",
+                "pole",
+                "and",
+                "the",
+                "manifest,",
+                "mild."
+            ],
+            [
+                "But",
+                "there",
+                "are",
+                "no",
+                "data",
+                "on",
+                "such",
+                "oscillations."
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is,",
+                "in",
+                "all",
+                "probability,",
+                "3."
+            ],
+            [
+                "The",
+                "adaptive",
+                "disorder",
+                "appears",
+                "within",
+                "3",
+                "months",
+                "after",
+                "the",
+                "stressful",
+                "event",
+                "and",
+                "does",
+                "not",
+                "last",
+                "more",
+                "than",
+                "6",
+                "months",
+                "if",
+                "the",
+                "stressful",
+                "event",
+                "or",
+                "its",
+                "consequences",
+                "have",
+                "ceased",
+                "(which",
+                "is",
+                "not",
+                "the",
+                "case",
+                "because",
+                "the",
+                "brother",
+                "of",
+                "the",
+                "imaginary",
+                "patient",
+                "is",
+                "still",
+                "dead)."
+            ],
+            [
+                "Mild",
+                "anxious-depressive",
+                "symptoms",
+                "fit",
+                "such",
+                "a",
+                "diagnosis."
+            ],
+            [
+                "One",
+                "more",
+                "example",
+                "of",
+                "how",
+                "to",
+                "conceptualize",
+                "as",
+                "illness",
+                "what",
+                "are",
+                "facts",
+                "(albeit",
+                "painful)",
+                "of",
+                "life."
+            ],
+            [
+                "Surely",
+                "the",
+                "imaginary",
+                "patient",
+                "takes",
+                "some",
+                "antidepressant",
+                "because",
+                "maybe",
+                "something",
+                "helps",
+                "(1)."
+            ]
+        ],
+        "labels": [
+            [
+                "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-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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "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",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "297_50",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTIOUS",
+                "DISEASES"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "58-year-old",
+                "man",
+                "reported",
+                "a",
+                "weeks-long",
+                "history",
+                "of",
+                "progressive,",
+                "mildly",
+                "painful",
+                "skin",
+                "lesions",
+                "on",
+                "his",
+                "left",
+                "arm."
+            ],
+            [
+                "It",
+                "had",
+                "started",
+                "as",
+                "an",
+                "erythematous",
+                "lesion",
+                "on",
+                "his",
+                "left",
+                "thumb."
+            ],
+            [
+                "He",
+                "had",
+                "visible",
+                "reddish",
+                "striae",
+                "as",
+                "connecting",
+                "lines",
+                "between",
+                "the",
+                "lesions."
+            ],
+            [
+                "The",
+                "patient",
+                "had",
+                "no",
+                "fever",
+                "or",
+                "other",
+                "general",
+                "symptoms."
+            ],
+            [
+                "He",
+                "had",
+                "been",
+                "working",
+                "in",
+                "his",
+                "garden",
+                "but",
+                "did",
+                "not",
+                "remember",
+                "any",
+                "injuries."
+            ],
+            [
+                "The",
+                "etiologic",
+                "diagnosis",
+                "was",
+                "made",
+                "by",
+                "culture",
+                "of",
+                "a",
+                "skin",
+                "biopsy."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "causative",
+                "agent",
+                "of",
+                "this",
+                "process?"
+            ],
+            [
+                "1-",
+                "Dermatophytosis",
+                "by",
+                "Microsporum",
+                "gypseum."
+            ],
+            [
+                "2-",
+                "Cutaneous",
+                "infection",
+                "by",
+                "Staphylococcus",
+                "aureus."
+            ],
+            [
+                "3-",
+                "Sporotrichosis."
+            ],
+            [
+                "4-",
+                "Cutaneous",
+                "infection",
+                "by",
+                "Mycobacterium",
+                "marinum."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "The",
+                "patient",
+                "carries",
+                "out",
+                "an",
+                "activity",
+                "in",
+                "contact",
+                "with",
+                "soil",
+                "and",
+                "plants",
+                "(which",
+                "are",
+                "not",
+                "provided",
+                "free",
+                "of",
+                "charge)."
+            ],
+            [
+                "The",
+                "symptoms",
+                "are",
+                "chronic,",
+                "which",
+                "started",
+                "distally",
+                "(left",
+                "thumb)",
+                "and",
+                "are",
+                "affecting",
+                "the",
+                "ipsilateral",
+                "arm",
+                "(reddish",
+                "striae)."
+            ],
+            [
+                "There",
+                "were",
+                "no",
+                "systemic",
+                "symptoms."
+            ],
+            [
+                "They",
+                "also",
+                "comment",
+                "that",
+                "the",
+                "diagnosis",
+                "was",
+                "made",
+                "on",
+                "the",
+                "basis",
+                "of",
+                "a",
+                "skin",
+                "biopsy."
+            ],
+            [
+                "Of",
+                "the",
+                "microorganisms",
+                "discussed,",
+                "Microsporum",
+                "gypseum",
+                "does",
+                "not",
+                "usually",
+                "manifest",
+                "dissemination",
+                "of",
+                "infection",
+                "of",
+                "a",
+                "lymphangitic",
+                "aspect,",
+                "in",
+                "general",
+                "keratinophilic",
+                "fungi",
+                "(dermatophytes)",
+                "do",
+                "not",
+                "have",
+                "any",
+                "ability",
+                "to",
+                "invade",
+                "deep",
+                "tissues,",
+                "so",
+                "we",
+                "ruled",
+                "out",
+                "this",
+                "option."
+            ],
+            [
+                "Staphylococcus",
+                "aureus",
+                "infection",
+                "can",
+                "affect",
+                "superficial",
+                "and",
+                "deep",
+                "tissue",
+                "layers,",
+                "they",
+                "can",
+                "spread",
+                "following",
+                "a",
+                "lymphangitic",
+                "path,",
+                "but",
+                "it",
+                "is",
+                "not",
+                "usual",
+                "such",
+                "a",
+                "long",
+                "evolution,",
+                "it",
+                "is",
+                "usually",
+                "acute",
+                "(days)",
+                "and",
+                "usually",
+                "accompanied",
+                "by",
+                "systemic",
+                "symptoms,",
+                "so",
+                "we",
+                "discard",
+                "this",
+                "option."
+            ],
+            [
+                "Mycobacterium",
+                "marinum",
+                "(and",
+                "not",
+                "Mycobacterum",
+                "marinum)",
+                "is",
+                "a",
+                "non-tuberculous",
+                "mycobacterium",
+                "characterized",
+                "by",
+                "being",
+                "environmental,",
+                "opportunistic",
+                "and",
+                "photochromogenic."
+            ],
+            [
+                "It",
+                "has",
+                "a",
+                "slow",
+                "growth,",
+                "from",
+                "2",
+                "to",
+                "8",
+                "weeks,",
+                "at",
+                "a",
+                "temperature",
+                "ranging",
+                "from",
+                "30",
+                "to",
+                "37",
+                "\u00b0C."
+            ],
+            [
+                "It",
+                "affects",
+                "different",
+                "species",
+                "of",
+                "fish",
+                "in",
+                "cold,",
+                "warm,",
+                "fresh",
+                "or",
+                "salt",
+                "water,",
+                "especially",
+                "stagnant",
+                "waters",
+                "of",
+                "fish",
+                "tanks",
+                "and",
+                "pools",
+                "without",
+                "chlorine."
+            ],
+            [
+                "Infection",
+                "in",
+                "humans",
+                "occurs",
+                "by",
+                "direct",
+                "contact",
+                "with",
+                "fish",
+                "or",
+                "contaminated",
+                "water",
+                "in",
+                "the",
+                "presence",
+                "of",
+                "a",
+                "loss",
+                "of",
+                "continuity",
+                "in",
+                "the",
+                "skin",
+                "of",
+                "the",
+                "host."
+            ],
+            [
+                "Our",
+                "patient",
+                "has",
+                "no",
+                "history",
+                "of",
+                "exposure",
+                "to",
+                "fish",
+                "or",
+                "water",
+                "(they",
+                "don't",
+                "say),",
+                "so",
+                "considering",
+                "that",
+                "usually",
+                "the",
+                "diagnosis",
+                "is",
+                "based",
+                "on",
+                "a",
+                "high",
+                "index",
+                "of",
+                "suspicion",
+                "and",
+                "specifically",
+                "asking",
+                "for",
+                "this",
+                "history,",
+                "our",
+                "case",
+                "is",
+                "far",
+                "from",
+                "this",
+                "possibility."
+            ],
+            [
+                "The",
+                "Sporothrix",
+                "schenckii",
+                "complex",
+                "is",
+                "the",
+                "causative",
+                "agent",
+                "of",
+                "Sporotrichosis,",
+                "this",
+                "dimorphic",
+                "fungus",
+                "is",
+                "located",
+                "in",
+                "the",
+                "soil,",
+                "the",
+                "complex",
+                "is",
+                "formed",
+                "by",
+                "5",
+                "species,",
+                "S.",
+                "schenckii",
+                "sensu",
+                "strictu,",
+                "S.",
+                "brasiliensis",
+                "and",
+                "S.",
+                "globosa,",
+                "capable",
+                "of",
+                "causing",
+                "human",
+                "and",
+                "animal",
+                "disease;",
+                "the",
+                "other",
+                "two",
+                "are",
+                "S.",
+                "mexicana",
+                "and",
+                "S.",
+                "albicana",
+                "not",
+                "associated",
+                "with",
+                "any",
+                "disease."
+            ],
+            [
+                "Patients",
+                "are",
+                "usually",
+                "infected",
+                "by",
+                "exposure",
+                "to",
+                "soil",
+                "by",
+                "means",
+                "of",
+                "a",
+                "sharp",
+                "object",
+                "(thorns,",
+                "stems,",
+                "animal",
+                "claws,",
+                "etc.)",
+                "and",
+                "have",
+                "a",
+                "slow",
+                "evolution,",
+                "affect",
+                "deep",
+                "tissues",
+                "and",
+                "their",
+                "dissemination",
+                "typically",
+                "follows",
+                "a",
+                "pathway",
+                "as",
+                "described",
+                "in",
+                "the",
+                "question."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
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+    },
+    {
+        "id": "74_63",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ANESTHESIOLOGY,",
+                "CRITICAL",
+                "CARE",
+                "AND",
+                "EMERGENCIES"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "67-year-old",
+                "woman",
+                "with",
+                "a",
+                "history",
+                "of",
+                "congestive",
+                "heart",
+                "failure",
+                "(treated",
+                "with",
+                "ramipril",
+                "and",
+                "furosemide)",
+                "and",
+                "type",
+                "2",
+                "diabetes",
+                "(treated",
+                "with",
+                "insulin)",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "room",
+                "for",
+                "dyspnea."
+            ],
+            [
+                "Blood",
+                "gas",
+                "analysis",
+                "performed",
+                "while",
+                "breathing",
+                "room",
+                "air",
+                "shows",
+                "pH",
+                "7.45,",
+                "paO2",
+                "56,",
+                "PaCO2",
+                "30",
+                "mm",
+                "Hg,",
+                "HCO3",
+                "26",
+                "mm",
+                "Hg."
+            ],
+            [
+                "What",
+                "gasometric",
+                "alteration",
+                "does",
+                "the",
+                "patient",
+                "present?"
+            ],
+            [
+                "1-",
+                "Hypoxemic",
+                "respiratory",
+                "failure",
+                "with",
+                "compensated",
+                "respiratory",
+                "alkalosis."
+            ],
+            [
+                "2-",
+                "Acute",
+                "metabolic",
+                "alkalosis",
+                "with",
+                "hypoxemic",
+                "and",
+                "hypocapnic",
+                "respiratory",
+                "failure."
+            ],
+            [
+                "3-",
+                "Chronic",
+                "normocapnic",
+                "respiratory",
+                "insufficiency,",
+                "without",
+                "alteration",
+                "of",
+                "acid-base",
+                "balance."
+            ],
+            [
+                "4-",
+                "Chronic",
+                "hypoxemic",
+                "respiratory",
+                "failure",
+                "with",
+                "compensated",
+                "metabolic",
+                "acidosis."
+            ],
+            [
+                "5-",
+                "Hypoxemic",
+                "respiratory",
+                "failure",
+                "with",
+                "compensated",
+                "mixed",
+                "alkalosis."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "I",
+                "found",
+                "this",
+                "question",
+                "tricky."
+            ],
+            [
+                "The",
+                "separate",
+                "findings",
+                "are:",
+                "normal",
+                "pH",
+                "but",
+                "with",
+                "alkalosis",
+                "tendency,",
+                "acute",
+                "respiratory",
+                "failure,",
+                "hypocapnia",
+                "and",
+                "normal",
+                "bicarbonate."
+            ],
+            [
+                "The",
+                "most",
+                "appropriate",
+                "answer",
+                "seems",
+                "to",
+                "me",
+                "to",
+                "be",
+                "1,",
+                "since",
+                "the",
+                "patient",
+                "does",
+                "not",
+                "present",
+                "a",
+                "metabolic",
+                "alkalosis",
+                "(bicarbonate",
+                "would",
+                "be",
+                "higher),",
+                "much",
+                "less",
+                "an",
+                "acidosis",
+                "(bicarbonate",
+                "would",
+                "be",
+                "low)."
+            ],
+            [
+                "The",
+                "alkalosis",
+                "is",
+                "not",
+                "mixed",
+                "either,",
+                "but",
+                "is",
+                "mainly",
+                "respiratory."
+            ],
+            [
+                "The",
+                "patient",
+                "is",
+                "probably",
+                "hyperventilating",
+                "because",
+                "of",
+                "her",
+                "respiratory",
+                "failure,",
+                "and",
+                "the",
+                "kidney",
+                "which",
+                "always",
+                "compensates",
+                "later",
+                "is",
+                "starting",
+                "to",
+                "retain",
+                "HCO3",
+                "to",
+                "compensate",
+                "and",
+                "maintain",
+                "pH."
+            ],
+            [
+                "Therefore",
+                "I",
+                "believe",
+                "the",
+                "correct",
+                "answer",
+                "is",
+                "1."
+            ]
+        ],
+        "labels": [
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+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
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+                "B-Claim",
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+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "288_227",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "460_174",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "TRAUMATOLOGY",
+                "AND",
+                "ORTHOPEDICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "60-year-old,",
+                "insulin-dependent",
+                "diabetic",
+                "woman",
+                "presents",
+                "with",
+                "right-sided,",
+                "nocturnal-predominant",
+                "omalgia",
+                "of",
+                "several",
+                "weeks'",
+                "duration."
+            ],
+            [
+                "She",
+                "does",
+                "not",
+                "report",
+                "any",
+                "trauma."
+            ],
+            [
+                "Physical",
+                "examination",
+                "shows",
+                "active",
+                "and",
+                "passive",
+                "limitation",
+                "of",
+                "all",
+                "the",
+                "arcs",
+                "of",
+                "movement",
+                "of",
+                "the",
+                "shoulder."
+            ],
+            [
+                "Which",
+                "clinical",
+                "picture",
+                "do",
+                "you",
+                "suspect",
+                "as",
+                "the",
+                "first",
+                "diagnostic",
+                "possibility?"
+            ],
+            [
+                "1-",
+                "A",
+                "malignant",
+                "tumor",
+                "located",
+                "in",
+                "the",
+                "proximal",
+                "epiphysis",
+                "of",
+                "the",
+                "humerus."
+            ],
+            [
+                "2-",
+                "Septic",
+                "arthritis",
+                "of",
+                "the",
+                "shoulder."
+            ],
+            [
+                "3-",
+                "Adhesive",
+                "capsulitis."
+            ],
+            [
+                "4-",
+                "A",
+                "degenerative",
+                "acromioclavicular",
+                "arthrosis",
+                "process."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Everything",
+                "points",
+                "to",
+                "adhesive",
+                "capsulitis,",
+                "as",
+                "you",
+                "say."
+            ],
+            [
+                "The",
+                "age,",
+                "the",
+                "sex,",
+                "the",
+                "clinic...",
+                "the",
+                "DM...."
+            ]
+        ],
+        "labels": [
+            [
+                "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"
+            ],
+            [
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "333_90",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "35-year-old",
+                "woman",
+                "consults",
+                "for",
+                "a",
+                "right",
+                "thyroid",
+                "nodule",
+                "detected",
+                "incidentally",
+                "one",
+                "morning",
+                "when",
+                "she",
+                "observed",
+                "in",
+                "the",
+                "mirror",
+                "a",
+                "lump",
+                "on",
+                "the",
+                "anterior",
+                "aspect",
+                "of",
+                "the",
+                "neck."
+            ],
+            [
+                "After",
+                "the",
+                "pertinent",
+                "studies,",
+                "it",
+                "was",
+                "decided",
+                "to",
+                "operate",
+                "on",
+                "the",
+                "patient,",
+                "performing",
+                "a",
+                "total",
+                "thyroidectomy",
+                "with",
+                "emptying",
+                "of",
+                "the",
+                "central",
+                "lymph",
+                "node",
+                "component."
+            ],
+            [
+                "The",
+                "pathologist's",
+                "report",
+                "was",
+                "that",
+                "the",
+                "2.3",
+                "cm",
+                "thyroid",
+                "nodule",
+                "was",
+                "entirely",
+                "occupied",
+                "by",
+                "a",
+                "papillary",
+                "thyroid",
+                "carcinoma,",
+                "tall",
+                "cell",
+                "variant,",
+                "without",
+                "vascular",
+                "infiltration",
+                "but",
+                "with",
+                "capsular",
+                "infiltration."
+            ],
+            [
+                "Thyroglobulin",
+                "concentrations",
+                "24",
+                "h",
+                "after",
+                "thyroidectomy",
+                "are",
+                "14",
+                "ng/mL."
+            ],
+            [
+                "What",
+                "would",
+                "be",
+                "the",
+                "next",
+                "step",
+                "you",
+                "would",
+                "take",
+                "in",
+                "this",
+                "patient?"
+            ],
+            [
+                "1-",
+                "Refer",
+                "patient",
+                "back",
+                "to",
+                "surgeon",
+                "for",
+                "right",
+                "laterocervical",
+                "lymph",
+                "node",
+                "stripping."
+            ],
+            [
+                "2-",
+                "Initiate",
+                "treatment",
+                "with",
+                "a",
+                "dose",
+                "of",
+                "TSH-suppressing",
+                "levothyroxine",
+                "and",
+                "schedule",
+                "for",
+                "review",
+                "6",
+                "months",
+                "later",
+                "with",
+                "a",
+                "new",
+                "analytical",
+                "determination",
+                "of",
+                "thyroglobulin",
+                "and",
+                "cervical",
+                "ultrasound."
+            ],
+            [
+                "3-",
+                "Request",
+                "a",
+                "PET-CT",
+                "scan",
+                "for",
+                "lymph",
+                "node",
+                "involvement."
+            ],
+            [
+                "4-",
+                "Delay",
+                "initiation",
+                "of",
+                "TSH",
+                "replacement-suppressive",
+                "treatment",
+                "with",
+                "levothyroxine",
+                "and",
+                "refer",
+                "the",
+                "patient",
+                "to",
+                "the",
+                "Nuclear",
+                "Medicine",
+                "service",
+                "for",
+                "administration",
+                "of",
+                "an",
+                "ablative",
+                "dose",
+                "of",
+                "100",
+                "mCi",
+                "of",
+                "I131."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "The",
+                "verification",
+                "of",
+                "the",
+                "presence",
+                "of",
+                "thyroglobulin",
+                "in",
+                "blood",
+                "and",
+                "the",
+                "development",
+                "of",
+                "techniques",
+                "by",
+                "which",
+                "it",
+                "can",
+                "be",
+                "determined",
+                "have",
+                "provided",
+                "a",
+                "new",
+                "procedure",
+                "for",
+                "monitoring",
+                "patients",
+                "with",
+                "papillary",
+                "or",
+                "follicular",
+                "thyroid",
+                "carcinoma."
+            ],
+            [
+                "Thyroglobulin",
+                "is",
+                "synthesized",
+                "in",
+                "the",
+                "follicular",
+                "cells",
+                "and",
+                "then",
+                "secreted",
+                "into",
+                "the",
+                "circulation,",
+                "therefore,",
+                "after",
+                "total",
+                "thyroidectomy",
+                "it",
+                "should",
+                "disappear,",
+                "if",
+                "this",
+                "does",
+                "not",
+                "occur",
+                "we",
+                "must",
+                "think",
+                "about",
+                "the",
+                "existence",
+                "of",
+                "remnants",
+                "of",
+                "metastatic",
+                "tissue."
+            ]
+        ],
+        "labels": [
+            [
+                "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-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",
+                "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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "185_66",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "74-year-old",
+                "patient",
+                "with",
+                "bowel",
+                "resection",
+                "following",
+                "mesenteric",
+                "thrombosis",
+                "comes",
+                "to",
+                "consult",
+                "for",
+                "fatigue",
+                "and",
+                "bone",
+                "pain."
+            ],
+            [
+                "He",
+                "had",
+                "suffered",
+                "a",
+                "Colles'",
+                "fracture",
+                "three",
+                "months",
+                "earlier."
+            ],
+            [
+                "Laboratory",
+                "tests",
+                "showed",
+                "anemia",
+                "of",
+                "9.5",
+                "g/dl,",
+                "microcytic,",
+                "albumin",
+                "3.5",
+                "g/di,",
+                "calcium",
+                "7.5",
+                "mg/dl,",
+                "phosphate",
+                "2.0",
+                "mg/dl",
+                "and",
+                "alkaline",
+                "phosphatase",
+                "224",
+                "IU",
+                "(normal",
+                "up",
+                "to",
+                "120",
+                "IU)."
+            ],
+            [
+                "Radiographs",
+                "of",
+                "the",
+                "femur",
+                "show",
+                "radiolucent",
+                "bands",
+                "perpendicular",
+                "to",
+                "the",
+                "cortex",
+                "on",
+                "the",
+                "inner",
+                "side",
+                "of",
+                "the",
+                "upper",
+                "femur."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Osteoporosis."
+            ],
+            [
+                "2-",
+                "Paget's",
+                "disease."
+            ],
+            [
+                "3-",
+                "Osteitis",
+                "fibrosa."
+            ],
+            [
+                "4-",
+                "Prostate",
+                "cancer",
+                "metastasis."
+            ],
+            [
+                "5-",
+                "Osteomalacia."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "Although",
+                "this",
+                "one",
+                "had",
+                "not",
+                "been",
+                "assigned",
+                "to",
+                "me,",
+                "I",
+                "am",
+                "answering",
+                "it",
+                "as",
+                "well",
+                "since",
+                "it",
+                "deals",
+                "with",
+                "an",
+                "endocrinology",
+                "topic:",
+                "vitamin",
+                "D."
+            ],
+            [
+                "In",
+                "this",
+                "case",
+                "there",
+                "are",
+                "important",
+                "data",
+                "such",
+                "as",
+                "the",
+                "history",
+                "of",
+                "intestinal",
+                "resection,",
+                "hypocalcemia",
+                "and",
+                "hypophosphoremoia;",
+                "this",
+                "should",
+                "lead",
+                "us",
+                "to",
+                "think",
+                "in",
+                "a",
+                "vitamin",
+                "D",
+                "deficit",
+                "due",
+                "to",
+                "malabsorption",
+                "and",
+                "therefore,",
+                "in",
+                "an",
+                "osteomalacia."
+            ],
+            [
+                "The",
+                "rest",
+                "of",
+                "the",
+                "data:",
+                "previous",
+                "fracture,",
+                "pain",
+                "and",
+                "the",
+                "X-ray",
+                "support",
+                "the",
+                "diagnosis."
+            ]
+        ],
+        "labels": [
+            [
+                "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",
+                "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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "107_206",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GENETICS",
+                "AND",
+                "IMMUNOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "8-year-old",
+                "girl",
+                "(index",
+                "case)",
+                "is",
+                "clinically",
+                "diagnosed",
+                "as",
+                "having",
+                "neurofibromatosis",
+                "type",
+                "1",
+                "(NF1)",
+                "or",
+                "Von",
+                "Recklinghausen's",
+                "disease",
+                "with",
+                "multiple",
+                "neurofibromas,",
+                "caf\u00e9-au-lait",
+                "spots,",
+                "and",
+                "Lisch",
+                "nodules."
+            ],
+            [
+                "Her",
+                "father",
+                "(not",
+                "diagnosed",
+                "with",
+                "NF1)",
+                "died",
+                "in",
+                "a",
+                "traffic",
+                "accident",
+                "at",
+                "the",
+                "age",
+                "of",
+                "38",
+                "years."
+            ],
+            [
+                "On",
+                "examination,",
+                "the",
+                "mother",
+                "presents",
+                "two",
+                "caf\u00e9-au-lait",
+                "spots",
+                "and",
+                "attends",
+                "the",
+                "genetic",
+                "counseling",
+                "consultation",
+                "with",
+                "her",
+                "new",
+                "partner",
+                "where",
+                "a",
+                "preimplantation",
+                "genetic",
+                "diagnosis",
+                "(PGD)",
+                "is",
+                "proposed."
+            ],
+            [
+                "Is",
+                "PGD",
+                "indicated",
+                "in",
+                "this",
+                "case?"
+            ],
+            [
+                "1-",
+                "Yes,",
+                "as",
+                "the",
+                "mother",
+                "has",
+                "2",
+                "caf\u00e9-au-lait",
+                "spots,",
+                "she",
+                "is",
+                "a",
+                "carrier",
+                "and",
+                "PGD",
+                "is",
+                "indicated",
+                "with",
+                "these",
+                "data."
+            ],
+            [
+                "2-",
+                "It",
+                "is",
+                "indicated",
+                "after",
+                "detection",
+                "of",
+                "the",
+                "causative",
+                "mutation",
+                "in",
+                "the",
+                "index",
+                "case",
+                "and",
+                "eventually",
+                "in",
+                "his",
+                "mother."
+            ],
+            [
+                "3-",
+                "It",
+                "is",
+                "not",
+                "indicated",
+                "because",
+                "NF1",
+                "responds",
+                "to",
+                "mutations",
+                "in",
+                "the",
+                "neurofibromin",
+                "gene",
+                "(17q11.2),",
+                "with",
+                "recessive",
+                "inheritance."
+            ],
+            [
+                "4-",
+                "No,",
+                "two",
+                "caf\u00e9-au-lait",
+                "spots",
+                "are",
+                "not",
+                "diagnostic",
+                "and",
+                "your",
+                "new",
+                "partner",
+                "is",
+                "very",
+                "unlikely",
+                "to",
+                "be",
+                "a",
+                "carrier",
+                "(NF1",
+                "is",
+                "a",
+                "rare",
+                "disease)."
+            ],
+            [
+                "5-",
+                "With",
+                "these",
+                "data,",
+                "PGD",
+                "is",
+                "indicated,",
+                "consisting",
+                "of",
+                "selecting",
+                "embryos",
+                "in",
+                "vitro,",
+                "to",
+                "implant",
+                "in",
+                "the",
+                "maternal",
+                "uterus",
+                "those",
+                "without",
+                "the",
+                "mutation."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "The",
+                "first",
+                "step",
+                "is",
+                "to",
+                "detect",
+                "the",
+                "mutation",
+                "and",
+                "once",
+                "detected,",
+                "if",
+                "the",
+                "mother",
+                "is",
+                "a",
+                "carrier,",
+                "to",
+                "proceed",
+                "with",
+                "PGD."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "B-Diagnostics",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "114_96",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "HEMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "43-year-old",
+                "woman",
+                "consults",
+                "her",
+                "primary",
+                "care",
+                "physician",
+                "for",
+                "fatigue,",
+                "gingivorrhea",
+                "and",
+                "petechiae."
+            ],
+            [
+                "Laboratory",
+                "tests",
+                "showed",
+                "anemia",
+                "of",
+                "8",
+                "g/dL,",
+                "thrombopenia",
+                "of",
+                "4000/microliter",
+                "and",
+                "leukopenia",
+                "of",
+                "1200/microliter",
+                "with",
+                "absolute",
+                "neutropenia."
+            ],
+            [
+                "The",
+                "coagulation",
+                "study",
+                "showed",
+                "APTT",
+                "elongation",
+                "(43\u2033),",
+                "decreased",
+                "prothrombin",
+                "activity",
+                "(55%),",
+                "hypofibrinogenemia",
+                "(98",
+                "mg/dl)",
+                "and",
+                "presence",
+                "of",
+                "high",
+                "concentration",
+                "of",
+                "D-Dimer",
+                "and",
+                "fibrin",
+                "monomers."
+            ],
+            [
+                "She",
+                "is",
+                "referred",
+                "for",
+                "urgent",
+                "hematologic",
+                "workup",
+                "and",
+                "a",
+                "bone",
+                "marrow",
+                "aspirate",
+                "is",
+                "performed",
+                "showing",
+                "massive",
+                "infiltration",
+                "by",
+                "immature",
+                "elements",
+                "with",
+                "cleaved",
+                "nuclei",
+                "and",
+                "Auer",
+                "rods",
+                "in",
+                "the",
+                "cytoplasm."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis",
+                "in",
+                "this",
+                "patient?"
+            ],
+            [
+                "1-",
+                "Chronic",
+                "myeloid",
+                "leukemia."
+            ],
+            [
+                "2-",
+                "Acute",
+                "promyelocytic",
+                "leukemia."
+            ],
+            [
+                "3-",
+                "Acute",
+                "monoblastic",
+                "leukemia."
+            ],
+            [
+                "4-",
+                "Chronic",
+                "lymphoid",
+                "leukemia."
+            ],
+            [
+                "5-",
+                "Acute",
+                "lymphoid",
+                "leukemia."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "After",
+                "reading",
+                "such",
+                "a",
+                "long",
+                "statement,",
+                "running",
+                "out",
+                "of",
+                "breath,",
+                "going",
+                "over",
+                "it",
+                "and",
+                "getting",
+                "overwhelmed,",
+                "it",
+                "is",
+                "time",
+                "to",
+                "take",
+                "a",
+                "look",
+                "at",
+                "it",
+                "and",
+                "grasp",
+                "at",
+                "something",
+                "very",
+                "characteristic."
+            ],
+            [
+                "A",
+                "woman",
+                "with",
+                "pancytopenia."
+            ],
+            [
+                "A",
+                "bone",
+                "marrow",
+                "showing",
+                "massive",
+                "infiltration",
+                "by",
+                "immature",
+                "elements",
+                "that",
+                "are",
+                "proliferating",
+                "non-stop...with",
+                "Auer's",
+                "canes?"
+            ],
+            [
+                "Acute",
+                "promyelocytic",
+                "leukemia."
+            ],
+            [
+                "Those",
+                "rods",
+                "are",
+                "the",
+                "fusion",
+                "of",
+                "primary",
+                "granules",
+                "of",
+                "developing",
+                "myelocytes."
+            ],
+            [
+                "Robin&Cotran",
+                "say",
+                "so",
+                "on",
+                "page",
+                "696",
+                "of",
+                "their",
+                "book",
+                "\"General",
+                "Pathology\"",
+                "[1]."
+            ],
+            [
+                "It",
+                "is",
+                "also",
+                "said",
+                "by",
+                "Carr",
+                "and",
+                "Rodak",
+                "in",
+                "their",
+                "book",
+                "\"Atlas",
+                "of",
+                "clinical",
+                "hematology\"",
+                "on",
+                "page",
+                "157",
+                "[2]."
+            ]
+        ],
+        "labels": [
+            [
+                "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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Disease",
+                "I-Disease",
+                "I-Disease"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Disease",
+                "I-Disease",
+                "I-Disease"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "61_92",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ANESTHESIOLOGY",
+                "AND",
+                "CRITICAL",
+                "CARE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "30-year-old",
+                "man",
+                "suffers",
+                "fall",
+                "from",
+                "a",
+                "standing",
+                "height",
+                "of",
+                "2",
+                "meters."
+            ],
+            [
+                "On",
+                "arrival",
+                "at",
+                "the",
+                "ER,",
+                "he",
+                "is",
+                "cyo,",
+                "catheterized",
+                "with",
+                "clear",
+                "urine."
+            ],
+            [
+                "He",
+                "shows",
+                "swelling",
+                "of",
+                "the",
+                "left",
+                "heel,",
+                "as",
+                "well",
+                "as",
+                "mild",
+                "tingling",
+                "in",
+                "the",
+                "anterior",
+                "aspect",
+                "of",
+                "the",
+                "right",
+                "thigh",
+                "and",
+                "scrotum,",
+                "and",
+                "dysesthesia",
+                "in",
+                "both",
+                "feet."
+            ],
+            [
+                "The",
+                "patient",
+                "says",
+                "goodbye",
+                "to",
+                "the",
+                "stretcher-bearer",
+                "with",
+                "a",
+                "handshake,",
+                "with",
+                "a",
+                "simultaneous",
+                "pat",
+                "on",
+                "the",
+                "shoulder."
+            ],
+            [
+                "Rotation",
+                "of",
+                "the",
+                "MMII",
+                "on",
+                "the",
+                "stretcher",
+                "grasped",
+                "by",
+                "the",
+                "ankles",
+                "is",
+                "painless",
+                "and",
+                "compression",
+                "of",
+                "the",
+                "pelvis",
+                "is",
+                "asymptomatic."
+            ],
+            [
+                "Next:"
+            ],
+            [
+                "1-",
+                "We",
+                "will",
+                "sit",
+                "him",
+                "on",
+                "the",
+                "stretcher",
+                "to",
+                "be",
+                "able",
+                "to",
+                "explore",
+                "the",
+                "cervical",
+                "spine."
+            ],
+            [
+                "2-",
+                "We",
+                "will",
+                "refer",
+                "to",
+                "Rx",
+                "to",
+                "perform",
+                "lower",
+                "extremities",
+                "study."
+            ],
+            [
+                "3-",
+                "Palpate",
+                "the",
+                "abdomen",
+                "and",
+                "rotate",
+                "it",
+                "en",
+                "bloc",
+                "to",
+                "palpate",
+                "the",
+                "thoracolumbar",
+                "spine."
+            ],
+            [
+                "4-",
+                "Place",
+                "a",
+                "cervical",
+                "collar",
+                "and",
+                "refer",
+                "to",
+                "radiology",
+                "for",
+                "cervical",
+                "spine",
+                "and",
+                "lower",
+                "extremity",
+                "imaging."
+            ],
+            [
+                "5-",
+                "We",
+                "will",
+                "request",
+                "an",
+                "abdominal",
+                "echo."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "From",
+                "the",
+                "symptoms",
+                "reported,",
+                "tingling",
+                "in",
+                "the",
+                "anterior",
+                "thigh,",
+                "scrotum",
+                "and",
+                "dysesthesia",
+                "in",
+                "the",
+                "feet,",
+                "there",
+                "seems",
+                "to",
+                "be",
+                "a",
+                "vertebral",
+                "involvement",
+                "at",
+                "L2-3",
+                "and",
+                "sacral",
+                "roots,",
+                "so",
+                "the",
+                "correct",
+                "thing",
+                "to",
+                "do",
+                "would",
+                "be",
+                "to",
+                "perform",
+                "a",
+                "radiological",
+                "examination",
+                "without",
+                "mobilizing",
+                "the",
+                "patient."
+            ],
+            [
+                "But",
+                "it",
+                "is",
+                "necessary",
+                "to",
+                "mobilize",
+                "him",
+                "to",
+                "explore",
+                "him,",
+                "obviously,",
+                "en",
+                "bloc."
+            ],
+            [
+                "The",
+                "cervical",
+                "spine",
+                "seems",
+                "to",
+                "be",
+                "undamaged",
+                "because",
+                "the",
+                "patient",
+                "mobilizes",
+                "both",
+                "arms",
+                "adequately,",
+                "without",
+                "paresthesia."
+            ]
+        ],
+        "labels": [
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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-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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ]
+        ]
+    },
+    {
+        "id": "231_180",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "1-month-old",
+                "infant",
+                "comes",
+                "to",
+                "the",
+                "hospital",
+                "emergency",
+                "department",
+                "referred",
+                "by",
+                "his",
+                "pediatrician",
+                "for",
+                "jaundice."
+            ],
+            [
+                "He",
+                "reports",
+                "jaundice",
+                "for",
+                "10",
+                "days",
+                "and",
+                "it",
+                "has",
+                "been",
+                "increasing."
+            ],
+            [
+                "The",
+                "blood",
+                "test",
+                "showed",
+                "a",
+                "total",
+                "bilirubin",
+                "of",
+                "7mg/dl",
+                "with",
+                "an",
+                "indirect",
+                "bilirubin",
+                "of",
+                "1.5mg/dl."
+            ],
+            [
+                "The",
+                "most",
+                "probable",
+                "cause,",
+                "among",
+                "the",
+                "following,",
+                "of",
+                "this",
+                "jaundice",
+                "is:"
+            ],
+            [
+                "1-",
+                "Bile",
+                "duct",
+                "atresia."
+            ],
+            [
+                "2-",
+                "Breastfeeding",
+                "jaundice."
+            ],
+            [
+                "3-",
+                "Late",
+                "onset",
+                "0-A",
+                "isoimmunization."
+            ],
+            [
+                "4-",
+                "Gilbert's",
+                "disease."
+            ],
+            [
+                "5-",
+                "Hereditary",
+                "spherocytosis."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "The",
+                "increase",
+                "in",
+                "direct",
+                "bilirubin",
+                "immediately",
+                "rules",
+                "out",
+                "the",
+                "rest",
+                "of",
+                "the",
+                "options",
+                "where",
+                "the",
+                "increase",
+                "in",
+                "total",
+                "bilirubin",
+                "would",
+                "be",
+                "at",
+                "the",
+                "expense",
+                "of",
+                "indirect",
+                "bilirubin."
+            ],
+            [
+                "Bile",
+                "duct",
+                "atresia",
+                "is",
+                "the",
+                "main",
+                "indication",
+                "for",
+                "infant",
+                "liver",
+                "transplantation."
+            ]
+        ],
+        "labels": [
+            [
+                "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",
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "87_54",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CARDIOLOGY",
+                "AND",
+                "VASCULAR",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "81-year-old",
+                "patient",
+                "consults",
+                "for",
+                "an",
+                "episode",
+                "of",
+                "syncope."
+            ],
+            [
+                "He",
+                "reports",
+                "dyspnea",
+                "on",
+                "exertion",
+                "for",
+                "a",
+                "year."
+            ],
+            [
+                "On",
+                "cardiac",
+                "auscultation",
+                "there",
+                "is",
+                "a",
+                "3/6",
+                "systolic",
+                "murmur",
+                "on",
+                "the",
+                "left",
+                "sternal",
+                "border",
+                "radiating",
+                "to",
+                "the",
+                "carotids",
+                "and",
+                "tip."
+            ],
+            [
+                "Which",
+                "pathology",
+                "seems",
+                "most",
+                "likely?"
+            ],
+            [
+                "1-",
+                "Third-degree",
+                "atrioventricular",
+                "block."
+            ],
+            [
+                "2-",
+                "Degenerative",
+                "aortic",
+                "stenosis."
+            ],
+            [
+                "3-",
+                "Mitral",
+                "valve",
+                "insufficiency."
+            ],
+            [
+                "4-",
+                "Hypertrophic",
+                "cardiomyopathy."
+            ],
+            [
+                "5-",
+                "Dilated",
+                "cardiomyopathy."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Very",
+                "easy",
+                "question."
+            ],
+            [
+                "They",
+                "are",
+                "describing",
+                "the",
+                "\"portrait\"",
+                "of",
+                "a",
+                "degenerative",
+                "aortic",
+                "stenosis..."
+            ],
+            [
+                "Elderly",
+                "patient",
+                "with",
+                "clinical",
+                "dyspnea",
+                "and",
+                "syncope,",
+                "and",
+                "systolic",
+                "murmur",
+                "radiating",
+                "to",
+                "carotids",
+                "and",
+                "tip,",
+                "all",
+                "typical",
+                "of",
+                "this",
+                "disease."
+            ]
+        ],
+        "labels": [
+            [
+                "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"
+            ],
+            [
+                "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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "102_87",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "512_153",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DIGESTIVE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "Patient",
+                "diagnosed",
+                "with",
+                "acute",
+                "diverticulitis,",
+                "treated",
+                "with",
+                "amoxicillin/clavulanic",
+                "acid."
+            ],
+            [
+                "After",
+                "5",
+                "days",
+                "he",
+                "starts",
+                "with",
+                "fever",
+                "and",
+                "diarrhea."
+            ],
+            [
+                "He",
+                "was",
+                "diagnosed",
+                "with",
+                "Clostridium",
+                "difficile",
+                "colitis,",
+                "amoxicillin/clavulanic",
+                "acid",
+                "was",
+                "discontinued",
+                "and",
+                "metronidazole",
+                "was",
+                "prescribed."
+            ],
+            [
+                "After",
+                "4",
+                "days",
+                "he",
+                "has",
+                "not",
+                "responded",
+                "to",
+                "metronidazole,",
+                "but",
+                "is",
+                "clinically",
+                "stable."
+            ],
+            [
+                "The",
+                "next",
+                "step",
+                "of",
+                "treatment",
+                "is:"
+            ],
+            [
+                "1-",
+                "Change",
+                "metronidazole",
+                "for",
+                "oral",
+                "vancomycin",
+                "(125",
+                "mg,",
+                "four",
+                "times",
+                "a",
+                "day",
+                "for",
+                "10",
+                "days)."
+            ],
+            [
+                "2-",
+                "Change",
+                "metronidazole",
+                "to",
+                "piperacillin/",
+                "tazobactam",
+                "(4",
+                "g",
+                "piperacillin/0.5",
+                "g",
+                "tazobactam",
+                "every",
+                "8",
+                "hours)."
+            ],
+            [
+                "3-",
+                "Indicate",
+                "a",
+                "subtotal",
+                "colectomy."
+            ],
+            [
+                "4-",
+                "Loop",
+                "ileostomy",
+                "with",
+                "antegrade",
+                "polyethylene",
+                "glycol",
+                "lavage."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "The",
+                "treatment",
+                "of",
+                "choice",
+                "for",
+                "Clostridioides",
+                "difficile",
+                "infection",
+                "is",
+                "vancomycin",
+                "orally",
+                "125mg/6h",
+                "for",
+                "10",
+                "days."
+            ],
+            [
+                "Metronidazole",
+                "has",
+                "been",
+                "relegated",
+                "to",
+                "situations",
+                "where",
+                "vancomycin",
+                "is",
+                "not",
+                "available."
+            ]
+        ],
+        "labels": [
+            [
+                "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"
+            ],
+            [
+                "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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "218_123",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "493_107",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "HEMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "18-year-old",
+                "patient",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "with",
+                "epistaxis",
+                "of",
+                "several",
+                "days'",
+                "evolution,",
+                "with",
+                "no",
+                "personal",
+                "or",
+                "family",
+                "history",
+                "of",
+                "interest."
+            ],
+            [
+                "On",
+                "examination",
+                "he",
+                "is",
+                "afebrile,",
+                "multiple",
+                "ecchymoses",
+                "are",
+                "observed,",
+                "no",
+                "splenomegaly",
+                "is",
+                "palpable."
+            ],
+            [
+                "Laboratory",
+                "tests:",
+                "leukocytes",
+                "7.2",
+                "x103/\u03bcL,",
+                "Hb",
+                "12.3",
+                "g/dL,",
+                "platelets",
+                "6.0",
+                "x103/\u03bcL."
+            ],
+            [
+                "Thrombocytopenia",
+                "is",
+                "confirmed",
+                "in",
+                "the",
+                "smear,",
+                "where",
+                "platelets",
+                "of",
+                "increased",
+                "size",
+                "are",
+                "observed."
+            ],
+            [
+                "Coagulation",
+                "and",
+                "biochemistry",
+                "studies",
+                "are",
+                "normal."
+            ],
+            [
+                "What",
+                "do",
+                "you",
+                "consider",
+                "the",
+                "most",
+                "probable",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Thrombotic",
+                "thrombocytopenic",
+                "purpura."
+            ],
+            [
+                "2-",
+                "Disseminated",
+                "intravascular",
+                "coagulation."
+            ],
+            [
+                "3-",
+                "Thrombocytopenia",
+                "induced",
+                "by",
+                "infection."
+            ],
+            [
+                "4-",
+                "Primary",
+                "immune",
+                "thrombocytopenia."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "If",
+                "they",
+                "wanted",
+                "us",
+                "to",
+                "answer",
+                "that",
+                "it",
+                "is",
+                "a",
+                "TTP",
+                "(answer",
+                "1)",
+                "they",
+                "would",
+                "probably",
+                "associate",
+                "anemia",
+                "and",
+                "in",
+                "the",
+                "smear",
+                "they",
+                "would",
+                "surely",
+                "tell",
+                "us",
+                "about",
+                "schistocytes."
+            ],
+            [
+                "Not",
+                "to",
+                "say",
+                "that",
+                "the",
+                "patient's",
+                "symptoms",
+                "would",
+                "probably",
+                "be",
+                "much",
+                "more",
+                "than",
+                "epistaxis."
+            ],
+            [
+                "The",
+                "other",
+                "two",
+                "answers,",
+                "you",
+                "do",
+                "not",
+                "have",
+                "to",
+                "hesitate",
+                "with",
+                "them."
+            ],
+            [
+                "Nothing",
+                "points",
+                "to",
+                "that."
+            ]
+        ],
+        "labels": [
+            [
+                "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"
+            ],
+            [
+                "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",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
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+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
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+                "I-Claim"
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+            [
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+                "O"
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+                "O"
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "566_149",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEPHROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "67-year-old",
+                "woman",
+                "with",
+                "chronic",
+                "kidney",
+                "disease",
+                "secondary",
+                "to",
+                "diabetic",
+                "nephropathy."
+            ],
+            [
+                "She",
+                "currently",
+                "has",
+                "a",
+                "creatinine",
+                "of",
+                "3.2",
+                "mg/dL",
+                "with",
+                "estimated",
+                "glomerular",
+                "filtration",
+                "rate",
+                "(CKD-EPI)",
+                "14",
+                "ml/min."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "is",
+                "true?"
+            ],
+            [
+                "1-",
+                "He",
+                "presents",
+                "stage",
+                "3",
+                "chronic",
+                "kidney",
+                "disease",
+                "and",
+                "should",
+                "initiate",
+                "phosphorus",
+                "chelators."
+            ],
+            [
+                "2-",
+                "He",
+                "has",
+                "stage",
+                "5",
+                "chronic",
+                "kidney",
+                "disease",
+                "and",
+                "renal",
+                "replacement",
+                "therapy",
+                "should",
+                "be",
+                "considered."
+            ],
+            [
+                "3-",
+                "Good",
+                "glycemic",
+                "control",
+                "can",
+                "reverse",
+                "renal",
+                "failure."
+            ],
+            [
+                "4-",
+                "It",
+                "is",
+                "unlikely",
+                "to",
+                "present",
+                "proteinuria",
+                "higher",
+                "than",
+                "500",
+                "mg/24",
+                "h."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "A",
+                "glomerular",
+                "filtration",
+                "rate",
+                "of",
+                "less",
+                "than",
+                "15",
+                "ml/min",
+                "is",
+                "classified",
+                "as",
+                "stage",
+                "5",
+                "(G5),",
+                "indicating",
+                "that",
+                "the",
+                "renal",
+                "disease",
+                "is",
+                "end-stage",
+                "and",
+                "the",
+                "initiation",
+                "of",
+                "replacement",
+                "therapy",
+                "should",
+                "be",
+                "considered",
+                "(option",
+                "2",
+                "true,",
+                "option",
+                "1",
+                "false)."
+            ],
+            [
+                "In",
+                "this",
+                "situation,",
+                "good",
+                "glycemic",
+                "control",
+                "is",
+                "not",
+                "expected",
+                "to",
+                "reverse",
+                "renal",
+                "damage,",
+                "although",
+                "it",
+                "may",
+                "help",
+                "to",
+                "delay",
+                "progression",
+                "(false",
+                "choice",
+                "3)."
+            ],
+            [
+                "These",
+                "patients",
+                "usually",
+                "present",
+                "stage",
+                "A3",
+                "albuminuria",
+                "(above",
+                "300",
+                "mg/24",
+                "h),",
+                "and",
+                "may",
+                "reach",
+                "the",
+                "nephrotic",
+                "range",
+                "(false",
+                "choice",
+                "4)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "254_89",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DIGESTIVE",
+                "TRACT"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "17-year-old",
+                "boy,",
+                "athletic",
+                "and",
+                "with",
+                "no",
+                "history",
+                "of",
+                "interest,",
+                "comes",
+                "to",
+                "the",
+                "doctor",
+                "for",
+                "occasional",
+                "conjunctival",
+                "jaundice."
+            ],
+            [
+                "He",
+                "denies",
+                "drug",
+                "intake",
+                "and",
+                "abdominal",
+                "pain."
+            ],
+            [
+                "Laboratory",
+                "tests",
+                "show",
+                "normal",
+                "ALT,",
+                "AST,",
+                "GGT",
+                "and",
+                "FA,",
+                "with",
+                "total",
+                "bilirubin",
+                "of",
+                "3.2",
+                "mg/dl",
+                "and",
+                "direct",
+                "bilirubin",
+                "of",
+                "0.4",
+                "mg/dl."
+            ],
+            [
+                "She",
+                "has",
+                "no",
+                "anemia",
+                "and",
+                "the",
+                "liver",
+                "is",
+                "ultrasonographically",
+                "normal."
+            ],
+            [
+                "What",
+                "is",
+                "her",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Rotor",
+                "syndrome."
+            ],
+            [
+                "2-",
+                "Choledocholithiasis."
+            ],
+            [
+                "3-",
+                "Dubin-Johnson",
+                "syndrome."
+            ],
+            [
+                "4-",
+                "Acute",
+                "hepatitis."
+            ],
+            [
+                "5-",
+                "Gilbert's",
+                "syndrome."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "An",
+                "increase",
+                "in",
+                "indirect",
+                "bilirubin",
+                "less",
+                "than",
+                "5",
+                "(intermittently,",
+                "under",
+                "stress)",
+                "in",
+                "a",
+                "young",
+                "healthy",
+                "boy",
+                "should",
+                "make",
+                "us",
+                "think",
+                "of",
+                "Gilbert's",
+                "syndrome."
+            ],
+            [
+                "In",
+                "Rotor",
+                "syndrome,",
+                "Dubin-Johnson",
+                "syndrome",
+                "and",
+                "choledocholithiasis",
+                "there",
+                "is",
+                "an",
+                "increase",
+                "in",
+                "direct",
+                "bilirubin."
+            ],
+            [
+                "In",
+                "the",
+                "case",
+                "of",
+                "acute",
+                "hepatitis",
+                "there",
+                "should",
+                "be",
+                "an",
+                "elevation",
+                "of",
+                "transaminases."
+            ]
+        ],
+        "labels": [
+            [
+                "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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "597_180",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "RHEUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "26-year-old",
+                "woman",
+                "diagnosed",
+                "with",
+                "systemic",
+                "lupus",
+                "erythematosus,",
+                "on",
+                "treatment",
+                "with",
+                "hydroxychloroquine,",
+                "who",
+                "consults",
+                "for",
+                "a",
+                "feeling",
+                "of",
+                "generalized",
+                "weakness",
+                "that",
+                "has",
+                "progressively",
+                "set",
+                "in",
+                "over",
+                "the",
+                "last",
+                "15",
+                "days."
+            ],
+            [
+                "The",
+                "physical",
+                "examination",
+                "reveals",
+                "cutaneous",
+                "pallor",
+                "and",
+                "the",
+                "CBC",
+                "shows",
+                "Hb",
+                "7.4",
+                "g/dL,",
+                "Hct",
+                "31%,",
+                "MCV",
+                "108."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "determinations",
+                "will",
+                "be",
+                "most",
+                "useful",
+                "in",
+                "deciding",
+                "the",
+                "course",
+                "of",
+                "action?"
+            ],
+            [
+                "1-",
+                "Haptoglobin."
+            ],
+            [
+                "2-",
+                "Coombs",
+                "test."
+            ],
+            [
+                "3-",
+                "Vitamin",
+                "B12."
+            ],
+            [
+                "4-",
+                "Antinuclear",
+                "antibodies."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "In",
+                "this",
+                "question,",
+                "we",
+                "are",
+                "presented",
+                "with",
+                "a",
+                "patient",
+                "with",
+                "systemic",
+                "lupus",
+                "erythematosus",
+                "presenting",
+                "with",
+                "autoimmune",
+                "hemolytic",
+                "anemia."
+            ],
+            [
+                "For",
+                "this,",
+                "the",
+                "best",
+                "option",
+                "would",
+                "be",
+                "to",
+                "request",
+                "reticulocytes,",
+                "however,",
+                "as",
+                "it",
+                "is",
+                "not",
+                "among",
+                "the",
+                "options,",
+                "we",
+                "should",
+                "request",
+                "a",
+                "Coombs'",
+                "test,",
+                "so",
+                "the",
+                "correct",
+                "answer",
+                "is",
+                "2."
+            ],
+            [
+                "Although",
+                "they",
+                "want",
+                "to",
+                "confuse",
+                "us",
+                "with",
+                "a",
+                "MCV",
+                "108,",
+                "so",
+                "that",
+                "we",
+                "think",
+                "of",
+                "a",
+                "megaloblastic",
+                "anemia,",
+                "the",
+                "MCV",
+                "is",
+                "not",
+                "excessively",
+                "high,",
+                "the",
+                "onset",
+                "of",
+                "anemia",
+                "in",
+                "our",
+                "patient",
+                "has",
+                "been",
+                "rapid",
+                "and",
+                "would",
+                "not",
+                "fit",
+                "with",
+                "SLE",
+                "or",
+                "the",
+                "form",
+                "of",
+                "presentation."
+            ],
+            [
+                "Antinuclear",
+                "antibodies",
+                "are",
+                "used",
+                "for",
+                "diagnosis,",
+                "but",
+                "not",
+                "for",
+                "monitoring",
+                "SLE."
+            ]
+        ],
+        "labels": [
+            [
+                "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-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",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "571_170",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEPHROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "75-year-old",
+                "woman",
+                "on",
+                "sertraline",
+                "treatment",
+                "who",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "with",
+                "confusional",
+                "symptoms."
+            ],
+            [
+                "There",
+                "is",
+                "no",
+                "evidence",
+                "of",
+                "edema",
+                "and",
+                "blood",
+                "pressure",
+                "is",
+                "130/70."
+            ],
+            [
+                "The",
+                "blood",
+                "test",
+                "shows",
+                "Na",
+                "126",
+                "mEq/l",
+                "and",
+                "K",
+                "4",
+                "mEq/l,",
+                "natriuria",
+                "is",
+                "45",
+                "mEq/l",
+                "and",
+                "diuretic",
+                "intake",
+                "has",
+                "been",
+                "ruled",
+                "out."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "is",
+                "the",
+                "most",
+                "correct",
+                "approach?"
+            ],
+            [
+                "1-",
+                "It",
+                "is",
+                "Addison's",
+                "disease",
+                "and",
+                "corticosteroids",
+                "should",
+                "be",
+                "administered",
+                "immediately."
+            ],
+            [
+                "2-",
+                "Administer",
+                "hypertonic",
+                "saline",
+                "to",
+                "restore",
+                "natremia",
+                "as",
+                "soon",
+                "as",
+                "possible."
+            ],
+            [
+                "3-",
+                "Indicate",
+                "water",
+                "restriction",
+                "and",
+                "if",
+                "natremia",
+                "does",
+                "not",
+                "rise,",
+                "switch",
+                "to",
+                "slow",
+                "infusion",
+                "of",
+                "saline."
+            ],
+            [
+                "4-",
+                "Request",
+                "brain",
+                "MRI,",
+                "since",
+                "it",
+                "is",
+                "probably",
+                "diabetes",
+                "insipidus."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "We",
+                "are",
+                "presented",
+                "with",
+                "a",
+                "patient",
+                "with",
+                "moderate",
+                "euvolemic",
+                "hyponatremia,",
+                "suggesting",
+                "a",
+                "syndrome",
+                "of",
+                "inadequate",
+                "antidiuresis",
+                "(SIAD)",
+                "secondary",
+                "to",
+                "sertraline,",
+                "although",
+                "it",
+                "would",
+                "be",
+                "necessary",
+                "to",
+                "have",
+                "urinary",
+                "osmolality",
+                "to",
+                "confirm",
+                "this."
+            ],
+            [
+                "Primary",
+                "adrenal",
+                "insufficiency",
+                "produces",
+                "hypovolemic",
+                "hyponatremia",
+                "(incorrect",
+                "option",
+                "1)."
+            ],
+            [
+                "Diabetes",
+                "insipidus",
+                "is",
+                "the",
+                "opposite",
+                "of",
+                "this",
+                "pathology,",
+                "usually",
+                "presenting",
+                "with",
+                "hypernatremia",
+                "(option",
+                "4",
+                "incorrect)."
+            ],
+            [
+                "The",
+                "question",
+                "remains",
+                "whether",
+                "to",
+                "treat",
+                "aggressively",
+                "with",
+                "hypertonic",
+                "saline,",
+                "or",
+                "to",
+                "be",
+                "more",
+                "conservative",
+                "by",
+                "indicating",
+                "hydric",
+                "restriction."
+            ],
+            [
+                "With",
+                "natremia",
+                "above",
+                "125",
+                "mmol/l",
+                "it",
+                "is",
+                "not",
+                "indicated",
+                "to",
+                "treat",
+                "with",
+                "HSS",
+                "unless",
+                "the",
+                "patient",
+                "has",
+                "severe",
+                "neurological",
+                "symptoms,",
+                "which",
+                "does",
+                "not",
+                "seem",
+                "to",
+                "be",
+                "the",
+                "case",
+                "(they",
+                "describe",
+                "a",
+                "confusional",
+                "picture",
+                "that",
+                "would",
+                "be",
+                "a",
+                "moderate",
+                "hyponatremic",
+                "encephalopathy),",
+                "and",
+                "it",
+                "is",
+                "not",
+                "indicated",
+                "to",
+                "restore",
+                "natremia",
+                "as",
+                "soon",
+                "as",
+                "possible",
+                "(due",
+                "to",
+                "the",
+                "risk",
+                "of",
+                "osmotic",
+                "demyelination",
+                "syndrome)."
+            ],
+            [
+                "Therefore,",
+                "the",
+                "correct",
+                "answer",
+                "would",
+                "be",
+                "3."
+            ],
+            [
+                "What",
+                "I",
+                "do",
+                "not",
+                "like",
+                "about",
+                "this",
+                "answer",
+                "is",
+                "that",
+                "the",
+                "second",
+                "part",
+                "(\"if",
+                "natraemia",
+                "does",
+                "not",
+                "rise,",
+                "switch",
+                "to",
+                "slow",
+                "infusion",
+                "of",
+                "saline\")",
+                "is",
+                "incorrect,",
+                "since",
+                "in",
+                "this",
+                "case",
+                "the",
+                "use",
+                "of",
+                "furosemide,",
+                "tolvaptan",
+                "or",
+                "urea",
+                "should",
+                "be",
+                "considered,",
+                "not",
+                "saline",
+                "(and",
+                "it",
+                "does",
+                "not",
+                "indicate",
+                "tonicity",
+                "either,",
+                "since",
+                "isotonic",
+                "is",
+                "not",
+                "the",
+                "same",
+                "as",
+                "hypertonic)."
+            ],
+            [
+                "In",
+                "any",
+                "case,",
+                "I",
+                "do",
+                "not",
+                "see",
+                "it",
+                "as",
+                "very",
+                "likely",
+                "to",
+                "be",
+                "overridden."
+            ]
+        ],
+        "labels": [
+            [
+                "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",
+                "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",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "466_91",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ORTHOPEDIC",
+                "SURGERY",
+                "AND",
+                "TRAUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "11-year-old,",
+                "6-month-old,",
+                "premenarchal",
+                "girl",
+                "with",
+                "known",
+                "idiopathic",
+                "scoliosis."
+            ],
+            [
+                "The",
+                "spine",
+                "x-ray",
+                "performed",
+                "6",
+                "months",
+                "ago",
+                "showed",
+                "a",
+                "left",
+                "thoracolumbar",
+                "curve",
+                "of",
+                "18\u00ba",
+                "(Cobb",
+                "angle)."
+            ],
+            [
+                "The",
+                "current",
+                "x-ray",
+                "shows",
+                "a",
+                "Cobb",
+                "angle",
+                "of",
+                "28\u00ba,",
+                "with",
+                "an",
+                "iliac",
+                "crest",
+                "maturation",
+                "(Risser's",
+                "sign)",
+                "of",
+                "2."
+            ],
+            [
+                "At",
+                "this",
+                "stage",
+                "of",
+                "evolution,",
+                "what",
+                "is",
+                "the",
+                "most",
+                "appropriate",
+                "treatment",
+                "to",
+                "try",
+                "to",
+                "stop",
+                "the",
+                "progression",
+                "of",
+                "the",
+                "curve?"
+            ],
+            [
+                "1-",
+                "Swimming",
+                "exercises."
+            ],
+            [
+                "2-",
+                "Postural",
+                "re-education",
+                "exercises."
+            ],
+            [
+                "3-",
+                "Corrective",
+                "orthopedic",
+                "brace."
+            ],
+            [
+                "4-",
+                "Surgical",
+                "intervention",
+                "by",
+                "spinal",
+                "arthrodesis."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "In",
+                "the",
+                "juvenile",
+                "and",
+                "adolescent",
+                "forms,",
+                "treatment",
+                "depends",
+                "on",
+                "the",
+                "degree",
+                "of",
+                "deformity:",
+                "-",
+                "10",
+                "-",
+                "20\u00b0:",
+                "serial",
+                "observation."
+            ],
+            [
+                "-",
+                "20-50\u00b0:",
+                "thermoplastic",
+                "corsets",
+                "(Boston,",
+                "Cheneau",
+                "or",
+                "Milwaukee,",
+                "according",
+                "to",
+                "where",
+                "the",
+                "apex",
+                "of",
+                "the",
+                "main",
+                "curve",
+                "is",
+                "located)."
+            ],
+            [
+                "-",
+                "40-50\u00b0:",
+                "with",
+                "Risser",
+                "less",
+                "than",
+                "3,",
+                "surgical",
+                "arthrodesis",
+                "would",
+                "be",
+                "indicated;",
+                "with",
+                "Risser",
+                "greater",
+                "than",
+                "or",
+                "equal",
+                "to",
+                "3,",
+                "the",
+                "remaining",
+                "growth",
+                "potential",
+                "of",
+                "the",
+                "curve",
+                "is",
+                "low",
+                "and",
+                "observation",
+                "may",
+                "be",
+                "considered",
+                "in",
+                "case",
+                "it",
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+            ]
+        ],
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+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
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+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "175_53",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PULMONOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "71-year-old",
+                "male,",
+                "retired",
+                "waiter,",
+                "non-smoker,",
+                "who",
+                "consults",
+                "for",
+                "nocturnal",
+                "snoring."
+            ],
+            [
+                "The",
+                "patient",
+                "has",
+                "a",
+                "body",
+                "mass",
+                "index",
+                "of",
+                "31.5",
+                "kg/m2",
+                "and",
+                "reports",
+                "mild",
+                "postprandial",
+                "daytime",
+                "sleepiness",
+                "(Epworth",
+                "Sleepiness",
+                "Scale",
+                "of",
+                "3)",
+                "with",
+                "no",
+                "other",
+                "relevant",
+                "symptoms,",
+                "signs",
+                "or",
+                "clinical",
+                "history."
+            ],
+            [
+                "The",
+                "apnea-hypopnea",
+                "index",
+                "obtained",
+                "in",
+                "the",
+                "polysomnography",
+                "was",
+                "18."
+            ],
+            [
+                "With",
+                "these",
+                "data,",
+                "what",
+                "is",
+                "the",
+                "most",
+                "appropriate",
+                "measure",
+                "to",
+                "adopt",
+                "in",
+                "this",
+                "patient?"
+            ],
+            [
+                "1-",
+                "Hygienic-dietary",
+                "measures",
+                "and",
+                "evolution",
+                "control."
+            ],
+            [
+                "2-",
+                "Uvulopalatopharyngoplasty."
+            ],
+            [
+                "3-",
+                "Nasal",
+                "CPAP",
+                "(Continuous",
+                "Positive",
+                "Airway",
+                "Pressure)."
+            ],
+            [
+                "4-",
+                "Non-invasive",
+                "mechanical",
+                "ventilation."
+            ],
+            [
+                "5-",
+                "Nocturnal",
+                "oxygen",
+                "therapy."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "With",
+                "an",
+                "Apneas-Hypopnea",
+                "Index",
+                "of",
+                "less",
+                "than",
+                "30,",
+                "and",
+                "in",
+                "the",
+                "absence",
+                "of",
+                "striking",
+                "symptoms",
+                "of",
+                "OSAHS",
+                "and",
+                "in",
+                "the",
+                "absence",
+                "of",
+                "risk",
+                "professions",
+                "such",
+                "as",
+                "professional",
+                "drivers,",
+                "etc.,",
+                "the",
+                "correct",
+                "thing",
+                "to",
+                "do",
+                "is",
+                "to",
+                "control",
+                "weight",
+                "and",
+                "the",
+                "rest",
+                "of",
+                "the",
+                "hygienic-dietary",
+                "measures,",
+                "with",
+                "periodic",
+                "follow-up."
+            ]
+        ],
+        "labels": [
+            [
+                "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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "91_35",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GENERAL",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "26-year-old",
+                "woman",
+                "presenting",
+                "with",
+                "fecal",
+                "incontinence",
+                "after",
+                "a",
+                "prolonged",
+                "instrumental",
+                "delivery."
+            ],
+            [
+                "An",
+                "endoanal",
+                "ultrasound",
+                "was",
+                "performed",
+                "showing",
+                "a",
+                "section",
+                "of",
+                "the",
+                "external",
+                "anal",
+                "sphincter",
+                "of",
+                "30\u00ba",
+                "amplitude."
+            ],
+            [
+                "The",
+                "electrophysiological",
+                "study",
+                "shows",
+                "normal",
+                "innervation."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "indicated",
+                "treatment?"
+            ],
+            [
+                "1-",
+                "Medical",
+                "treatment",
+                "with",
+                "hygienic",
+                "and",
+                "dietary",
+                "norms."
+            ],
+            [
+                "2-",
+                "Sphincter",
+                "biofeedback."
+            ],
+            [
+                "3-",
+                "Surgical",
+                "sphincteroplasty."
+            ],
+            [
+                "4-",
+                "Surgical",
+                "repair",
+                "of",
+                "the",
+                "pelvic",
+                "floor."
+            ],
+            [
+                "5-",
+                "Artificial",
+                "anal",
+                "sphincter."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "The",
+                "answer",
+                "is",
+                "surgical",
+                "sphincteroplasty",
+                "3."
+            ],
+            [
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+                "is",
+                "not",
+                "effective,",
+                "2",
+                "is",
+                "not",
+                "effective",
+                "for",
+                "an",
+                "organic",
+                "lesion",
+                "with",
+                "normal",
+                "electromyography,",
+                "4",
+                "is",
+                "not",
+                "necessary",
+                "since",
+                "the",
+                "lesion",
+                "is",
+                "only",
+                "of",
+                "the",
+                "external",
+                "sphincter,",
+                "5",
+                "is",
+                "not",
+                "indicated",
+                "in",
+                "a",
+                "lesion",
+                "that",
+                "can",
+                "be",
+                "repaired",
+                "with",
+                "surgery",
+                "with",
+                "good",
+                "results."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "65_218",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PATHOLOGICAL",
+                "ANATOMY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "56-year-old",
+                "man,",
+                "diabetic",
+                "and",
+                "moderately",
+                "overweight,",
+                "presents",
+                "a",
+                "discrete",
+                "hepatomegaly."
+            ],
+            [
+                "The",
+                "patient",
+                "indicates",
+                "that",
+                "he",
+                "is",
+                "not",
+                "a",
+                "regular",
+                "drinker,",
+                "only",
+                "exceptionally",
+                "does",
+                "he",
+                "drink",
+                "some",
+                "wine."
+            ],
+            [
+                "A",
+                "liver",
+                "biopsy",
+                "shows",
+                "accumulations",
+                "of",
+                "clear",
+                "cytoplasmic",
+                "vacuoles",
+                "in",
+                "50%",
+                "of",
+                "the",
+                "hepatocytes."
+            ],
+            [
+                "Multiple",
+                "inflammatory",
+                "foci",
+                "with",
+                "neutrophils,",
+                "Mallory's",
+                "hyaline",
+                "degeneration",
+                "and",
+                "fibrosis",
+                "around",
+                "the",
+                "terminal",
+                "hepatic",
+                "venules."
+            ],
+            [
+                "Point",
+                "out",
+                "the",
+                "correct",
+                "answer",
+                "in",
+                "this",
+                "case:"
+            ],
+            [
+                "1-",
+                "Biopsy",
+                "should",
+                "be",
+                "repeated",
+                "to",
+                "see",
+                "if",
+                "the",
+                "changes",
+                "are",
+                "diffuse."
+            ],
+            [
+                "2-",
+                "Diagnosis",
+                "is",
+                "hepatic",
+                "glycogenosis",
+                "associated",
+                "with",
+                "diabetes."
+            ],
+            [
+                "3-",
+                "Histological",
+                "changes",
+                "are",
+                "irreversible",
+                "and",
+                "will",
+                "eventually",
+                "lead",
+                "to",
+                "cirrhosis."
+            ],
+            [
+                "4-",
+                "The",
+                "injury",
+                "is",
+                "clearly",
+                "caused",
+                "by",
+                "alcohol",
+                "despite",
+                "the",
+                "patient's",
+                "refusal."
+            ],
+            [
+                "5-",
+                "It",
+                "is",
+                "important",
+                "to",
+                "reduce",
+                "weight",
+                "and",
+                "adequately",
+                "control",
+                "diabetes",
+                "to",
+                "avoid",
+                "the",
+                "possible",
+                "development",
+                "of",
+                "cirrhosis."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "The",
+                "changes",
+                "described",
+                "in",
+                "the",
+                "question",
+                "statement",
+                "correspond",
+                "to",
+                "an",
+                "early",
+                "precirrhotic",
+                "situation."
+            ],
+            [
+                "Although",
+                "alcohol",
+                "is",
+                "the",
+                "most",
+                "frequent",
+                "toxicant",
+                "that",
+                "causes",
+                "this",
+                "condition,",
+                "it",
+                "is",
+                "not",
+                "the",
+                "exclusive",
+                "cause."
+            ],
+            [
+                "Diabetes",
+                "mellitus",
+                "causes",
+                "similar",
+                "hepatic",
+                "alterations:",
+                "fat",
+                "accumulation",
+                "in",
+                "hepatocytes,",
+                "centroacinar",
+                "fibrosis,",
+                "inflammatory",
+                "infiltrate",
+                "by",
+                "polymorphonuclear",
+                "neutrophils",
+                "and",
+                "hyaline",
+                "degeneration",
+                "of",
+                "perinuclear",
+                "mallory."
+            ],
+            [
+                "Taking",
+                "this",
+                "into",
+                "consideration,",
+                "we",
+                "can",
+                "rule",
+                "out",
+                "the",
+                "second",
+                "question",
+                "(they",
+                "are",
+                "intracellular",
+                "fat",
+                "accumulations,",
+                "not",
+                "glycogen)",
+                "and",
+                "the",
+                "fourth",
+                "(if",
+                "diabetes",
+                "also",
+                "produces",
+                "this",
+                "situation,",
+                "there",
+                "is",
+                "no",
+                "reason",
+                "to",
+                "mistrust",
+                "the",
+                "patient)."
+            ],
+            [
+                "Based",
+                "on",
+                "the",
+                "primum",
+                "non",
+                "nocere",
+                "and",
+                "not",
+                "having",
+                "special",
+                "relevance",
+                "for",
+                "the",
+                "treatment",
+                "if",
+                "it",
+                "is",
+                "a",
+                "focal",
+                "or",
+                "generalized",
+                "disease,",
+                "it",
+                "is",
+                "not",
+                "necessary",
+                "to",
+                "repeat",
+                "a",
+                "liver",
+                "biopsy",
+                "that",
+                "would",
+                "not",
+                "expand",
+                "information,",
+                "discarding",
+                "the",
+                "first",
+                "question."
+            ],
+            [
+                "Fortunately",
+                "for",
+                "the",
+                "hypothetical",
+                "patient,",
+                "in",
+                "the",
+                "initial",
+                "phase",
+                "these",
+                "changes",
+                "are",
+                "reversible",
+                "when",
+                "the",
+                "noxa",
+                "disappears,",
+                "so",
+                "we",
+                "are",
+                "left",
+                "with",
+                "answer",
+                "number",
+                "5."
+            ]
+        ],
+        "labels": [
+            [
+                "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",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "50_160",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "5-year-old",
+                "girl,",
+                "completely",
+                "asymptomatic,",
+                "who",
+                "comes",
+                "to",
+                "the",
+                "pediatrician",
+                "for",
+                "a",
+                "regular",
+                "check-up."
+            ],
+            [
+                "She",
+                "consults",
+                "because",
+                "her",
+                "mother",
+                "was",
+                "operated",
+                "on",
+                "for",
+                "a",
+                "thyroid",
+                "tumor",
+                "and",
+                "a",
+                "grandmother",
+                "died",
+                "10",
+                "years",
+                "ago",
+                "from",
+                "a",
+                "pheochromocytoma."
+            ],
+            [
+                "The",
+                "priority",
+                "therapeutic",
+                "attitude",
+                "we",
+                "will",
+                "adopt",
+                "will",
+                "be:"
+            ],
+            [
+                "1-",
+                "Exhaustive",
+                "physical",
+                "examination",
+                "with",
+                "blood",
+                "pressure",
+                "control",
+                "to",
+                "assess",
+                "whether",
+                "the",
+                "child",
+                "may",
+                "have",
+                "a",
+                "familial",
+                "disease."
+            ],
+            [
+                "2-",
+                "Biochemical",
+                "analysis",
+                "with",
+                "calcitonin.",
+                "If",
+                "it",
+                "is",
+                "normal,",
+                "no",
+                "further",
+                "control",
+                "is",
+                "necessary",
+                "at",
+                "this",
+                "age."
+            ],
+            [
+                "3-",
+                "Annual",
+                "monitoring",
+                "of",
+                "calcitonin",
+                "levels",
+                "with",
+                "pentagastrin",
+                "stimulation",
+                "and,",
+                "if",
+                "elevated,",
+                "indication",
+                "of",
+                "prophylactic",
+                "thyroidectomy."
+            ],
+            [
+                "4-",
+                "Genetic",
+                "study",
+                "of",
+                "the",
+                "RET",
+                "c634",
+                "proto-oncogene",
+                "mutation,",
+                "and",
+                "if",
+                "positive,",
+                "prophylactic",
+                "radical",
+                "thyroidectomy",
+                "will",
+                "be",
+                "performed",
+                "at",
+                "this",
+                "age."
+            ],
+            [
+                "5-",
+                "Genetic",
+                "study",
+                "of",
+                "the",
+                "RET",
+                "c634",
+                "proto-oncogene",
+                "mutation,",
+                "calcitonin",
+                "levels",
+                "and",
+                "FNA",
+                "(fine",
+                "needle",
+                "aspiration)",
+                "and",
+                "if",
+                "positive,",
+                "radical",
+                "thyroidectomy",
+                "will",
+                "be",
+                "performed."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "4."
+            ],
+            [
+                "It",
+                "seems",
+                "to",
+                "me",
+                "to",
+                "be",
+                "more",
+                "of",
+                "an",
+                "endocrine",
+                "question",
+                "than",
+                "a",
+                "pediatric",
+                "question."
+            ],
+            [
+                "Proto-oncogene",
+                "carriers",
+                "usually",
+                "have",
+                "early",
+                "thyroid",
+                "tumors",
+                "so",
+                "radical",
+                "thyroidectomy",
+                "is",
+                "usually",
+                "recommended",
+                "before",
+                "the",
+                "age",
+                "of",
+                "5",
+                "years."
+            ],
+            [
+                "Obviously",
+                "I",
+                "had",
+                "to",
+                "look",
+                "this",
+                "up...it",
+                "is",
+                "not",
+                "very",
+                "common",
+                "in",
+                "our",
+                "routine",
+                "practice."
+            ]
+        ],
+        "labels": [
+            [
+                "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",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "326_173",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CRITICAL,",
+                "PALLIATIVE",
+                "AND",
+                "EMERGENCY",
+                "CARE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "35-year-old",
+                "man",
+                "suffers",
+                "a",
+                "high-voltage",
+                "electrical",
+                "burn",
+                "(3000",
+                "volts)",
+                "from",
+                "direct",
+                "contact",
+                "with",
+                "wire",
+                "with",
+                "his",
+                "left",
+                "hand."
+            ],
+            [
+                "On",
+                "admission",
+                "he",
+                "presents",
+                "flexion",
+                "contracture",
+                "of",
+                "the",
+                "hand,",
+                "pallor",
+                "of",
+                "the",
+                "fingers",
+                "and",
+                "absence",
+                "of",
+                "radial",
+                "and",
+                "ulnar",
+                "pulse",
+                "on",
+                "palpation",
+                "What",
+                "is",
+                "the",
+                "emergency",
+                "invasive",
+                "measure",
+                "to",
+                "be",
+                "performed?"
+            ],
+            [
+                "1-",
+                "Axillary",
+                "block",
+                "with",
+                "catheter."
+            ],
+            [
+                "2-",
+                "Decompressive",
+                "scarotomy."
+            ],
+            [
+                "3-",
+                "Intracompartmental",
+                "pressure",
+                "monitoring."
+            ],
+            [
+                "4-",
+                "Scarectomy."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "3."
+            ],
+            [
+                "In",
+                "the",
+                "case",
+                "of",
+                "suspected",
+                "compartment",
+                "syndrome,",
+                "the",
+                "urgent",
+                "invasive",
+                "measure",
+                "to",
+                "perform",
+                "would",
+                "be",
+                "to",
+                "measure",
+                "the",
+                "intracompartmental",
+                "pressure",
+                "and,",
+                "depending",
+                "on",
+                "the",
+                "result,",
+                "proceed",
+                "with",
+                "treatment."
+            ]
+        ],
+        "labels": [
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "354_166",
+        "text": [
+            [
+                "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",
+                "was",
+                "in",
+                "good",
+                "general",
+                "condition,",
+                "with",
+                "only",
+                "mild",
+                "headache,",
+                "which",
+                "was",
+                "the",
+                "reason",
+                "for",
+                "taking",
+                "her",
+                "blood",
+                "pressure."
+            ],
+            [
+                "After",
+                "4",
+                "hours",
+                "of",
+                "rest",
+                "she",
+                "presented",
+                "with",
+                "a",
+                "blood",
+                "pressure",
+                "of",
+                "150/95mmHg."
+            ],
+            [
+                "A",
+                "complete",
+                "blood",
+                "count",
+                "is",
+                "normal",
+                "and",
+                "proteinuria",
+                "is",
+                "negative."
+            ],
+            [
+                "What",
+                "type",
+                "of",
+                "hypertension",
+                "is",
+                "present?"
+            ],
+            [
+                "1-",
+                "Moderate",
+                "preeclampsia."
+            ],
+            [
+                "2-",
+                "Pregnancy-induced",
+                "hypertension."
+            ],
+            [
+                "3-",
+                "Chronic",
+                "hypertension."
+            ],
+            [
+                "4-",
+                "Eclampsia."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Chronic",
+                "hypertension",
+                "is",
+                "defined",
+                "as",
+                "hypertension",
+                "that",
+                "is",
+                "present",
+                "before",
+                "pregnancy",
+                "or",
+                "that",
+                "is",
+                "diagnosed",
+                "before",
+                "the",
+                "20th",
+                "week",
+                "of",
+                "gestation."
+            ],
+            [
+                "In",
+                "this",
+                "case,",
+                "the",
+                "patient",
+                "is",
+                "10",
+                "weeks",
+                "pregnant,",
+                "so",
+                "the",
+                "correct",
+                "answer",
+                "is",
+                "3."
+            ]
+        ],
+        "labels": [
+            [
+                "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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "531_58",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ONCOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "Faced",
+                "with",
+                "a",
+                "patient",
+                "presenting",
+                "with",
+                "an",
+                "ulcerovegetating",
+                "lesion",
+                "on",
+                "the",
+                "mandibular",
+                "gingiva",
+                "at",
+                "the",
+                "level",
+                "of",
+                "the",
+                "molar",
+                "region",
+                "of",
+                "5",
+                "months",
+                "of",
+                "evolution,",
+                "the",
+                "appearance",
+                "of",
+                "hypoesthesia",
+                "in",
+                "the",
+                "mentonian",
+                "region",
+                "requires",
+                "ruling",
+                "out:"
+            ],
+            [
+                "1-",
+                "Paraneoplastic",
+                "neuropathy."
+            ],
+            [
+                "2-",
+                "Diagnosis",
+                "of",
+                "sarcoidosis",
+                "with",
+                "\"on",
+                "the",
+                "scale\"",
+                "facial",
+                "paralysis."
+            ],
+            [
+                "3-",
+                "Herpes",
+                "virus",
+                "infection",
+                "in",
+                "immunosuppressed",
+                "patient."
+            ],
+            [
+                "4-",
+                "Diagnosis",
+                "of",
+                "carcinoma",
+                "with",
+                "infiltration",
+                "of",
+                "the",
+                "mandibular",
+                "canal."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Mentonian",
+                "paresthesias",
+                "(Roger's",
+                "sign)",
+                "are",
+                "associated",
+                "with",
+                "bone",
+                "metastases",
+                "(it",
+                "is",
+                "not",
+                "paraneoplastic",
+                "but",
+                "direct",
+                "infiltration)."
+            ],
+            [
+                "In",
+                "this",
+                "case",
+                "what",
+                "you",
+                "describe",
+                "is",
+                "an",
+                "oral",
+                "tumor",
+                "growing",
+                "locally",
+                "and",
+                "infiltrating",
+                "the",
+                "mandibular",
+                "canal,",
+                "I",
+                "believe."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "B-Marker",
+                "I-Marker"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "93_31",
+        "text": [
+            [
+                "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",
+                "the",
+                "appearance",
+                "for",
+                "5",
+                "days",
+                "of",
+                "subcutaneous",
+                "purplish",
+                "red,",
+                "hot,",
+                "painful,",
+                "bilateral,",
+                "pretibial",
+                "localization",
+                "nodules,",
+                "associated",
+                "with",
+                "an",
+                "increase",
+                "in",
+                "the",
+                "number",
+                "of",
+                "stools",
+                "and",
+                "abdominal",
+                "pain."
+            ],
+            [
+                "The",
+                "most",
+                "appropriate",
+                "approach",
+                "in",
+                "this",
+                "case",
+                "is:"
+            ],
+            [
+                "1-",
+                "Recommend",
+                "relative",
+                "rest",
+                "and",
+                "warm",
+                "cloths",
+                "on",
+                "both",
+                "legs",
+                "and",
+                "add",
+                "antidepressant",
+                "treatment."
+            ],
+            [
+                "2-",
+                "Biopsy",
+                "skin",
+                "areas",
+                "away",
+                "from",
+                "the",
+                "injured",
+                "areas",
+                "and",
+                "prescribe",
+                "entry",
+                "opioid",
+                "analgesics."
+            ],
+            [
+                "3-",
+                "Suspect",
+                "the",
+                "existence",
+                "of",
+                "a",
+                "malignant",
+                "intestinal",
+                "tumor",
+                "lesion",
+                "as",
+                "a",
+                "trigger",
+                "of",
+                "the",
+                "cutaneous",
+                "process."
+            ],
+            [
+                "4-",
+                "Suspect",
+                "bilateral",
+                "lower",
+                "extremity",
+                "ischemia",
+                "of",
+                "drug",
+                "origin."
+            ],
+            [
+                "5-",
+                "Adjustment",
+                "of",
+                "bowel",
+                "disease",
+                "treatment."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "2",
+                "and",
+                "4",
+                "are",
+                "discarded",
+                "alone."
+            ],
+            [
+                "They",
+                "are",
+                "explaining",
+                "erythema",
+                "nodosum,",
+                "so",
+                "we",
+                "would",
+                "recommend",
+                "relative",
+                "rest",
+                "(but",
+                "antidepressants",
+                "do",
+                "not",
+                "make",
+                "any",
+                "sense,",
+                "so",
+                "we",
+                "also",
+                "rule",
+                "out",
+                "(1))."
+            ],
+            [
+                "Although",
+                "erythema",
+                "nodosum",
+                "can",
+                "be",
+                "secondary",
+                "to",
+                "a",
+                "malignant",
+                "process,",
+                "it",
+                "is",
+                "more",
+                "frequent",
+                "that",
+                "it",
+                "is",
+                "due",
+                "to",
+                "Crohn's",
+                "disease",
+                "itself",
+                "(moreover,",
+                "in",
+                "a",
+                "17-year-old",
+                "boy",
+                "it",
+                "would",
+                "be",
+                "extremely",
+                "rare),",
+                "so",
+                "if",
+                "the",
+                "picture",
+                "is",
+                "also",
+                "accompanied",
+                "by",
+                "a",
+                "flare-up",
+                "of",
+                "inflammatory",
+                "bowel",
+                "disease,",
+                "the",
+                "last",
+                "option",
+                "(5)",
+                "seems",
+                "the",
+                "most",
+                "correct."
+            ]
+        ],
+        "labels": [
+            [
+                "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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "390_188",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PSYCHIATRY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "80-year-old",
+                "man",
+                "is",
+                "brought",
+                "to",
+                "the",
+                "ER",
+                "by",
+                "the",
+                "police",
+                "to",
+                "find",
+                "him",
+                "at",
+                "night,",
+                "on",
+                "the",
+                "street,",
+                "several",
+                "blocks",
+                "from",
+                "his",
+                "home,",
+                "somewhat",
+                "lost."
+            ],
+            [
+                "He",
+                "tells",
+                "the",
+                "ER",
+                "doctor",
+                "\"I",
+                "feel",
+                "fine,",
+                "I",
+                "was",
+                "walking",
+                "and",
+                "I",
+                "got",
+                "lost\"."
+            ],
+            [
+                "The",
+                "examination,",
+                "by",
+                "systems,",
+                "is",
+                "anodyne."
+            ],
+            [
+                "When",
+                "asked",
+                "about",
+                "his",
+                "medication,",
+                "he",
+                "does",
+                "not",
+                "remember."
+            ],
+            [
+                "His",
+                "history",
+                "includes",
+                "glipizide,",
+                "atenolol",
+                "and",
+                "acenocoumarol."
+            ],
+            [
+                "She",
+                "has",
+                "been",
+                "to",
+                "the",
+                "ER",
+                "3",
+                "times",
+                "in",
+                "the",
+                "last",
+                "three",
+                "months",
+                "for",
+                "\"dizziness\",",
+                "low",
+                "back",
+                "pain",
+                "and",
+                "an",
+                "INR",
+                "of",
+                "5."
+            ],
+            [
+                "She",
+                "reports",
+                "independence",
+                "in",
+                "basic",
+                "and",
+                "instrumental",
+                "activities",
+                "of",
+                "daily",
+                "living."
+            ],
+            [
+                "There",
+                "is",
+                "no",
+                "evidence",
+                "of",
+                "family",
+                "or",
+                "close",
+                "friends."
+            ],
+            [
+                "Several",
+                "references",
+                "from",
+                "the",
+                "social",
+                "work",
+                "in",
+                "the",
+                "area",
+                "indicate",
+                "that",
+                "she",
+                "refuses",
+                "medical",
+                "or",
+                "nursing",
+                "aids",
+                "or",
+                "visits."
+            ],
+            [
+                "In",
+                "the",
+                "physical",
+                "examination,",
+                "only",
+                "temperature",
+                "of",
+                "37.7,",
+                "BMI",
+                "of",
+                "16,",
+                "BP",
+                "of",
+                "160/90,",
+                "HR",
+                "of",
+                "90",
+                "and",
+                "SO2",
+                "of",
+                "99%",
+                "stand",
+                "out."
+            ],
+            [
+                "He",
+                "has",
+                "global",
+                "loss",
+                "of",
+                "muscle",
+                "mass."
+            ],
+            [
+                "He",
+                "is",
+                "dressed",
+                "in",
+                "his",
+                "robe",
+                "and",
+                "smells",
+                "of",
+                "urine."
+            ],
+            [
+                "He",
+                "refuses",
+                "to",
+                "answer",
+                "Minimental's",
+                "questions."
+            ],
+            [
+                "Laboratory",
+                "tests",
+                "include",
+                "13,000",
+                "leukocytes,",
+                "blood",
+                "glucose",
+                "300,",
+                "glycosylated",
+                "hemoglobin",
+                "11%,",
+                "INR",
+                "0.9,",
+                "urine",
+                "over",
+                "50",
+                "leukocytes/field,",
+                "nitrites+",
+                "and",
+                "urine",
+                "culture",
+                ">",
+                "100,000",
+                "Gram",
+                "negative",
+                "bacilli."
+            ],
+            [
+                "He",
+                "is",
+                "admitted",
+                "to",
+                "the",
+                "hospital,",
+                "receives",
+                "antibiotics,",
+                "insulin",
+                "and",
+                "restarts",
+                "acenocoumarol",
+                "with",
+                "good",
+                "evolution."
+            ],
+            [
+                "He",
+                "is",
+                "stable",
+                "and",
+                "wants",
+                "to",
+                "go",
+                "home."
+            ],
+            [
+                "The",
+                "ward",
+                "nurse",
+                "says",
+                "he",
+                "is",
+                "unable",
+                "to",
+                "self-administer",
+                "insulin."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "is",
+                "the",
+                "next",
+                "step",
+                "in",
+                "determining",
+                "the",
+                "patient's",
+                "safety",
+                "at",
+                "home?"
+            ],
+            [
+                "1-",
+                "Refer",
+                "to",
+                "Primary",
+                "Care",
+                "and",
+                "social",
+                "work",
+                "in",
+                "the",
+                "area",
+                "to",
+                "determine",
+                "safety",
+                "at",
+                "home."
+            ],
+            [
+                "2-",
+                "Formal",
+                "evaluation",
+                "of",
+                "the",
+                "capacity",
+                "to",
+                "make",
+                "decisions",
+                "concerning",
+                "their",
+                "health."
+            ],
+            [
+                "3-",
+                "Evaluation",
+                "to",
+                "rule",
+                "out",
+                "dementia."
+            ],
+            [
+                "4-",
+                "Evaluation",
+                "to",
+                "rule",
+                "out",
+                "depression."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Assessing",
+                "capacity",
+                "is",
+                "not",
+                "about",
+                "taking",
+                "away",
+                "the",
+                "patient's",
+                "autonomy,",
+                "but",
+                "making",
+                "sure",
+                "that",
+                "the",
+                "patient",
+                "understands",
+                "and",
+                "is",
+                "aware",
+                "of",
+                "the",
+                "consequences",
+                "of",
+                "his",
+                "decisions."
+            ],
+            [
+                "In",
+                "fact,",
+                "it",
+                "is",
+                "a",
+                "protective",
+                "measure",
+                "for",
+                "the",
+                "most",
+                "fragile",
+                "patients",
+                "to",
+                "ensure",
+                "the",
+                "best",
+                "care."
+            ],
+            [
+                "This",
+                "is",
+                "not",
+                "done",
+                "by",
+                "a",
+                "psychiatrist,",
+                "but",
+                "by",
+                "the",
+                "attending",
+                "physician."
+            ],
+            [
+                "There",
+                "are",
+                "several",
+                "tests",
+                "or",
+                "semi-structured",
+                "interviews",
+                "to",
+                "assess",
+                "the",
+                "capacity",
+                "of",
+                "patients,",
+                "and",
+                "all",
+                "physicians",
+                "should",
+                "be",
+                "familiar",
+                "with",
+                "these",
+                "instruments."
+            ],
+            [
+                "It",
+                "is",
+                "important",
+                "that",
+                "it",
+                "is",
+                "the",
+                "attending",
+                "physician",
+                "who",
+                "performs",
+                "this",
+                "assessment,",
+                "because",
+                "he/she",
+                "is",
+                "the",
+                "one",
+                "who",
+                "previously",
+                "informs",
+                "the",
+                "patient",
+                "(informed",
+                "consent)",
+                "of",
+                "the",
+                "therapeutic",
+                "plan",
+                "and",
+                "is",
+                "the",
+                "one",
+                "who",
+                "is",
+                "best",
+                "able",
+                "to",
+                "assess",
+                "whether",
+                "the",
+                "patient",
+                "has",
+                "understood",
+                "everything:",
+                "what",
+                "the",
+                "medical",
+                "problem",
+                "is,",
+                "what",
+                "treatment",
+                "is",
+                "proposed,",
+                "the",
+                "alternatives",
+                "if",
+                "any,",
+                "whether",
+                "to",
+                "accept",
+                "or",
+                "reject",
+                "any",
+                "of",
+                "them",
+                "and",
+                "why,",
+                "the",
+                "consequences",
+                "of",
+                "making",
+                "these",
+                "decisions",
+                "(also",
+                "those",
+                "of",
+                "not",
+                "wanting",
+                "treatment),",
+                "even",
+                "assessing",
+                "psychopathology",
+                "susceptible",
+                "to",
+                "an",
+                "ICP",
+                "to",
+                "Psychiatry."
+            ]
+        ],
+        "labels": [
+            [
+                "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-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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "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-Premise"
+            ],
+            [
+                "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",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "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-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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "577_105",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "45-year-old",
+                "male",
+                "brought",
+                "to",
+                "the",
+                "consultation",
+                "by",
+                "his",
+                "relatives",
+                "for",
+                "a",
+                "one-year",
+                "history",
+                "of",
+                "memory",
+                "loss,",
+                "which",
+                "has",
+                "progressed",
+                "to",
+                "the",
+                "point",
+                "of",
+                "needing",
+                "help",
+                "with",
+                "some",
+                "activities",
+                "of",
+                "daily",
+                "living."
+            ],
+            [
+                "He",
+                "has",
+                "a",
+                "history",
+                "of",
+                "migraines",
+                "and",
+                "some",
+                "episode",
+                "of",
+                "self-limited",
+                "neurological",
+                "focality",
+                "for",
+                "which",
+                "he",
+                "has",
+                "never",
+                "consulted."
+            ],
+            [
+                "The",
+                "neuropsychological",
+                "examination",
+                "is",
+                "compatible",
+                "with",
+                "an",
+                "initial",
+                "dementia",
+                "and",
+                "the",
+                "brain",
+                "MRI",
+                "shows",
+                "a",
+                "severe",
+                "leukoencephalopathy."
+            ],
+            [
+                "Which",
+                "test",
+                "should",
+                "be",
+                "ordered?"
+            ],
+            [
+                "1-",
+                "Lumbar",
+                "puncture",
+                "to",
+                "analyze",
+                "amyloid",
+                "and",
+                "tau",
+                "protein",
+                "in",
+                "CSF."
+            ],
+            [
+                "2-",
+                "Genetic",
+                "study",
+                "for",
+                "presenilin",
+                "1",
+                "(PSEN1)."
+            ],
+            [
+                "3-",
+                "Genetic",
+                "study",
+                "for",
+                "NOTCH3."
+            ],
+            [
+                "4-",
+                "Genetic",
+                "study",
+                "for",
+                "progranulin."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "They",
+                "describe",
+                "a",
+                "characteristic",
+                "case",
+                "of",
+                "CADASIL",
+                "(Cerebral",
+                "Autosomal",
+                "Dominant",
+                "Arteriopathy",
+                "with",
+                "Sub-cortical",
+                "Infarcts",
+                "and",
+                "Leukoencephalopathy)."
+            ],
+            [
+                "It",
+                "is",
+                "a",
+                "genetic",
+                "disease",
+                "of",
+                "autosomal",
+                "dominant",
+                "inheritance",
+                "by",
+                "mutation",
+                "of",
+                "the",
+                "NOTCH3",
+                "gene."
+            ],
+            [
+                "This",
+                "mutation",
+                "causes",
+                "vascular",
+                "involvement",
+                "of",
+                "small",
+                "vessel",
+                "that",
+                "generates",
+                "severe",
+                "leukoencephalopathy",
+                "early,",
+                "which",
+                "generates",
+                "various",
+                "symptoms."
+            ],
+            [
+                "Migraines,",
+                "cerebrovascular",
+                "disease",
+                "and",
+                "cognitive",
+                "impairment",
+                "at",
+                "early",
+                "ages",
+                "stand",
+                "out,",
+                "as",
+                "shown",
+                "in",
+                "the",
+                "clinical",
+                "case",
+                "of",
+                "the",
+                "question."
+            ]
+        ],
+        "labels": [
+            [
+                "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-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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "615_118",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "TRAUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "41-year-old",
+                "male",
+                "consults",
+                "for",
+                "gonalgia",
+                "of",
+                "several",
+                "days'",
+                "evolution."
+            ],
+            [
+                "During",
+                "the",
+                "examination,",
+                "the",
+                "Thessaly",
+                "test",
+                "is",
+                "performed",
+                "(pain",
+                "with",
+                "internal",
+                "and",
+                "external",
+                "rotation",
+                "movements",
+                "with",
+                "the",
+                "knee",
+                "flexed),",
+                "which",
+                "is",
+                "positive."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "lesions",
+                "is",
+                "more",
+                "probable?"
+            ],
+            [
+                "1-",
+                "Meniscal",
+                "injury."
+            ],
+            [
+                "2-",
+                "Injury",
+                "due",
+                "to",
+                "rupture",
+                "of",
+                "the",
+                "anterior",
+                "cruciate",
+                "ligament."
+            ],
+            [
+                "3-",
+                "Injury",
+                "due",
+                "to",
+                "rupture",
+                "of",
+                "the",
+                "posterior",
+                "cruciate",
+                "ligament."
+            ],
+            [
+                "4-",
+                "Injury",
+                "due",
+                "to",
+                "degenerative",
+                "arthropathy."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Answer",
+                "1",
+                "correct:",
+                "The",
+                "Thessaly",
+                "test",
+                "is",
+                "a",
+                "meniscal",
+                "exploration",
+                "maneuver."
+            ],
+            [
+                "The",
+                "statement",
+                "focuses",
+                "exclusively",
+                "on",
+                "this",
+                "part",
+                "of",
+                "the",
+                "examination",
+                "and",
+                "also",
+                "explains",
+                "that",
+                "it",
+                "is",
+                "indeed",
+                "positive,",
+                "which",
+                "leads",
+                "to",
+                "the",
+                "suspicion",
+                "of",
+                "a",
+                "meniscal",
+                "lesion."
+            ],
+            [
+                "\"The",
+                "Thessaly",
+                "test",
+                "is",
+                "a",
+                "dynamic",
+                "reproduction",
+                "of",
+                "load",
+                "transmission",
+                "in",
+                "the",
+                "knee",
+                "joint",
+                "and",
+                "is",
+                "performed",
+                "at",
+                "5\u00b0",
+                "and",
+                "20\u00b0",
+                "of",
+                "flexion."
+            ],
+            [
+                "The",
+                "examiner",
+                "supports",
+                "the",
+                "patient",
+                "by",
+                "holding",
+                "his",
+                "or",
+                "her",
+                "outstretched",
+                "hands",
+                "while",
+                "the",
+                "patient",
+                "stands",
+                "flatfooted",
+                "on",
+                "the",
+                "floor."
+            ],
+            [
+                "The",
+                "patient",
+                "then",
+                "rotates",
+                "his",
+                "or",
+                "her",
+                "knee",
+                "and",
+                "body,",
+                "internally",
+                "and",
+                "externally,",
+                "three",
+                "times,",
+                "keeping",
+                "the",
+                "knee",
+                "in",
+                "slight",
+                "flexion",
+                "(5\u00b0)."
+            ],
+            [
+                "Then",
+                "the",
+                "same",
+                "procedure",
+                "is",
+                "carried",
+                "out",
+                "with",
+                "the",
+                "knee",
+                "flexed",
+                "at",
+                "20\u00b0."
+            ],
+            [
+                "Patients",
+                "with",
+                "suspected",
+                "meniscal",
+                "tears",
+                "experience",
+                "medial",
+                "or",
+                "lateral",
+                "joint-line",
+                "discomfort",
+                "and",
+                "may",
+                "have",
+                "a",
+                "sense",
+                "of",
+                "locking",
+                "or",
+                "catching."
+            ],
+            [
+                "The",
+                "theory",
+                "behind",
+                "the",
+                "test",
+                "is",
+                "that,",
+                "with",
+                "this",
+                "maneuver,",
+                "the",
+                "knee",
+                "with",
+                "a",
+                "meniscal",
+                "tear",
+                "is",
+                "subjected",
+                "to",
+                "excessive",
+                "loading",
+                "conditions",
+                "and",
+                "almost",
+                "certainly",
+                "will",
+                "have",
+                "the",
+                "same",
+                "symptoms",
+                "that",
+                "the",
+                "patient",
+                "reported."
+            ],
+            [
+                "The",
+                "test",
+                "is",
+                "always",
+                "performed",
+                "first",
+                "on",
+                "the",
+                "normal",
+                "knee",
+                "so",
+                "that",
+                "the",
+                "patient",
+                "may",
+                "be",
+                "trained,",
+                "especially",
+                "with",
+                "regard",
+                "to",
+                "how",
+                "to",
+                "keep",
+                "the",
+                "knee",
+                "in",
+                "5\u00b0",
+                "and",
+                "then",
+                "in",
+                "20\u00b0",
+                "of",
+                "flexion",
+                "and",
+                "how",
+                "to",
+                "recognize,",
+                "by",
+                "comparison,",
+                "a",
+                "possible",
+                "positive",
+                "result",
+                "in",
+                "the",
+                "symptomatic",
+                "knee.\"",
+                "Answer",
+                "2",
+                "incorrect:",
+                "At",
+                "no",
+                "time",
+                "do",
+                "they",
+                "describe",
+                "any",
+                "exploration",
+                "maneuvers",
+                "of",
+                "the",
+                "anterior",
+                "cruciate",
+                "ligament,",
+                "nor",
+                "do",
+                "they",
+                "mention",
+                "any",
+                "trauma",
+                "that",
+                "may",
+                "have",
+                "injured",
+                "it."
+            ],
+            [
+                "Answer",
+                "3",
+                "incorrect:",
+                "At",
+                "no",
+                "time",
+                "do",
+                "they",
+                "describe",
+                "any",
+                "exploration",
+                "maneuvers",
+                "of",
+                "the",
+                "posterior",
+                "cruciate",
+                "ligament,",
+                "nor",
+                "do",
+                "they",
+                "mention",
+                "any",
+                "trauma",
+                "that",
+                "could",
+                "have",
+                "injured",
+                "it."
+            ],
+            [
+                "Wrong",
+                "answer",
+                "4:",
+                "Although",
+                "it",
+                "could",
+                "occur,",
+                "it",
+                "is",
+                "not",
+                "to",
+                "be",
+                "expected",
+                "in",
+                "a",
+                "41",
+                "year",
+                "old",
+                "person",
+                "with",
+                "an",
+                "acutely",
+                "established",
+                "clinical",
+                "condition."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Claim",
+                "I-Claim",
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+    },
+    {
+        "id": "456_200",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "OPHTHALMOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "67-year-old",
+                "man,",
+                "diabetic",
+                "and",
+                "asthmatic,",
+                "with",
+                "primary",
+                "open-angle",
+                "glaucoma",
+                "in",
+                "both",
+                "eyes."
+            ],
+            [
+                "He",
+                "has",
+                "an",
+                "ocular",
+                "pressure",
+                "of",
+                "34",
+                "mmHg",
+                "in",
+                "his",
+                "right",
+                "eye",
+                "and",
+                "31",
+                "mmHg",
+                "in",
+                "his",
+                "left",
+                "eye."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "pharmacological",
+                "groups",
+                "is",
+                "the",
+                "most",
+                "indicated",
+                "as",
+                "first",
+                "choice",
+                "as",
+                "hypotensive",
+                "treatment?"
+            ],
+            [
+                "1-",
+                "Carbonic",
+                "anhydrase",
+                "inhibitors."
+            ],
+            [
+                "2-",
+                "Beta-blockers."
+            ],
+            [
+                "3-",
+                "Alpha-2",
+                "agonists."
+            ],
+            [
+                "4-",
+                "Prostaglandin",
+                "derivatives."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "We",
+                "are",
+                "asked",
+                "about",
+                "the",
+                "first",
+                "choice",
+                "treatment",
+                "for",
+                "glaucoma."
+            ],
+            [
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+                "the",
+                "past,",
+                "beta-blockers",
+                "were",
+                "the",
+                "first",
+                "choice,",
+                "but",
+                "nowadays",
+                "they",
+                "have",
+                "been",
+                "displaced",
+                "by",
+                "the",
+                "group",
+                "that",
+                "lowers",
+                "intraocular",
+                "pressure",
+                "the",
+                "most:",
+                "prostaglandins."
+            ],
+            [
+                "Their",
+                "efficacy",
+                "and",
+                "more",
+                "convenient",
+                "dosage",
+                "(once",
+                "a",
+                "day)",
+                "generally",
+                "make",
+                "them",
+                "the",
+                "group",
+                "of",
+                "choice."
+            ],
+            [
+                "Beta-blockers",
+                "would",
+                "remain",
+                "as",
+                "a",
+                "second",
+                "choice",
+                "in",
+                "cases",
+                "in",
+                "which",
+                "the",
+                "side",
+                "effects",
+                "of",
+                "prostaglandins",
+                "(change",
+                "in",
+                "eye",
+                "color,",
+                "increase",
+                "in",
+                "eyelash",
+                "size)",
+                "make",
+                "us",
+                "initially",
+                "leave",
+                "them",
+                "aside."
+            ],
+            [
+                "Since",
+                "the",
+                "patient",
+                "is",
+                "asthmatic,",
+                "we",
+                "should",
+                "rule",
+                "out",
+                "beta-blockers",
+                "(wrong",
+                "answer",
+                "2)."
+            ],
+            [
+                "Also,",
+                "since",
+                "we",
+                "need",
+                "a",
+                "significant",
+                "drop",
+                "in",
+                "intraocular",
+                "pressure",
+                "because",
+                "the",
+                "numbers",
+                "are",
+                "high",
+                "(34",
+                "and",
+                "31),",
+                "we",
+                "can",
+                "also",
+                "rule",
+                "out",
+                "carbonic",
+                "anhydrase",
+                "inhibitors",
+                "and",
+                "alpha-2",
+                "agonists",
+                "(options",
+                "1",
+                "and",
+                "3",
+                "incorrect)."
+            ],
+            [
+                "And",
+                "opt",
+                "for",
+                "the",
+                "group",
+                "that",
+                "can",
+                "lower",
+                "intraocular",
+                "pressure",
+                "the",
+                "most."
+            ],
+            [
+                "Answer",
+                "4",
+                "correct."
+            ],
+            [
+                "And",
+                "then",
+                "a",
+                "couple",
+                "of",
+                "nuances",
+                "of",
+                "the",
+                "statement."
+            ],
+            [
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+                "be",
+                "more",
+                "correct",
+                "to",
+                "talk",
+                "about",
+                "intraocular",
+                "pressure",
+                "and",
+                "not",
+                "\"ocular",
+                "pressure\"."
+            ],
+            [
+                "And",
+                "the",
+                "wording",
+                "could",
+                "be",
+                "improved",
+                "so",
+                "as",
+                "not",
+                "to",
+                "repeat",
+                "the",
+                "word",
+                "\"as\"",
+                "in",
+                "the",
+                "last",
+                "sentence."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
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+                "O"
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+                "I-Premise",
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+                "O",
+                "O",
+                "O",
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+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
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+                "O",
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+                "I-Claim"
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
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+                "I-Claim",
+                "I-Claim"
+            ],
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "484_175",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CRITICAL",
+                "CARE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "18-year-old",
+                "man",
+                "arrives",
+                "at",
+                "the",
+                "hospital",
+                "emergency",
+                "department",
+                "transported",
+                "by",
+                "a",
+                "basic",
+                "life",
+                "support",
+                "unit."
+            ],
+            [
+                "He",
+                "has",
+                "been",
+                "hit",
+                "by",
+                "a",
+                "car",
+                "while",
+                "riding",
+                "a",
+                "bicycle."
+            ],
+            [
+                "On",
+                "arrival",
+                "he",
+                "has",
+                "a",
+                "heart",
+                "rate",
+                "of",
+                "115",
+                "bpm,",
+                "a",
+                "blood",
+                "pressure",
+                "of",
+                "110/75",
+                "mmHg,",
+                "a",
+                "palpable",
+                "radial",
+                "pulse,",
+                "a",
+                "capillary",
+                "refill",
+                "of",
+                "2.5",
+                "seconds",
+                "and",
+                "a",
+                "respiratory",
+                "rate",
+                "of",
+                "25",
+                "rpm."
+            ],
+            [
+                "What",
+                "do",
+                "these",
+                "data",
+                "tell",
+                "us:"
+            ],
+            [
+                "1-",
+                "The",
+                "patient",
+                "has",
+                "lost",
+                "15",
+                "to",
+                "30%",
+                "of",
+                "blood",
+                "volume",
+                "and",
+                "requires",
+                "volume",
+                "replacement."
+            ],
+            [
+                "2-",
+                "She",
+                "has",
+                "lost",
+                "more",
+                "than",
+                "30%",
+                "of",
+                "volemia",
+                "and",
+                "needs",
+                "volume",
+                "and",
+                "blood",
+                "replacement."
+            ],
+            [
+                "3-",
+                "He",
+                "has",
+                "lost",
+                "more",
+                "than",
+                "40%",
+                "of",
+                "blood",
+                "volume",
+                "and",
+                "will",
+                "require",
+                "surgical",
+                "treatment."
+            ],
+            [
+                "4-",
+                "Has",
+                "lost",
+                "more",
+                "than",
+                "50%",
+                "of",
+                "volemia",
+                "and",
+                "requires",
+                "volume",
+                "and",
+                "blood",
+                "replacement."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Technically",
+                "the",
+                "patient",
+                "is",
+                "in",
+                "a",
+                "grade",
+                "II",
+                "hemorrhage",
+                "according",
+                "to",
+                "the",
+                "ATLS",
+                "classification,",
+                "in",
+                "principle",
+                "this",
+                "means",
+                "a",
+                "loss",
+                "of",
+                "between",
+                "750",
+                "and",
+                "1500mL",
+                "of",
+                "blood",
+                "and",
+                "the",
+                "indicated",
+                "action",
+                "is",
+                "resuscitation",
+                "with",
+                "crystalloids;",
+                "however,",
+                "in",
+                "the",
+                "guidelines",
+                "for",
+                "the",
+                "care",
+                "of",
+                "severe",
+                "polytraumatized",
+                "patients,",
+                "the",
+                "early",
+                "use",
+                "of",
+                "blood",
+                "products",
+                "is",
+                "increasingly",
+                "recommended,",
+                "especially",
+                "in",
+                "borderline",
+                "cases",
+                "like",
+                "this",
+                "one,",
+                "and",
+                "in",
+                "young",
+                "patients,",
+                "who",
+                "may",
+                "not",
+                "be",
+                "able",
+                "to",
+                "translate",
+                "the",
+                "severity",
+                "of",
+                "the",
+                "blood",
+                "loss",
+                "until",
+                "it",
+                "becomes",
+                "much",
+                "more",
+                "significant."
+            ],
+            [
+                "I",
+                "would",
+                "therefore",
+                "hesitate",
+                "between",
+                "options",
+                "1",
+                "and",
+                "2."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    }
+]
\ No newline at end of file