id,text,labels
19094,"[['QUESTION', 'TYPE:', 'PEDIATRICS'], ['CLINICAL', 'CASE:'], ['An', '18-month-old', 'boy,', 'with', 'complete', 'immunization', 'schedule', 'to', 'date,', 'who', 'consults', 'the', 'Emergency', 'Department', 'for', 'right', 'knee', 'swelling', 'after', 'playing', 'in', 'the', 'park,', 'without', 'obvious', 'trauma.'], ['In', 'the', 'directed', 'anamnesis,', 'the', 'mother', 'refers', 'that', 'an', 'uncle', 'of', 'hers', 'had', 'similar', 'problems.'], ['The', 'ultrasound', 'examination', 'is', 'compatible', 'with', 'hemarthrosis', 'and', 'in', 'the', 'analytical', 'analysis', 'only', 'an', 'APTT', 'lengthening', 'of', ""52''"", '(normal', ""25-35'')"", 'stands', 'out.'], ['What', 'is', 'the', 'most', 'probable', 'diagnostic', 'hypothesis?'], ['1-', 'Marfan', 'syndrome.'], ['2-', ""Von-Willebrand's"", 'disease.'], ['3-', 'Ehlers-Danlos', 'disease.'], ['4-', 'Hemophilia', 'A.'], ['5-', 'Bernard-Soulier', 'disease.'], ['CORRECT', 'ANSWER:', '4'], ['Although', 'other', 'hemorrhagic', 'diseases', 'can', 'have', 'a', 'prolonged', 'thromboplastin', 'time,', 'due', 'to', 'the', 'intensity', 'of', 'the', 'lesion', 'and', 'the', ""child's"", 'sex', 'and', 'family', 'history,', 'the', 'most', 'likely', 'diagnosis', 'is', 'hemophilia.']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
150201,"[['QUESTION', 'TYPE:', 'PSYCHIATRY'], ['CLINICAL', 'CASE:'], ['We', 'are', 'consulted', 'by', 'an', '84-year-old', 'woman', 'for', 'insomnia', 'of', 'conciliation.'], ['After', 'failing', 'sleep', 'hygiene', 'measures,', 'it', 'is', 'decided', 'to', 'initiate', 'pharmacological', 'treatment.'], ['Which', 'of', 'the', 'following', 'drugs', 'would', 'you', 'select', 'for', 'the', 'patient?'], ['1-', 'Diacepam.'], ['2-', 'Lormetacepam.'], ['3-', 'Phenobarbital.'], ['4-', 'Chlordiazepoxide.'], ['5-', 'Chloracepate.'], ['CORRECT', 'ANSWER:', '2'], ['Knowing', 'that', 'we', 'have', 'taken', 'measures', 'of', 'sleep', 'hygiene,', 'we', 'have', 'explored', 'what', 'provokes', 'him', 'not', 'to', 'sleep,', 'and', 'he', 'does', 'not', 'sleep', 'nine', 'hours', 'and', 'still', 'wants', 'to', 'sleep', 'more,...then', 'the', 'less', 'harmful', 'answer', 'is', 'the', '2.'], ['Because', 'it', 'is', 'the', 'one', 'with', 'the', 'shortest', 'half-life', 'and', 'he', 'does', 'not', 'want', 'the', 'lady', 'to', 'fall', 'down', 'the', 'next', 'day.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['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', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim'], ['O', 'B-Claim'], ['O', 'B-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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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']]"
454153,"[['QUESTION', 'TYPE:', 'NEUROLOGY'], ['CLINICAL', 'CASE:'], ['A', '65-year-old', 'woman', 'consults', 'for', 'weakness', 'in', 'the', 'right', 'hand', 'that', 'has', 'spread', 'in', 'a', 'few', 'months', 'to', 'other', 'muscle', 'territories', 'of', 'both', 'arms', 'and', 'legs,', 'with', 'distal', 'predominance.'], ['On', 'examination', 'there', 'is', 'atrophy', 'and', 'fasciculations', 'in', 'different', 'metameric', 'territories', 'with', 'preserved', 'sensitivity.'], ['There', 'is', 'a', 'bilateral', ""Babinski's"", 'sign,', 'what', 'is', 'the', 'diagnostic', 'test', 'that', 'would', 'confirm', 'the', 'suspected', 'diagnosis?'], ['1-', 'Cerebral', 'CT.'], ['2-', 'Electromyographic', 'study.'], ['3-', 'Cerebral', 'MRI.'], ['4-', 'Multimodal', 'evoked', 'potentials.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '2'], ['The', 'answer', 'is', '2,', 'an', 'EMG,', 'which', 'would', 'be', 'the', 'diagnostic', 'test', 'to', 'confirm', 'the', 'diagnostic', 'suspicion', 'of', 'ALS,', 'the', 'imaging', 'tests', 'both', 'CT,', 'but', 'especially', 'MRI', 'would', 'help', 'us', 'to', 'rule', 'out,', 'but', 'would', 'not', 'confirm', 'the', 'diagnosis.']]","[['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'], ['B-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'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-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', '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']]"
5415,,
602112,"[['QUESTION', 'TYPE:', 'TRAUMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '61-year-old', 'woman,', 'administrative,', 'with', 'a', 'history', 'of', 'overweight,', 'hypertension,', 'dyslipidemia', 'and', 'metabolic', 'syndrome,', 'who', 'consults', 'for', 'pain', 'in', 'both', 'buttocks,', 'left', 'trochanteric', 'region,', 'lateral', 'aspect', 'of', 'the', 'left', 'thigh', 'up', 'to', 'the', 'knee', 'and', 'left', 'leg', 'up', 'to', 'the', 'middle', 'third.'], ['The', 'pain', 'appears', 'when', 'the', 'lower', 'limb', 'is', 'lifted', 'with', 'the', 'knee', 'extended,', 'but', 'is', 'relieved', 'when', 'the', 'knee', 'is', 'flexed.'], ['What', 'is', 'the', 'first', 'clinical', 'suspicion?'], ['1-', 'Gouty', 'arthritis', 'of', 'left', 'hip.'], ['2-', 'Left', 'coxofemoral', 'arthrosis.'], ['3-', 'Radiated', 'low', 'back', 'pain', '/', 'lumbosciatica.'], ['4-', 'Claudication', 'due', 'to', 'canal', 'stenosis.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['In', 'this', 'case,', 'when', 'speaking', 'of', '""reappearance', 'of', 'the', 'symptoms', 'when', 'we', 'lift', 'the', 'lower', 'limb', 'with', 'the', 'knee', 'extended""', 'we', 'are', 'describing', 'the', 'Lasègue', 'Maneuver.'], ['This', 'maneuver', 'is', 'positive', 'in', 'cases', 'of', 'lumbosciatic', 'pain,', 'since', 'it', 'causes', 'a', 'stretching', 'of', 'the', 'sciatic', 'nerve,', 'therefore', 'the', 'correct', 'answer', 'is', 'number', '3.'], ['The', 'rest', 'of', 'the', 'pathologies', 'do', 'not', 'have', 'a', 'positive', 'Lasègue', 'maneuver,', 'so', 'these', 'options', 'would', 'not', 'be', 'correct.']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', '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'], ['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', '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', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
12777,"[['QUESTION', 'TYPE:', 'NEUROLOGY', 'AND', 'NEUROSURGERY'], ['CLINICAL', 'CASE:'], ['A', '32-year-old', 'diabetic', 'patient', 'on', 'insulin', 'therapy', 'with', 'good', 'control', 'of', 'his', 'blood', 'glucose', 'levels', 'comes', 'to', 'your', 'office', 'with', 'tingling', 'in', 'both', 'hands,', 'with', 'a', 'sensation', 'of', 'corking', 'and', 'thermal', 'insensitivity', 'of', 'progressive', 'onset', 'over', 'the', 'course', 'of', '2', 'weeks.'], ['She', 'does', 'not', 'report', 'visual', 'disturbances,', 'strength', 'deficit,', 'motor', 'clumsiness', 'or', 'other', 'symptoms.'], ['On', 'examination', 'she', 'found', 'anesthesia', 'to', 'pain', 'and', 'temperature', 'in', 'both', 'hands', 'and', 'distal', 'forearms;', 'positional', 'and', 'vibratory', 'sensitivity', 'were', 'preserved.'], ['There', 'is', 'no', 'muscle', 'atrophy', 'or', 'strength', 'deficit.'], ['Muscle', 'reflexes', 'are', 'normal', 'and', 'symmetrical.'], ['There', 'is', 'no', 'dysmetria,', 'dysdiadochokinesia', 'or', 'intention', 'tremor.'], ['The', 'rest', 'of', 'the', 'neurological', 'examination', 'is', 'strictly', 'normal.'], ['Indicate', 'the', 'most', 'likely', 'diagnosis', 'in', 'this', 'case:'], ['1-', 'Peripheral', 'sensitvo', 'symmetric', 'distal', 'peripheral', 'neuropathy', 'of', 'diabetic', 'cause.'], ['2-', 'Compressive', 'cervical', 'spinal', 'cord', 'injury.'], ['3-', 'Bilateral', 'carpal', 'tunnel', 'syndrome.'], ['4-', 'Multiple', 'sclerosis', 'type', 'demyelinating', 'disease.'], ['5-', 'Central', 'cervical', 'spinal', 'cord', 'injury.'], ['CORRECT', 'ANSWER:', '5'], ['This', ""year's"", 'Neurology', ""section's"", 'burning', 'question.'], ['He', 'presents', 'a', 'diabetic', 'patient', 'on', 'insulin', 'treatment', 'with', 'good', 'control', '(although', 'diabetic', 'neuropathies', 'do', 'not', 'only', 'develop', 'in', 'patients', 'with', 'poor', 'control)', 'with', 'a', 'sensory', 'picture', 'limited', 'to', 'the', 'upper', 'limbs', 'and', 'of', 'short', 'onset', 'time,', 'without', 'motor', 'symptoms', 'or', 'at', 'any', 'other', 'level.'], ['In', 'the', 'examination', 'there', 'is', 'a', 'clear', 'dissociation', 'with', 'thermoalgesic', 'anesthesia', 'and', 'preservation', 'of', 'arthrokinetic', 'and', 'vibratory.'], ['Reflexes', 'are', 'normal,', 'neither', 'abolished', 'nor', 'exalted.'], ['In', 'addition,', 'the', 'rest', 'of', 'the', 'examination', 'is', 'strictly', 'normal.'], ['With', 'all', 'this', 'I', 'believe', 'that', 'the', 'correct', 'answer', 'is', '5,', 'that', 'is', 'a', 'syringomyelic', 'lesion,', 'whose', 'initial', 'characteristic', 'is', 'the', 'sensitive', 'dissociation', 'with', 'anesthesia', 'for', 'the', 'thermoalgesic', 'and', 'conservation', 'of', 'the', 'posterior', 'cord.'], ['MS', 'and', 'other', 'spinal', 'cord', 'lesions', 'would', 'be', 'accompanied', 'by', 'other', 'exploratory', 'signs', 'such', 'as', 'exaltation', 'of', 'reflexes,', 'for', 'carpal', 'tunnel', 'the', 'exploration', 'exceeds', 'the', 'territory', 'distal', 'to', 'the', 'carpus,', 'and', 'as', 'for', 'answer', '1,', 'although', 'there', 'are', 'forms', 'of', 'peripheral', 'polyneuropathy', '""pseudosyringomyelic""', 'they', 'are', 'usually', 'of', 'lumbar', 'onset.'], ['The', 'short', 'evolution', 'time', '(2', 'weeks),', 'the', 'respect', 'of', 'the', 'lower', 'limbs', 'and', 'the', 'preservation', 'of', 'muscle', 'reflexes', 'make', 'me', 'rule', 'out', 'this', 'response', 'despite', 'the', 'distribution', 'being', '""glove-like"".']]","[['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'], ['B-Premise', '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'], ['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'], ['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'], ['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'], ['O', 'B-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'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['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'], 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'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'], ['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']]"
316138,"[['QUESTION', 'TYPE:', 'RHEUMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '37-year-old', 'man', 'presents', 'with', 'arthritis', 'of', 'the', 'metacarpophalangeal', 'joints', 'of', 'both', 'hands', 'and', 'right', 'pleuritis.'], ['Bilateral', 'malar', 'erythema', 'is', 'seen', 'on', 'examination.'], ['Positive', 'antinuclear', 'antibodies', 'were', 'detected', '(titer', '1/640),', 'with', 'anti', 'native', 'DNA', 'antibodies', 'also', 'positive;', 'anti-Sm', 'negative', 'What', 'would', 'be', 'the', 'initial', 'treatment', 'of', 'choice', 'for', 'this', 'patient?'], ['1-', 'Glucocorticoids', 'at', 'high', 'doses.'], ['2-', 'Glucocorticoids', 'and', 'mycophenolate.'], ['3-', 'Nonsteroidal', 'anti-inflammatory', 'drugs', 'and', 'antimalarials.'], ['4-', 'The', 'picture', 'will', 'probably', 'be', 'self-limited', 'and', 'does', 'not', 'require', 'treatment.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '1'], ['It', 'is', 'SLE', 'with', 'joint,', 'skin', 'and', 'serositis', 'involvement.'], ['Treatment', 'is', 'EC', 'at', 'moderate-high', 'doses.'], ['Mycophenolate', 'is', 'never', 'a', 'treatment', 'in', 'acute', 'phase', 'but', 'in', 'maintenance,', 'nor', 'has', 'it', 'proved', 'useful', 'in', 'joint', 'involvement.']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['O', 'B-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', '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'], ['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']]"
15374,"[['QUESTION', 'TYPE:', 'RHEUMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '75-year-old', 'woman', 'consults', 'for', 'violaceous', 'lesions', 'on', 'the', 'hands', 'and', 'neck', 'together', 'with', 'progressive', 'muscle', 'weakness', 'of', '3', 'months', 'of', 'evolution.'], ['What', 'diagnostic', 'tests,', 'among', 'those', 'indicated,', 'can', 'be', 'useful', 'for', 'the', 'diagnosis?'], ['1-', 'Determination', 'of', 'serum', 'aldolase.'], ['2-', 'Electroencephalogram.'], ['3-', 'Biopsy', 'of', 'subcutaneous', 'cellular', 'tissue.'], ['4-', 'Determination', 'of', 'anti-smooth', 'muscle', 'antibodies.'], ['5-', 'Genetic', 'study', 'of', 'their', 'descendants.'], ['CORRECT', 'ANSWER:', '1'], ['Given', 'this', 'clinical', 'picture,', 'one', 'possibility', 'is', 'dermatomyositis.'], ['Of', 'the', 'proposed', 'tests,', 'the', 'determination', 'of', 'serum', 'aldolase', 'may', 'be', 'useful.'], ['Its', 'elevation', 'is', 'characteristic', 'of', 'this', 'disease.'], ['The', 'biopsy', 'should', 'be', 'muscular', 'and', 'not', 'subcutaneous.'], ['Anti-smooth', 'muscle', 'antibodies', 'are', 'not', 'characteristic', 'of', 'this', 'disease.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'B-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'], ['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'], ['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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
369122,,
41368,"[['QUESTION', 'TYPE:', 'CARDIOLOGY', 'AND', 'CARDIOVASCULAR', 'SURGERY'], ['CLINICAL', 'CASE:'], ['An', '87-year-old', 'woman', 'with', 'a', 'history', 'of', 'hypertension', 'was', 'admitted', '48', 'hours', 'ago', 'to', 'the', 'coronary', 'unit', 'for', 'acute', 'myocardial', 'infarction', 'with', 'ST-segment', 'elevation', 'of', 'anterior', 'location.'], ['She', 'reported', 'dyspnea.'], ['Examination', 'revealed', 'a', 'systolic', 'murmur', 'with', 'fremitus,', 'radiating', 'to', 'the', 'right', 'sternal', 'border,', 'which', 'was', 'not', 'present', 'on', 'admission.'], ['What', 'complication', 'do', 'you', 'suspect?'], ['1-', 'Heart', 'failure', 'due', 'to', 'extensive', 'necrosis.'], ['2-', 'Anterior', 'aneurysm.'], ['3-', 'Left', 'ventricular', 'free', 'wall', 'rupture.'], ['4-', 'Rupture', 'in', 'the', 'interventricular', 'septum.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '4'], ['Rupture', 'of', 'the', 'interventricular', 'septum.'], ['Mechanical', 'complications', 'are', 'typical', 'in', 'infarctions', 'in', 'elderly', 'women.'], ['Likewise,', 'a', 'murmur', 'that', 'was', 'not', 'present', 'indicates', 'abnormal', 'blood', 'flow:', 'the', 'most', 'frequent', 'complications', 'are', 'mitral', 'insufficiency,', 'which', 'would', 'present', 'with', 'a', 'musical', 'or', 'piante', 'murmur,', 'and', 'VSD,', 'which', 'presents', 'with', 'a', 'murmur', 'radiating', 'to', 'the', 'right', 'border', '(think', 'of', 'the', 'direction', 'of', 'blood', 'flow).']]","[['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'], ['B-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', 'B-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'], ['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'], ['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', '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']]"
314178,"[['QUESTION', 'TYPE:', 'ONCOLOGY'], ['CLINICAL', 'CASE:'], ['A', '66-year-old', 'patient', 'diagnosed', 'with', 'stage', 'IV', 'pancreatic', 'adenocarcinoma', '8', 'months', 'ago.'], ['He', 'follows', 'treatment', 'with', 'delayed', 'release', 'morphine', '200', 'mg/12', 'hours', 'orally,', 'kerosene', 'and', 'lactulose.'], ['For', 'the', 'last', '15', 'days', 'he', 'has', 'reported', 'paresthesias', 'and', 'occasional', 'lancinating', 'pain', 'in', 'the', 'right', 'lumbar', 'and', 'periumbilical', 'area', 'that', 'does', 'not', 'subside', 'with', 'rescue', 'morphine.'], ['The', 'neurological', 'examination', 'is', 'normal.'], ['Indicate', 'the', 'most', 'appropriate', 'management:'], ['1-', 'Perform', 'computed', 'axial', 'tomography', 'and', 'evaluate', 'nerve', 'compression', 'since', 'it', 'is', 'neuropathic', 'pain.'], ['2-', 'Evaluate', 'neurolytic', 'treatment', 'since', 'neuropathic', 'pain', 'is', 'difficult', 'to', 'control.'], ['3-', 'Decrease', 'the', 'dose', 'of', 'morphine', 'as', 'it', 'is', 'ineffective', 'in', 'this', 'type', 'of', 'pain.'], ['4-', 'Administer', 'amitriptyline', 'or', 'gabapentin,', 'dexamethasone', 'and', 'increase', 'the', 'dose', 'of', 'morphine.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '4'], ['We', 'have', 'before', 'us', 'a', 'patient', 'with', 'neuropathic', 'pain,', 'which', 'due', 'to', 'the', 'origin', 'of', 'the', 'tumor,', 'is', 'most', 'likely', 'due', 'to', 'involvement', 'of', 'the', 'celiac', 'plexus.'], ['It', 'is', 'important', 'to', 'have', 'a', 'radiological', 'diagnosis', 'in', 'view', 'of', 'a', 'possible', 'local', 'treatment,', 'such', 'as', 'neurolytic', 'treatment', 'or', 'plexus', 'blockade.'], ['However,', 'we', 'should', 'not', 'leave', 'the', 'patient', 'without', 'a', 'treatment', 'that', 'can', 'alleviate', 'but', 'rather', 'solve', 'the', 'current', 'situation.'], ['He', 'is', 'taking', 'WHO', 'step', '3', 'analgesia,', 'which', 'is', 'clearly', 'insufficient,', 'so', 'he', 'will', 'need', 'adjuvants;', 'although', 'opioids', 'for', 'neuropathic', 'pain', 'are', 'not', 'very', 'effective,', 'we', 'will', 'not', 'reduce', 'the', 'dose', 'but', 'will', 'associate', 'the', 'adjuvants.'], ['We', 'would', 'manage', 'the', 'patient', 'with', 'gabapentin', 'and', 'corticosteroids', '(true', 'answer', '4);', 'we', 'would', 'not', 'decrease', 'the', 'dose', 'of', 'morphine', '(false', 'answer', '3),', 'and', 'in', 'the', 'meantime', 'we', 'would', 'ask', 'for', 'a', 'CT', 'scan', '(or', 'abdominal', 'MRI)', 'to', 'subsequently', 'assess', 'the', 'plexus', 'block', '(answers', '1', 'and', '2', 'for', 'future', 'management).']]","[['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', 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26337,"[['QUESTION', 'TYPE:', 'PNEUMOLOGY'], ['CLINICAL', 'CASE:'], ['Juan', 'is', '60', 'years', 'old,', 'has', 'been', 'smoking', '2', 'packs/day', 'for', 'years', 'and', 'has', 'reported', 'a', 'persistent', 'cough', 'for', 'the', 'last', '6', 'months.'], ['He', 'notes', 'that', 'his', 'left', 'eyelid', 'is', 'more', 'droopy', 'and', 'that', 'the', 'pupil', 'of', 'this', 'eye', 'is', 'smaller.'], ['John', 'reports', 'that', 'the', 'medial', 'side', 'of', 'his', 'left', 'hand', 'is', 'numb', 'and', 'with', 'less', 'strength.'], ['His', 'physician', 'checks', 'for', 'palpebral', 'ptosis', 'and', 'left', 'miosis;', 'he', 'checks', 'that', 'he', 'can', 'close', 'both', 'eyelids', 'symmetrically', 'and', 'that', 'both', 'pupils', 'respond', 'correctly', 'to', 'light.'], ['In', 'addition,', 'he', 'checks', 'that', 'there', 'is', 'no', 'sweating', 'from', 'the', 'left', 'hemiface,', 'that', 'he', 'feels', 'less', 'prickling', 'on', 'the', 'inner', 'surface', 'of', 'the', 'left', 'hand', 'and', 'that', 'he', 'has', 'less', 'strength', 'in', 'the', 'grip', 'of', 'the', 'left', 'hand.'], ['Regarding', 'the', 'ocular', 'symptomatology,', 'where', 'is', 'the', 'lesion', 'located?'], ['1-', 'Sympathetic', 'fibers,', 'at', 'some', 'level', 'that', 'would', 'span', 'from', 'the', 'hypothalamus', 'to', 'the', 'interinedio-lateral', ""Clark's"", 'column', 'of', 'the', 'dorsal', 'medulla.'], ['2-', 'Left', 'common', 'ocular', 'motor', 'nerve', 'in', 'the', 'midbrain.'], ['3-', 'Edinger-Westphal', 'nucleus', 'above', 'the', 'left', 'common', 'ocular', 'motor', 'nerve', 'nucleus.'], ['4-', 'Parasympathetic', 'fibers,', 'at', 'some', 'level', 'ranging', 'from', 'the', 'Edinger-Westphal', 'nucleus', 'to', 'the', 'constrictor', 'muscle', 'of', 'the', 'left', 'pupil.'], ['5-', 'Tarsal', 'muscle', 'exclusively.'], ['CORRECT', 'ANSWER:', '1'], ['The', 'question', 'would', 'be', 'more', 'of', 'neurology.'], ['It', 'is', 'a', 'claude', 'bernard', 'horner', 'syndrome', 'and', 'probably', 'the', 'correct', 'one', 'is', '1.'], ['But', 'for', ""safety's"", 'sake', 'it', 'is', 'better', 'to', 'have', 'it', 'checked', 'by', 'a', 'neurologist.']]","[['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', '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', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['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'], ['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'], ['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'], ['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'], ['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']]"
344158,"[['QUESTION', 'TYPE:', 'GYNECOLOGY', 'AND', 'OBSTETRICS'], ['CLINICAL', 'CASE:'], ['A', '24-year-old', 'woman,', 'primigestation,', 'suffers', 'a', 'spontaneous', 'abortion', 'at', '7', 'weeks', 'gestation.'], ['The', 'anatomopathological', 'study', 'of', 'the', 'abortive', 'remains', 'indicates', 'molar', 'disease.'], ['We', 'should', 'inform', 'you', 'that:'], ['1-', 'The', 'risk', 'of', 'a', 'new', 'molar', 'gestation', 'in', 'a', 'future', 'pregnancy', 'is', '50%.'], ['2-', 'She', 'should', 'not', 'become', 'pregnant', 'until', 'periodic', 'check-ups', 'and', 'after', 'one', 'year', 'with', 'negative', 'BHCG', 'levels.'], ['3-', 'Subsequent', 'controls', 'are', 'not', 'necessary', 'if', 'the', 'evacuation', 'of', 'the', 'trophoblastic', 'tissue', 'was', 'complete.'], ['4-', 'Periodic', 'check-ups', 'are', 'necessary', 'since', '40%', 'of', 'cases', 'will', 'develop', 'gestational', 'trophoblastic', 'neoplasia.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '2'], ['She', 'should', 'not', 'become', 'pregnant', 'until', 'she', 'has', 'undergone', 'regular', 'check-ups', 'and', 'one', 'year', 'has', 'passed', 'with', 'negative', 'beta-HCG', 'levels.'], ['Patients', 'will', 'be', 'monitored', 'weekly', 'with', 'hCG', 'dosing', 'until', 'it', 'becomes', 'undetectable,', 'for', 'three', 'consecutive', 'times.'], ['After', 'that', 'the', 'monitoring', 'will', 'be', 'monthly', 'for', 'six', 'months', 'and', 'then', 'every', 'two', 'months', 'for', 'another', 'six', 'months', 'before', 'a', 'new', 'pregnancy.']]","[['O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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', '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'], ['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', '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']]"
43151,"[['QUESTION', 'TYPE:', 'PEDIATRICS'], ['CLINICAL', 'CASE:'], ['A', '10-year-old', 'girl', 'comes', 'for', 'a', 'health', 'check-up.'], ['Physical', 'examination', 'is', 'normal', 'with', 'weight', 'and', 'height', 'in', 'the', '50th', 'percentile', 'and', 'BP', '109/65.'], ['A', 'routine', 'urinalysis', 'shows', 'a', 'specific', 'gravity', 'of', '1035', 'pH6', 'blood', '2+', 'with', 'no', 'protein.'], ['Urine', 'sediment', 'shows', '5-10', 'red', 'blood', 'cells', 'per', 'field.'], ['What', 'would', 'be', 'the', 'most', 'appropriate', 'course', 'of', 'action?'], ['1-', 'Determination', 'of', 'creatinine', 'and', 'nitrogen', 'in', 'blood.'], ['2-', 'Refer', 'the', 'child', 'for', 'cystoscopy.'], ['3-', 'Determine', 'antinuclear', 'antibodies', 'and', 'complement.'], ['4-', 'Repeat', 'urine', 'sediment', 'in', '15', 'days.'], ['5-', 'Abdominal', 'computed', 'axial', 'tomography.'], ['CORRECT', 'ANSWER:', '4'], ['The', 'correct', 'answer', 'is', '4.'], ['What', 'is', 'not', 'very', 'clear', 'to', 'me', 'is', '""routine', 'urinalysis""', 'because', 'it', 'is', 'not', 'usually', 'done', 'in', 'an', 'asymptomatic', 'healthy', 'child.'], ['Microhematuria', 'without', 'associated', 'symptoms', 'may', 'be', 'a', 'finding', 'without', 'pathologic', 'significance', 'and', 'must', 'be', 'confirmed', 'in', 'a', 'subsequent', 'new', 'sediment', '(although', 'I', 'do', 'not', 'know', 'if', 'at', '15', 'days', 'or', 'later).']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['O', 'O', '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'], ['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'], ['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', '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']]"
616119,"[['QUESTION', 'TYPE:', 'TRAUMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '13-year-old', 'female,', 'with', 'no', 'relevant', 'history,', 'with', 'menarche', '3', 'months', 'ago,', 'followed', 'since', 'the', 'age', 'of', '10', 'years', 'by', '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', 'thoracolumbar', 'curve', 'T4-L1', 'of', '35', 'degrees', 'of', 'Cobb', 'and', 'a', 'Risser', '0.'], ['The', 'correct', 'attitude', 'to', 'take', 'will', 'be:'], ['1-', 'Recommend', 'swimming', 'and', 'revision', 'in', 'three', 'months.'], ['2-', 'Prescribe', 'a', 'corset-type', 'orthosis.'], ['3-', 'Refer', 'to', 'physiotherapy', 'for', 'spine', 'elastification.'], ['4-', 'Review', 'in', '6', 'months', 'with', 'a', 'new', 'X-ray.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '2'], ['Orthosis.'], ['Cobb', 'angle', 'between', '25º', '-', '45º.'], ['Immature', 'skeleton', '(Risser', '0).']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['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-Claim'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'B-Premise', 'I-Premise']]"
489105,"[['QUESTION', 'TYPE:', 'HEMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '67-year-old', 'patient', 'who', 'in', 'the', 'last', '6', 'months,', 'in', 'two', 'routine', 'analyses,', 'presents', 'progressive', 'lymphocytosis.'], ['In', 'the', 'last', 'one,', 'hemoglobin', '15.4', 'g/dL;', 'leukocytes', '18.5', 'x103/μL', 'with', '82', '%', 'of', 'mature', 'lymphocytes', 'that', 'by', 'flow', 'cytometry', 'express', 'CD5/CD19/CD23', 'antigens', 'and', 'platelets', '240', 'x103/μL.'], ['What', 'do', 'you', 'think', 'is', 'the', 'correct', 'approach?'], ['1-', 'Study', 'of', 'TP53', 'mutations', 'to', 'establish', 'prognosis.'], ['2-', 'Bone', 'aspirate/biopsy', 'to', 'confirm', 'diagnosis.'], ['3-', 'PET/CT', 'to', 'establish', 'the', 'therapeutic', 'attitude.'], ['4-', 'New', 'clinical', 'and', 'analytical', 'control', 'in', '6', 'months.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '4'], ['The', 'patient', 'is', 'already', 'diagnosed', 'with', 'chronic', 'lymphocytic', 'leukemia', 'B', '(B-CLLL),', 'presents', 'lymphocytosis', 'that', 'is', 'maintained', 'for', 'more', 'than', '3', 'months', 'and', 'by', 'flow', 'cytometry', 'presents', 'a', 'phenotype', 'compatible', 'with', 'it.'], ['Therefore,', 'we', 'must', 'first', 'know', 'the', 'risk', 'factors', 'that', 'will', 'indicate', 'with', 'what', 'priority', 'treatment', 'will', 'need', 'to', 'be', 'initiated,', 'their', 'intensity', 'and', 'prognosis;', 'the', 'presence', 'of', 'TP53', 'mutations', 'or', '17p', 'deletions', 'depends', 'on', 'this.'], ['The', 'bone', 'marrow', 'aspirate', 'or', 'biopsy', 'is', 'only', 'indicated', 'if', 'there', 'are', 'other', 'accompanying', 'cytopenias', 'that', 'are', 'not', 'justified', 'by', 'the', 'B-CLL', 'itself,', 'PET-CT', 'is', 'only', 'indicated', 'if', ""Ritcher's"", 'syndrome', 'is', 'suspected', 'and', 'we', 'do', 'not', 'have', 'enough', 'data', 'to', 'suspect', 'it,', 'there', 'are', 'no', 'B', 'symptoms,', 'nor', 'is', 'there', 'any', 'mention', 'of', 'LDH', 'elevation.']]","[['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'], ['O', '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'], ['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', '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', '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', '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-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise']]"
534119,"[['QUESTION', 'TYPE:', 'RHEUMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '45-year-old', 'female', 'patient', 'with', 'a', 'history', 'of', 'gastroesophageal', 'reflux', 'has', 'been', 'presenting', 'for', 'the', 'past', 'year', 'with', 'episodes', 'of', 'pallor', 'in', 'some', 'fingers', 'with', 'exposure', 'to', 'cold.'], ['She', 'had', 'recently', 'been', 'prescribed', 'prednisone', 'at', 'a', 'dose', 'of', '20', 'mg/day', 'for', 'joint', 'pain', 'and', 'skin', 'induration', 'in', 'the', 'hands', 'and', 'arms.'], ['For', 'the', 'last', '48', 'hours,', 'she', 'presented', 'with', 'general', 'malaise', 'and', 'intense', 'headache,', 'for', 'which', 'she', 'went', 'to', 'the', 'emergency', 'department.'], ['Examination', 'revealed', 'only', 'a', 'rhythmic', 'tachycardia', 'at', '100', 'bpm,', 'with', 'no', 'neurological', 'focality.'], ['Blood', 'pressure', 'was', '200/110', 'mmHg.'], ['The', 'blood', 'test', 'shows', 'only', 'a', 'creatinine', 'level', 'of', '2.5', 'mg/dL.'], ['Indicate', 'which', 'of', 'the', 'following', 'autoantibodies', 'is', 'best', 'related', 'to', 'the', 'process', 'described:'], ['1-', 'Anti-RNA', 'polymerase', 'III', 'antibodies.'], ['2-', 'Anti-centromere', 'antibodies.'], ['3-', 'Anti-proteinase', '3', 'antibodies.'], ['4-', 'Anti-PM-Scl', 'antibodies.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '1'], ['This', 'is', 'a', 'clear', 'clinical', 'case', 'of', 'systemic', 'sclerosis', ""(Raynaud's,"", 'esophageal', 'involvement,', 'skin', 'induration)', 'presenting', 'with', 'renal', 'crisis.'], ['Apart', 'from', 'anti-proteinase', '3', 'antibodies,', 'which', 'are', 'not', 'related', 'to', 'scleroderma', '(incorrect', 'answer', '3),', 'the', 'most', 'likely', 'ones', 'would', 'be', 'antiRNA', 'polymerase', 'III', 'antibodies,', 'which', 'appear', 'in', 'younger', 'patients', 'with', 'renal', 'crises.']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['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', 'B-Marker', 'I-Marker', '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', '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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
27371,"[['QUESTION', 'TYPE:', 'DIGESTIVE', 'SYSTEM'], ['CLINICAL', 'CASE:'], ['18-year-old', 'young', 'man', 'with', 'a', 'history', 'of', 'asthma,', 'allergy', 'to', 'pollens,', 'mites', 'and', 'cat', 'hair,', 'comes', 'to', 'the', 'emergency', 'room', 'referring', 'sensation', 'of', 'food', 'detention', 'at', 'retrosternal', 'level', 'with', 'practical', 'inability', 'to', 'swallow', 'his', 'own', 'saliva.'], ['He', 'refers', 'similar', 'episodes', 'on', 'other', 'occasions', 'that', 'have', 'subsided', 'spontaneously', 'within', 'a', 'few', 'minutes.'], ['Which', 'of', 'the', 'following', 'is', 'the', 'most', 'likely', 'diagnosis?'], ['1-', ""Barrett's"", 'esophagus.'], ['2-', 'Distal', 'esophageal', 'ring', '(Schatzki).'], ['3-', 'Infectious', 'esophagitis.'], ['4-', 'Eosinophilic', 'esophagitis.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '4'], ['This', 'is', 'intermittent', 'dysphagia.'], [""Barrett's"", 'esophagus', 'does', 'not', 'necessarily', 'imply', 'peptic', 'stricture,', 'but', 'assuming', 'it', 'does,', 'it', 'is', 'progressive.'], ['Infectious', 'esophagitis', 'is', 'more', 'typical', 'of', 'immunocompromised', 'patients.'], ['That', 'leaves', 'distal', 'esophageal', 'ring', 'and', 'eosinophilic', 'esophagitis;', 'both', 'are', 'possible,', 'but', 'the', 'insistence', 'on', 'the', ""patient's"", 'atopic', 'burden', 'indicates', 'the', 'likelihood', 'of', 'the', 'latter.']]","[['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', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-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'], ['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'], ['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']]"
5676,"[['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['14-year-old', 'girl', 'who', 'consults', 'for', 'decreased', 'growth', 'for', '2-3', 'years', 'previously', 'normal', '(provides', 'data)', 'and', 'that', 'other', 'girls', 'her', 'age', 'have', 'greater', 'physical', 'and', 'sexual', 'development.'], ['Lately', 'she', 'has', 'had', 'headaches', 'and', 'visual', 'problems', 'that', 'she', 'notices', 'in', 'class', 'and', 'when', 'studying.'], ['She', 'has', 'not', 'had', 'menarche', 'or', 'polydipsia', 'or', 'polyuria.'], ['Parents', 'with', 'normal', 'height.'], ['Examination:', 'short', 'stature', 'at', '-2.1', 'standard', 'deviations,', 'normal', 'body', 'proportions,', 'little', 'pubic', 'hair', 'and', 'breast', 'development.'], ['Campimetry', 'shows', 'left', 'temporal', 'partial', 'hemianopsia.'], ['Bone', 'age:', 'delay', 'of', '2', 'years.'], ['General', 'laboratory', 'tests', 'were', 'normal.'], ['Gonadotrophins', '(FSH', 'and', 'LH)', 'and', 'estradiol', 'are', 'low.'], ['What', 'do', 'you', 'think', 'is', 'the', 'most', 'appropriate', 'response?'], ['1-', 'Decreased', 'growth', 'and', 'sexual', 'development,', 'delayed', 'bone', 'age,', 'headache', 'and', 'visual', 'alteration', 'suggest', 'hormonal', 'deficit', 'and', 'involvement', 'of', 'the', 'optic', 'chiasm.'], ['2-', 'As', 'she', 'is', 'a', 'girl', 'of', 'pubertal', 'age,', 'it', 'is', 'most', 'likely', 'that', 'her', 'decreased', 'growth', 'and', 'sexual', 'retardation', 'are', 'due', 'to', 'Turner', 'syndrome.'], ['3-', 'She', 'must', 'not', 'have', 'a', 'hypothalamic', 'tumor', 'because', 'of', 'the', 'absence', 'of', 'polyuria', 'and', 'polydipsia.', 'She', 'probably', 'has', 'constitutional', 'delay', 'and', 'her', 'visual', 'problem', 'is', 'refractive.'], ['4-', 'A', 'growth', 'hormone', 'deficiency', 'may', 'explain', 'the', 'developmental', 'delay', 'and', 'low', 'estradiol.', 'To', 'evaluate', 'if', 'she', 'needs', 'glasses,', 'due', 'to', 'her', 'headaches', 'and', 'visual', 'disturbances.'], ['5-', 'She', 'could', 'have', 'a', 'craniopharyngioma,', 'but', 'it', 'would', 'be', 'rare', 'if', 'she', 'had', 'not', 'shown', 'symptoms', 'before.', 'Also,', 'it', 'would', 'not', 'justify', 'low', 'gonadotrophins', 'and', 'estradiol.'], ['CORRECT', 'ANSWER:', '1'], ['Answer', '2', 'is', 'false', '(Turner', 'syndrome:', 'low', 'estradiol', 'and', 'elevated', 'gonadotrophins),', 'brain', 'tumors', 'affecting', 'the', 'hypothalamus-pituitary', 'gland', 'do', 'not', 'give', 'low', 'gonadotrophins', '(5', 'false),', 'and', 'it', 'seems', 'obvious', 'that', 'refractive', 'defects', 'do', 'not', 'give', 'hemianopsia', '(3', 'and', '4', 'false).']]","[['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', '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'], ['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['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'], ['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'], ['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', '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', 'O', 'O'], ['B-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', 'B-Claim', 'I-Claim', 'O', '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']]"
409191,"[['QUESTION', 'TYPE:', 'PRIMARY', 'CARE'], ['CLINICAL', 'CASE:'], ['The', 'patient', 'comes', 'to', 'the', 'home', 'of', 'an', 'oncology', 'patient', 'whose', 'pain', 'has', 'not', 'been', 'well', 'controlled', 'lately.'], ['On', 'physical', 'examination', 'there', 'appears', 'to', 'be', 'no', 'evidence', 'of', 'tumor', 'progression,', 'and', 'no', 'previously', 'known', 'data', 'of', 'interest', 'is', 'revealed.'], ['In', 'the', 'anamnesis,', 'the', 'main', 'caregiver', 'states', 'that', 'the', 'patient', 'has', 'pain', '8', 'hours', 'after', 'receiving', 'the', 'prescribed', 'basal', 'dose', 'of', 'morphine', 'every', '12', 'hours.'], ['This', 'clinical', 'situation', 'is', 'referred', 'to', 'as:'], ['1-', 'Tolerance'], ['2-', 'Hyperalgesia'], ['3-', 'Dependency'], ['4-', 'Ineffectiveness'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '1'], ['The', 'correct', 'answer', 'is', '1.'], ['The', 'statement', 'perfectly', 'defines', 'a', 'tolerance', 'phenomenon', 'in', 'which', 'the', 'patient', 'has', 'become', '""used', 'to""', 'the', 'dose', 'and', 'needs', 'more', 'in', 'order', 'to', 'have', 'the', 'same', 'analgesic', 'effect.']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['O', 'B-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim'], ['O', 'O'], ['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']]"
17998,"[['QUESTION', 'TYPE:', 'HEMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '33-year-old', 'woman', 'consults', 'for', 'repeated', 'epistaxis,', 'petechiae', 'and', 'ecchymosis.'], ['Laboratory', 'tests', 'show', 'thrombocytopenia', 'with', 'a', 'platelet', 'count', 'of', '4000', 'platelets/microliter.'], ['The', 'initial', 'presumptive', 'diagnosis', 'is', 'chronic', 'immune', 'thrombocytopenic', 'purpura', '(ITP).'], ['Which', 'of', 'the', 'following', 'statements', 'is', 'FALSE', 'regarding', 'the', 'diagnosis', 'of', 'ITP?'], ['1-', 'The', 'presence', 'of', 'lymphadenopathy', 'or', 'splenomegaly', 'in', 'the', 'physical', 'examination', 'suggests', 'a', 'different', 'diagnosis', 'of', 'ITP.'], ['2-', 'Bone', 'marrow', 'analysis', 'shows', 'a', 'decreased', 'number', 'of', 'megakaryocytes', 'without', 'other', 'alterations.'], ['3-', 'Complete', 'blood', 'count', 'shows', 'isolated', 'thrombocytopenia', 'with', 'often', 'large', 'platelets,', 'without', 'anemia', 'unless', 'there', 'is', 'significant', 'bleeding', 'or', 'associated', 'autoimmune', 'hemolysis', '(Evans', 'syndrome).'], ['4-', 'The', 'diagnosis', 'of', 'ITP', 'is', 'established', 'by', 'exclusion', 'of', 'other', 'processes', 'causing', 'thrombocytopenia.'], ['5-', 'The', 'determination', 'of', 'antiplatelet', 'antibodies', 'is', 'not', 'accurate', 'to', 'establish', 'the', 'diagnosis.'], ['CORRECT', 'ANSWER:', '2'], ['In', 'the', 'presence', 'of', 'isolated', 'thrombocytopenia', 'we', 'must', 'not', 'lose', 'sight', 'of', 'the', 'physical', 'examination;', 'thus,', 'the', 'presence', 'of', 'lymphadenopathy', 'forces', 'us', 'to', 'rule', 'out', 'the', 'presence', 'of', 'lymphoma,', 'for', 'example.'], ['1', 'is', 'correct.'], ['When', 'performing', 'a', 'bone', 'marrow', 'biopsy-aspirate', 'it', 'is', 'seen', 'that', 'the', 'number', 'of', 'megakaryocytes', 'is', 'normal', 'or', 'even', 'increased,', 'the', 'failure', 'is', 'not', 'in', 'the', 'marrow', 'but', 'in', 'the', 'peripheral', 'blood,', 'where', 'platelets', 'are', 'destroyed.'], ['So.'], ['The', 'false', 'answer', 'is', '2.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-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'], ['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'], ['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', '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'], ['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'], ['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-Marker'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
353161,"[['QUESTION', 'TYPE:', 'GYNECOLOGY', 'AND', 'OBSTETRICS'], ['CLINICAL', 'CASE:'], ['A', '27-year-old', 'woman', 'referred', 'to', 'the', 'gynecology', 'office', 'for', 'evaluation', 'referring', 'dyspareunia', 'for', 'about', '8', 'months,', 'along', 'with', 'dyschezia', 'and', 'occasional', 'rectorrhagia', 'coinciding', 'with', 'menstruation', 'for', '3-4', 'months.'], ['She', 'also', 'reports', 'dysmenorrhea', 'for', 'years,', 'which', 'she', 'controls', 'well', 'with', 'ibuprofen.'], ['She', 'has', 'been', 'trying', 'to', 'get', 'pregnant', 'for', '16', 'months', 'without', 'success.'], ['In', 'the', 'gynecological', 'examination', 'she', 'only', 'has', 'pain', 'when', 'pressing', 'on', 'the', 'posterior', 'vaginal', 'fornix.'], ['Which', 'test', 'do', 'you', 'consider', 'would', 'allow', 'you', 'to', 'reach', 'a', 'diagnosis', 'of', 'certainty', 'of', 'her', 'pathology?'], ['1-', 'Transvaginal', 'ultrasound.'], ['2-', 'Diagnostic', 'laparoscopy.'], ['3-', 'Magnetic', 'resonance', 'imaging.'], ['4-', 'Colonoscopy.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '2'], ['Diagnostic', 'laparoscopy.'], ['It', 'is', 'a', 'typical', 'case', 'of', 'deep', 'endometriosis,', 'with', 'implants', 'in', 'different', 'parts', 'of', 'the', 'pelvis.'], ['The', 'definitive', 'diagnosis', 'will', 'be', 'given', 'by', 'the', 'pathological', 'anatomy,', 'so', 'for', 'this', 'we', 'have', 'to', 'do', 'Laparoscopy', 'and', 'send', 'to', 'PA.']]","[['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'], ['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'], ['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'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim'], ['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'], ['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']]"
438119,"[['QUESTION', 'TYPE:', 'EPIDEMIOLOGY', 'AND', 'PREVENTIVE', 'MEDICINE'], ['CLINICAL', 'CASE:'], ['A', '38-year-old', 'woman', 'of', 'veterinary', 'profession,', 'in', 'charge', 'of', 'monitoring', 'wild', 'animals', 'and', 'assisting', 'in', 'the', 'delivery', 'of', 'domestic', 'livestock.'], ['She', 'starts', 'with', 'a', 'high', 'fever', 'with', 'chills,', 'headache,', 'myalgia', 'and', 'non-productive', 'cough', 'that', 'she', 'interprets', 'as', 'a', 'flu-like', 'process.'], ['She', 'presented', 'with', 'chest', 'pain.'], ['Chest', 'X-ray', 'showed', 'bilateral', 'pulmonary', 'infiltrates', 'in', 'lower', 'fields.'], ['A', 'serologic', 'test', 'was', 'performed', 'with', 'elevated', 'titers', 'of', 'antibodies', 'against', 'phase', 'II', 'antigens.'], ['Which', 'of', 'the', 'following', 'statements', 'is', 'TRUE?'], ['1-', 'This', 'entity', 'is', 'transmitted', 'by', 'ticks.'], ['2-', 'Both', 'doxycycline', 'and', 'hydroxychloroquine', 'are', 'effective', 'in', 'treating', 'acute', 'forms', 'of', 'this', 'disease.'], ['3-', 'In', 'the', 'acute', 'form,', 'the', 'patient', 'also', 'generally', 'has', 'elevated', 'antibodies', 'to', 'phase', 'I', 'antigens.'], ['4-', 'Mortality', 'in', 'acute', 'forms', 'is', 'almost', 'nonexistent.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '4'], ['As', 'a', 'possible', 'disease', 'I', 'would', 'consider', 'Brucellosis,', 'typical', 'of', 'cattle', '(milk,', 'abortion,', 'genital', 'secretions...).'], ['It', 'presents', 'with', 'a', 'pseudo-flu-like', 'symptomatology', '(headache,', 'arthralgias,', 'myalgias,', 'fever...)', 'and', 'other', 'symptoms', 'depending', 'on', 'the', 'route', 'of', 'entry.'], ['In', 'our', 'case,', 'when', 'attending', 'animal', 'births,', 'the', 'entry', 'is', 'through', 'the', 'respiratory', 'route,', 'so', 'the', 'pulmonary', 'infiltrates', 'and', 'chest', 'pain', 'are', 'due', 'to', 'the', 'bacteria.'], ['The', 'treatment', 'varies', 'according', 'to', 'the', 'affectation', 'and', 'mortality', 'is', 'very', 'low,', 'almost', 'null.'], ['Morbidity', 'and', 'involvement', 'in', 'pregnant', 'women', 'are', 'of', 'greater', 'concern.'], ['Important:', 'it', 'is', 'very', 'frequent', 'in', 'livestock', 'workers', '(veterinarians,', 'farmers,', 'slaughterhouses...)', 'if', 'you', 'read', 'something', 'like', '""attends', 'births', 'of', 'livestock', 'animals"",', '""works', 'on', 'a', 'farm"",', '""is', 'a', 'veterinarian""', 'suspect', 'Brucellosis.']]","[['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['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'], ['O', 'O', 'O', 'O', 'O', 'O', 'O'], ['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', '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'], ['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', '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-Marker', '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'], ['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', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O']]"
579108,"[['QUESTION', 'TYPE:', 'NEUROLOGY'], ['CLINICAL', 'CASE:'], ['A', '49-year-old', 'man', 'is', 'admitted', 'to', 'the', 'ICU', 'for', 'traumatic', 'brain', 'injury', 'after', 'an', 'accident', 'at', 'work.'], ['In', 'the', 'physical', 'examination', 'he', 'does', 'not', 'open', 'his', 'eyes,', 'does', 'not', 'emit', 'sounds', 'before', 'being', 'intubated', 'and', 'presents', 'extension', 'of', 'extremities', 'to', 'nociceptive', 'stimulus.'], ['An', 'intracranial', 'pressure', 'sensor', 'is', 'placed', 'and', 'a', 'decompressive', 'craniotomy', 'must', 'be', 'performed', 'due', 'to', 'intraparenchymal', 'hemorrhage.'], ['Which', 'of', 'the', 'following', 'statements', 'is', 'correct?'], ['1-', 'On', 'arrival', 'she', 'is', 'in', 'a', 'Glasgow', 'scale', 'coma', 'of', '7.'], ['2-', 'Cerebral', 'perfusion', 'pressure', 'is', 'mean', 'arterial', 'pressure', 'plus', 'intracranial', 'pressure.'], ['3-', 'Vasogenic', 'cerebral', 'edema', 'is', 'due', 'to', 'cellular', 'edema,', 'membrane', 'rupture', 'and', 'cell', 'death.'], ['4-', 'Cerebral', 'vascular', 'flow', 'increases', 'with', 'hypercapnia', 'and', 'acidosis.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '4'], ['Hypercapnia', 'and', 'acidosis', 'produce', 'vasodilatation', 'causing', 'increased', 'cerebral', 'blood', 'flow.'], ['According', 'to', 'the', 'described', 'examination', 'the', 'Glasgow', 'is', '4', '(O1V1M2).'], ['Cerebral', 'perfusion', 'pressure', 'is', 'mean', 'arterial', 'pressure', 'minus', 'intracranial', 'pressure.'], ['Cerebral', 'edema', 'in', 'which', 'cellular', 'edema', 'is', 'produced', 'by', 'the', 'introduction', 'of', 'extracellular', 'fluid', 'into', 'the', 'intracellular', 'compartment', 'is', 'cytotoxic.']]","[['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', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', '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'], ['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'], ['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-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']]"
21288,"[['QUESTION', 'TYPE:', 'GENERAL', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '45-year-old', 'man', 'undergoes', 'a', 'truncal', 'vagotomy', 'and', 'antrectomy', 'with', 'Billroth', 'II', 'reconstruction', 'for', 'chronic', 'peptic', 'ulcer', 'disease', 'with', 'pyloro-duodenal', 'stricture.'], ['Six', 'weeks', 'after', 'the', 'surgery', 'she', 'reports', 'that', 'shortly', 'after', '(less', 'than', 'half', 'an', 'hour)', 'after', 'ingestions', 'she', 'presents', 'nausea,', 'asthenia', 'and', 'sweating,', 'dizziness', 'and', 'abdominal', 'cramps', 'usually', 'accompanied', 'by', 'diarrhea.'], ['Which', 'of', 'the', 'following', 'is', 'the', 'most', 'appropriate', 'approach', 'for', 'her', 'initial', 'management?'], ['1-', 'Apply', 'treatment', 'with', 'a', 'somatostatin', 'inhibitor', '(octreotide).'], ['2-', 'Follow', 'specific', 'dietary', 'measures.'], ['3-', 'Trial', 'treatment', 'with', 'a', 'benzodiazepine.'], ['4-', 'Search', 'for', 'a', 'probable', 'neuroendocrine', 'tumor', '(e.g.', 'carcinoid).'], ['5-', 'Indicate', 'surgical', 'treatment', 'to', 'perform', 'an', 'antiperistaltic', 'Roux-en-Y', 'gastrojejunostomy.'], ['CORRECT', 'ANSWER:', '2'], ['Answers', '1,', '2', 'and', '5', 'are', 'appropriate', 'treatments', 'for', 'dumping', 'syndrome', 'or', 'postgastrectomy,', 'but', 'the', 'question', 'is', 'focused', 'on', 'initial', 'management,', 'so', 'the', 'most', 'appropriate', 'answer', 'seems', 'to', 'be', '2.']]","[['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', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', 'B-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'], ['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', '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-Marker', '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']]"
50789,"[['QUESTION', 'TYPE:', 'PSYCHIATRY'], ['CLINICAL', 'CASE:'], ['A', '46-year-old', 'man', 'with', 'bipolar', 'disorder', 'is', 'brought', 'to', 'the', 'emergency', 'department', 'after', 'an', 'over-ingestion', 'of', 'lithium', 'carbonate.'], ['Examination', 'reveals', 'severe', 'tremor,', 'ataxia,', 'dysarthria,', 'myoclonus', 'and', 'fasciculations.'], ['Lithemia', 'is', '4.1', 'mEq/L', '(toxicity', '>', '1.6', 'mEq/L).'], ['Which', 'of', 'the', 'following', 'therapeutic', 'options', 'would', 'be', 'most', 'indicated?'], ['1-', 'Aminophylline', 'associated', 'with', 'a', 'cathartic.'], ['2-', 'Activated', 'charcoal.'], ['3-', 'Hemodialysis.'], ['4-', 'Forced', 'diuresis.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['Be', 'careful', 'with', 'lithium.'], ['Intoxications', 'have', 'been', 'seen', 'with', 'normal', 'lithium.'], ['It', 'is', 'not', 'rare', '-especially', 'due', 'to', 'interactions-.'], ['A', 'very', 'effective', 'drug', 'if', 'everyone', 'is', 'forewarned.']]","[['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'], ['B-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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'B-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'], ['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']]"
55289,"[['QUESTION', 'TYPE:', 'DERMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '4-year-old', 'girl', 'presenting', 'with', 'a', 'high', 'fever', 'of', '6', ""days'"", 'evolution.'], ['On', 'clinical', 'examination', 'she', 'presents', 'an', 'erythematous', 'maculopapular', 'rash', 'on', 'the', 'trunk', 'and', 'genital', 'area,', 'with', 'a', 'tendency', 'to', 'confluence,', 'without', 'becoming', 'scarlatiniform;', 'conjunctival', 'injection', 'without', 'secretions', 'and', 'red', 'lips', 'with', 'raspberry', 'tongue.'], ['She', 'also', 'presents', 'erythema', 'with', 'edema', 'in', 'hands', 'and', 'feet', 'and', 'a', 'unilateral', 'cervical', 'adenopathy', 'of', '2', 'cm', 'in', 'diameter.'], ['The', 'most', 'likely', 'clinical', 'diagnosis', 'of', 'suspicion', 'is:'], ['1-', 'Kawasaki', 'disease.'], ['2-', 'Measles.'], ['3-', 'Rubella.'], ['4-', 'Scarlet', 'fever.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '1'], ['There', 'is', 'no', 'doubt,', 'they', 'are', 'not', 'meeting', 'the', 'diagnostic', 'criteria', 'of', 'Kawasaki', 'disease', '(fever', 'of', 'several', 'days', 'of', 'evolution,', 'exanthema,', 'conjunctival', 'injection,', 'red', 'lips,', 'raspberry', 'tongue,', 'edema', 'of', 'acral', 'parts', 'and', 'adenopathy).']]","[['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', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim'], ['O', 'B-Disease', 'I-Disease'], ['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-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise']]"
598181,"[['QUESTION', 'TYPE:', 'RHEUMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '67-year-old', 'man', 'presents', 'with', '3', 'months', 'of', 'asthenia', 'and', 'febrile', 'fever,', 'with', 'nasal', 'obstruction', 'and', 'mucus', 'emission', 'with', 'some', 'clots', 'in', 'the', 'last', 'month.'], ['In', 'the', 'last', 'few', 'days', 'she', 'noticed', 'pain', 'in', 'the', 'right', 'eye', 'and', 'asymmetry', 'with', 'respect', 'to', 'the', 'contralateral', 'eye.'], ['Physical', 'examination', 'reveals', 'proptosis', 'of', 'the', 'right', 'eyeball', 'and', 'inspection', 'of', 'the', 'nostrils', 'reveals', 'an', 'erythematous', 'mucosa', 'with', 'serohematic', 'crusts.'], ['The', 'rest', 'of', 'the', 'examination', 'was', 'normal.'], ['Blood', 'tests', '(hemogram,', 'renal', 'and', 'hepatic', 'function)', 'are', 'normal,', 'except', 'for', 'an', 'ESR', 'of', '65', 'mm/h;', 'urinalysis', 'shows', 'microhematuria', 'and', 'proteinuria', 'of', '520', 'mg/24h.'], ['What', 'is', 'the', 'most', 'probable', 'initial', 'diagnosis?'], ['1-', 'Eosinophilic', 'granulomatosis', 'with', 'polyangiitis.'], ['2-', 'Microscopic', 'polyangiitis.'], ['3-', 'Granulomatosis', 'with', 'polyangiitis.'], ['4-', 'Polyarteritis', 'nodosa.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['In', 'this', 'patient,', 'he', 'presents', 'with', 'a', 'granulomatosis', 'with', 'polyangiitis', 'formerly', 'known', 'as', ""Wegener's"", 'granulomatosis.'], ['In', 'the', 'clinical', 'case', 'we', 'are', 'told', 'about', 'the', 'otorhinolaryngologic', 'involvement', 'that', 'is', 'present', 'in', '92%', 'of', 'patients.'], ['At', 'the', 'pulmonary', 'level,', 'we', 'were', 'told', 'that', 'mucus', 'with', 'a', 'clot', 'was', 'present', 'in', '85%', 'of', 'the', 'patients.'], ['Also', 'at', 'the', 'end', 'of', 'the', 'case,', 'they', 'comment', 'us', 'the', 'urinalysis', 'with', 'a', 'glomerulonephritis', 'that', 'is', 'present', 'in', '77%', 'of', 'the', 'patients.']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-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'], ['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'], ['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']]"
133168,"[['QUESTION', 'TYPE:', 'OPHTHALMOLOGY'], ['CLINICAL', 'CASE:'], ['75-year-old', 'woman', 'diagnosed', '3', 'years', 'ago', 'with', 'soft', 'drusen', 'in', 'the', 'fundus.'], ['She', 'reports', 'presenting,', 'since', '2', 'weeks', 'ago,', 'metamorphopsia', 'and', 'significant', 'visual', 'loss', 'in', 'her', 'right', 'eye', 'that', 'prevents', 'her', 'from', 'reading.'], ['Indicate', 'the', 'most', 'probable', 'diagnosis:'], ['1-', 'Macular', 'epiretinal', 'membrane.'], ['2-', 'Macular', 'hole.'], ['3-', 'Thrombosis', 'of', 'the', 'central', 'retinal', 'vein.'], ['4-', 'Senile', 'macular', 'degeneration.'], ['5-', 'Central', 'serous', 'chorioretinopathy.'], ['CORRECT', 'ANSWER:', '4'], ['Of', 'the', 'five', 'options,', 'four', 'could', 'be', 'compatible', 'with', 'the', 'referred', 'symptoms.'], ['We', 'could', 'initially', 'rule', 'out', 'central', 'serous', 'chorioretinopathy', 'because', 'by', 'definition', 'it', 'occurs', 'in', 'young', 'people', '(up', 'to', '55', 'years', 'of', 'age,', 'more', 'or', 'less).'], ['The', 'key', 'to', 'differentiate', 'between', 'the', 'other', 'four', 'is', 'that', 'he', 'had', 'soft', 'drusen', 'in', 'the', 'fundus.'], ['That', 'while', 'not', 'a', '""diagnosis""', '(the', 'question', 'could', 'have', 'been', 'better', 'worded)', 'is', 'a', 'finding', 'related', 'to', 'age-related', 'macular', 'degeneration,', 'or', 'age-related', 'macular', 'degeneration.'], ['The', 'dry', 'or', 'atrophic', 'form', 'presents', 'with', 'slowly', 'progressive', 'visual', 'loss.'], ['But', 'the', 'wet', 'or', 'exudative', 'form', 'produces', 'acute', 'or', 'rapidly', 'progressive', 'severe', 'visual', 'loss', '(usually', 'due', 'to', 'subretinal', 'hemorrhage', 'accompanied', 'by', 'metamorphopsia', '(image', 'distortion', 'due', 'to', 'retinal', 'lifting).'], ['An', 'epiretinal', 'membrane', 'usually', 'has', 'a', 'slower', 'course.'], ['In', 'a', 'macular', 'hole,', 'visual', 'loss', 'is', 'more', 'relevant', '(metamorphopsia', 'may', 'also', 'be', 'reported,', 'but', 'it', 'is', 'less', 'likely', 'in', 'the', 'acute', 'stage).'], ['In', 'thrombosis', 'of', 'the', 'central', 'retinal', 'vein,', 'visual', 'loss', 'is', 'more', 'important', 'and', 'does', 'not', 'usually', 'explain', 'metamorphopsia', '(but', 'may', 'have', 'it,', 'due', 'to', 'macular', 'edema).']]","[['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', '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'], ['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'], ['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'], ['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'], ['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-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']]"
18667,"[['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['A', '56-year-old', 'female', 'patient', 'consulted', 'for', 'dorso-lumbar', 'spine', 'pain', 'and', 'progressive', 'difficulty', 'in', 'performing', 'usual', 'tasks.'], ['In', 'the', 'last', '5', 'years', 'she', 'gained', 'weight,', 'she', 'has', 'ecchymosis', 'easily', 'and', 'arterial', 'hypertension', 'was', 'detected.'], ['Physical', 'examination:', 'Obesity', 'of', 'central', 'predominance,', 'rounded', 'facies,', 'increased', 'supraclavicular', 'fat,', 'decreased', 'proximal', 'muscle', 'strength', 'and', 'some', 'reddish', 'striae', 'in', 'the', 'abdomen.'], ['She', 'has', 'a', 'blood', 'glucose', 'of', '136', 'mg/dL', 'and', 'the', 'radiological', 'study', 'showed', 'osteoporosis', 'and', 'vertebral', 'crushing.'], ['What', 'do', 'you', 'think', 'is', 'the', 'most', 'coherent', 'interpretation', 'and', 'attitude?'], ['1-', 'Postmenopausal', 'osteoporosis,', 'type', '2', 'diabetes', 'mellitus', 'and', 'essential', 'hypertension,', 'with', 'decreased', 'strength', 'due', 'to', 'diabetic', 'polyneuropathy.'], ['2-', 'It', 'is', 'necessary', 'to', 'rule', 'out', ""Cushing's"", 'disease', 'by', 'dexamethasone', 'suppression', 'test', 'and', 'perform', 'a', 'cranial', 'CT', 'scan.'], ['3-', 'Suggest', ""Cushing's.""], ['Determine', 'urinary', 'free', 'cortisol', 'and', 'basal', 'ACTH,', 'which', 'serves', 'to', 'orient', 'its', 'etiology', 'and', 'select', 'the', 'most', 'appropriate', 'imaging', 'technique.'], ['4-', 'It', 'looks', 'like', ""Cushing's.""], ['If', 'basal', 'ACTH', 'is', 'high,', 'it', 'may', 'be', 'due', 'to', 'corticosteroid', 'use', 'or', 'an', 'adrenal', 'tumor,', 'and', 'an', 'MRI', 'should', 'be', 'performed.'], ['5-', 'Probably', 'has', ""Cushing's.""], ['If', 'the', 'basal', 'ACTH', 'is', 'low,', 'he', 'probably', 'has', 'a', 'pituitary', 'micro-adenoma,', 'and', 'a', 'cranial', 'CT', 'scan', 'should', 'be', 'performed.'], ['CORRECT', 'ANSWER:', '3'], ['This', 'question', 'is', 'a', 'bit', 'convoluted', 'for', 'the', 'diagnosis', 'of', ""Cushing's"", 'syndrome', 'but', 'easy', 'if', 'the', 'steps', 'are', 'clear.'], ['We', 'all', 'agree', 'that', 'the', 'patient', 'seems', 'to', 'have', ""Cushing's"", 'syndrome', '(we', 'rule', 'out', '1).'], ['For', 'the', 'diagnosis', 'we', 'have', 'to', 'measure', 'urinary', 'free', 'cortisol,', 'do', 'a', 'dexamethasone', 'suppression', 'test', 'or', 'measure', 'nocturnal', 'salivary', 'cortisol.'], ['If', 'hypercortisolism', 'is', 'confirmed,', 'the', 'origin', 'should', 'be', 'sought;', 'the', 'ACTH', 'measurement', 'indicates', 'the', 'origin:', 'suppressed', 'in', 'hypercortisolism', 'of', 'adrenal', 'origin', 'or', 'prolonged', 'use', 'of', 'corticoids', 'and', 'elevated', 'or', 'normal', 'if', 'the', 'origin', 'is', 'pituitary', 'or', 'by', 'ectopic', 'ACTH', 'secretion.'], ['(Therefore,', '4', 'and', '5', 'are', 'false).'], ['If', 'ACTH', 'is', 'low,', 'a', 'CT', 'scan', 'of', 'the', 'abdomen', 'should', 'be', 'performed', 'to', 'locate', 'the', 'origin.'], ['If', 'ACTH', 'is', 'normal', 'or', 'high,', 'a', 'pituitary', 'MRI', 'should', 'be', 'performed', '(pituitary', 'adenomas', 'responsible', 'for', ""Cushing's"", 'syndrome', 'are', 'very', 'small', 'and', 'CT', 'of', 'the', 'pituitary', 'is', 'less', 'sensitive', 'than', 'MRI).'], ['It', 'is', 'very', 'important', 'to', 'perform', 'the', 'order', 'well', 'to', 'arrive', 'at', 'a', 'proper', 'diagnosis:', '1st:', 'confirm', 'hypercortisolism', 'or', 's.'], [""Cushing's"", 'syndrome,', '2nd:', 'measure', 'ACTH', 'to', 'orient', 'etiology.'], ['3rd:', 'imaging', 'test', 'according', 'to', 'ACTH', 'levels.'], ['Therefore,', 'answer', '2', 'is', 'false', '(abdominal', 'CT', 'is', 'not', 'a', 'test', 'to', 'rule', 'out', 's.', ""Cushing's);"", 'an', 'imaging', 'test', 'should', 'only', 'be', 'done', 'once', 'a', 'clear', 'diagnosis', 'of', 'hypercortisolism', 'has', 'been', 'made.'], ['Therefore,', 'the', 'true', 'one', 'is', '3.']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', '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', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-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'], ['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', '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', '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'], ['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', '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'], ['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'], ['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'], ['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'], ['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']]"
7208,"[['QUESTION', 'TYPE:', 'DIGESTIVE'], ['CLINICAL', 'CASE:'], ['During', 'a', 'colonoscopy,', 'a', '5-cm', 'tumor', 'located', 'in', 'the', 'right', 'colon', 'is', 'detected', 'in', 'a', '48-year-old', 'man.'], ['No', 'other', 'lesions', 'were', 'found.'], ['His', 'maternal', 'grandmother', 'also', 'suffered', 'from', 'colon', 'cancer.'], ['The', 'biopsies', 'are', 'superficial', 'and', 'show', 'a', 'poorly', 'differentiated', 'tumor', 'with', 'abundant', 'inflammatory', 'cells', 'in', 'the', 'stroma', 'that', 'is', 'diagnosed', 'as', 'a', 'medullary', 'type', 'carcinoma.'], ['1-', 'Chemotherapy', 'is', 'the', 'treatment', 'of', 'choice.'], ['2-', 'Since', 'the', 'biopsy', 'is', 'superficial,', 'it', 'should', 'be', 'repeated', 'before', 'proceeding', 'with', 'treatment.'], ['3-', 'The', 'prognosis', 'of', 'the', 'tumor', 'depends', 'mainly', 'on', 'its', 'high', 'degree', 'of', 'anaplasia.'], ['4-', 'It', 'is', 'unlikely', 'that', 'this', 'tumor', 'has', 'developed', 'over', 'a', 'previous', 'adenoma.'], ['5-', 'Microsatellite', 'instability', 'and', 'DNA', 'error', 'repair', 'genes', 'should', 'be', 'studied.'], ['CORRECT', 'ANSWER:', '5'], ['Complicated', 'question', 'about', 'an', 'unusual', 'adenocarcinoma.'], ['By', 'rule', '1', 'would', 'be', 'easy', 'to', 'eliminate,', 'the', 'treatment', 'of', 'colon', 'cancer', 'is', 'surgical', '(with', 'neoadjuvant', 'in', 'rectal', 'cancer).'], ['If', 'biopsies', 'confirm', 'adenocarcinoma,', 'there', 'is', 'no', 'need', 'to', 'repeat', 'them,', 'since', 'it', 'is', 'necessary', 'to', 'have', 'the', 'complete', 'specimen.'], ['Most', 'colon', 'cancer', 'develops', 'on', 'adenomas,', 'so', 'we', 'could', 'eliminate', 'this', 'one.'], ['Among', 'the', 'other', '2,', 'it', 'is', 'important', 'to', 'know', 'that', '5', 'is', 'correct', 'since', 'they', 'almost', 'always', 'present', 'microsatellite', 'instability', 'even', 'without', 'fulfilling', 'the', 'Amsterdam', 'criteria', 'and', 'have', 'a', 'better', 'prognosis', 'than', 'other', 'poorly', 'differentiated', 'colon', 'cancer.']]","[['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'], ['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', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['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', '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'], ['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'], ['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'], ['B-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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', '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', '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', 'I-Claim']]"
15272,"[['QUESTION', 'TYPE:', 'RHEUMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', 'hyperuricemic', 'patient', 'who', 'usually', 'takes', '100', 'mg', 'of', 'allopurinol', 'daily', 'comes', 'to', 'the', 'ED', 'with', 'acute', 'pain', 'and', 'inflammatory', 'signs', 'in', 'the', 'right', 'knee.'], ['Arthrocentesis', 'is', 'performed', 'and', 'polarized', 'light', 'microscopy', 'shows', 'intracellular', 'crystals', 'with', 'negative', 'birefringence.'], ['Which', 'of', 'the', 'following', 'therapeutic', 'approaches', 'is', 'the', 'most', 'appropriate', 'in', 'this', 'case?'], ['1-', 'Discontinue', 'allopurinol', 'and', 'start', 'colchicine', 'treatment.'], ['2-', 'Discontinue', 'allopurinol', 'and', 'start', 'NSAIDs.'], ['3-', 'Add', 'an', 'NSAID', 'until', 'the', 'crisis', 'remits.'], ['4-', 'Increase', 'the', 'dose', 'of', 'allopurinol', 'to', '300', 'mg/day.'], ['5-', 'Substitute', 'allopurinol', 'for', 'uricosuric', 'acid.'], ['CORRECT', 'ANSWER:', '3'], ['In', 'the', 'presence', 'of', 'acute', 'gouty', 'arthritis', '(the', 'presence', 'of', 'intracellular', 'crystals', 'with', 'negative', 'birefringence', 'confirms', 'this)', 'in', 'a', 'hyperuricemic', 'patient', 'previously', 'treated', 'with', 'allopurinol,', 'an', 'NSAID', 'should', 'be', 'added', 'until', 'the', 'crisis', 'subsides.'], ['No', 'changes', 'should', 'be', 'made', 'in', 'the', 'hypouricemic', 'treatment', 'during', 'this', 'period', 'because', 'the', 'uric', 'acid', 'metabolic', 'chain', 'is', 'altered', 'and', 'the', 'situation', 'may', 'worsen.']]","[['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'], ['B-Premise', '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', 'B-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', '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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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']]"
243112,"[['QUESTION', 'TYPE:', 'INFECTIOUS', 'DISEASES'], ['CLINICAL', 'CASE:'], ['A', '20-year-old', 'girl', 'comes', 'to', 'the', 'clinic', 'with', 'an', 'acute', 'fever,', 'cervical', 'lymphadenopathy', 'and', 'skin', 'rash.'], ['According', 'to', 'the', 'patient,', '3', 'weeks', 'ago', 'she', 'had', 'a', 'sexual', 'relationship', 'that', 'could', 'be', 'a', 'risk', 'for', 'contracting', 'the', 'HIV', 'virus.'], ['Indicate', 'which', 'of', 'the', 'following', 'answers', 'is', 'true:'], ['1-', 'A', 'negative', 'HIV-1/HIV-2', 'serology', 'performed', 'by', 'ELISA', 'technique', 'rules', 'out', 'the', 'possibility', 'that', 'the', 'patient', 'has', 'been', 'infected', 'with', 'the', 'HIV', 'virus.'], ['2-', 'The', 'clinical', 'process', 'that', 'the', 'patient', 'suffers', 'from', 'is', 'not', 'consistent', 'with', 'acute', 'HIV', 'infection.'], ['3-', 'If', 'the', ""patient's"", 'ELISA', 'test', 'was', 'positive,', 'nothing', 'further', 'would', 'be', 'necessary', 'for', 'the', 'diagnosis', 'of', 'HIV', 'infection.'], ['4-', 'The', 'ELISA', 'technique', 'has', 'a', 'high', 'sensitivity', 'for', 'the', 'diagnosis', 'of', 'HIV', 'infection,', 'but', 'its', 'specificity', 'is', 'even', 'higher.'], ['5-', 'If', 'the', 'ELISA', 'test', 'to', 'diagnose', 'HIV', 'in', 'the', 'patient', 'was', 'negative,', 'we', 'could', 'determine', 'by', 'PCR', 'technique', 'the', 'viral', 'load', 'in', 'blood.'], ['CORRECT', 'ANSWER:', '5'], ['A', 'simple', 'question', 'if', 'we', 'are', 'clear', 'about', 'the', 'diagnostic', 'process', 'of', 'HIV.'], ['At', 'first', 'glance,', 'we', 'could', 'directly', 'rule', 'out', 'answer', '2', 'since', 'we', 'know', 'that', 'mononucleosis', 'can', 'be', 'an', 'expression', 'of', 'the', 'first', 'phase', 'of', 'HIV', 'infection,', 'especially', 'when', 'we', 'have', 'a', 'history', 'of', 'a', 'risk', 'contact.'], ['Answers', '3', 'and', '4', 'are', 'also', 'easily', 'ruled', 'out;', 'ELISA', 'is', 'a', 'very', 'sensitive', 'but', 'not', 'very', 'specific', 'technique', 'and', 'confirmation', 'with', 'a', 'Western-blot', 'test', 'is', 'ALWAYS', 'necessary.'], ['Answers', '1', 'and', '5', 'contradict', 'each', 'other', 'if', 'you', 'notice,', 'so', 'one', 'of', 'the', 'two', 'is', 'correct.'], ['In', 'this', 'case,', 'the', 'false', 'answer', 'is', '1,', 'it', 'is', 'a', 'very', 'categorical', 'answer', '(""rule', 'out"")', 'that', 'does', 'not', 'quite', 'fit', 'the', 'reality;', 'As', 'we', 'have', 'said,', 'ELISA', 'is', 'a', 'very', 'sensitive', 'technique,', 'so', 'a', 'negative', 'result', 'could', 'leave', 'us', 'quite', 'calm,', 'however,', 'we', 'all', 'know', 'that', 'there', 'is', 'no', 'medical', 'test', 'that', 'rules', 'out', 'anything', 'with', 'total', 'certainty', '(unless', 'its', 'sensitivity', 'is', '100%,', 'which', 'is', 'not', 'the', 'case)', 'and,', 'on', 'the', 'other', 'hand,', 'we', 'could', 'say', 'that', 'in', 'this', 'case', 'we', 'have', 'a', 'high', 'clinical', 'suspicion', '(the', 'picture', 'is', 'suggestive,', 'and', 'the', 'antecedents', 'are', 'there).'], ['In', 'addition,', 'it', 'is', 'only', '3', 'weeks', 'since', 'the', 'contact,', 'so', 'our', 'patient', 'is', 'probably', 'in', 'the', '""window', 'period""', 'during', 'which', 'serological', 'techniques', 'may', 'be', 'unprofitable.'], ['In', 'conclusion,', 'the', 'answer', 'that', 'best', 'fits', 'us', 'would', 'be', '5,', 'in', 'the', 'window', 'period', 'a', 'viral', 'load', 'may', 'be', 'indicated', 'for', 'diagnosis', '(positive', 'if', 'there', 'are', 'more', 'than', '10,000', 'copies),', 'although', 'this', 'test', 'is', 'not', 'done', 'routinely.']]","[['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', 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'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
458126,"[['QUESTION', 'TYPE:', 'OTOLARYNGOLOGY', 'AND', 'MAXILLOFACIAL', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '47-year-old', 'man,', 'with', 'a', 'history', 'of', 'a', 'right', 'parotid', 'pleomorphic', 'adenoma,', 'treated', 'with', 'surgery', '(extrafacial', 'parotidectomy)', '6', 'months', 'ago,', 'who', 'comes', 'to', 'our', 'office', 'for', 'presenting', 'pain', 'with', 'sweating', 'and', 'reddening', 'of', 'the', 'skin', 'in', 'the', 'preauricular', 'region', 'during', 'mastication.'], ['What', 'treatment', 'would', 'be', 'the', 'treatment', 'of', 'choice?'], ['1-', 'Extended', 'total', 'parotidectomy', 'on', 'suspicion', 'of', 'tumor', 'recurrence.'], ['2-', 'Pregabalin.'], ['3-', 'Intradermal', 'botulinum', 'toxin', 'injection.'], ['4-', 'Broad-spectrum', 'antibiotherapy.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['You', 'are', 'asking', 'about', 'auriculotemporal', 'syndrome', 'or', ""Frey's"", 'syndrome.'], ['It', 'is', 'the', 'clinical', 'expression', 'of', 'a', 'vegetative', 'neuropathy', 'caused', 'by', 'mechanical', 'or', 'irritative', 'lesion', 'of', 'the', 'vegetative', 'fibers', 'of', 'the', 'auriculotemporal', 'nerve', 'in', 'its', 'infratemporal', 'pathway.'], ['In', 'our', 'environment', 'the', 'most', 'frequent', 'cause', 'is', 'surgery', 'of', 'the', 'split', 'gland', 'with', 'a', 'percentage', 'of', 'occurrence', 'between', '10', 'and', '80%.'], ['Conservative', 'treatment', 'with', 'botulinum', 'toxin', 'offers', 'good', 'results.']]","[['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'], ['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'], ['O', 'B-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-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'], ['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', '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']]"
123223,"[['QUESTION', 'TYPE:', 'MICROBIOLOGY'], ['CLINICAL', 'CASE:'], ['Pregnant', 'woman,', '27', 'years', 'old,', '30', 'weeks', 'of', 'gestation.'], ['She', 'comes', 'to', 'the', 'emergency', 'room', 'because', 'she', 'noticed', 'pain', 'in', 'the', 'left', 'lumbar', 'region', 'and', 'dysuria', 'since', 'yesterday.'], ['She', 'has', 'no', 'febrile', 'sensation.'], ['She', 'refers', 'repeated', 'urinary', 'tract', 'infections', '(UTI).'], ['Urinalysis', 'shows', 'Hb', '3+,', 'leukocytes', '3+,', 'nitrites', '2+,', 'sediment:', '15-20', 'leukocytes', 'per', 'field', 'and', '5-10', 'red', 'blood', 'cells', 'per', 'field.'], ['Which', 'of', 'the', 'following', 'microorganisms', 'is', 'the', 'most', 'frequent', 'culprit', 'in', 'pregnant', 'women?'], ['1-', 'Escherichia', 'coli.'], ['2-', 'Enterococcus', 'faecalis.'], ['3-', 'Streptococcus', 'agalactiae.'], ['4-', 'Proteus', 'mirabilis.'], ['5-', 'Satphylococcus', 'saprophyticus.'], ['CORRECT', 'ANSWER:', '1'], ['The', 'correct', 'answer', 'is', 'the', 'first', 'one.'], ['The', 'most', 'frequent', 'cause', 'of', 'urinary', 'tract', 'infections', 'is', 'Escherichia', 'coli', 'and', 'in', 'the', 'case', 'of', 'pregnant', 'women', 'as', 'well.']]","[['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'], ['B-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'], ['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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
522165,"[['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['A', '66-year-old', 'woman', 'diagnosed', 'with', 'type', '2', 'diabetes', 'mellitus', 'since', 'three', 'months', 'ago.'], ['She', 'has', 'a', 'BMI', 'of', '31', 'kg/m2', 'and', 'presents', 'poor', 'glycemic', 'control', 'despite', 'a', 'program', 'of', 'non-pharmacological', 'measures', '(healthy', 'diet,', 'exercise).'], ['Which', 'of', 'the', 'following', 'hypoglycemic', 'drugs', 'is', 'associated', 'with', 'weight', 'gain', 'and', 'should', 'we', 'avoid', 'in', 'this', 'patient?:'], ['1-', 'Metformin', '(biguanide).'], ['2-', 'Pioglitazone', '(thiazolidinedione).'], ['3-', 'Canagliflozin', '(sodium-glucose', 'cotransporter', '2', 'inhibitor-', 'iSGLT2).'], ['4-', 'Liraglutide', '(GLP-1', 'receptor', 'agonist).'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '2'], ['A', 'somewhat', 'more', 'complicated', 'question', 'than', 'the', 'previous', 'one.'], ['Regarding', 'weight,', 'metformin', 'to', 'a', 'lesser', 'extent,', 'SGLT-2', 'inhibitors', 'and,', 'above', 'all,', 'GLP-1', 'agonists', 'have', 'been', 'associated', 'with', 'a', 'significant', 'decrease', 'in', 'weight', 'in', 'patients', 'with', 'DM-2', '(answers', '1,3', 'and', '4', 'incorrect).'], ['On', 'the', 'other', 'hand,', 'pioglitazone,', 'as', 'reflected', 'in', 'its', 'data', 'sheet,', 'can', 'produce', 'dose-dependent', 'weight', 'gain,', 'mainly', 'due', 'to', 'fat', 'accumulation', 'and', 'added,', 'in', 'some', 'cases,', 'to', 'water', 'retention.']]","[['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', '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', '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', 'I-Claim'], ['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', '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']]"
209185,"[['QUESTION', 'TYPE:', 'GYNECOLOGY', 'AND', 'OBSTETRICS'], ['CLINICAL', 'CASE:'], ['A', '32-year-old', 'woman', 'requests', 'preconception', 'counseling.'], ['The', 'patient', 'reports', 'that', 'she', 'underwent', 'cervical', 'conization', 'for', 'a', 'high-grade', 'intraepithelial', 'lesion', '(H-SIL)', 'and', 'subsequently', 'had', 'three', 'miscarriages', 'between', '20', 'and', '22', 'weeks', 'gestation.'], ['She', 'has', 'no', 'living', 'children.'], ['On', 'all', 'three', 'occasions', 'she', 'came', 'to', 'the', 'emergency', 'department', 'with', 'a', 'feeling', 'of', 'weight', 'in', 'the', 'hypogastrium,', 'where', 'she', 'was', 'found', 'to', 'be', '8', 'cm', 'dilated', 'and', 'with', 'prominent', 'amniotic', 'membranes.'], ['She', 'had', 'never', 'felt', 'contractions', 'before,', 'what', 'advice', 'would', 'you', 'give', 'her', 'for', 'the', 'next', 'pregnancy?'], ['1-', 'I', 'would', 'prescribe', 'oral', 'atosiban', 'prophylaxis', 'throughout', 'the', 'pregnancy.'], ['2-', 'I', 'would', 'offer', 'lung', 'maturation', 'with', 'corticosteroids', 'from', '19-20', 'weeks', 'of', 'gestation.'], ['3-', 'I', 'would', 'recommend', 'a', 'cervical', 'cerclage', 'at', '14', 'weeks', 'gestation.'], ['4-', 'I', 'would', 'advise', 'her', 'not', 'to', 'attempt', 'any', 'more', 'pregnancies', 'because', 'of', 'the', 'high', 'risk', 'of', 'recurrence.'], ['5-', 'I', 'would', 'recommend', 'resorting', 'to', 'assisted', 'reproductive', 'techniques.'], ['CORRECT', 'ANSWER:', '3'], ['This', 'is', 'a', 'typical', 'case', 'of', 'cervical', 'incompetence', '(and', 'this', 'patient', 'has', 'conization', 'as', 'a', 'risk', 'factor).'], ['This', 'pathology', 'consists', 'of', 'dilatation', 'of', 'the', 'cervix', 'in', 'the', 'absence', 'of', 'contractions,', 'requiring', 'cerclage', 'to', 'prevent', 'miscarriage', 'or', 'immature', 'delivery.'], ['The', 'cerclage', 'is', 'ideally', 'performed', 'electively,', 'programmed,', 'and', 'not', 'when', 'the', 'patient', 'arrives', 'at', 'the', 'ER', '""in', 'extemis""', '(which', 'are', 'also', 'done,', 'but', 'with', 'a', 'lower', 'success', 'rate...', 'the', 'ideal', 'is', 'to', 'do', 'them', 'cold).']]","[['O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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-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'], ['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', 'I-Claim', 'I-Claim'], ['O', 'B-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'], ['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']]"
28255,,
464155,"[['QUESTION', 'TYPE:', 'CRITICAL', 'CARE', 'AND', 'EMERGENCIES'], ['CLINICAL', 'CASE:'], ['A', '58-year-old', 'man,', 'three', 'weeks', 'after', 'a', 'severe', 'ankle', 'sprain', 'presents,', 'rapidly', 'progressive,', 'with', 'dyspnea', 'at', 'rest,', 'dizziness', 'and', 'syncope.'], ['On', 'arrival', 'at', 'the', 'hospital', 'he', 'has', 'hypotension', '(systolic', 'BP', '80', 'mmHg,', 'diastolic', '40', 'mmHg)', 'and', 'poor', 'perfusion.'], ['He', 'is', 'intubated', 'and', 'connected', 'to', 'mechanical', 'ventilation', 'and', 'noradrenaline', 'is', 'started.'], ['Echocardiogram', 'shows', 'signs', 'of', 'pulmonary', 'hypertension.'], ['Angio-CT', 'shows', 'multiple', 'repletion', 'defects', 'occupying', 'both', 'main', 'pulmonary', 'arteries.'], ['Which', 'of', 'the', 'following', 'treatments', 'would', 'be', 'associated', 'with', 'the', 'most', 'rapid', 'hemodynamic', 'improvement', 'in', 'this', 'case?'], ['1-', 'Intravenous', 'perfused', 'sodium', 'heparin.'], ['2-', 'Thromboendartectomy.'], ['3-', 'Systemic', 'fibrinolysis', 'with', 'rt-PA', '(alteplase)', '100', 'mg', 'intravenous.'], ['4-', 'Inferior', 'vena', 'cava', 'filter.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['The', 'patient', 'presented', 'pulmonary', 'thromboembolism', 'which,', 'in', 'addition', 'to', 'being', 'bilateral,', 'produced', 'severe', 'hemodynamic', 'involvement,', 'shock', 'and', 'required', 'mechanical', 'ventilation.'], ['We', 'are', 'not', 'told', 'that', 'he', 'has', 'any', 'contraindication', 'to', 'fibrinolysis,', 'so', 'this', 'would', 'be', 'the', 'most', 'appropriate', 'option', 'due', 'to', 'its', 'rapid', 'administration', 'and', 'action.'], ['Sodium', 'heparin', 'is', 'reserved', 'for', 'cases', 'in', 'which', 'the', 'patient', 'is', 'stable.'], ['Thromboendarterectomy', 'could', 'be', 'performed', 'urgently', 'in', 'selected', 'centers', '(not', 'available', 'in', 'all)', 'in', 'patients', 'in', 'whom', 'systemic', 'fibrinolysis', 'is', 'contraindicated,', 'or', 'in', 'centers', 'where', 'the', 'experience', 'with', 'this', 'technique', 'is', 'proven', 'and', 'it', 'can', 'be', 'performed', 'quickly.'], ['The', 'inferior', 'vena', 'cava', 'filter', 'is', 'a', 'treatment', 'indicated', 'in', 'the', 'acute', 'phase', 'in', 'stable', 'patients,', 'when', 'anticoagulation', 'is', 'contraindicated;', 'or', 'a', 'posteriori,', 'as', 'prophylaxis,', 'in', 'this', 'group', 'of', 'patients.'], ['The', 'indications', 'for', 'fibrinolysis', 'in', 'the', 'last', 'SEPAR', 'consensus', 'document', 'included', 'patients', 'at', 'intermediate', 'risk', '(they', 'could', 'benefit', 'from', 'it)', 'and', 'high', 'risk.'], ['They', 'classify', 'intermediate', 'risk', 'as', 'PESIs', '≥', '1', 'or', 'PESI', 'III-IV.'], ['In', 'this', 'subgroup,', 'patients', 'with', 'right', 'ventricular', 'dysfunction,', 'troponin', 'or', 'BNP', 'above', 'the', 'cutoff', 'and', 'deep', 'vein', 'thrombosis', 'appear', 'to', 'benefit', 'most', 'from', 'fibrinolysis.'], ['In', 'the', 'subgroup', 'of', 'high-risk', 'patients', '(defined', 'by', 'hypotension', 'or', 'cardiogenic', 'shock', 'criteria),', 'the', 'use', 'of', 'systemic', 'fibrinolysis', 'is', 'much', 'clearer,', 'as', 'in', 'the', 'case', 'presented', 'in', 'the', 'question.']]","[['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['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', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-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'], ['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-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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', 'I-Claim', 'I-Claim', 'I-Claim', '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'], ['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'], ['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-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise']]"
50277,"[['QUESTION', 'TYPE:', 'PEDIATRICS'], ['CLINICAL', 'CASE:'], ['6-month-old', 'infant', 'presenting', 'to', 'the', 'emergency', 'department', 'for', 'respiratory', 'distress.'], ['Examination:', 'axillary', 'temperature', '37.2°C,', 'respiratory', 'rate', '40', 'rpm,', 'heart', 'rate', '160', 'bpm,', 'blood', 'pressure', '90/45', 'mmHg,', 'SatO2', '95%', 'on', 'room', 'air.'], ['He', 'shows', 'moderate', 'respiratory', 'distress', 'with', 'intercostal', 'and', 'subcostal', 'retraction.'], ['Pulmonary', 'auscultation:', 'scattered', 'expiratory', 'rhonchi,', 'elongated', 'expiration', 'and', 'slight', 'decrease', 'in', 'air', 'entry', 'in', 'both', 'lung', 'fields.'], ['Cardiac', 'auscultation:', 'no', 'murmurs.'], ['It', 'is', 'decided', 'to', 'keep', 'the', 'patient', 'under', 'observation', 'in', 'the', 'hospital', 'for', 'a', 'few', 'hours.'], ['What', 'do', 'you', 'consider', 'the', 'most', 'appropriate', 'attitude', 'at', 'this', 'time', 'with', 'regard', 'to', 'the', 'complementary', 'tests?'], ['1-', 'Request', 'venous', 'blood', 'gas,', 'leukocyte', 'count', 'and', 'acute', 'phase', 'reactants.'], ['2-', 'Request', 'chest', 'X-ray.'], ['3-', 'Request', 'arterial', 'blood', 'gases', 'and', 'acute', 'phase', 'reactants.'], ['4-', 'Do', 'not', 'request', 'complementary', 'tests.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '4'], ['The', 'patient', 'probably', 'presents', 'with', 'bronchiolitis.'], ['At', 'this', 'stage,', 'no', 'additional', 'tests', 'should', 'be', 'performed', 'unless', 'there', 'is', 'a', 'clinical', 'worsening.']]","[['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'], ['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['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'], ['O', 'B-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', 'O', 'O'], ['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']]"
7150,"[['QUESTION', 'TYPE:', 'ANESTHESIOLOGY,', 'CRITICAL', 'CARE', 'AND', 'EMERGENCIES'], ['CLINICAL', 'CASE:'], ['A', 'patient', 'with', 'a', 'history', 'of', 'fever', 'and', 'chest', 'pain', 'comes', 'to', 'the', 'hospital', 'with', 'dyspnea', 'and', 'tachypnea.'], ['On', 'physical', 'examination,', 'the', 'blood', 'pressure', 'cyphrads', 'are', 'low,', 'jugular', 'venous', 'pressure', 'is', 'elevated', 'with', 'a', 'deep', 'descending', 'sinus', 'X,', 'and', 'he', 'has', 'a', 'pulsus', 'paradoxus.'], ['What', 'pathology', 'should', 'be', 'suspected?'], ['1-', 'Ischemic', 'heart', 'disease.'], ['2-', 'Dilated', 'cardiomyopathy.'], ['3-', 'Severe', 'aortic', 'valve', 'stenosis.'], ['4-', 'Constrictive', 'pericarditis.'], ['5-', 'Pericardial', 'effusion', 'with', 'cardiac', 'tamponade.'], ['CORRECT', 'ANSWER:', '5'], ['Low', 'BP', 'with', 'high', 'jugular', 'pressure', 'should', 'always', 'raise', 'the', 'suspicion', 'of', 'cardiac', 'tamponade.'], ['Fever', 'and', 'chest', 'pain', 'with', 'dyspnea', 'and', 'tachypnea', 'should', 'raise', 'suspicion', 'of', 'pericardial', 'effusion', 'with', 'hemodynamic', 'compromise.'], ['Paradoxical', 'pulse', 'is', 'a', 'typical', 'finding', 'of', 'cardiac', 'tamponade.'], ['Therefore,', 'the', 'correct', 'answer', 'is', '5.']]","[['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'], ['O', 'O', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'O', 'B-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'], ['O', 'B-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'], ['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'], ['B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
48645,"[['QUESTION', 'TYPE:', 'GENETICS'], ['CLINICAL', 'CASE:'], ['15-year-old', 'female', 'presenting', 'with', 'delayed', 'menarche', 'and', 'short', 'stature.'], ['She', 'does', 'not', 'have', 'intellectual', 'disability.'], ['Which', 'of', 'the', 'following', 'genetic', 'tests', 'would', 'be', 'routinely', 'used', 'for', 'the', 'diagnosis', 'of', 'this', 'patient:'], ['1-', 'Massive', 'sequencing', '(NGS).'], ['2-', 'FISH.'], ['3-', 'DNA', 'and/or', 'RNA', 'microarrays.'], ['4-', 'Karyotype.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '4'], ['This', 'question', 'may', 'be', 'a', 'little', 'more', 'difficult,', 'as', 'the', 'clinical', 'case', 'presented', 'to', 'us', 'is', 'very', 'vague.'], ['An', 'adolescent', 'with', 'pubertal', 'delay', 'and', 'short', 'stature;', 'nothing', 'more.'], ['With', 'this', 'information,', 'she', 'could', 'have', 'several', 'genetic', 'pathologies,', 'but', 'this', 'is', 'the', 'MIR', 'and', 'we', 'are', 'told', 'that', 'the', 'patient', 'does', 'not', 'have', 'an', 'intellectual', 'disability.'], ['In', 'the', 'MIR,', 'an', 'adolescent', 'with', 'pubertal', 'delay', 'and', 'short', 'stature', 'should', 'be', 'a', 'Turner', 'until', 'proven', 'otherwise', '(there', 'were', 'two', 'questions', 'in', '2017).'], ['Therefore,', 'if', 'that', 'is', 'our', 'first', 'diagnostic', 'suspicion,', 'the', 'HABITUAL', 'test', '(as', 'the', 'statement', 'says)', 'for', 'diagnosis', 'should', 'be', 'a', 'conventional', 'karyotype', '(formula:', '45,', 'X0).'], ['A', 'Turner', 'can', 'also', 'be', 'diagnosed', 'with', 'a', 'FISH', '(there', 'would', 'only', 'be', 'one', 'signal', 'for', 'the', 'X', 'instead', 'of', 'the', 'two', 'that', 'females', 'usually', 'have)', 'or', 'with', 'an', 'array.'], ['However,', 'both', 'array', 'and', 'NGS', 'are', 'usually', 'reserved', 'for', 'patients', 'with', 'non-obvious', 'clinical', 'pictures,', 'intellectual', 'disability,', 'or', 'suspicion', 'of', 'a', 'genetic', 'syndrome', 'that', 'requires', 'these', 'specific', 'tests', '(for', 'example,', 'an', 'array', 'to', 'diagnose', 'a', '22q11', 'deletion', 'syndrome', 'or', 'an', 'NGS', 'panel', 'to', 'diagnose', 'a', 'Noonan', 'syndrome).']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim', 'I-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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', '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', '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', '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'], ['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'], ['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']]"
216121,"[['QUESTION', 'TYPE:', 'NEPHROLOGY'], ['CLINICAL', 'CASE:'], ['A', '38-year-old', 'man', 'consults', 'for', 'dyspnea', 'and', 'hemoptysis.'], ['Blood', 'tests', 'show', 'creatinine', '7', 'mg/dL,', 'urea', '250', 'mg/dL', 'and', 'high', 'titer', 'positive', 'anti-GBM', '(anti-glomerular', 'basement', 'membrane', 'antibodies).'], ['Renal', 'biopsy', 'shows', 'crescents', 'in', '75%', 'of', 'the', 'glomeruli', 'and', 'immunofluorescence', 'shows', 'a', 'linear', 'Ig', 'deposition', 'pattern.'], ['Which', 'of', 'the', 'following', 'is', 'the', 'correct', 'answer?'], ['1-', 'It', 'is', 'an', 'IgA', 'nephropathy', 'with', 'acute', 'renal', 'failure.'], ['2-', 'Plasmapheresis', 'would', 'be', 'indicated.'], ['3-', 'It', 'is', 'a', 'membranous', 'glomerulonephritis.'], ['4-', 'Mycophenolate', 'mofetil', 'is', 'the', 'initial', 'treatment', 'of', 'choice.'], ['5-', 'Glomerular', 'involvement', 'is', 'caused', 'by', 'the', 'presence', 'of', 'circulating', 'immunocomplexes.'], ['CORRECT', 'ANSWER:', '2'], ['The', 'diagnostic', 'suspicion', 'for', 'the', 'data', 'given', '(especially', 'the', 'anti-GBM', 'antibodies', 'and', 'the', 'presence', 'of', 'renopulmonary', 'syndrome)', 'is', 'that', 'of', ""Goodpasture's"", 'syndrome.'], ['The', 'rest', 'of', 'the', 'data', '(seminules', 'in', 'the', 'biopsy,', 'linear', 'IgG', 'deposition)', 'supports', 'the', 'diagnosis.'], ['Knowing', 'this,', 'the', 'options', 'are', 'easily', 'discarded:', 'option', '1', 'speaks', 'to', 'us', 'of', 'an', 'IgA', 'nephropathy', '(it', 'is', 'not', 'the', 'case', 'because', 'the', 'deposits', 'are', 'of', 'IgG);', 'option', '3', 'is', 'also', 'discarded,', 'because', 'it', 'is', 'not', 'a', 'primary', 'GMN,', 'like', 'the', 'membranous', 'one,', 'but', 'a', 'secondary', 'glomerulopathy;', 'option', '4', 'is', 'also', 'false:', 'the', 'initial', 'treatment', 'is', 'with', 'corticosteroids', 'and', 'cyclophosphamide', 'associated', 'to', 'plasmapheresis;', 'and', 'option', '5', 'is', 'also', 'false,', 'since', 'the', 'damage', 'is', 'not', 'due', 'to', 'circulating', 'immunocomplexes,', 'but', 'to', 'antibodies', 'deposited', 'in', 'the', 'glomerular', 'basement', 'membrane.'], ['This', 'leaves', 'option', '2', 'as', 'true:', 'as', 'it', 'has', 'been', 'previously', 'said,', 'the', 'treatment', 'would', 'be', 'performed', 'combining', 'corticosteroids,', 'cyclophosphamide', 'and', 'plasmapheresis.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', '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'], ['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'], ['O', 'B-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'], ['B-Premise', 'I-Premise', 'I-Premise', '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', '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-Marker', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'B-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', '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', 'O', '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', '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-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
384151,"[['QUESTION', 'TYPE:', 'PEDIATRICS'], ['CLINICAL', 'CASE:'], ['A', 'woman', 'comes', 'to', 'the', 'office', 'with', 'her', '3', 'year', 'old', 'daughter', 'because', 'she', 'has', 'detected', 'a', 'slight', 'mammary', 'development', 'since', '3', 'months', 'without', 'taking', 'any', 'medication', 'or', 'any', 'relevant', 'history.'], ['Indeed,', 'the', 'physical', 'examination', 'shows', 'a', 'Tanner', 'stage', 'IV,', 'with', 'no', 'growth', 'of', 'pubic', 'or', 'axillary', 'hair.'], ['The', 'external', 'genitalia', 'are', 'normal.'], ['Ultrasonography', 'reveals', 'a', 'small', 'uterus', 'and', 'radiology', 'reveals', 'a', 'bone', 'age', 'of', '3', 'years.'], ['What', 'attitude', 'should', 'be', 'adopted?'], ['1-', 'Follow-up', 'every', '3-4', 'months,', 'as', 'this', 'is', 'a', 'temporary', 'condition', 'that', 'often', 'resolves', 'on', 'its', 'own.'], ['2-', 'Breast', 'biopsy.'], ['3-', 'Mammography.'], ['4-', 'Administration', 'of', 'GnRh', 'analogues.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '1'], ['It', 'seems', 'that', 'they', 'want', 'to', 'present', 'us', 'with', 'precocious', 'puberty', '(or', 'premature', 'telarche)', 'but', 'they', 'do', 'not', 'provide', 'any', 'analytical', 'data', 'and', 'the', 'ultrasound', 'data', 'are', 'ambiguous', '(we', 'should', 'assume', 'that', 'by', 'a', 'small', 'uterus', 'they', 'are', 'referring', 'to', 'a', 'prepubertal', 'uterus,', 'but', 'they', 'do', 'not', 'provide', 'any', 'data', 'on', 'ovarian', 'size).'], ['We', 'are', 'presented', 'with', 'the', 'case', 'of', 'a', 'three-year-old', 'girl', 'with', 'advanced', 'mammary', 'development,', 'in', 'principle', 'without', 'any', 'associated', 'cause', '(in', 'principle', 'she', 'does', 'not', 'take', 'drugs', 'that', 'can', 'increase', 'the', 'level', 'of', 'estrogen', 'in', 'the', 'blood,', 'she', 'does', 'not', 'seem', 'to', 'use', 'body', 'creams', 'or', 'eat', 'a', 'lot', 'of', 'chicken', 'meat).'], ['If', 'we', 'follow', 'the', 'diagnostic', 'scheme', 'for', 'a', 'premature', 'telarche', 'or', 'suspicion', 'of', 'precocious', 'puberty,', 'we', 'request', 'bone', 'age', 'and', 'abdominal', 'ultrasound', '(the', 'EO', 'is', 'not', 'advanced', 'as', 'in', 'precocious', 'puberty,', 'and', 'we', 'assume', 'that', 'with', 'a', 'small', 'uterus', 'they', 'mean', 'a', 'prepubertal', 'uterus);', 'according', 'to', 'the', 'complementary', 'examinations', 'that', 'we', 'are', 'given,', 'it', 'does', 'not', 'seem', 'to', 'be', 'precocious', 'puberty,', 'except', 'for', 'the', 'clinical', '(Tanner', 'IV).'], ['Strictly', 'speaking,', 'without', 'analytical', 'hormonal', 'data,', 'it', 'seems', 'that', 'we', 'could', 'mark', 'option', '1,', 'being', 'necessary', 'to', 'follow', 'the', 'girl', 'closely.'], ['If', 'we', 'take', 'all', 'the', 'above', 'data', 'for', 'granted,', 'we', 'could', 'rule', 'out', 'option', '4,', 'which', 'would', 'be', 'the', 'treatment', 'of', 'a', 'central', 'precocious', 'puberty.'], ['Regarding', 'the', 'option', 'of', 'mammography,', 'breast', 'ultrasound', 'is', 'used', 'in', 'pediatrics,', 'and', 'in', 'this', 'case', 'it', 'would', 'be', 'indicated', 'if', 'we', 'were', 'told', 'that', 'there', 'is', 'breast', 'asymmetry', '(we', 'discard', 'option', '3).'], ['Regarding', 'breast', 'biopsy,', 'it', 'would', 'only', 'be', 'indicated', 'if', 'there', 'are', 'warning', 'signs.']]","[['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-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['B-Premise', 'I-Premise', '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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-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', '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', '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-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', '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', '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', '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'], ['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-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']]"
238145,"[['QUESTION', 'TYPE:', 'NEUROLOGY'], ['CLINICAL', 'CASE:'], ['A', '40-year-old', 'woman', 'consults', 'for', 'approximately', '20', 'episodes', 'per', 'day', 'of', 'intense', 'left', 'periocular', 'pain', 'lasting', '15', 'minutes,', 'accompanied', 'by', 'intense', 'tearing', 'and', 'rhinorrhea.'], ['Her', 'examination', 'and', 'MRI', 'are', 'normal.'], ['His', 'treatment', 'of', 'choice', 'would', 'be:'], ['1-', 'Indomethacin.'], ['2-', 'Lamotrigine.'], ['3-', 'Verapamil.'], ['4-', 'Prednisone.'], ['5-', 'Lithium', 'carbonate.'], ['CORRECT', 'ANSWER:', '1'], ['In', 'this', 'question', 'we', 'are', 'presented', 'with', 'a', 'case', 'to', 'deduce', 'a', 'diagnosis', 'and', 'then', 'indicate', 'which', 'would', 'be', 'the', 'treatment', 'of', 'choice.'], ['Both', 'the', 'characteristics', 'of', 'the', 'case', 'and', 'the', 'answers', 'suggest', 'that', 'it', 'is', 'a', 'trigemino-autonomic', 'headache', '(intense,', 'periocular', 'pain', 'with', 'lacrimation', 'and', 'rhinorrhea).'], ['The', 'idea', 'is', 'to', 'make', 'a', 'differential', 'diagnosis', 'mainly', 'between', 'a', 'cluster', 'headache', '(whose', 'treatments', 'include', 'answers', '2,', '3,', '4', 'and', '5),', 'a', 'paroxysmal', 'hemicrania', '(whose', 'treatment', 'of', 'choice', 'is', 'the', 'indomethacin', 'of', 'answer', '1)', 'and', 'a', 'SUNCT', '(unilateral', 'neuralgiform', 'headache', 'with', 'conjunctival', 'injection', 'and', 'lacrimation).'], ['Cluster', 'headache', 'predominates', 'in', 'males', 'whose', 'duration', 'can', 'vary', 'between', '15-180', 'minutes,', 'between', 'once', 'every', '2', 'days,', 'up', 'to', '8', 'times', 'a', 'day.'], ['Paroxysmal', 'hemicrania', 'predominates', 'in', 'women,', 'with', 'episodes', 'of', 'pain', 'similar', 'to', 'cluster', 'headache,', 'but', 'with', 'a', 'shorter', 'duration', '(2-30', 'min),', 'and', 'a', 'higher', 'frequency', '(5-30', 'episodes', 'per', 'day).'], ['As', 'for', 'SUNCT,', 'the', 'crises', 'are', 'much', 'shorter,', 'lasting', 'seconds', '(5-240', 'seconds)', 'and', 'are', 'usually', 'refractory', 'to', 'treatment.'], ['Therefore', 'the', 'diagnosis', 'would', 'be', 'of', 'a', 'paroxysmal', 'hemicrania', 'and', 'its', 'treatment', 'of', 'choice', 'is', 'indomethacin', '(which', 'also', 'the', 'answer', 'is', 'a', 'diagnostic', 'criterion).'], ['Therefore', 'correct', 'answer', '1', '(Indomethacin).'], ['All', 'data', 'provided', 'are', 'based', 'on', 'the', 'Diagnostic', 'Criteria', 'of', 'the', 'International', 'Headache', 'Society.']]","[['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'], ['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim'], ['O', 'B-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'], ['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', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O']]"
47157,"[['QUESTION', 'TYPE:', 'PEDIATRICS'], ['CLINICAL', 'CASE:'], ['A', '6-year-old', 'boy', 'comes', 'to', 'the', 'clinic', 'accompanied', 'by', 'the', 'monitor', 'of', 'a', 'day', 'care', 'center', 'in', 'our', 'neighborhood', 'because', 'of', 'a', 'painful', 'lump', '3', 'cm', 'in', 'diameter', 'on', 'palpation', 'in', 'the', 'right', 'occipital', 'area', 'of', 'the', 'scalp.'], ['He', 'suffers', 'from', 'alopecia', 'in', 'this', 'area', 'and', '3', 'adenomegalies', 'of', 'quite', 'hard', 'consistency', 'in', 'the', 'right', 'posterior', 'cervical', 'region.'], ['What', 'would', 'be', 'the', 'most', 'appropriate', 'treatment?'], ['1-', 'Incision', 'and', 'drainage.'], ['2-', 'Topical', 'Mupirocin.'], ['3-', 'Griseofulvin', 'orally.'], ['4-', 'Intravenous', 'cefazolin.'], ['5-', 'Topical', 'Ketoconazole.'], ['CORRECT', 'ANSWER:', '3'], ['The', 'correct', 'answer', 'is', '3.'], ['If', 'I', 'am', 'not', 'mistaken,', 'you', 'are', 'describing', 'a', ""Celso's"", 'kerion', 'for', 'which', 'the', 'treatment', 'of', 'choice', 'is', 'oral', 'griseofulvin.']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Treatment', 'I-Treatment'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-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']]"
381139,"[['QUESTION', 'TYPE:', 'NEUROLOGY'], ['CLINICAL', 'CASE:'], ['A', '70-year-old', 'woman', 'with', 'a', 'history', 'of', 'anorexia,', 'weight', 'loss,', 'discomfort', 'in', 'the', 'muscles', 'and', 'proximal', 'joints', 'and', 'pain', 'in', 'the', 'temporomandibular', 'region', 'who', 'comes', 'to', 'the', 'emergency', 'department', 'for', 'unilateral', 'loss', 'of', 'vision', '(hand', 'movement),', 'sudden', 'and', 'painless', 'onset', '(afferent', 'pupillary', 'defect).what', 'test', 'would', 'you', 'request', 'first', 'for', 'diagnostic', 'purposes?'], ['1-', 'Lumbar', 'puncture.'], ['2-', 'C', 'Reactive', 'Protein.'], ['3-', 'Magnetic', 'resonance', 'angiography.'], ['4-', 'Carotid', 'ultrasound.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '2'], ['We', 'are', 'presented', 'with', 'a', 'case', 'of', 'monocular', 'amaurosis', 'with', 'a', 'vascular', 'profile,', 'also', 'in', 'an', 'older', 'woman', 'with', 'a', 'history', 'of', 'weight', 'loss', 'and', 'what', 'seems', 'to', 'be', 'symptoms', 'of', 'mandibular', 'claudication', 'and', 'polymyalgia', 'rheumatica,', 'so', 'the', 'first', 'cause', 'to', 'think', 'about', 'is', 'giant', 'cell', 'arteritis', 'as', 'the', 'cause', 'of', 'NOIA,', 'so', 'the', 'correct', 'option', 'would', 'be', '2.'], ['Option', '4', 'would', 'be', 'considered', 'if', 'we', 'were', 'told', 'of', 'an', 'AINO', 'but', 'with', 'non-arteritic', 'characteristics', '(without', 'all', 'the', 'accompanying', 'symptomatology).']]","[['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', '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', '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', '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', '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', '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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
3264,"[['QUESTION', 'TYPE:', 'NEUROLOGY', 'AND', 'NEUROSURGERY'], ['CLINICAL', 'CASE:'], ['In', 'a', 'patient', 'diagnosed', 'with', 'epilepsy', 'who', 'presents', 'with', 'episodes', 'of', 'unresponsiveness', 'to', 'external', 'stimuli,', 'irregular', 'movements', 'of', 'all', 'four', 'limbs,', 'closed', 'eyes,', 'crying', 'and', 'pelvic', 'movements,', 'lasting', 'five', 'to', 'twenty', 'seconds', 'and', 'unresponsive', 'to', 'treatment', 'with', 'antiepileptic', 'drugs,', 'which', 'complementary', 'study', 'is', 'most', 'likely', 'to', 'clarify', 'the', 'diagnosis?'], ['1-', 'Video-EEG', 'monitoring', 'for', 'diagnosis', 'of', 'pseudocrisis', '(psychogenic', 'seizures).'], ['2-', 'Holter', 'ECG', 'for', 'diagnosis', 'of', 'arrhythmic', 'heart', 'disease.'], ['3-', 'Routine', 'EEG', 'to', 'diagnose', 'the', 'type', 'of', 'epilepsy', '(generalized', 'or', 'foc).'], ['4-', 'Brain', 'MRI', 'to', 'detect', 'epileptogenic', 'lesions', '(cortical', 'dysplasia,', 'tumor,', 'medial', 'temporal', 'sclerosis).'], ['5-', 'Determine', 'capillary', 'blood', 'glucose', 'for', 'diagnosis', 'of', 'hypoglycemia.'], ['CORRECT', 'ANSWER:', '1'], ['Correct', 'answer', '1:', 'The', 'picture', 'described', 'is', 'very', 'suggestive', 'of', 'pseudocrisis', 'with', 'asynchronous', 'limb', 'movements,', 'pelvic', 'movements,', 'crying', 'and', 'poor', 'response', 'to', 'antiepileptic', 'drugs.']]","[['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', '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'], ['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'], ['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'], ['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']]"
106135,"[['QUESTION', 'TYPE:', 'GENETICS', 'AND', 'IMMUNOLOGY'], ['CLINICAL', 'CASE:'], ['2-year-old', 'boy.'], ['His', 'personal', 'history', 'includes', '3', 'episodes', 'of', 'acute', 'otitis', 'media,', '1', 'meningococcal', 'meningitis', 'and', '2', 'pneumonias', '(one', 'middle', 'lobe', 'and', 'one', 'left', 'upper', 'lobe).'], ['She', 'has', 'been', 'admitted', 'on', '3', 'occasions', 'for', 'thrombopenic', 'purpura', '(on', 'three', 'occasions', 'antiplatelet', 'antibodies', 'were', 'negative', 'and', 'bone', 'marrow', 'showed', 'normal', 'megakaryocytes).'], ['Several', 'males', 'of', 'the', 'maternal', 'family', 'had', 'died', 'in', 'childhood', 'due', 'to', 'infectious', 'processes.'], ['Physical', 'examination', 'showed', 'lesions', 'typical', 'of', 'atopic', 'dermatitis.'], ['The', 'immunological', 'study', 'showed', 'a', 'slight', 'decrease', 'in', 'T-lymphocyte', 'subpopulations;', 'elevated', 'IgA', 'and', 'IgE;', 'decreased', 'IgM', 'and', 'IgG', 'at', 'the', 'lower', 'limit', 'of', 'normal.'], ['What', 'is', 'the', 'most', 'likely', 'diagnosis?'], ['1-', 'Wiskott-Aldrich', 'syndrome.'], ['2-', 'Hyper', 'IgE', 'syndrome.'], ['3-', 'Transient', 'hypogammaglobulinemia', 'of', 'childhood.'], ['4-', 'X-linked', 'severe', 'combined', 'immunodeficiency.'], ['5-', 'Common', 'variable', 'immunodeficiency.'], ['CORRECT', 'ANSWER:', '4'], ['To', 'correctly', 'answer', 'this', 'question', 'it', 'should', 'be', 'emphasized', 'that', 'among', 'the', 'symptomatology', 'that', 'is', 'exposed', 'we', 'find:', '-', '2-year-old', 'child.'], ['-', 'ENT', 'infections.'], ['-', 'Pulmonary', 'infections.'], ['-', 'Hospital', 'admissions.'], ['-', 'PTI.'], ['-', 'Family', 'history', 'of', 'infections', 'with', 'deaths', 'due', 'to', 'infections', 'in', 'males', '(maternal', 'family).'], ['-', 'Atopic', 'Dermatitis.'], ['All', 'these', 'data,', 'in', 'addition', 'to', 'the', 'analytical', 'data,', 'are', 'describing', 'an', 'immunodeficiency', 'that', 'by', 'the', 'family-maternal', 'history,', 'seems', 'to', 'be', 'X-linked,', 'as', 'several', 'males', 'have', 'died', 'of', 'a', 'similar', 'clinical', 'condition', '(the', 'father', 'of', 'the', 'patient', 'contributed', 'the', 'Y', 'chromosome,', 'the', 'mother', 'the', 'X).'], ['Among', 'the', 'X-linked', 'immunodeficiencies', 'is', 'Wiskott-Aldrich', 'syndrome,', 'an', 'entity', 'described', 'with', 'an', 'initial', 'triad', 'of', 'symptoms', 'consisting', 'of', 'bleeding', '(typical', 'BUT', 'absent', 'in', 'the', 'case:', 'heavy', 'bleeding', 'after', 'circumcision,', 'bloody', 'diarrhea),', 'recurrent', 'infections', 'and', 'eczema.'], ['In', 'addition', 'to', 'thrombocytopenia,', 'they', 'are', 'at', 'increased', 'risk', 'for', 'autoimmune', 'phenomena', 'and', 'lymphoid', 'neoplasms.'], ['The', 'Hyper-IgE', 'option', 'lacks', 'very', 'characteristic', 'clinical', 'data', 'such', 'as', 'bone', 'alterations', 'and', 'skin', 'lesions,', 'which', 'are', 'not', 'atopic', 'dermatitis,', 'since', 'they', 'follow', 'a', 'different', 'pattern', '(papulopustular', 'rash', 'on', 'the', 'face', 'and', 'scalp).'], ['The', 'option', 'of', 'transient', 'hypogammaglobulinemia', 'of', 'infancy', 'and', 'the', 'common', 'severe', 'and', 'variable', 'combined', 'immunodeficiency', 'fails,', 'among', 'other', 'features,', 'the', 'determination', 'of', 'immunoglobulins', 'G', 'and', 'M,', 'which', 'are', 'at', 'the', 'lower', 'limit,', 'but', 'within', 'normality.']]","[['O', 'O', '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', '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'], ['B-Premise', 'I-Premise', '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', 'I-Premise', 'I-Premise', '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'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-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', 'B-Premise', 'I-Premise'], ['O', 'B-Premise', 'I-Premise'], ['O', 'B-Premise', 'I-Premise'], ['O', 'B-Premise', 'I-Premise'], ['O', 'B-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'], ['O', 'B-Disease', 'I-Disease'], ['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'], ['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'], ['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'], ['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']]"
62119,"[['QUESTION', 'TYPE:', 'ANESTHESIOLOGY', 'AND', 'CRITICAL', 'CARE'], ['CLINICAL', 'CASE:'], ['We', 'are', 'consulted', 'to', 'assess', 'an', '83-year-old', 'woman', 'admitted', 'to', 'the', 'Trauma', 'service', 'for', 'a', 'hip', 'fracture', '6', 'hours', 'ago.'], ['She', 'has', 'AP', 'of', 'hypertension,', 'LBP,', 'moderate', 'dementia', 'and', 'lives', 'in', 'a', 'nursing', 'home.'], ['Her', 'usual', 'treatment', 'is', 'thiazide,', 'atorvastatin,', 'donepezil,', 'Calcium', 'and', 'vitamin', 'D.'], ['EF:', 'Confused', 'patient,', 'pulse', '90', 'bpm,', 'respiratory', 'rate', '20', 'rpm,', 'T', 'art', '170/88,', 'jugular', 'venous', 'pressure', 'normal.'], ['The', 'CBC', 'and', 'chest', 'X-ray', 'are', 'normal', 'and', 'the', 'ECG', 'shows', 'sinus', 'rhythm', 'without', 'ischemic', 'alterations.'], ['Which', 'of', 'the', 'following', 'is', 'the', 'most', 'correct', 'therapeutic', 'approach?'], ['1-', 'Delay', 'surgery', 'until', 'the', 'confusional', 'picture', 'has', 'disappeared.'], ['2-', 'Delay', 'surgery', 'and', 'perform', 'an', 'echocardiogram.'], ['3-', 'Delay', 'surgery', 'until', 'good', 'blood', 'pressure', 'control.'], ['4-', 'Start', 'a', 'beta-blocker', 'and', 'initiate', 'surgery.'], ['5-', 'Perform', 'closed', 'osteosynthesis,', 'avoiding', 'in', 'any', 'case', 'the', 'implantation', 'of', 'prosthesis.'], ['CORRECT', 'ANSWER:', '4'], ['The', 'confusional', 'picture', 'is', 'determined', 'by', 'the', 'dementia', 'that', 'the', 'patient', 'already', 'suffers,', 'so', 'no', 'matter', 'how', 'much', 'we', 'delay', 'surgery,', 'we', 'are', 'not', 'going', 'to', 'achieve', 'anything.'], ['The', 'elevation', 'of', 'blood', 'pressure', 'is', 'due,', 'in', 'principle,', 'to', 'pain', '(so', 'the', 'first', 'option', 'is', 'an', 'analgesic)', 'and', 'then', 'to', 'the', 'stressful', 'situation', 'that', 'leads', 'an', 'already', 'hypertensive', 'patient', 'to', 'increase', 'her', 'blood', 'pressure,', 'so', 'labetalol', 'could', 'help', 'us.'], ['The', 'last', 'answer', 'is', 'not', 'correct', 'because', 'it', 'depends', 'on', 'the', 'type', 'of', 'fracture,', 'which', 'is', 'not', 'specified', 'in', 'the', 'statement:', 'a', 'pertrochanteric', 'fracture', 'would', 'require', 'closed', 'osteosynthesis', 'and', 'a', 'subcapital', 'fracture', 'would', 'require', 'a', 'prosthesis.']]","[['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', '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', 'I-Premise', 'I-Premise'], ['O', 'B-Premise', 'I-Premise', 'B-Premise', 'I-Premise', 'I-Premise', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'B-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', 'O', 'B-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', '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'], ['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', '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', 'B-Marker', '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'], ['B-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', 'O', 'B-Marker', '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-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['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', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise']]"
59276,"[['QUESTION', 'TYPE:', 'ONCOLOGY'], ['CLINICAL', 'CASE:'], ['A', '40-year-old', 'woman', 'consults', 'because', 'she', 'has', 'noticed', 'a', 'lump', 'in', 'the', 'superoexternal', 'quadrant', 'of', 'the', 'right', 'breast', 'for', 'the', 'past', 'month.'], ['She', 'provides', 'a', 'mammography', 'report', 'describing', 'a', 'BIRADS', '3', 'lesion.'], ['What', 'is', 'the', 'best', 'course', 'of', 'action?'], ['1-', 'Reassure', 'him,', 'since', 'an', 'imaging', 'test', 'has', 'already', 'been', 'done', 'and', 'malignancy', 'has', 'been', 'ruled', 'out.'], ['2-', 'This', 'classification', 'probably', 'implies', 'surgery', 'since', 'the', 'probability', 'of', 'cancer', 'is', 'greater', 'than', '10%.', 'He', 'explains', 'it', 'to', 'you', 'and', 'refers', 'you', 'preferentially', 'to', 'the', 'Breast', 'Unit.'], ['3-', 'This', 'is', 'a', 'probably', 'benign', 'finding,', 'since', 'there', 'is', 'less', 'than', 'a', '2%', 'chance', 'of', 'cancer.', 'He', 'explains', 'that', 'it', 'requires', 'follow-up', 'every', '6-12', 'months', 'until', '24', 'months', 'or', 'a', 'biopsy.'], ['4-', 'The', 'findings', 'are', 'of', 'low', 'suspicion', 'of', 'cancer', '(between', '2', 'and', '10', '%)', 'but', 'a', 'biopsy', 'is', 'necessary.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['BI-RADS', 'Breast', 'Imaging', 'Reporting', 'and', 'Data', 'System.'], ['BI-RADS', '3', 'is', 'defined', 'by', 'answer', '3.']]","[['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'], ['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'], ['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', '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', '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']]"
26117,"[['QUESTION', 'TYPE:', 'INFECTIOUS'], ['CLINICAL', 'CASE:'], ['An', 'immunodeficient', 'patient', 'who', 'presents', 'a', 'pneumonia', 'with', 'meniscus', 'halo', 'sign', 'or', 'crescentic', 'contour', 'on', 'chest', 'X-ray/CT', 'suggests', 'infection', 'by', 'a', 'microorganism:'], ['1-', 'Staphylococcus', 'aureus.'], ['2-', 'Streptococcus', 'pneumoniae.'], ['3-', 'Candida', 'albicans.'], ['4-', 'Pseudomonas', 'aeruginosa.'], ['5-', 'Aspergillus', 'fumigatus.'], ['CORRECT', 'ANSWER:', '5'], ['The', 'halo', 'sign', 'is', 'characteristic', 'of', 'pulmonary', 'aspergillosis,', 'especially', 'in', 'an', 'immuodepressed', 'patient.'], ['But', 'it', 'is', 'not', 'pathognomonic;', 'it', 'has', 'also', 'been', 'associated', 'with', 'TB,', 'some', 'neoplasms', 'and', ""Wegener's"", 'granulomatosis.']]","[['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', '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', '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']]"
435121,"[['QUESTION', 'TYPE:', 'INFECTIOUS', 'DISEASES', 'AND', 'MICROBIOLOGY'], ['CLINICAL', 'CASE:'], ['A', '45-year-old', 'man', 'consults', 'for', 'a', 'productive', 'cough,', 'pleuritic', 'pain', 'in', 'the', 'right', 'flank', 'and', 'fever', 'of', '48', 'h', 'of', 'evolution.'], ['He', 'has', 'a', 'baseline', 'O2', 'saturation', 'of', '88%', 'and', 'rales', 'in', 'the', 'right', 'base.'], ['Chest', 'X-ray', 'shows', 'a', 'right', 'basal', 'consolidation.'], ['She', 'has', 'a', 'history', 'of', 'HIV', 'infection', 'well', 'controlled', 'with', 'antiretroviral', 'drugs', '(CD4', 'lymphocytes', '550', 'ce/uL', 'and', 'undetectable', 'HIV', 'viral', 'load).'], ['Which', 'of', 'the', 'following', 'empirical', 'antimicrobial', 'treatments', 'do', 'you', 'consider', 'most', 'appropriate?'], ['1-', 'Cefiriaxone', '2', 'g', 'and', 'azithromycin', '500', 'mg', 'every', '24', 'hours.'], ['2-', 'Cefiriaxone', '2', 'g,', 'azithrornicin', '500', 'mg', 'every', '24', 'h', 'and', 'trimethoprim-sulfamethoxazole', '5', 'mg/kg/8', 'h', '(based', 'on', 'trimethoprim', 'doses).'], ['3-', 'Methyl-prednisolone', '40', 'mg/day,', 'cefiriaxone', '2', 'g', 'IV', '124', 'h', 'and', 'trimethoprim-sulfamethoxazole', '5', 'mg/kg/8', 'h', '(based', 'on', 'trimethoprim', 'doses).'], ['4-', 'Meropenem', 'I', 'g/8', 'h', 'and', 'vancomycin', 'I', 'g/l2', 'h.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '1'], ['The', 'first', 'option', 'seems', 'to', 'be', 'the', 'correct', 'one,', 'due', 'to', 'the', 'low', 'probability', 'of', 'P.', 'jirovecii', 'infection', 'in', 'a', 'patient', 'with', 'more', 'than', '500', 'CD4', 'lymphocytes', 'and', 'undetectable', 'viral', 'load.'], ['It', 'is', 'most', 'likely', 'to', 'be', 'a', 'pneumococcal', 'infection', 'that', 'we', 'cover', 'with', 'Ceftriaxone', 'and', 'with', 'azithromycin', 'we', 'cover', 'the', 'so-called', '""atypical""', 'ones.'], ['Meropenem', 'is', 'an', 'antibiotic', 'with', 'too', 'broad', 'a', 'spectrum,', 'which', 'would', 'be', 'an', 'option', 'in', 'in-hospital', 'pneumonia', 'caused', 'by', 'P.', 'aeruginosa,', 'a', 'bacterial', 'agent', 'that', 'can', 'also', 'cause', 'pneumonia', 'in', 'HIV', 'patients,', 'but', 'this', 'is', 'not', 'common.']]","[['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'], ['B-Premise', 'I-Premise', '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'], ['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'], ['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', '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'], ['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']]"
474142,"[['QUESTION', 'TYPE:', 'ORTHOPEDIC', 'SURGERY', 'AND', 'TRAUMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '70-year-old', 'woman,', 'diabetic', 'and', 'hypertensive,', 'who', 'suffers', 'a', 'fall', 'at', 'home,', 'presenting', 'a', '9', 'cm', 'wound', 'communicating', 'with', 'a', 'fracture', 'site', 'of', 'the', 'right', 'tibia.'], ['Radiographically,', 'a', 'short', 'oblique', 'fracture', 'of', 'the', 'mid-distal', 'third', 'of', 'the', 'tibia', 'was', 'observed.'], ['An', 'emergency', 'operation', 'was', 'performed', 'by', 'cleaning', '(Friederich)', 'and', 'placement', 'of', 'an', 'endomedullary', 'steel-plated', 'nail.'], ['At', '11', 'months', 'he', 'presents', 'with', 'atrophic', 'pseudarthrosis', 'of', 'the', 'tibia', 'with', 'suppuration', 'in', 'the', 'wound', 'area.'], ['What', 'will', 'be', 'his', 'best', 'immediate', 'therapeutic', 'option?'], ['1-', 'Triple', 'antibiotherapy', '(gram-positive,', 'gram-negative', 'and', 'anaerobic)', 'and', 'cleaning', 'of', 'the', 'surgical', 'wound,', 'removing', 'the', 'distal', 'locks', 'to', 'promote', 'bone', 'consolidation.'], ['2-', 'Expectant', 'attitude', 'and', 'antibiotic', 'treatment', 'with', 'quinolones.'], ['3-', 'Autologous', 'graft', 'and', 'growth', 'factors', '(BMP', '2', 'and', '7)', 'to', 'stimulate', 'the', 'bone', 'consolidation', 'process,', 'which', 'is', 'slowing.'], ['4-', 'Removal', 'of', 'the', 'nail,', 'debridement,', 'placement', 'of', 'external', 'fixator', 'and', 'antibiotherapy', 'adjusted', 'to', 'culture', 'results.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '4'], ['The', 'first', 'thing', 'is', 'to', 'treat', 'the', 'infection', 'and', 'for', 'this', 'we', 'must', 'remove', 'all', 'the', 'osteosynthesis', 'material,', 'debride', 'and', 'give', 'antibiotherapy.'], ['Fixation', 'in', 'this', 'case', 'is', 'better', 'external', 'to', 'avoid', 'all', 'the', 'material', 'around', 'the', 'affected', 'area,', 'so', '4', 'is', 'correct', 'and', '1', 'and', '2', 'is', 'not.'], ['The', '3', 'would', 'be', 'considered', 'after', 'expiration', 'of', 'the', 'infectious', 'picture.'], ['TREATMENT', '-', 'Suppressive', 'antibiotic', 'treatment:', 'indicated', 'in', 'patients', 'with', 'Ciemy', 'type', 'C,', 'it', 'consists', 'of', 'prolonged', 'oral', 'antibiotic', 'therapy', 'for', 'at', 'least', '6', 'months', 'to', '""cool""', 'the', 'exacerbation', 'of', 'the', 'clinical', 'picture.'], ['-', 'Curative', 'treatment:', 'includes', 'a', 'first', 'surgery', 'with', 'aggressive', 'tumor-like', 'debridement', 'of', 'all', 'affected', 'tissues,', 'profuse', 'irrigation,', 'stabilization', 'with', 'external', 'fixator', 'if', 'stability', 'is', 'compromised,', 'and', 'eventual', 'filling', 'of', 'the', 'cavities', 'with', 'antibiotic-releasing', 'substances.'], ['After', 'prolonged', 'periods', 'of', 'antibiotic', 'therapy', 'selected', 'according', 'to', 'the', 'antibiograms', 'of', 'the', 'cultures,', 'and', 'once', 'it', 'is', 'certain', 'that', 'the', 'infection', 'has', 'been', 'cured,', 'special', 'techniques', 'for', 'the', 'reconstruction', 'of', 'the', 'bone', 'defect', 'and', 'to', 'achieve', 'adequate', 'coverage', 'of', 'soft', 'tissues', 'should', 'be', 'considered.'], ['We', 'are', 'dealing', 'with', 'an', 'infection', 'associated', 'with', 'an', 'implant', '(intramedullary', 'nail)', 'and', 'pseudoarthrosis', 'of', 'the', 'tibia', 'fracture', '(absence', 'of', 'union', 'after', '11', 'months).'], ['The', 'infection', 'is', 'understood', 'by', 'the', 'clinical', 'manifestations', '(suppuration,', 'nonunion)', 'and', 'the', 'history', 'of', 'diabetes', 'and', 'open', 'fracture.'], ['Management', 'overlaps', 'with', 'the', 'management', 'of', 'chronic', 'osteomyelitis.'], ['Isolated', 'antibiotherapy', '(option', '2)', 'is', 'indicated', 'only', 'in', 'patients', 'with', 'severe', 'comorbidity', 'in', 'whom', 'surgical', 'treatment', 'would', 'be', 'more', 'aggressive', 'than', 'continuing', 'the', 'disease.'], ['Nail', 'dynamization', 'associated', 'with', 'broad-spectrum', 'antibiotherapy', '(option', '1)', 'is', 'not', 'indicated', 'either,', 'because', '(a)', 'it', 'has', 'not', 'demonstrated', 'benefit', 'in', 'established', 'pseudarthrosis', 'and', '(b)', 'we', 'have', 'the', 'same', 'issue', 'as', 'option', '1,', 'we', 'do', 'not', 'eliminate', 'biofilm.'], ['Option', '3,', 'discussed,', 'would', 'be', 'considered', 'only', 'if', 'there', 'was', 'no', 'associated', 'infection.']]","[['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'], ['B-Premise', 'I-Premise', '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', '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', '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', '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', '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'], ['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-Marker', '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'], ['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'], ['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'], ['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'], ['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-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['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', 'B-Marker', 'O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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']]"
17137,"[['QUESTION', 'TYPE:', 'DERMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '14-year-old', 'female', 'patient', 'in', 'good', 'general', 'condition', 'presents', 'since', '4', 'days', 'ago', 'a', 'very', 'pruritic', 'generalized', 'cutaneous', 'eruption', 'formed', 'by', 'erythematous-edematous', 'plaques', 'between', '2', 'and', '15', 'cm', 'in', 'diameter', 'without', 'desquamation', 'with', 'a', 'tendency', 'to', 'acquire', 'an', 'annular', 'morphology', 'that', 'individually', 'disappear', 'in', 'less', 'than', '24', 'hours.'], ['The', 'mucous', 'membranes', 'are', 'respected.'], ['Your', 'first', 'diagnostic', 'impression', 'would', 'be:'], ['1-', 'Urticaria.'], ['2-', 'Rubella.'], ['3-', 'Toxicoderma.'], ['4-', 'Staphylococcal', 'toxic', 'shock.'], ['5-', 'Scabies.'], ['CORRECT', 'ANSWER:', '1'], ['Acute', 'urticaria:', 'characterized', 'by', 'erythematous-edematous,', 'evanescent,', 'pruritic,', 'evanescent', 'lesions,', 'lasting', 'less', 'than', '24', 'hours,', 'without', 'desquamation.'], ['The', 'general', 'condition', 'is', 'usually', 'preserved.'], ['In', 'children', 'the', 'annular', 'pattern', 'is', 'more', 'frequent.'], ['In', 'both', 'rubella', 'and', 'toxicoderma,', 'the', 'general', 'condition', 'is', 'not', 'preserved.'], ['In', 'staphylococcal', 'shock,', 'the', 'general', 'condition', 'is', 'affected', 'and', 'the', 'lesions', 'are', 'blistering.'], ['Scabies', 'lesions', 'are', 'preferably', 'interdigital,', 'in', 'the', 'form', 'of', 'papulocoses', 'that', 'can', 'follow', 'linear', 'trajectories.']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-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'], ['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'], ['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'], ['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']]"
42592,"[['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['A', '34-year-old', 'woman', 'is', 'admitted', 'for', 'polyuria', 'and', 'polydipsia.'], ['In', 'the', 'first', '24', 'hours', 'of', 'admission', 'a', 'diuresis', 'of', '8.2', 'liters', 'is', 'found', 'and', 'a', 'blood', 'test', 'shows', 'a', 'glycemia', 'of', '96', 'mg/dL,', 'natremia', 'of', '148', 'mEq/L', 'and', 'plasma', 'osmolality', 'of', '309', 'mOsm/kg', 'with', 'urinary', 'osmolality', 'of', '89', 'mOsmlkg.'], ['What', 'diagnostic', 'test', 'should', 'be', 'performed', 'next?'], ['1-', 'Hypertonic', 'saline', 'infusion', 'test', 'for', 'serial', 'determination', 'of', 'antidiuretic', 'hormone.'], ['2-', 'Dehydration', 'test', '(Miller', 'test).'], ['3-', 'Administration', 'of', 'desmopressin', 'with', 'serial', 'monitoring', 'of', 'urine', 'osmolality.'], ['4-', 'Determination', 'of', 'antidiuretic', 'hormone', 'in', 'plasma.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['We', 'are', 'faced', 'with', 'polyuria.'], ['Initially', 'we', 'rule', 'out', 'diabetes', 'mellitus', '(our', 'patient', 'has', 'a', 'normal', 'blood', 'glucose', 'of', '96mg/dl).'], ['The', 'analytical', 'data', 'suggest', 'diabetes', 'insipidus', '(high', 'plasma', 'osm', 'with', 'low', 'urinary', 'osm).'], ['Now', 'we', 'must', 'differentiate', 'between', 'central', 'diabetes', 'insipidus', '(lack', 'of', 'ADH)', 'or', 'nephrogenic', 'diabetes', 'insipidus', '(ADH', 'does', 'not', 'exert', 'its', 'action', 'at', 'the', 'renal', 'level).'], ['This', 'is', 'achieved', 'by', 'the', 'vasopressin', 'test', '(intravenous', 'administration', 'of', 'ADH', 'and', 'remeasurement', 'of', 'urinary', 'osmolarity).'], ['Therefore,', 'the', 'correct', 'answer', 'is', 'option', '3.']]","[['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', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['O', 'B-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'], ['O', 'O'], ['O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-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-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'], ['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']]"
8232,"[['QUESTION', 'TYPE:', 'DIGESTIVE'], ['CLINICAL', 'CASE:'], ['A', '52-year-old', 'woman', 'consulted', 'because', 'she', 'had', 'noticed', 'during', 'the', 'previous', 'week', 'a', 'yellowish', 'discoloration', 'of', 'the', 'conjunctivae.'], ['She', 'does', 'not', 'refer', 'to', 'risky', 'sexual', 'behaviors', 'or', 'epidemiological', 'history', 'of', 'risk', 'of', 'viral', 'hepatitis.'], ['She', 'does', 'not', 'consume', 'alcohol', 'or', 'hepatotoxic', 'drugs.'], ['She', 'reports', 'a', 'one-year', 'history', 'of', 'generalized', 'pruritus,', 'asthenia,', 'dry', 'mouth', 'and', 'absence', 'of', 'lacrimation', 'with', 'no', 'known', 'cause.'], ['Rest', 'of', 'the', 'anamnesis', 'without', 'pathological', 'data.'], ['Physical', 'examination', 'showed', 'scratching', 'lesions,', 'conjunctival', 'jaundice', 'and', 'non-painful', 'hepatomegaly.'], ['The', 'patient', 'brings', 'a', 'blood', 'test', 'carried', 'out', 'in', 'his', 'company', 'with', 'the', 'following', 'pathological', 'results:', 'Bilirubin', '3', 'mg/dl,', 'FA', '400', 'UI/', 'VSG', '40mm', '1', 'hour.'], ['Indicate', 'which', 'would', 'be', 'the', 'best', 'recommendation', 'to', 'establish', 'the', 'etiological', 'diagnosis', 'of', 'the', ""patient's"", 'condition:'], ['1-', 'Anti-mitochondrial', 'antibodies.'], ['2-', 'Study', 'of', 'Fe', 'metabolism.'], ['3-', 'Study', 'of', 'copper', 'metabolism.'], ['4-', 'Hepatic', 'MRI.'], ['5-', 'Serology', 'for', 'B', 'and', 'C', 'viruses.'], ['CORRECT', 'ANSWER:', '1'], ['Book', 'picture', 'of', 'Primary', 'Biliary', 'Cirrhosis,', 'one', 'of', 'those', 'that', 'do', 'not', 'occur', 'in', 'real', 'life.'], ['The', 'diagnosis', 'would', 'be', 'practically', 'made', 'with', 'the', 'AMA', '(1).'], ['With', '2', 'we', 'would', 'rule', 'out', 'hemochromatosis,', 'with', '3', 'we', 'would', 'rule', 'out', ""Wilson's"", 'disease.'], ['With', '4', 'we', 'could', 'rule', 'out', 'rare', 'diseases', 'such', 'as', 'biliary', 'tract', 'malformations', 'or', ""Caroli's"", 'disease', 'and', 'with', '5', 'we', 'could', 'rule', 'out', 'viral', 'hepatitis.']]","[['O', 'O', 'O'], ['O', 'O'], ['O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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', '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', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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-Claim', 'I-Claim'], ['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', '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'], ['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', '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', 'O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
62160,"[['QUESTION', 'TYPE:', 'OPHTHALMOLOGY', '(ECTOPIC)'], ['CLINICAL', 'CASE:'], ['20-year-old', 'patient', 'who', 'comes', 'to', 'the', 'emergency', 'department', 'after', 'suffering', 'a', 'bicycle', 'accident', 'with', 'facial', 'trauma.'], ['A', 'cranial', 'CT', 'scan', 'was', 'performed', 'showing', 'a', 'fracture', 'of', 'the', 'middle', 'third', 'of', 'the', 'face', 'involving', 'the', 'orbito-malar', 'region.'], ['One', 'of', 'the', 'most', 'frequent', 'complications', 'of', 'this', 'type', 'of', 'fracture', 'is:'], ['1-', 'Temporomandibular', 'ankylosis.'], ['2-', 'Dental', 'malocclusion.'], ['3-', 'Naso-ethmoidal', 'pseudoarthrosis.'], ['4-', 'Enophthalmos.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '4'], ['Fractures', 'of', 'the', 'midface', 'in', 'the', 'orbito-malar', 'region', 'may', 'involve', 'the', 'floor', 'and,', 'to', 'a', 'lesser', 'extent,', 'the', 'lateral', 'wall', 'of', 'the', 'orbit.'], ['Assuming', 'therefore', 'that', 'we', 'are', 'asked', 'which', 'is', 'one', 'of', 'the', 'most', 'frequent', 'complications', 'of', 'the', 'floor', 'of', 'the', 'orbit,', 'two', 'complications', 'should', 'always', 'be', 'highlighted', 'that', 'may', 'indicate', 'surgical', 'treatment,', 'even', 'urgent:', 'diplopia,', 'due', 'to', 'dislocation', 'of', 'the', 'inferior', 'rectus', 'muscle', 'to', 'the', 'underlying', 'maxillary', 'sinus', '(and', 'even', 'its', 'entrapment);', 'and', 'enophthalmos,', 'which', 'may', 'cause', 'other', 'associated', 'complications', 'in', 'the', 'medium', 'and', 'long', 'term,', 'such', 'as', 'superior', 'palpebral', 'pseudo-ptosis', 'due', 'to', 'loss', 'of', 'orbital', 'volume', '(option', '4', 'correct).'], ['Temporomandibular', 'ankylosis', 'is', 'not', 'considered', 'because,', 'although', 'relatively', 'close', 'to', 'the', 'orbital', 'cavity,', 'it', 'is', 'not', 'part', 'of', 'the', 'orbito-malar', 'complex', '(option', '1', 'discarded).'], ['Involvement', 'of', 'the', 'maxilla', 'can', 'lead', 'to', 'dental', 'malocclusion,', 'but', 'usually', 'occurs', 'in', 'fractures', 'located', 'lower', 'than', 'the', 'orbital', 'cavity', '(option', '2', 'discarded).'], ['Naso-ethmoidal', 'fractures', 'are', 'included', 'in', 'midface', 'fractures,', 'but', 'the', 'bones', 'of', 'the', 'nose', 'are', 'located', 'more', 'anteriorly', 'to', 'the', 'medial', 'orbital', 'rim,', 'and', 'therefore', 'outside', 'the', 'orbit', '(option', '3', 'discarded).']]","[['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'], ['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'], ['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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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', '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', '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', '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']]"
470138,"[['QUESTION', 'TYPE:', 'ORTHOPEDIC', 'SURGERY', 'AND', 'TRAUMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '73-year-old', 'woman', 'with', 'a', 'history', 'of', 'obesity,', 'type', '2', 'diabetes', 'mellitus,', 'hypertension', 'and', 'dyslipidemia.'], ['She', 'consults', 'for', 'unbearable', 'pain', 'in', 'the', 'right', 'knee', 'of', '5', 'days', 'of', 'evolution,', 'without', 'previous', 'trauma.'], ['Examination:', 'globular', 'knee,', 'moderate', 'varus,', 'extension', 'and', 'flexion', 'limited', 'by', 'pain,', 'diffuse', 'medial', 'pain.'], ['X-ray', 'shows', 'osteophytes', 'and', 'mild', 'impingement', 'of', 'the', 'medial', 'interlining.'], ['What', 'would', 'be', 'his', 'initial', 'management?'], ['1-', 'Explanation', 'of', 'the', 'diagnosis,', 'relative', 'rest,', 'paracetamol', '1g/8h', 'plus', 'metamizol', '500', 'mg/', '8', 'h', 'rescue', 'naproxen.'], ['2-', 'Preferential', 'referral', 'to', 'Traumatology', 'outpatients', 'for', 'evaluation', 'of', 'total', 'cemented', 'prosthesis.'], ['3-', 'Preferential', 'referral', 'to', 'Traumatology', 'outpatient', 'clinic', 'for', 'arthroscopic', 'debridement.'], ['4-', 'Preferred', 'MRI', 'request', 'for', 'evaluation', 'of', 'meniscopathy,', ""Baker's"", 'cyst', 'and/or', 'tendinitis.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '1'], ['We', 'are', 'being', 'described', 'an', 'acute', 'pain', 'crisis', 'in', 'a', 'patient', 'with', 'gonarthrosis.'], ['In', 'this', 'situation,', 'the', 'first', 'thing', 'to', 'do', 'is', 'to', 'resolve', 'the', 'pain', 'crisis', 'and', 'to', 'propose', 'an', 'appropriate', 'conservative', 'treatment', 'for', 'this', 'osteoarthritis', '(1', 'correct).'], ['A', 'knee', 'arthroplasty', 'is', 'not', 'considered', 'at', 'the', 'outset,', 'so', '2', 'is', 'false.'], ['They', 'are', 'not', 'telling', 'us', 'an', 'infectious', 'clinic', 'to', 'suspect', 'an', 'arthritis', 'that', 'would', 'justify', 'a', 'debridement', 'and', 'washing', 'so', '3', 'is', 'false.'], ['In', 'a', 'patient', 'with', 'gonarthrosis', 'there', 'will', 'always', 'be', 'meniscopathy,', 'it', 'is', 'part', 'of', 'the', 'degenerative', 'changes.'], [""Baker's"", 'cyst', 'would', 'only', 'interest', 'us', 'in', 'a', 'severe', 'pain', 'crisis', 'in', 'the', 'differential', 'diagnosis', 'with', 'a', 'deep', 'thrombosis', 'and', 'it', 'is', 'evaluated', 'with', 'an', 'echo-Doppler,', 'in', 'the', 'picture', 'of', 'gonarthrosis', 'it', 'has', 'no', 'value', 'to', 'detect', 'a', ""Baker's"", 'cyst.'], ['Tendinitis', 'is', 'diagnosed', 'by', 'examination,', 'not', 'with', 'MRI.'], ['Therefore,', '4', 'is', 'false.']]","[['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 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'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', '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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
298103,"[['QUESTION', 'TYPE:', 'INFECTIOUS', 'DISEASES'], ['CLINICAL', 'CASE:'], ['A', '25-year-old', 'man', 'with', 'no', 'past', 'history', 'of', 'interest', 'presents', 'to', 'the', 'emergency', 'department', 'with', 'fever,', 'headache,', 'myalgia,', 'nausea,', 'vomiting,', 'abdominal', 'pain,', 'jaundice', 'and', 'conjunctival', 'injection,', '2', 'weeks', 'after', 'traveling', 'to', 'Thailand', 'to', 'participate', 'in', 'a', 'freshwater', 'regatta.'], ['What', 'is', 'the', 'most', 'likely', 'diagnosis?'], ['1-', 'Malaria.'], ['2-', 'Schistosomiasis.'], ['3-', 'Leptospirosis.'], ['4-', 'Rabies.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['The', 'history', 'of', 'contact', 'with', 'fresh', 'water', 'in', 'an', 'endemic', 'area', 'points', 'to', 'leptospirosis,', 'and', 'in', 'the', 'clinical', 'picture', 'we', 'also', 'find', 'jaundice', 'and', 'conjunctival', 'injection', 'which', 'also', 'points', 'to', 'leptospirosis', 'and', 'is', 'not', 'so', 'characteristically', 'related', 'to', 'the', 'other', 'three', 'pathogens.']]","[['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'], ['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', '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']]"
365100,"[['QUESTION', 'TYPE:', 'PNEUMOLOGY', 'AND', 'THORACIC', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '64-year-old', 'patient,', 'farmer,', 'former', 'smoker', '(5', 'years),', 'COPD', 'and', 'afflicted', 'with', 'rheumatoid', 'arthritis', 'on', 'corticosteroid', 'therapy.'], ['He', 'consults', 'the', 'emergency', 'department', 'for', 'presenting', 'intense', 'headache', 'of', '2', 'days', 'of', 'evolution', 'with', 'deviation', 'of', 'the', 'oral', 'commissure.'], ['As', 'background,', 'he', 'reports', 'that', 'after', 'a', 'month', 'of', 'influenza,', 'he', 'persists', 'with', 'cough,', 'purulent', 'and', 'occasionally', 'hemoptotic', 'expectoration,', 'febrile', 'fever,', 'anorexia,', 'asthenia', 'and', 'weight', 'loss.'], ['On', 'arrival,', 'the', 'patient', 'had', 'a', 'fever', 'of', '38.2ºC,', 'multiple', 'skin', 'abscesses', 'on', 'the', 'hands,', 'back', 'and', 'buttocks', '(some', 'with', 'fistulous', 'tracts)', 'and', 'right', 'central', 'facial', 'paralysis,', 'apical', 'infiltrates', 'with', 'small', 'associated', 'pleural', 'effusion', 'on', 'chest', 'X-ray', 'and', 'leukocytosis', 'with', 'neutrophilia.'], ['Among', 'the', 'following', 'suspected', 'diagnoses', 'I', 'would', 'consider', 'MOST', 'likely:'], ['1-', 'Lung', 'neoplasm', 'with', 'brain', 'metastases.'], ['2-', 'Disseminated', 'tuberculosis.'], ['3-', 'Nocardiosis.'], ['4-', 'Aspergillosis.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '4'], ['Nocardia', 'can', 'typically', 'affect', 'immunosuppressed', 'patients,', 'especially', 'those', 'with', 'impaired', 'cell-mediated', 'immunity', 'such', 'as', 'that', 'produced', 'by', 'steroids,', 'and', 'can', 'present', 'with', 'pulmonary', 'involvement,', 'brain', 'abscesses', 'and', 'skin', 'abscesses.'], ['Tuberculosis', 'can', 'affect', 'lung', 'and', 'brain', 'but', 'not', 'cutaneous', 'abscesses.'], ['Aspergillus', 'also', 'does', 'not', 'affect', 'the', 'skin.']]","[['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['O', 'O', 'O', 'O', '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'], ['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', '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']]"
392223,"[['QUESTION', 'TYPE:', 'PSYCHIATRY'], ['CLINICAL', 'CASE:'], ['68-year-old', 'woman,', 'with', 'a', 'history', 'of', '2', 'major', 'depressive', 'episodes', 'in', 'her', 'lifetime,', 'who', 'consults', 'for', 'symptoms', 'of', 'sadness,', 'depressed', 'mood,', 'anhedonia,', 'asthenia', 'and', 'anorexia', 'compatible', 'with', 'a', 'new', 'depressive', 'episode.'], ['She', 'was', 'prescribed', '10', 'mg', 'of', 'escitalopram', 'and', 'was', 'evaluated', '2', 'weeks', 'later.'], ['In', 'this', 'review', 'the', 'patient', 'reports', 'feeling', 'very', 'well,', 'she', 'wakes', 'up', 'early', 'very', 'hyperactive', 'and', 'with', ""'a"", 'lot', 'of', 'desire', 'to', 'do', ""things',"", 'she', 'says', 'she', 'has', 'a', 'lot', 'of', 'energy', 'and', 'is', 'more', 'talkative', 'than', 'usual.'], ['She', 'does', 'not', 'report', 'being', 'irritable', 'and', 'is', 'able', 'to', 'sleep', 'for', '6', 'hours', 'continuously.'], ['Given', 'this', 'situation,', 'what', 'would', 'you', 'think', 'the', 'patient', 'has?'], ['1-', 'Bipolar', 'disorder', 'type', 'I.'], ['2-', 'Drug-induced', 'hypomania.'], ['3-', 'Normal', 'response', 'to', 'escitalopram.'], ['4-', 'Frontal', 'dementia.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['In', 'this', 'question,', 'one', 'might', 'suspect', 'the', 'possibility', 'of', 'an', 'affective', 'shift', 'after', 'the', 'introduction', 'of', 'the', 'antidepressant', 'drug,', 'according', 'to', 'the', 'patient,', 'but', 'if', 'we', 'look', 'at', 'the', ""patient's"", 'ability', 'to', 'maintain', 'sleep,', 'there', 'is', 'a', 'clear', 'fact', 'that', '""rules', 'out""', 'the', 'hypo/manic', 'shift.'], ['Two', 'weeks', 'is', 'not', 'enough', 'time', 'for', 'the', 'drug', 'to', 'have', 'taken', 'full', 'effect', 'on', 'mood,', 'but', 'an', 'initial', 'activation', 'may', 'appear,', 'which', 'patients', 'sometimes', 'do', 'not', 'cope', 'with', 'very', 'well', '(something', 'that', 'does', 'not', 'seem', 'to', 'be', 'the', 'case).'], ['In', 'this', 'patient', 'it', 'is', 'indicated', 'to', 'maintain', 'the', 'treatment', 'and', 'reevaluate', 'in', 'no', 'more', 'than', 'one', 'month.']]","[['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'], ['B-Premise', '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'], ['B-Premise', 'I-Premise', 'I-Premise', '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', 'I-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', '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-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'], ['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-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', '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']]"
28559,,
301232,"[['QUESTION', 'TYPE:', 'INFECTIOUS', 'DISEASES'], ['CLINICAL', 'CASE:'], ['A', '24-year-old', 'woman', 'consults', 'after', 'noticing', 'inguinal', 'lymphadenopathy.'], ['The', 'interrogation', 'does', 'not', 'reveal', 'the', 'presence', 'of', 'any', 'local', 'discomfort', 'or', 'data', 'suggestive', 'of', 'sexually', 'transmitted', 'infection.'], ['The', 'examination', 'revealed', 'two', 'lymphadenopathies,', 'one', 'in', 'each', 'groin,', '1', 'cm', 'in', 'diameter,', 'soft,', 'mobile,', 'non-painful.'], ['There', 'are', 'no', 'skin', 'lesions', 'on', 'the', 'lower', 'limbs,', 'anus', 'or', 'perineum.'], ['Which', 'test', 'do', 'you', 'consider', 'essential?'], ['1-', 'A', 'lues', 'serology', 'since', 'it', 'is', 'most', 'likely', 'a', 'Treponema', 'pallidum', 'infection.'], ['2-', 'A', 'gynecological', 'examination', 'to', 'rule', 'out', 'ovarian', 'cancer.'], ['3-', 'By', 'the', 'clinical', 'characteristics', 'it', 'seems', 'to', 'be', 'normal', 'lymph', 'nodes', 'and', 'complementary', 'explorations', 'should', 'not', 'be', 'done.'], ['4-', 'A', 'Paul-Bunnell', 'test', 'should', 'be', 'performed', 'in', 'order', 'to', 'rule', 'out', 'infectious', 'mononucleosis.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['In', 'healthy', 'adults', 'there', 'may', 'be', 'palpable', 'inguinal', 'nodes', 'up', 'to', '2', 'centimeters', 'that', 'can', 'be', 'considered', 'normal.'], ['A', 'complementary', 'study', 'of', 'these', 'normal', 'lymph', 'nodes', 'is', 'not', 'warranted.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['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'], ['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'], ['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']]"
23113,"[['QUESTION', 'TYPE:', 'INFECTIOUS'], ['CLINICAL', 'CASE:'], ['A', '71-year-old', 'woman', 'with', 'a', 'history', 'of', 'rheumatoid', 'arthritis', 'on', 'sulfasalazine,', 'prednisone', 'and', 'etanercept.'], ['She', 'goes', 'to', 'the', 'emergency', 'room', 'for', '72', 'hours', 'of', 'clinical', 'manifestations', 'compatible', 'with', 'facial', 'herpes', 'zoster', 'affecting', 'the', 'right', 'hemiface,', 'auricular', 'pavilion,', 'respecting', 'the', 'forehead', 'and', 'conjunctival', 'chemosis.'], ['What', 'would', 'be', 'the', 'appropriate', 'treatment?'], ['1-', 'Symptomatic', 'treatment', 'of', 'pain', 'only.'], ['2-', 'Topical', 'treatment', 'with', 'acyclovir.'], ['3-', 'Outpatient', 'treatment', 'with', 'acyclovir,', 'valacyclovir', 'or', 'oral', 'famciclovir.'], ['4-', 'Hospital', 'admission', 'and', 'treatment', 'with', 'acyclovir', 'or', 'famciclovir', 'iv.'], ['5-', 'Parenteral', 'Ig', 'and', 'vaccination.'], ['CORRECT', 'ANSWER:', '4'], ['I', 'think', 'this', 'question', 'is', 'not', 'clearly', 'in', 'the', 'Infectious', 'Diseases', 'syllabus,', 'and', 'may', 'overlap', 'with', 'OFT', 'and', 'DERMA,', 'but', 'as', 'I', 'understand', 'it,', 'in', 'an', 'immunocompromised', 'patient', 'and', 'also', 'with', 'data', 'of', 'ocular', 'involvement,', 'admission', 'for', 'intravenous', 'treatment', 'would', 'be', 'indicated', 'due', 'to', 'the', 'high', 'risk', 'of', 'possible', 'complications.']]","[['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', 'I-Premise', 'I-Premise', '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', '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'], ['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']]"
564126,"[['QUESTION', 'TYPE:', 'NEPHROLOGY'], ['CLINICAL', 'CASE:'], ['A', '58-year-old', 'man', 'with', 'a', '6-year', 'history', 'of', 'hypertension', 'consults', 'for', 'poor', 'blood', 'pressure', 'control', 'despite', 'treatment', 'with', 'an', 'angiotensin-converting', 'enzyme', 'inhibitor,', 'a', 'diuretic', 'and', 'a', 'calcium', 'antagonist.'], ['On', 'consultation', 'she', 'presented', 'with', 'blood', 'pressure', 'of', '149/100', 'mmHg.'], ['Laboratory', 'tests:', 'creatinine', '1.2', 'mg/dl,', 'potassium', '2.2', 'mEq/l', 'and', 'compensated', 'metabolic', 'alkalosis;', 'the', 'rest', 'of', 'the', 'biochemical', 'study,', 'blood', 'count,', 'coagulation', 'and', 'urinary', 'sediment', 'were', 'normal.'], ['Point', 'out', 'the', 'correct', 'statement:'], ['1-', 'The', 'origin', 'of', 'hypertension', 'in', 'this', 'case', 'is', 'excessive', 'secretion', 'of', 'aldosterone', 'caused', 'by', 'autonomic', 'hyperfunction', 'of', 'the', 'adrenal', 'medulla.'], ['2-', 'In', 'most', 'cases', 'the', 'anatomical', 'substrate', 'is', 'a', 'bilateral', 'hyperplasia', 'of', 'the', 'adrenal', 'cortex.'], ['3-', 'CT', 'scan', 'is', 'part', 'of', 'the', 'diagnostic', 'study', 'in', 'case', 'of', 'biochemical', 'confirmation.'], ['4-', 'Spironolactone', 'is', 'contraindicated', 'in', 'the', 'management', 'of', 'this', 'pathology.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['We', 'are', 'presented', 'with', 'a', 'patient', 'with', 'resistant', 'arterial', 'hypertension,', 'assuming', 'that', 'he', 'has', 'primary', 'hyperaldosteronism', 'due', 'to', 'hypokalemic', 'metabolic', 'alkalosis.'], ['When', 'the', 'diagnosis', 'is', 'biochemically', 'confirmed,', 'the', 'next', 'test', 'to', 'be', 'performed', 'is', 'a', 'CT', 'scan', 'to', 'determine', 'the', 'subtype', 'and', 'rule', 'out', 'the', 'presence', 'of', 'an', 'adrenal', 'carcinoma', '(option', '3', 'correct).'], ['Therefore,', 'it', 'is', 'necessary', 'to', 'wait', 'for', 'the', 'imaging', 'test', 'to', 'confirm', 'the', 'etiology', '(option', '1', 'incorrect).'], ['The', 'most', 'frequent', 'cause', 'is', 'aldosterone-producing', 'adenoma', '(option', '2', 'incorrect).'], ['Spironolactone', 'is', 'the', 'medical', 'treatment', 'of', 'choice', '(option', '4', 'incorrect).']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', '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', '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'], ['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'], ['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'], ['B-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', 'B-Claim', 'I-Claim', 'I-Claim']]"
292213,"[['QUESTION', 'TYPE:', 'DERMATOLOGY,', 'VENEREOLOGY', 'AND', 'PLASTIC', 'SURGERY'], ['CLINICAL', 'CASE:'], ['Gustavo', 'comes', 'to', 'the', 'emergency', 'room', 'with', 'skin', 'lesions', 'and', 'general', 'malaise', 'of', 'several', 'days', 'of', 'evolution.'], ['He', 'has', 'psoriasiform', 'lesions', 'on', 'the', 'trunk', 'with', 'involvement', 'of', 'palms', 'and', 'soles.'], ['He', 'also', 'presents', 'asymmetric', 'non-suppurative', 'joint', 'inflammation', 'and', 'bilateral', 'ocular', 'redness', 'as', 'well', 'as', 'erosions', 'on', 'the', 'glans', 'penis.'], ['In', 'the', 'subsequent', 'anamnesis', 'Gustavo', 'recognizes', 'a', 'risky', 'sexual', 'contact', '20', 'days', 'before.'], ['What', 'is', 'his', 'diagnosis?'], ['1-', 'HIV', 'infection.'], ['2-', 'Secondary', 'syphilis.'], ['3-', ""Reiter's"", 'syndrome.'], ['4-', 'Erythema', 'multiforme.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['He', 'is', 'describing', 'a', 'textbook', ""Reiter's"", 'syndrome:', 'palmo-plantar', 'keratoderma,', 'arthritis', 'and', 'ocular', 'manifestations,', 'together', 'with', 'probably', 'a', 'chlamydial', 'urethritis,', 'perhaps', 'asymptomatic', '(they', 'do', 'not', 'explain', 'urethral', 'exudate).'], ['Of', 'course,', 'the', 'patient', 'may', 'also', 'have', 'HIV', 'infection', 'or', 'even', 'secondary', 'syphilis', '(in', 'addition', 'to', ""Reiter's).""]]","[['O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-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'], ['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', 'O'], ['O', 'O', 'O'], ['B-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'], ['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']]"
477128,"[['QUESTION', 'TYPE:', 'CRITICAL', 'CARE'], ['CLINICAL', 'CASE:'], ['35-year-old', 'man', 'admitted', 'for', 'severe', 'chest', 'trauma', 'with', 'multiple', 'rib', 'fractures.'], ['After', 'responding', 'favorably', 'to', 'treatment', 'with', 'analgesics', 'and', 'oxygen,', 'he', 'begins', 'to', 'present', 'severe', 'hypoxemia.'], ['Indicate', 'the', 'most', 'probable', 'cause', 'of', 'this', 'deterioration:'], ['1-', 'Chest', 'wall', 'instability', 'due', 'to', 'multiple', 'fractures.'], ['2-', 'Aspiration', 'respiratory', 'infection.'], ['3-', 'Alteration', 'of', 'gas', 'exchange', 'due', 'to', 'pulmonary', 'contusion.'], ['4-', 'Post-traumatic', 'hypovolemia.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['Pulmonary', 'contusion', 'is', 'the', 'most', 'serious', 'lesion', 'and', 'the', 'one', 'with', 'the', 'worst', 'prognosis', 'in', 'thoracic', 'trauma.'], ['It', 'is', 'also', 'the', 'injury', 'that', 'causes', 'hypoxemia', 'the', 'earliest.'], ['Contrary', 'to', 'what', 'we', 'may', 'think,', 'an', 'unstable', 'thorax', 'due', 'to', 'multiple', 'rib', 'fractures', '(costal', 'volet)', 'would', 'cause', 'progressive', 'hypoventilation', 'with', 'atelectasis', 'of', 'the', 'pulmonary', 'parenchyma,', 'which', 'would', 'progress', 'on', 'the', 'one', 'hand', 'to', 'hypercapnia', 'and', 'respiratory', 'acidosis,', 'and', 'on', 'the', 'other,', 'to', 'later', 'hypoxemia', 'due', 'to', 'infection', 'associated', 'with', 'atelectasis.'], ['Respiratory', 'infection', 'due', 'to', 'aspiration', 'would', 'also', 'occur', 'later,', 'and', 'does', 'not', 'appear', 'in', 'all', 'cases', 'of', 'severe', 'chest', 'trauma,', 'only', 'if', 'there', 'has', 'been', 'a', 'decrease', 'in', 'the', 'level', 'of', 'consciousness', '(associated', 'TBI,', 'uncontrolled', 'intubation', 'with', 'bronchoaspiration...).'], ['Post-traumatic', 'hypovolemia', '(in', 'this', 'case,', 'as', 'there', 'are', 'multiple', 'rib', 'fractures,', 'it', 'could', 'be', 'due', 'to', 'hemothorax)', 'would', 'occur', 'earlier', 'and', 'would', 'be', 'associated', 'in', 'the', 'first', 'place', 'with', 'hemodynamic', 'instability.']]","[['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'], ['O', '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'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-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'], ['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', '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'], ['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']]"
572195,"[['QUESTION', 'TYPE:', 'NEPHROLOGY'], ['CLINICAL', 'CASE:'], ['A', '66-year-old', 'woman', 'with', 'type', '2', 'diabetes', 'mellitus.'], ['When', 'assessing', 'her', 'renal', 'function,', 'she', 'presents', 'a', 'G3a/A1', 'stage.'], ['To', 'which', 'values', 'does', 'this', 'stage', 'correspond,', 'the', 'most', 'frequent', 'in', 'patients', 'with', 'diabetic', 'nephropathy?'], ['1-', 'Glomerular', 'filtration', 'rate', '45-59', 'ml/min/1.73', 'm²', 'and', 'albuminuria', '<30', 'mg/ml.'], ['2-', 'Glomerular', 'filtration', 'rate', '30-44', 'ml/min/1.73', 'm²', 'and', 'albuminuria', '<30', 'mg/ml.'], ['3-', 'Glomerular', 'filtration', 'rate', '45-59', 'ml/min/1.73', 'm²', 'and', 'albuminuria', '30-300', 'mg/ml.'], ['4-', 'Glomerular', 'filtration', 'rate', '15-29', 'ml/min/1.73', 'm²', 'and', 'albuminuria', '<30', 'mg/ml.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '1'], ['Easy', 'question.'], ['Stage', 'G3a', 'corresponds', 'to', 'a', 'filtration', 'rate', 'between', '45-59', 'ml/min.'], ['Stage', 'A1', 'corresponds', 'to', 'albuminuria', 'less', 'than', '30', 'mg/ml.'], ['Therefore', 'the', 'correct', 'option', 'is', '1.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['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'], ['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'], ['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'], ['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']]"
180232,"[['QUESTION', 'TYPE:', 'HEMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '29-year-old', 'patient', 'comes', 'to', 'your', 'office', 'with', 'a', 'diagnosis', 'of', 'severe', 'bone', 'marrow', 'aplasia.'], ['What', 'is', 'the', 'treatment', 'of', 'choice?'], ['1-', 'Periodic', 'transfusions', 'and', 'antibiotics.'], ['2-', 'Androgens', 'and', 'platelet', 'transfusions.'], ['3-', 'Allogeneic', 'bone', 'marrow', 'transplantation', 'if', 'HLA', 'identical', 'sibling.'], ['4-', 'Autologous', 'bone', 'marrow', 'transplantation', 'to', 'avoid', 'rejection.'], ['5-', 'Cyclosporin', 'A', 'and', 'antithymocyte', 'globulin.'], ['CORRECT', 'ANSWER:', '3'], ['Transfusing', 'this', 'patient', 'and', 'stuffing', 'him', 'with', 'antibiotics', 'is', 'giving', 'him', 'bread', 'for', 'today', 'and', 'hunger', 'for', 'tomorrow.'], ['We', 'want', 'something', 'more', 'lasting.'], ['Androgens', 'and', 'platelet', 'transfusions', ""don't"", 'fix', 'the', 'problem', 'either.'], ['We', 'are', 'left', 'with', 'the', 'other', 'three', 'options.'], ['An', 'autologous', 'transplant', 'is', 'not', 'reasonable,', 'since', 'the', 'bone', 'marrow', 'of', 'a', 'patient', 'with', 'bone', 'marrow', 'aplasia', 'is', 'less', 'than', '25%,', 'so', 'little', 'can', 'be', 'obtained.'], ['Therefore,', 'we', 'are', 'inclined', 'towards', 'allogeneic', 'bone', 'marrow', 'transplantation', 'if', 'he', 'has', 'an', 'HLA-identical', 'sibling,', 'since', 'this', 'is', 'the', 'treatment', 'of', 'choice', 'according', 'to', 'the', 'protocol', 'of', 'the', 'Spanish', 'Society', 'of', 'Hematology', 'and', 'Hemotherapy', 'for', 'patients', 'under', '40', 'years', 'of', 'age', 'with', 'severe', 'bone', 'marrow', 'aplasia.'], ['Correct', 'answer,', '3.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-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', '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'], ['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'], ['O', 'O', 'O', 'O', 'O'], ['B-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'], ['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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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']]"
270135,"[['QUESTION', 'TYPE:', 'DERMATOLOGY', 'AND', 'PLASTIC', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', 'young', 'man', 'comes', 'to', 'the', 'emergency', 'room', 'with', 'a', 'second-degree', 'flame', 'burn', 'of', '10%', 'of', 'the', 'body', 'surface,', 'affecting', 'the', 'right', 'arm', 'in', 'an', 'extensive', 'and', 'circular', 'manner.'], ['There', 'is', 'no', 'arterial', 'pulse', 'in', 'the', 'hand', 'measured', 'by', 'Doppler.'], ['What', 'is', 'the', 'treatment', 'of', 'choice?'], ['1-', 'Occlusive', 'sulfadiazine-arginine', 'cures', 'and', 'depth', 'assessment', 'at', 'one', 'week.'], ['2-', 'Lymphatic', 'drainage', 'and', 'assess', 'a', 'vascular', 'by-pass.'], ['3-', 'Escharotomy', 'or', 'emergency', 'decompression', 'incisions.'], ['4-', 'Expectant', 'management.'], ['5-', 'Amputation', 'of', 'the', 'extremity.'], ['CORRECT', 'ANSWER:', '3'], ['The', 'question', 'is', 'tricky:', 'it', 'speaks', 'of', 'a', 'burn', 'of', '10%', 'of', 'the', 'body', 'surface', 'and', 'the', 'treatment', 'of', 'choice', 'for', 'second', 'degree', 'burns', 'less', 'than', '20%', 'of', 'the', 'BSA', 'should', 'be', 'topical', 'and', 'monitored.'], ['However,', 'there', 'is', 'a', 'warning', 'sign:', 'there', 'is', 'no', 'arterial', 'pulse', 'and', 'the', 'burn', 'is', 'circumferential', 'to', 'the', 'limb.'], ['This', 'is', 'an', 'emergency', 'that,', 'if', 'allowed', 'to', 'evolve,', 'will', 'compromise', 'the', 'viability', 'of', 'the', 'affected', 'limb', 'and', 'end', 'in', 'amputation:', 'an', 'emergency', 'escharotomy', 'must', 'be', 'performed', 'in', 'order', 'to', 'relieve', 'the', 'pressure', 'of', 'the', 'third', 'space', 'on', 'the', 'arterial', 'vascular', 'trunk.']]","[['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'], ['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'], ['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'], ['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', '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-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', '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']]"
368121,"[['QUESTION', 'TYPE:', 'PNEUMOLOGY', 'AND', 'THORACIC', 'SURGERY'], ['CLINICAL', 'CASE:'], ['While', 'you', 'are', 'on', 'call', 'in', 'the', 'Emergency', 'Department', 'of', 'your', 'hospital,', 'you', 'have', 'to', 'attend', 'a', '64-year-old', 'patient', 'with', 'acute', 'respiratory', 'failure.'], ['His', 'clinical', 'condition', 'is', 'critical,', 'with', 'low', 'oxygen', 'saturation', 'and', 'hemodynamic', 'instability.'], ['An', 'urgent', 'chest', 'X-ray', 'was', 'performed', 'showing', 'atelectasis', 'of', '2/3', 'of', 'the', 'right', 'lung.'], ['Orotracheal', 'intubation', 'and', 'assisted', 'ventilation', 'were', 'performed,', 'with', 'Fi02', 'of', '1.0.'], ['Subsequent', 'arterial', 'blood', 'gas', 'analysis', 'showed', 'pH', '7.23,', 'Pa02', '60', 'mmHg', 'and', 'PaC02', '30', 'mmHg.'], ['What', 'was', 'the', 'cause', 'of', 'the', 'hypoxemia?'], ['1-', 'Short', 'circuit.'], ['2-', 'Hypoventilation.'], ['3-', 'Low', 'inspired', '02', 'pressure.'], ['4-', 'Neuromuscular', 'disease.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '1'], ['FiO2', 'of', '1', 'and', 'hyperventilation', 'with', 'mechanical', 'ventilation,', 'demonstrated', 'by', 'the', 'low', 'PCO2,', 'fail', 'to', 'sufficiently', 'raise', 'PO2,', 'due', 'to', 'a', 'V/Q', 'disturbance,', 'with', 'probable', 'shunt', 'in', 'the', 'area', 'of', 'pulmonary', 'atelectasis,', 'probably', 'acute,', 'since', 'the', 'lung', 'has', 'not', 'been', 'able', 'to', 'create', 'compensatory', 'mechanisms', 'to', 'limit', 'perfusion', 'in', 'the', 'poorly', 'ventilated', 'areas.']]","[['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'], ['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'], ['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', 'B-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
16785,"[['QUESTION', 'TYPE:', 'CARDIOLOGY', 'AND', 'CARDIOVASCULAR', 'SURGERY'], ['CLINICAL', 'CASE:'], ['If', 'in', 'a', 'patient', 'with', 'chronic', 'heart', 'failure', 'we', 'detect', 'prominent', 'v', 'waves', 'in', 'the', 'jugular', 'venous', 'pulse', 'and', 'on', 'cardiac', 'auscultation', 'a', 'holosystolic', 'murmur', 'is', 'auscultated', 'in', 'the', 'area', 'of', 'the', 'xiphoid', 'appendage', 'that', 'is', 'accentuated', 'with', 'deep', 'inspiration.'], ['What', 'is', 'the', 'valvulopathy', 'responsible', 'for', 'this', 'physical', 'examination?'], ['1-', 'Mitral', 'insufficiency.'], ['2-', 'Pulmonary', 'insufficiency.'], ['3-', 'Tricuspid', 'insufficiency.'], ['4-', 'Aortic', 'insufficiency.'], ['5-', 'Aortic', 'stenosis.'], ['CORRECT', 'ANSWER:', '3'], ['Basic', 'semiology.'], ['However,', 'emergency', 'reasoning:', 'systolic', 'murmur,', 'something', 'that', 'in', 'systole', 'had', 'to', 'be', 'closed', 'and', 'is', 'not,', 'or', 'had', 'to', 'open,', 'and', 'does', 'not:', 'options', '1,', '3', 'and', '5.'], ['And', 'if', 'we', 'see', 'repercussion', 'in', 'the', 'jugular', 'pulse,', 'it', 'must', 'be', 'in', 'the', 'right', 'cavities.'], ['Apart', 'from', 'the', 'fact', 'that', 'the', 'v', 'wave', 'appears', 'during', 'systole,', 'while', 'the', 'atria', 'are', 'filling:', 'if', 'the', 'RV', 'flow', 'rises', 'to', 'the', 'RA,', 'what', 'will', 'happen', 'is', 'that', 'the', 'v', 'wave', 'will', 'be', 'very', 'large?']]","[['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', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'B-Disease', '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'], ['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'], ['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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
15475,"[['QUESTION', 'TYPE:', 'RHEUMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '42-year-old', 'female', 'patient', 'reports', 'pain', 'with', 'inflammatory', 'features', 'and', 'swelling', 'in', 'both', 'wrists,', '2nd', 'and', '3rd', 'metacarpophalangeal', 'and', 'proximal', 'interphalangeal', 'joints', 'bilaterally', 'and', 'left', 'ankle', 'of', '4', 'months', 'of', 'evolution', 'accompanied', 'by', 'morning', 'stiffness', 'of', 'more', 'than', 'one', 'hour', 'duration.'], ['Hand', 'X-ray', 'shows', 'an', 'erosion', 'in', 'the', 'styloid', 'process', 'of', 'the', 'ulna', 'in', 'the', 'right', 'carpus.'], ['Laboratory', 'tests', 'showed', 'Hb:', '10', 'g/dL', 'with', 'ESR', 'of', '45', 'mm', 'in', 'the', 'first', 'hour,', 'CRP', '16', 'mg/L,', 'rheumatoid', 'factor', '160', 'IU/ML.'], ['After', '6', 'months', 'of', 'treatment', 'with', 'indomethacin', 'and', 'methotrexate,', 'the', 'patient', 'persists', 'with', 'pain', 'and', 'swelling', 'of', 'both', 'carpals,', 'morning', 'stiffness', 'lasting', '30', 'minutes', 'and', 'a', 'CBC', 'showing', 'an', 'ESR', '30', 'mm', 'in', 'the', 'first', 'hour', 'and', 'a', 'CRP', '9', 'mg/dL.'], ['Regarding', 'the', 'attitude', 'to', 'take,', 'which', 'of', 'the', 'following', 'is', 'true:'], ['1-', 'Suspend', 'the', 'prescribed', 'treatment', 'due', 'to', 'lack', 'of', 'response', 'and', 'initiate', 'prednisone', 'at', 'high', 'doses', 'for', 'symptom', 'control', 'only.'], ['2-', 'Maintain', 'the', 'therapeutic', 'attitude', 'taken', 'since', 'we', 'have', 'only', 'been', 'on', 'it', 'for', '6', 'months', 'and', 'it', 'would', 'be', 'necessary', 'to', 'wait', 'a', 'minimum', 'of', '9', 'months', 'to', 'evaluate', 'therapeutic', 'response.'], ['3-', 'If', 'there', 'is', 'no', 'medical', 'contraindication,', 'consider', 'adding', 'an', 'anti-TNF', 'alpha', 'to', 'the', 'treatment.'], ['4-', 'Start', 'a', 'second', 'disease-modifying', 'drug', 'as', 'soon', 'as', 'possible,', 'since', 'it', 'would', 'not', 'be', 'possible', 'to', 'start', 'treatment', 'with', 'biologic', 'therapy', 'alone', 'after', 'methotrexate.'], ['5-', 'Consider', 'starting', 'treatment', 'with', 'anti-CD20', 'therapy', 'associated', 'with', 'methotrexate.'], ['CORRECT', 'ANSWER:', '2'], ['This', 'is', 'a', 'patient', 'with', 'rheumatoid', 'arthritis.'], ['In', 'my', 'opinion,', 'as', 'in', 'these', 'six', 'months', 'she', 'has', 'shown', 'a', 'clear', 'clinical', 'and', 'biological', 'improvement', '(decrease', 'in', 'acute', 'phase', 'reactants),', 'I', 'would', 'maintain', 'the', 'therapeutic', 'approach', 'taken', 'and', 'wait', 'for', 'a', 'new', 'evaluation.'], ['However,', 'I', 'consider', 'that', 'this', 'question', 'could', 'have', 'another', 'valid', 'answer,', '3.'], ['It', 'depends', 'a', 'little', 'on', 'the', 'attitude', 'of', 'each', 'rheumatologist.'], ['If', 'what', 'you', 'are', 'looking', 'for', 'is', 'a', 'remission', 'of', 'the', 'disease', 'as', 'soon', 'as', 'possible,', 'you', 'could', 'choose', 'to', 'consider', 'associating', 'an', 'anti-TNF', 'alpha?']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', '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'], ['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', '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'], ['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'], ['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']]"
17657,"[['QUESTION', 'TYPE:', 'PNEUMOLOGY'], ['CLINICAL', 'CASE:'], ['A', '56-year-old', 'woman', 'with', 'a', 'history', 'of', 'well-controlled', 'schizophrenia', 'and', 'no', 'toxic', 'habits.'], ['Admitted', 'for', 'middle', 'lobe', 'pneumonia', 'with', 'a', 'small', 'associated', 'metaneumonic', 'pleural', 'effusion', 'and', 'on', 'treatment', 'with', 'levofloxacin', '500', 'mg/24h', '.'], ['She', 'presented', 'good', 'clinical', 'evolution', 'except', 'for', 'persistent', 'febrile', 'fever', 'and', 'leukocytosis', 'on', 'the', 'sixth', 'day', 'of', 'treatment.'], ['Microbiological', 'studies', 'are', 'not', 'available.'], ['The', 'most', 'appropriate', 'course', 'of', 'action', 'is:'], ['1-', 'The', 'evolution', 'is', 'normal,', 'treatment', 'should', 'be', 'maintained', 'until', 'completing', '10', 'days.'], ['2-', 'It', 'is', 'considered', 'a', 'therapeutic', 'failure', 'and', 'antibiotic', 'treatment', 'should', 'be', 'modified.'], ['3-', 'Perform', 'thoracentesis', 'to', 'rule', 'out', 'empyema.'], ['4-', 'Add', 'corticosteroids', 'at', 'a', 'dose', 'of', '0.5', 'mg/Kg/day', 'to', 'antibiotic', 'treatment.'], ['5-', 'Bronchoscopy', 'with', 'biopsy,', 'aspiration', 'and', 'bronchoalveolar', 'lavage.'], ['CORRECT', 'ANSWER:', '3'], ['As', 'long', 'as', 'fever', 'persists', 'in', 'an', 'evolving', 'pneumonia,', 'there', 'is', 'a', 'risk', 'of', 'empyematization,', 'especially', 'if', 'a', 'small', 'effusion', 'has', 'already', 'occurred', 'at', 'the', 'beginning', 'of', 'the', 'picture.'], ['In', 'principle,', 'antibiotic', 'treatment', 'is', 'correct', 'and', 'before', 'considering', 'changes', 'in', 'treatment,', 'the', 'possibility', 'of', 'empyematization', 'should', 'be', 'evaluated.']]","[['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', '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', 'I-Premise', 'I-Premise'], ['B-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'], ['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', 'I-Claim', 'I-Claim'], ['O', 'B-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'], ['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']]"
13082,"[['QUESTION', 'TYPE:', 'NEUROLOGY', 'AND', 'NEUROSURGERY'], ['CLINICAL', 'CASE:'], ['An', '18-year-old', 'female', 'patient', 'with', 'a', 'history', 'of', 'absences', 'between', '6', 'and', '9', 'years', 'of', 'age,', 'generalized', 'tonic-clonic', 'seizures', 'of', 'recent', 'onset', 'and', 'violent', 'jumping', 'of', 'the', 'upper', 'limbs', 'at', 'breakfast.'], ['The', 'clinical', 'manifestations', 'worsen', 'with', 'nighttime', 'weekend', 'outings.'], ['An', 'EEG', 'shows', 'acute', 'polyp', 'spike', 'discharges', 'at', '6', 'cycles/second.'], ['The', 'most', 'likely', 'diagnosis', 'is:'], ['1-', 'Great', 'epileptic', 'disease.'], ['2-', 'Lennox-Gastaut', 'syndrome.'], ['3-', 'Symptomatic', 'epilepsy', 'due', 'to', 'mesial', 'temporal', 'sclerosis.'], ['4-', 'Small', 'atypical', 'disease.'], ['5-', 'Juvenile', 'myoclonic', 'epilepsy.'], ['CORRECT', 'ANSWER:', '5'], ['A', 'patient', 'of', 'adolescent', 'age', 'with', 'myoclonus', '(""violent', 'jumps"")', 'at', 'breakfast', 'time', 'will', 'almost', 'always', 'lead', 'us', 'to', 'juvenile', 'myoclonic', 'epilepsy', '(answer', '5', 'correct),', 'a', 'very', 'well', 'characterized', 'entity.'], ['Among', 'other', 'features', 'is', 'the', 'previous', 'history', 'of', 'seizures', 'or', 'absences,', 'the', 'worsening', 'with', 'nighttime', 'departures,', 'and', 'the', 'EEG', 'with', 'generalized', 'polyp', 'spike', 'discharges', 'at', 'a', 'higher', 'frequency', 'than', 'that', 'of', 'absences.'], ['Of', 'the', 'remaining', 'answers,', 'Lennox', 'Gastaut', 'develops', 'at', 'an', 'early', 'age', 'with', 'other', 'symptomatology,', '4', 'is', 'the', 'same', 'as', 'absences,', 'and', '3', 'usually', 'presents', 'with', 'complex', 'partial', 'seizures', 'and', 'either', 'way,', 'the', 'EEG', 'is', 'clearly', 'distinct', 'from', 'a', 'temporal', 'focus.']]","[['O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['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'], ['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'], ['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'], ['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', 'O', 'O', 'O', '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', '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']]"
27675,"[['QUESTION', 'TYPE:', 'DIGESTIVE', 'SYSTEM'], ['CLINICAL', 'CASE:'], ['Indicate', 'the', 'clinical', 'situation', 'in', 'relation', 'to', 'hepatitis', 'B', 'virus', 'infection', 'in', 'a', '5-year-old', 'patient', 'from', 'Nigeria,', 'with', 'normal', 'physical', 'examination', 'and', 'the', 'following', 'serology', 'for', 'hepatitis', 'B:', 'HBsAg', '+', '/', 'ANTI-HBs', '-', '/', 'HbeAg', '-', '/', 'ANTI-HBe', '+', '/', 'ANTI-HBc', 'IgM', '-', '/', 'ANTI-HBc', 'IgG', '+', '/', 'DNA', 'HBV', '+:'], ['1-', 'Acute', 'infection.'], ['2-', 'Chronic', 'infection.'], ['3-', 'Vaccinated', 'patient.'], ['4-', 'Asymptomatic', 'carrier.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '4'], ['Having', 'antibodies', 'against', 'the', 'core', 'implies', 'natural', 'contact,', 'and', 'that', 'it', 'is', 'IgG,', 'which', 'is', 'not', 'acute.'], ['The', 'absence', 'of', 'e', 'antigen', 'rules', 'out', 'active', 'replication.'], ['And', 'the', 'persistence', 'of', 'surface', 'antigen', '(HBsAg)', 'and', 'virus', 'DNA', 'indicates', 'that', 'it', 'is', 'still', 'present.'], ['Together,', 'these', 'indicate', 'an', 'asymptomatic', 'carrier.'], ['Carriers', 'of', 'the', 'pre-core', 'mutant', 'usually', 'have', 'recurrent', 'symptomatic', 'periods', 'and', 'increased', 'liver', 'inflammation.'], ['There', 'would', 'be', 'insufficient', 'data', 'to', 'rule', 'it', 'out', 'completely,', 'but', 'it', 'is', 'not', 'among', 'the', 'answers', 'and', 'indicates', 'a', 'completely', 'normal', 'physical', 'examination.']]","[['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', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['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'], ['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'], ['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'], ['B-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']]"
18364,"[['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['A', 'patient', 'on', 'enteral', 'nutritional', 'support', 'presents', '72', 'hours', 'after', 'starting', 'enteral', 'nutrition', 'with', 'a', 'CBC', 'showing', 'hypophosphoremia', 'and', 'hypokalemia,', 'with', 'clinical', 'signs', 'of', 'heart', 'failure.'], ['The', 'patient', 'is', 'diagnosed', 'with', 'refeeding', 'syndrome.'], ['Indicate', 'which', 'of', 'the', 'following', 'is', 'NOT', 'considered', 'a', 'risk', 'factor', 'for', 'a', 'patient', 'presenting', 'with', 'this', 'condition:'], ['1-', 'Previous', 'caloric', 'malnutrition.'], ['2-', 'Anorexia', 'nervosa.'], ['3-', 'Non-morbid', 'obesity.'], ['4-', 'Elderly.'], ['5-', 'Prolonged', 'vomiting', 'and', 'diarrhea.'], ['CORRECT', 'ANSWER:', '3'], ['Refeeding', 'syndrome', 'occurs', 'in', 'patients', 'with', 'previous', 'malnutrition', 'exposed', 'to', 'either', 'oral,', 'enteral', 'or', 'parenteral', 'nutritional', 'therapy.'], ['All', 'responses', 'are', 'causes', 'of', 'malnutrition', 'except', '3.']]","[['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'], ['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'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'B-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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
11598,"[['QUESTION', 'TYPE:', 'HEMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '32-year-old', 'woman', 'with', 'cerebral', 'palsy', 'from', 'childbirth', 'comes', 'to', 'the', 'emergency', 'department', 'for', 'a', 'few', 'days', 'of', 'dark', 'urine', 'associated', 'with', 'an', 'episode', 'of', 'high', 'fever', 'and', 'dry', 'cough.'], ['On', 'admission,', 'the', 'CBC', 'showed', '16900', 'leukocytes/mm3', '(85%', 'S,', '11%', 'L,', '4%', 'M),', 'hemoglobin', '6.3', 'g/dL;', 'MCV', '109', 'fl,', '360000', 'platelets/mm3.'], ['In', 'the', 'biochemistry', 'LDH', '2408;', 'bilirubin', '6.8', 'mg/dl,', '(unconjugated', 'bilirubin', '6.1', 'mg/dl),', 'normal', 'GOT', 'and', 'GPT.'], ['The', 'morphological', 'study', 'of', 'blood', 'showed', 'macrocytic', 'anisocytosis', 'with', 'frequent', 'spherocytic', 'forms', 'and', 'polychromatophilia', 'without', 'blasts.'], ['The', 'irregular', 'antibody', 'study', 'is', 'positive', 'for', 'panagglutinin,', 'making', 'crossmatching', 'difficult.'], ['What', 'would', 'be', 'your', 'suspicion', 'and', 'the', 'most', 'appropriate', 'treatment?'], ['1-', 'Medullary', 'aplasia', 'and', 'immunotherapy', 'with', 'thymoglobulin', 'and', 'cyclosporine.'], ['2-', 'Hereditary', 'spherocytosis', 'and', 'splenectomy.'], ['3-', 'Autoimmune', 'hemolytic', 'anemia', 'associated', 'with', 'respiratory', 'infection', 'and', 'corticosteroids.'], ['4-', 'Pernicious', 'anemia', 'and', 'periodic', 'injections', 'of', 'vitamin', 'B12.'], ['5-', 'Acute', 'leukemia', 'and', 'chemotherapy.'], ['CORRECT', 'ANSWER:', '3'], ['A', 'long', 'statement', 'full', 'of', 'rather', 'confusing', 'data.'], ['We', 'can', 'attack', 'that', 'question', 'in', 'two', 'ways:', 'by', 'looking', 'at', 'the', 'key', 'data', 'and', 'going', 'all', 'the', 'way', 'to', 'the', 'diagnosis', 'we', 'are', 'considering', 'or', 'by', 'discarding', 'one', 'by', 'one.'], ['The', 'choluria,', 'LDH,', 'presence', 'of', 'panagglutinin', 'and', 'the', 'peripheral', 'blood', 'smear', '""smells""', 'like', 'hemolytic', 'anemia.'], ['Answer', '1', 'cannot', 'be', 'because', 'a', 'marrow', 'aplasia', 'does', 'not', 'explain', 'the', 'choluria,', 'the', 'elevation', 'of', 'LDH,', 'nor', 'in', 'the', 'study', 'of', 'irregular', 'antibodies', 'is', 'positive', 'in', 'the', 'form', 'of', 'panagglutinin;', 'an', 'aplasia', 'is', 'a', 'marrow', 'failure', 'characterized', 'by', 'a', 'total', 'or', 'partial', 'disappearance', 'of', 'hemopoietic', 'progenitors.'], ['In', 'addition,', 'pancytopenia', 'is', 'not', 'observed,', 'which', 'is', 'what', 'would', 'incline', 'us', 'more', 'towards', 'this', 'pathology.'], ['Answer', '2', 'is', 'not', 'possible', 'either,', 'since', 'a', 'spherocytosis', 'does', 'not', 'justify', 'the', 'presence', 'of', 'panagglutinin.'], ['Answer', '3', 'is', 'the', 'one', 'I', 'consider', 'correct:', 'an', 'autoimmune', 'hemolytic', 'anemia', 'would', 'justify', 'the', 'data', 'given:', 'elevated', 'LDH', 'and', 'bilirubinemia', 'due', 'to', 'red', 'cell', 'destruction,', 'polychromatophilia,', 'spherocytosis', 'and', 'anisocytosis', 'because', 'the', 'marrow', 'is', 'working', 'hard', 'to', 'try', 'to', 'compensate', 'for', 'the', 'anemia,', 'which', 'is', 'regenerative.'], ['The', 'study', 'of', 'irregular', 'antibodies', 'and', 'the', 'presence', 'of', 'panagglutinin', 'also', 'supports', 'this', 'response,', 'since', 'the', 'binding', 'of', 'an', 'antibody', 'to', 'the', 'hematocyte', 'promotes', 'its', 'lysis', 'and', 'destruction.'], ['The', 'girl', 'presents', 'cough', 'and', 'fever,', 'consistent', 'with', 'a', 'respiratory', 'infection.'], ['And', 'the', 'initial', 'treatment', 'is', 'corticosteroids.'], ['This', 'is', 'confirmed', 'by', 'Sans', 'Sabrafens', 'in', 'his', 'book', '""Clinical', 'Hematology""', '[1].'], ['Answer', '4', 'gives', 'rise', 'to', 'considerable', 'doubt;', 'it', 'is', 'not', 'possible', 'because', 'a', 'pernicious', 'anemia', 'does', 'not', 'justify', 'the', 'presence', 'of', 'panagglutinin', 'although', 'it', 'would', 'justify', 'the', 'elevation', 'of', 'LDH', 'and', 'bilirubin;', 'moreover,', 'it', 'is', 'an', 'intramedullary,', 'arregenerative', 'hemolysis,', 'there', 'is', 'no', 'reticulocytosis', 'or', 'release', 'into', 'the', 'blood', 'of', 'immature', 'forms', 'in', 'an', 'attempt', 'to', 'compensate', 'and', 'fix', 'the', 'situation.'], ['Answer', '5', 'is', 'not', 'true', 'because', 'no', 'blasts', 'are', 'seen', 'in', 'the', 'blood', 'nor', 'does', 'it', 'explain', 'the', 'presence', 'of', 'panagglutinin.']]","[['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', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', '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', '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'], ['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'], ['O', 'B-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'], ['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', 'I-Claim', 'I-Claim', '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'], ['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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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-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'], ['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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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']]"
7565,"[['QUESTION', 'TYPE:', 'ANESTHESIOLOGY,', 'CRITICAL', 'CARE', 'AND', 'EMERGENCIES'], ['CLINICAL', 'CASE:'], ['A', 'patient', 'admitted', 'for', 'acute', 'pancreatitis', 'starts', 'with', 'tachypnea,', 'tachycardia,', 'sweating', 'and', 'progressive', 'cyanosis.'], ['PaO2', 'is', '55', 'mm', 'Hg', '(PaO2/FiO2', 'ratio<200).'], ['CXR', 'shows', 'bilateral', 'alveolar', 'pulmonary', 'infiltrates.'], ['Pulmonary', 'capillary', 'wedge', 'pressure', 'is', 'normal.'], ['Oxygen', 'therapy', 'does', 'not', 'improve', 'the', 'situation.'], ['What', 'is', 'the', 'most', 'probable', 'diagnosis:'], ['1-', 'Nosocomial', 'pneumonia.'], ['2-', 'Cardiac', 'failure.'], ['3-', 'Carcinomatous', 'lymphangitis.'], ['4-', 'Pulmonary', 'thromboembolism.'], ['5-', 'Respiratory', 'distress.'], ['CORRECT', 'ANSWER:', '5'], ['Direct', 'response', 'question.'], ['The', 'question', 'tells', 'the', 'story', 'of', 'a', 'patient', 'with', 'acute', 'pancreatitis', 'who', 'is', 'developing', 'acute', 'respiratory', 'failure.'], ['The', 'statement', 'lists', 'the', 'criteria', 'for', 'ARDS', '(acute', 'respiratory', 'distress', 'syndrome):', 'PaO2/fiO2', '<', '200', '+', 'bilateral', 'pulmonary', 'infiltrates', '+', 'PCP<18.'], ['So', 'the', 'diagnosis', 'is', 'respiratory', 'distress', 'and', 'therefore', 'the', 'correct', 'answer', 'is', 'option', '5.']]","[['O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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'], ['B-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', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'O', 'O'], ['O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', 'O', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
191125,"[['QUESTION', 'TYPE:', 'PEDIATRICS'], ['CLINICAL', 'CASE:'], ['A', '13-month-old', 'infant', 'comes', 'to', 'the', 'emergency', 'department', 'with', 'fever', 'up', 'to', '39ºC', 'of', '48h', 'of', 'evolution', 'with', 'no', 'other', 'associated', 'symptoms.'], ['Examination', 'by', 'organs', 'and', 'devices', 'with', 'no', 'significant', 'findings,', 'highlighting', 'good', 'general', 'condition.'], ['You', 'were', 'going', 'to', 'discharge', 'him', 'home', 'but', 'the', 'Pediatrics', 'attending', 'on', 'duty', 'asks', 'for', 'a', 'systematic', 'urine', 'and', 'urine', 'culture', 'by', 'catheterization.'], ['The', 'urine', 'shows', 'leukocyturia', '++,', 'hematuria', '+', 'and', 'nitrites', '++', 'and', 'the', 'urine', 'Gram-negative', 'bacilli', 'are', 'observed.'], ['In', 'the', 'blood', 'analysis', 'there', 'is', 'no', 'leukocytosis', 'and', 'the', 'C-reactive', 'protein', 'is', '50', 'mg/l.'], ['The', 'attending', 'now', 'tells', 'you', 'that', 'the', 'child', 'does', 'not', 'need', 'to', 'be', 'admitted', 'and', 'to', 'prescribe', 'an', 'oral', 'antibiotic.'], ['State', 'the', 'least', 'appropriate', 'empirical', 'antibiotic', 'treatment', 'in', 'this', 'case:'], ['1-', 'Amoxicillin.'], ['2-', 'Amoxicillin-clavulanic', 'acid.'], ['3-', 'Cefuroxime-axetil.'], ['4-', 'Cotrimoxazole.'], ['5-', 'Cefixime.'], ['CORRECT', 'ANSWER:', '1'], ['Other', 'drugs', 'are', 'a', 'good', 'choice', 'in', 'urinary', 'tract', 'infections', 'caused', 'by', 'large', 'negative', 'bacilli', '(most', 'likely:', 'E.', 'coli).'], ['The', 'presence', 'of', 'leukocytes', '+', 'nitrites', 'in', 'the', 'urine', 'is', 'very', 'suggestive', 'of', 'UTI.'], ['And', 'if', 'the', 'urine', 'Gram', 'detects', 'G-', 'bacteria,', 'it', 'is', 'probably', 'a', 'UTI', 'due', 'to', 'E', 'Coli.'], ['Many', 'E', 'Coli', 'are', 'resistant', 'to', 'amoxicillin.']]","[['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', '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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['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'], ['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']]"
323150,"[['QUESTION', 'TYPE:', 'UROLOGY'], ['CLINICAL', 'CASE:'], ['12-month-old', 'boy,', 'who', 'in', 'the', 'health', 'examinations', 'practiced', 'since', 'birth', 'presents', 'right', 'testicle', 'in', 'inguinal', 'canal', 'that', 'is', 'not', 'possible', 'to', 'descend', 'to', 'the', 'scrotum.'], ['Mark', 'the', 'CORRECT', 'answer:'], ['1-', 'The', 'most', 'likely', 'diagnosis', 'is', 'retractile', 'testis.'], ['2-', 'Wait', 'until', 'two', 'years', 'of', 'age', 'for', 'spontaneous', 'decrease', 'of', 'the', 'synovial', 'fluid.'], ['3-', 'Human', 'chorionic', 'gonadotropin', 'is', 'the', 'treatment', 'of', 'first', 'choice.'], ['4-', 'The', 'indication', 'for', 'orchidopexy', 'should', 'not', 'be', 'deferred.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '4'], ['This', 'is', 'cryptorchidism.'], ['It', 'has', 'to', 'be', 'treated', 'before', 'the', 'age', 'of', '2', 'years,', 'and', 'hormonal', 'treatment', 'is', 'currently', 'in', 'disuse.'], ['The', 'treatment', 'of', 'first', 'choice', 'is', 'orchidopexy.']]","[['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'], ['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'], ['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'], ['O', 'O'], ['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', 'O', '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']]"
311217,"[['QUESTION', 'TYPE:', 'OPHTHALMOLOGY'], ['CLINICAL', 'CASE:'], ['An', '84-year-old', 'woman', 'presents', 'with', 'loss', 'of', 'vision', 'in', 'the', 'left', 'eye', 'of', '4', 'days', 'of', 'evolution', 'accompanied', 'by', 'metamorphopsia.'], ['The', 'macula', 'shows', 'abundant', 'hard', 'exudates,', 'two', 'small', 'deep', 'hemorrhages', 'and', 'a', 'localized', 'neurosensory', 'retinal', 'detachment.'], ['In', 'the', 'contralateral', 'eye', 'there', 'are', 'abundant', 'soft', 'drusen.'], ['Which', 'of', 'the', 'following', 'diagnoses', 'do', 'you', 'think', 'is', 'the', 'most', 'likely?'], ['1-', 'Acute', 'posterior', 'vitreous', 'detachment.'], ['2-', 'Exudative', 'age-related', 'macular', 'degeneration', '(AMD).'], ['3-', 'Central', 'retinal', 'artery', 'obstruction.'], ['4-', 'Non-arteritic', 'anterior', 'ischemic', 'optic', 'neuropathy.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '2'], ['None', 'of', 'the', 'other', 'three', 'options', 'give', 'that', 'clinical', 'picture', '(DPV', 'is', 'usually', 'asymptomatic,', 'CRVO', 'produces', 'abrupt', 'and', 'total', 'or', 'near', 'total', 'loss', 'of', 'vision', 'with', 'the', 'typical', '""cherry', 'red', 'spot""', 'in', 'the', 'fundus,', 'and', 'both', 'an', 'arteritic', 'and', 'non-arteritic', 'NOIA', 'would', 'produce', 'papillary', 'edema', 'usually', 'with', 'peripapillary', 'but', 'not', 'macular', 'hemorrhages,', 'and', 'none', 'of', 'these', '3', 'options', 'have', 'any', 'association', 'with', 'drusen', 'in', 'the', 'contralateral', 'eye).'], ['AMD', 'in', 'its', 'exudative', 'form', 'presents', 'with', 'both', 'this', 'clinical', 'presentation', '(loss', 'of', 'vision', 'and', 'metamorphopsia)', 'and', 'the', 'characteristic', 'fundus', 'described', 'in', 'the', 'question,', 'in', 'addition', 'to', 'the', 'fact', 'that', 'drusen', 'are', 'usually', 'observed', 'in', 'the', 'contralateral', 'eye.']]","[['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', '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'], ['O', 'B-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'], ['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-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', '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'], ['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']]"
137164,"[['QUESTION', 'TYPE:', 'OTORHINOLARYNGOLOGY', 'AND', 'MAXILLOFACIAL', 'SURGERY'], ['CLINICAL', 'CASE:'], ['Given', 'a', 'direct', 'trauma', 'to', 'the', 'right', 'side', 'of', 'the', 'face', 'after', 'which', 'the', 'patient', 'presents', 'unilateral', 'palpebral', 'hematoma,', 'diplopia', 'in', 'the', 'vertical', 'gaze', 'and', 'difficulty', 'in', 'opening', 'the', 'mouth,', 'which', 'of', 'the', 'following', 'statements', 'is', 'true?'], ['1-', 'We', 'are', 'with', 'great', 'probability', 'in', 'front', 'of', 'a', 'Lefort', 'I', 'type', 'fracture', 'of', 'the', 'middle', 'third', 'of', 'the', 'face.'], ['2-', 'This', 'is', 'probably', 'a', 'unilateral', 'orbitomalar', 'fracture.'], ['The', 'diagnosis', 'would', 'ideally', 'be', 'verified', 'by', 'CT', '(computed', 'axial', 'tomography).'], ['3-', 'It', 'is', 'a', 'fracture', 'of', 'the', 'base', 'of', 'the', 'skull', 'at', 'the', 'level', 'of', 'the', 'carotid', 'foramen.'], ['4-', 'The', 'probable', 'diagnosis', 'is', 'fracture', 'with', 'dislocation', 'of', 'the', 'mandibular', 'condyle.'], ['5-', 'A', 'mandibular', 'fracture', 'is', 'probably', 'associated', 'with', 'a', 'Lefort', 'I', 'type', 'midface', 'fracture.'], ['CORRECT', 'ANSWER:', '2'], ['Diplopia', 'on', 'vertical', 'gaze', 'is', 'highly', 'suggestive', 'that', 'the', 'bony', 'walls', 'of', 'the', 'orbit', 'are', 'affected.'], ['Lefort', 'type', 'I', 'fracture', 'does', 'not', 'affect', 'the', 'orbital', 'contents.'], ['Knowing', 'this', 'information,', 'the', 'only', 'correct', 'answer', 'is', '2.'], ['If', 'we', 'were', 'in', 'doubt', 'about', 'whether', 'or', 'not', ""Lefort's"", 'type', 'I', 'fracture', 'affects', 'the', 'orbit,', 'just', 'look', 'at', 'the', 'answers.'], ['Whoever', 'posted', 'the', 'question', 'wanted', 'to', 'make', 'sure', 'that', 'the', 'only', 'valid', 'answer', 'was', 'number', '2;', 'that', 'is', 'why', 'they', 'added', 'the', 'tag', 'line', '""but', 'just', 'in', 'case', 'we', 'check', 'it', 'with', 'a', 'CT', 'scan"".']]","[['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', 'O', 'B-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'], ['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'], ['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'], ['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'], ['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'], ['B-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'], ['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']]"
309215,"[['QUESTION', 'TYPE:', 'OPHTHALMOLOGY'], ['CLINICAL', 'CASE:'], ['A', '47-year-old', 'man', 'with', 'myopia', 'magna,', 'who', 'underwent', 'cataract', 'surgery', '2', 'years', 'ago,', 'comes', 'to', 'the', 'emergency', 'room', 'reporting', 'a', 'profound', 'and', 'painless', 'loss', 'of', 'vision', 'in', 'his', 'right', 'eye.'], ['Which', 'of', 'the', 'following', 'diagnoses', 'can', 'cause', 'this', 'symptomatology?'], ['1-', 'Post-surgical', 'endophthalmitis.'], ['2-', 'Retinal', 'detachment.'], ['3-', 'Age-related', 'macular', 'degeneration,', 'wet', 'form.'], ['4-', 'Posterior', 'vitreous', 'detachment.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '2'], ['This', 'question', 'could', 'be', 'controversial.'], ['Option', '1', 'is', 'strongly', 'discarded', 'because', 'endophthalmitis', 'typically', 'presents', 'with', 'a', 'lot', 'of', 'pain.'], ['Option', '3', 'of', 'wet', 'form', 'of', 'age-related', 'macular', 'degeneration', 'is', 'also', 'ruled', 'out,', 'because', 'it', 'usually', 'occurs', 'in', 'older', 'patients,', 'although', 'what', 'a', 'patient', 'with', 'myopia', 'magna', 'may', 'present', 'with', 'is', 'myopic', 'macular', 'degeneration', '(with', 'a', 'similar', 'clinical', 'picture', 'to', 'AMD,', 'but', 'this', 'is', 'a', 'different', 'pathology).'], ['A', 'posterior', 'vitreous', 'detachment', '(PVD)', 'is', 'usually', 'not', 'very', 'symptomatic,', 'producing', 'myodesopsias', 'but', 'no', 'loss', 'of', 'vision', 'or', 'pain;', 'however,', 'some', 'PVDs', 'are', 'of', 'the', 'hemorrhagic', 'type,', 'by', 'traction', 'of', 'the', 'vessels,', 'producing', 'a', 'vitreous', 'hemorrhage', 'that', 'would', 'cause', 'loss', 'of', 'vision.'], ['In', 'any', 'case,', 'due', 'to', 'the', 'history', 'of', 'myopia', 'magna', 'and', 'previous', 'intraocular', 'surgery,', 'the', 'first', 'diagnosis', 'to', 'rule', 'out', 'would', 'be', 'retinal', 'detachment,', 'since', 'these', 'are', 'two', 'risk', 'factors', 'for', 'this', 'pathology.'], ['Technically,', 'both', 'option', '2', 'and', '4', '(an', 'acute', 'hemorrhagic', 'DPV)', 'could', 'cause', 'these', 'symptoms,', 'but', 'the', 'most', 'correct', 'option', 'is', 'option', '2', '(and', 'I', 'am', 'sure', 'it', 'is', 'the', 'one', 'the', 'examiner', 'wants', 'answered).']]","[['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'], ['O', 'O', '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', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['O', 'O', 'O', 'O', 'O'], ['B-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'], ['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-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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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', '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'], ['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']]"
27932,"[['QUESTION', 'TYPE:', 'PATHOLOGICAL', 'ANATOMY'], ['CLINICAL', 'CASE:'], ['A', '59-year-old', 'woman', 'presenting', 'with', 'chronic', 'watery', 'diarrhea', 'of', '4', ""months'"", 'evolution.'], ['In', 'the', 'endoscopy,', 'the', 'mucosa', 'did', 'not', 'show', 'relevant', 'aspects.'], ['In', 'particular,', 'no', 'ulcers', 'or', 'friable', 'areas', 'were', 'observed.'], ['A', 'biopsy', 'of', 'the', 'transverse', 'colon', 'was', 'performed.'], ['Histopathology', 'revealed', 'a', 'thickened', 'area', 'below', 'the', 'superficial', 'lining', 'epithelium,', 'which', 'was', 'more', 'evident', 'by', ""Masson's"", 'trichrome', 'technique', 'and', 'involved', 'epithelial', 'atrophy', 'and', 'denudation.'], ['There', 'was', 'also', 'a', 'clear', 'increase', 'in', 'intraepithelial', 'lymphocyte', 'density.'], ['The', 'diagnosis', 'of', 'the', 'intestinal', 'lesion', 'is?'], ['1-', 'Chronic', 'ulcerative', 'colitis.'], ['2-', 'Pseudomembranous', 'colitis.'], ['3-', 'Collagenous', 'colitis.'], ['4-', 'Fibrosing', ""Crohn's"", 'disease.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['In', 'this', 'case,', 'the', 'presence', 'of', 'thickening', 'of', 'the', 'subepithelial', 'collagen', 'layer,', 'more', 'evident', 'with', ""Masson's"", 'trichrome', '(special', 'stain', 'that', 'allows', 'differentiation', 'of', 'the', 'collagen', 'fibers),', 'is', 'pathognomonic', 'of', 'collagenous', 'colitis.'], ['Atrophy', 'together', 'with', 'epithelial', 'denudation', 'are', 'characteristic', 'of', 'this', 'disease,', 'which', 'does', 'not', 'usually', 'cause', 'macroscopic', 'alterations', 'of', 'the', 'mucosa.'], ['An', 'increased', 'density', 'of', 'intraepithelial', 'lymphocytes', 'and', 'the', 'absence', 'of', 'mention', 'of', 'architectural', 'alterations', 'of', 'the', 'crypts', '(characteristic', 'of', 'ulcerative', 'colitis', 'and', ""Crohn's"", 'disease)', 'support', 'this', 'diagnosis.']]","[['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'], ['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', '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', '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', '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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise']]"
437118,"[['QUESTION', 'TYPE:', 'EPIDEMIOLOGY', 'AND', 'PREVENTIVE', 'MEDICINE'], ['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.'], ['He', 'went', 'to', 'his', 'health', 'center', '(located', '3', 'hours', 'from', 'the', 'nearest', 'hospital)', 'for', 'fever', 'of', '39ºC,', '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', 'ganunaglobulin.'], ['3-', 'Give', '400', 'mg', 'of', 'oral', 'moxifloxacin', 'and', 'send', 'to', 'the', 'hospital.'], ['4-', 'Give', 'clindamycin', '600', 'mg', 'oral', 'every', '8', 'hours', 'and', 'observation.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['Since', 'a', 'splenectomized', 'patient', 'is', 'considered', 'a', '""special""', 'patient,', 'he', 'should', 'receive', 'antibiotic', 'treatment', 'as', 'soon', 'as', 'possible,', 'even', 'if', 'the', 'wound', 'does', 'not', 'appear', 'infected.'], ['It', 'is', 'necessary', 'to', 'make', 'sure', 'that', 'the', 'dog', 'is', 'yours', '(you', 'should', 'ask', 'if', 'the', 'animal', 'is', 'correctly', 'vaccinated)', 'and', 'if', 'the', 'patient', 'is', 'correctly', 'vaccinated', '(5', 'doses', 'of', 'tetanus,', 'it', 'would', 'not', 'require', 'tetanus);', 'make', 'a', 'notification', 'of', 'Animal', 'Aggression,', 'for', 'observation', 'of', 'this', 'and', 'take', 'measures', 'in', 'case', 'this', 'is', 'necessary.']]","[['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'], ['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'], ['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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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']]"
112154,"[['QUESTION', 'TYPE:', 'GYNECOLOGY', 'AND', 'OBSTETRICS'], ['CLINICAL', 'CASE:'], ['A', '67-year-old', 'patient', 'with', 'a', 'history', 'of', 'menopause', 'at', '55', 'years', 'of', 'age,', '3', 'pregnancies', 'with', '3', 'euthyroid', 'deliveries,', 'type', '2', 'diabetes', 'of', '6', 'years', 'of', 'evolution,', 'treatment', 'with', 'nifedipone', 'for', 'hypertension.'], ['She', 'consulted', 'for', 'intermittent', 'scanty', 'metrorrhagia', 'of', '2', 'months', 'of', 'evolution.'], ['The', 'gynecological', 'examination', 'showed', 'external', 'genitalia', 'without', 'lesions,', 'an', 'atrophic', 'cervix,', 'a', 'normal', 'uterus', 'and', 'appendages', 'on', 'palpation', 'and', 'a', 'normal', 'cytological', 'study', 'of', 'the', 'cervix.'], ['The', 'transvaginal', 'ultrasound', 'study', 'shows', 'a', '7', 'mm', 'hyperechogenic', 'endometrium.'], ['Which', 'of', 'the', 'following', 'tests', 'is', 'the', 'most', 'appropriate', 'and', 'most', 'sensitive', 'to', 'establish', 'a', 'diagnosis?'], ['1-', 'Conization', 'of', 'the', 'cervix.'], ['2-', 'Endometrial', 'cytology.'], ['3-', 'Hysteroscopy', 'and', 'endometrial', 'biopsy.'], ['4-', 'Magnetic', 'resonance', 'imaging', 'of', 'the', 'pelvis.'], ['5-', 'Examination', 'under', 'anesthesia', 'of', 'the', 'genital', 'tract', 'and', 'biopsy', 'of', 'the', 'cervix', 'and', 'endometrium.'], ['CORRECT', 'ANSWER:', '3'], ['The', 'correct', 'answer', 'is', '3.'], ['The', 'study', 'that', 'gives', 'us', 'more', 'information', 'about', 'endometrial', 'pathology', 'is', 'hysteroscopy,', 'which', 'allows', 'us', 'to', 'perform', 'a', 'directed', 'endometrial', 'biopsy.'], ['Endometrial', 'cytology', 'is', 'performed', 'blindly', 'and', 'has', 'a', 'large', 'number', 'of', 'false', 'negatives.'], ['MRI', 'will', 'help', 'us', 'to', 'stage', 'endometrial', 'cancer.']]","[['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'], ['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'], ['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'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['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', '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'], ['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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
374101,"[['QUESTION', 'TYPE:', 'NEUROLOGY'], ['CLINICAL', 'CASE:'], ['A', '52-year-old', 'man', 'comes', 'to', 'the', 'Emergency', 'Department', 'with', 'headache', 'and', 'fever', '(37.8°C)', 'of', '2', ""days'"", 'evolution.'], ['In', 'the', 'last', 'few', 'hours,', 'he', 'also', 'had', 'difficulty', 'in', 'nomination', 'and', 'comprehension.'], ['The', 'examination', 'did', 'not', 'show', 'nuchal', 'rigidity,', 'the', 'most', 'striking', 'finding', 'being', 'the', 'presence', 'of', 'a', 'mixed', 'aphasia.'], ['The', 'cranial', 'CT', 'shows', 'a', 'faint', 'hypodensity', 'in', 'the', 'left', 'temporal', 'lobe', 'without', 'mass', 'effect', 'and', 'without', 'contrast', 'uptake.'], ['Which', 'of', 'the', 'following', 'statements', 'is', 'correct?'], ['1-', 'Bacterial', 'meningitis', 'is', 'the', 'first', 'diagnostic', 'impression', 'and', 'treatment', 'with', '3rd', 'generation', 'cephalosporin', 'should', 'be', 'initiated', 'as', 'soon', 'as', 'possible.'], ['2-', 'Most', 'likely', 'this', ""patient's"", 'CSF', 'shows', 'a', 'lymphocyte-predominant', 'pleocytosis', 'with', 'normal', 'glycorrhachia.'], ['3-', 'We', 'would', 'suspect', 'limbic', 'encephalitis.'], ['4-', 'This', 'is', 'an', 'early', 'stage', 'brain', 'abscess.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '2'], ['The', 'picture', 'described', 'is', 'typical', 'of', 'a', 'viral', 'meningoencephalitis,', 'more', 'specifically', 'VHZ,', 'with', 'significant', 'tropism', 'by', 'the', 'temporal', 'lobe,', 'causing', 'febrile', 'fever', 'and', 'in', 'many', 'cases', 'aphasia,', 'so', 'the', 'correct', 'option', 'would', 'be', '2,', 'since', 'the', 'cerebrospinal', 'fluid', 'normally', 'shows', 'a', 'moderate', 'lymphocytic', 'pleocytosis,', 'with', 'normal', 'glycorrhachia.'], ['The', 'rest', 'are', 'not', 'correct', 'because:', 'The', 'first', 'one', 'because', 'it', 'is', 'not', 'a', 'bacterial', 'meningitis', 'that', 'would', 'present', 'with', 'more', 'fever,', 'the', 'third', 'one', 'because', 'limbic', 'encephalitis', 'usually', 'presents', 'afebrile', 'with', 'behavioral', 'changes', 'and', 'the', 'last', 'one', 'because', 'the', 'image', 'they', 'describe', 'is', 'not', 'an', 'abscess,', 'well', 'delimited.']]","[['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', '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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['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'], ['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', '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', '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'], ['B-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', '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']]"
116101,"[['QUESTION', 'TYPE:', 'HEMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '25-year-old', 'woman', 'who', 'wishes', 'to', 'become', 'pregnant', 'and', 'wants', 'to', 'know', 'what', 'treatment', 'she', 'should', 'take', 'during', 'the', 'eventual', 'pregnancy,', 'as', 'she', 'is', 'a', 'heterozygous', 'factor', 'V', 'Leiden', 'carrier.'], ['She', 'has', 'never', 'had', 'any', 'thrombotic', 'phenomena.'], ['The', 'determination', 'of', 'this', 'factor', 'was', 'performed', 'as', 'a', 'family', 'study', 'after', 'an', 'episode', 'of', 'pulmonary', 'embolism', 'in', 'a', 'sibling.'], ['What', 'treatment', 'should', 'be', 'advised?'], ['1-', 'Since', 'pregnancy', 'is', 'a', 'prothrombotic', 'state,', 'there', 'would', 'be', 'a', 'high', 'risk', 'of', 'venous', 'thromboembolism,', 'so', 'pregnancy', 'should', 'be', 'discouraged.'], ['2-', 'Treatment', 'with', 'low', 'molecular', 'weight', 'heparin', 'at', 'prophylactic', 'doses', 'should', 'be', 'carried', 'out', 'in', 'the', 'immediate', 'puerperium,', 'with', 'optional', 'follow-up', 'during', 'pregnancy.'], ['3-', 'Factor', 'V', 'Leiden', 'in', 'heterozygosis', 'is', 'a', 'low-risk', 'thrombophilia', 'and', 'there', 'is', 'no', 'need', 'for', 'any', 'treatment', 'in', 'pregnancy', 'and', 'puerperium.'], ['4-', 'Low-dose', 'aspirin', 'should', 'be', 'advised', 'during', 'pregnancy', 'and', 'puerperium.'], ['5-', 'Treatment', 'with', 'antivitamin', 'K', 'drugs', '(acenocoumarol)', 'during', 'pregnancy.'], ['CORRECT', 'ANSWER:', '3'], ['Reading', 'the', 'answers,', 'the', 'first', 'thing', 'that', 'is', 'clear', 'to', 'us', 'is', 'that', 'acenocoumarol', 'should', 'NOT', 'be', 'given', 'to', 'a', 'pregnant', 'woman', 'because', 'of', 'the', 'risk', 'of', 'teratogenicity.'], ['Anyone', 'who', 'does', 'so', 'during', 'residency', 'should', 'be', 'punished', 'with', '100', 'slaps', 'on', 'the', 'back.'], ['We', 'discard', 'answer', '5.'], ['Second:', 'if', 'treatment', 'is', 'given,', 'it', 'should', 'be', 'during', 'the', 'entire', 'pregnancy,', 'prothrombotic', 'status', 'is', 'not', 'only', 'during', 'the', 'puerperium,', 'so', 'answer', '2', 'discarded.'], ['Advise', 'a', 'woman', 'not', 'to', 'become', 'pregnant', 'when', 'there', 'are', 'treatments', 'that', 'ensure', 'a', 'very', 'low', 'risk', 'of', 'thrombosis', 'and/or', 'fetal', 'involvement?'], ['Answer', '1', 'discarded.'], ['We', 'are', 'left', 'with', 'the', 'possibility', 'of', 'not', 'giving', 'any', 'treatment', 'because', 'it', 'is', 'low', 'risk', 'or', 'administering', 'low-dose', 'aspirin.'], ['It', 'is', 'true', 'that', 'factor', 'V', 'Leiden', 'in', 'heterozygosis', 'is', 'classified', 'as', 'low', 'risk,', 'who', 'has', 'not', 'presented', 'a', 'previous', 'thrombotic', 'episode', 'nor', 'is', 'there', 'a', 'combination', 'with', 'another', 'thrombophilia;', 'if', 'we', 'look', 'at', 'the', 'CHEST', 'guide,', 'VIII', 'edition', 'and', 'review', 'what', 'was', 'said', 'at', 'the', 'last', 'congress', 'of', 'the', 'Spanish', 'Society', 'of', 'Gynecology', 'and', 'Obstetrics,', 'we', 'see', 'that', 'aspirin', 'is', 'used', 'in', 'case', 'of', 'phospholipid', 'syndrome', 'and', 'that', 'in', 'the', 'case', 'of', 'this', 'woman,', 'without', 'previous', 'thrombosis,', 'without', 'previous', 'abortions', '(at', 'least', 'two', 'are', 'needed)', 'and', 'also', 'being', 'heterozygous,', 'treatment', 'is', 'not', 'necessary.'], ['Correct', 'answer,', '3.']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 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'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Treatment', 'I-Treatment', 'I-Treatment', 'I-Treatment', 'I-Treatment', 'I-Treatment', 'I-Treatment', 'I-Treatment'], ['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'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', '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', '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', 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473141,"[['QUESTION', 'TYPE:', 'ORTHOPEDIC', 'SURGERY', 'AND', 'TRAUMATOLOGY'], ['CLINICAL', 'CASE:'], ['The', 'most', 'likely', 'diagnosis', 'of', 'a', '74-year-old', 'patient', 'who', 'since', 'two', 'months', 'ago', 'begins', 'with', 'lumbar', 'pain', 'radiating', 'to', 'lower', 'limbs,', 'neurogenic', 'claudication', 'and', 'limitation', 'to', 'extension', 'the', 'trunk', 'is:'], ['1-', 'L4-L5', 'disc', 'herniation.'], ['2-', 'Lumbar', 'vertebral', 'fracture.'], ['3-', 'L5-S1', 'vertebral', 'instability.'], ['4-', 'Lumbar', 'canal', 'stenosis.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '4'], ['We', 'are', 'being', 'shown', 'a', 'picture', 'of', 'lumbar', 'canal', 'stenosis', '(Answer', '4', 'correct).'], ['The', 'patient', 'shows', 'the', 'characteristic', 'clinical', 'picture:', 'lumbar', 'pain', 'that', 'is', 'relieved', 'by', 'flexing', 'the', 'trunk', 'forward,', 'radicular', 'pain', 'with', 'lower', 'limb', 'involvement', 'and', 'neurogenic', 'claudication.'], ['Low', 'back', 'pain', 'in', 'a', 'patient', 'over', '60', 'years', 'of', 'age', 'accompanied', 'by', 'leg', 'weakness', 'when', 'walking,', 'which', 'has', 'to', 'be', 'interrupted', 'at', 'a', 'certain', 'distance,', 'called', 'neurogenic', 'claudication,', 'is', 'the', 'typical', 'picture', 'of', 'stenosis.'], ['The', 'patient', 'is', 'relieved', 'by', 'flexing', 'the', 'spine', 'forward', 'because', 'it', 'widens', 'the', 'lumbar', 'canal', 'and', 'worsens', 'with', 'extension...']]","[['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', 'I-Premise', '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', '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', 'B-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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['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']]"
3466,"[['QUESTION', 'TYPE:', 'NEUROLOGY', 'AND', 'NEUROSURGERY'], ['CLINICAL', 'CASE:'], ['A', '51-year-old', 'woman', 'comes', 'to', 'the', 'emergency', 'department', 'with', 'a', 'sudden', 'decrease', 'in', 'visual', 'acuity,', 'severe', 'headache,', 'nausea', 'and', 'vomiting.'], ['Hypotensive', 'and', 'afebrile.'], ['She', 'presented', 'right', 'ophthalmoparesis', 'due', 'to', 'involvement', 'of', 'the', 'third', 'cranial', 'nerve.'], ['A', 'cranial', 'CT', 'scan', 'shows', 'a', 'mass', 'in', 'the', 'hyperdense', 'selar', 'region', 'with', 'erosion', 'of', 'the', 'anterior', 'clinoid', 'processes.'], ['What', 'is', 'the', 'best', 'approach', 'to', 'follow?'], ['1-', 'Suspect', 'chemical', 'meningitis', 'derived', 'from', 'a', 'ruptured', 'epidermoid', 'tumor', 'and', 'start', 'immediate', 'treatment', 'with', 'corticosteroids.'], ['2-', 'It', 'would', 'indicate', 'the', 'performance', 'of', 'a', 'cerebral', 'angiography', 'to', 'rule', 'out', 'an', 'aneurysm,', 'since', 'it', 'is', 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343158,"[['QUESTION', 'TYPE:', 'GYNECOLOGY', 'AND', 'OBSTETRICS'], ['CLINICAL', 'CASE:'], ['A', '24-year-old', 'woman,', 'primigestation,', 'suffers', 'a', 'spontaneous', 'abortion', 'at', '7', 'weeks', 'gestation.'], ['The', 'anatomopathological', 'study', 'of', 'the', 'abortive', 'remains', 'indicates', 'molar', 'disease.'], ['We', 'should', 'inform', 'you', 'that:'], ['1-', 'The', 'risk', 'of', 'a', 'new', 'molar', 'gestation', 'in', 'a', 'future', 'pregnancy', 'is', '50%.'], ['2-', 'You', 'should', 'not', 'become', 'pregnant', 'until', 'periodic', 'controls', 'and', 'have', 'spent', 'one', 'year', 'with', 'negative', 'BHCG', 'levels.'], ['3-', 'Subsequent', 'controls', 'are', 'not', 'necessary', 'if', 'the', 'evacuation', 'of', 'the', 'trophoblastic', 'tissue', 'was', 'complete.'], ['4-', 'It', 'is', 'necessary', 'to', 'perform', 'periodic', 'controls', 'since', '40%', 'of', 'the', 'cases', 'will', 'develop', 'a', 'gestational', 'trophoblastic', 'neoplasia.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '2'], ['The', 'answer', 'is', '2.'], ['According', 'to', 'the', 'SEGO', '(Spanish', 'Society', 'of', 'Gynecology', 'and', 'Obstetrics)', 'in', 'its', '2005', 'protocol', '""Gestational', 'trophoblastic', 'disease"",', 'the', 'risk', 'of', 'malignization,', 'i.e.', 'of', 'developing', 'a', 'gestational', 'trophoblastic', 'neoplasm,', 'ranges', 'from', '5', 'to', '20%', 'depending', 'on', 'whether', 'it', 'is', 'a', 'partial', 'mole', 'or', 'a', 'complete', 'mole,', 'respectively.'], ['According', 'to', 'this', 'protocol:', '""Patients', 'will', 'be', 'monitored', 'weekly', 'with', 'hcg', 'dosage', 'until', 'it', 'becomes', 'undetectable,', 'for', 'three', 'consecutive', 'times.'], ['After', 'that', 'the', 'monitoring', 'will', 'be', 'monthly,', 'for', 'six', 'months', 'and', 'then', 'every', 'two', 'months', 'for', 'another', 'six', 'months.'], ['Based', 'on', 'the', 'available', 'data,', 'a', 'follow-up', 'of', 'three', 'to', 'six', 'months', 'is', 'recommended', 'for', 'partial', 'mole', 'and', '12', 'months', 'for', 'complete', 'mole.""', 'Therefore,', 'subsequent', 'controls', 'are', 'strictly', 'necessary.The', 'risk', 'of', 'a', 'new', 'molar', 'gestation,', 'although', 'increased', 'compared', 'to', 'the', 'normal', 'population,', 'is', 'not', '50%.']]","[['O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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', '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'], ['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', '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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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'], ['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']]"
210187,,
18768,"[['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['A', '52-year-old', 'woman', 'from', 'a', 'village', 'on', 'the', 'Costa', 'Brava', 'notices', 'an', 'otherwise', 'asymptomatic', 'lump', 'in', 'the', 'anterior', 'region', 'when', 'applying', 'cream', 'to', 'her', 'neck;', 'she', 'goes', 'to', 'her', 'general', 'practitioner', 'who', 'confirms', 'the', 'presence', 'of', 'a', 'firm,', 'smooth', 'mass,', '2', 'cm', 'in', 'maximum', 'diameter,', 'which', 'rises', 'with', 'swallowing.'], ['No', 'palpable', 'lymphadenopathy.'], ['What', 'tests', 'would', 'you', 'order', 'at', 'the', 'outset?'], ['1-', 'A', 'determination', 'of', 'thyroglobulin', 'in', 'blood.'], ['2-', 'A', 'cervical', 'CT', 'scan.'], ['3-', 'A', 'determination', 'of', 'circulating', 'antithyroid', 'antibodies', '(antithyroglubulin', 'and', 'antiperoxidase).'], ['4-', 'A', 'fine', 'needle', 'puncture.'], ['5-', 'A', 'determination', 'of', 'free', 'T3.'], ['CORRECT', 'ANSWER:', '4'], ['It', 'refers', 'to', 'a', 'thyroid', 'nodule,', 'and', 'the', 'indicated', 'test', 'is', 'a', 'FNA', '(fine', 'needle', 'puncture).'], ['I', 'have', 'read', 'the', 'answer', 'Emilio', 'has', 'written', 'on', 'the', 'challenge;', 'the', 'question', 'is', 'in', 'the', 'endocrine', 'block', 'and', 'it', 'seems', 'he', 'is', 'trying', 'to', 'make', 'it', 'clear', 'that', 'it', 'is', 'a', 'nodule.'], ['Ultrasound', 'facilitates', 'FNA', 'but', 'is', 'not', 'mandatory,', 'a', '2', 'cm', 'thyroid', 'nodule', 'can', 'be', 'punctured', 'without', 'echo.'], ['It', 'is', 'important', 'to', 'have', 'an', 'analysis', 'of', 'thyroid', 'function', 'prior', 'to', 'the', 'puncture;', 'but', 'since', 'he', 'is', 'talking', 'about', 'an', 'asymptomatic', 'patient,', 'it', 'seems', 'clear', 'that', 'she', 'is', 'not', 'hyperthyroid.'], ['I', 'do', 'not', 'think', 'it', 'is', 'contested', 'and', 'I', 'think', 'it', 'is', 'a', 'question', 'that', 'most', 'will', 'have', 'answered', 'well.']]","[['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'], ['B-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'], ['O', 'B-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'], ['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', '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'], ['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'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O']]"
40633,"[['QUESTION', 'TYPE:', 'ONCOLOGY', '(ECTOPIC)'], ['CLINICAL', 'CASE:'], ['A', '67-year-old', 'woman', 'diagnosed', 'with', 'an', 'infiltrating', 'ductal', 'carcinoma', 'of', 'the', 'breast', 'with', 'no', 'family', 'history', 'of', 'neoplasia.'], ['What', 'additional', 'studies', 'should', 'be', 'performed', 'on', 'the', 'tumor', 'because', 'of', 'its', 'clinical', 'and', 'therapeutic', 'implications:'], ['1-', 'Complete', 'phenotypic', 'study', 'by', 'flow', 'cytometry.'], ['2-', 'Study', 'of', 'hormone', 'receptors', 'and', 'HER2.'], ['3-', 'Study', 'of', 'hormone', 'receptors,', 'ecadherin', 'and', 'study', 'of', 'first', 'degree', 'relatives.'], ['4-', 'BRCA', 'l-2', 'study', 'and', 'study', 'of', 'first-degree', 'relatives.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '2'], ['Currently', 'the', 'molecular', 'classification', 'of', 'breast', 'cancer', 'is', 'based', 'on', 'the', 'study', 'of', 'hormone', 'receptors,', 'HER2', 'and', 'the', 'tumor', 'cell', 'proliferation', 'index', '(Ki67).'], ['We', 'have', 'four', 'fundamental', 'types:', 'Luminal', '(A:', 'HR+,', 'HER2-', 'and', 'low', 'Ki67', 'and', 'B:', 'HR+,', 'HER2+/', '-', 'and', 'high', 'Ki67),', 'HER2', '+', '(HR', '-,', 'HER2', '+', 'and', 'high', 'Ki67)', 'and', 'Basal', 'Like', 'or', 'triple', 'negative', '(HR', '-,', 'HER2', '-', 'and', 'high', 'Ki67).']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['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'], ['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'], ['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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
52654,"[['QUESTION', 'TYPE:', 'PREVENTIVE', 'MEDICINE'], ['CLINICAL', 'CASE:'], ['An', '86-year-old', 'woman', 'in', 'whom', 'nonvalvular', 'atrial', 'fibrillation', 'has', 'been', 'detected.'], ['She', 'has', 'a', 'CHADS2', 'score', 'of', '3', 'points.'], ['In', 'the', 'literature,', 'similar', 'patients', 'on', 'warfarin', 'therapy', 'have', 'a', 'stroke', 'risk', 'of', '2.2%', 'versus', '5.2%', 'in', 'patients', 'without', 'warfarin.'], ['What', 'would', 'be', 'the', 'number', 'needed', 'to', 'treat', '(NNT)', 'to', 'prevent', 'embolic', 'stroke', 'with', 'anticoagulation', 'therapy?'], ['1-', '3'], ['2-', '19,2.'], ['3-', '33,3.'], ['4-', '49,5.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['The', 'NNT', '(number', 'needed', 'to', 'treat),', 'means', 'how', 'many', 'patients', 'we', 'would', 'need', 'to', 'treat', 'with', 'an', 'intervention', 'to', 'obtain', 'a', 'benefit;', 'in', 'this', 'question', 'how', 'many', 'patients', 'do', 'we', 'need', 'to', 'treat', 'with', 'warfarin', 'to', 'prevent', 'a', 'stroke.'], ['To', 'calculate', 'this', 'we', 'use', 'the', 'following', 'formula:', 'NNT=', '1/RRA', '(RRA:', 'absolute', 'risk', 'reduction).'], ['RRA=', 'Io', '-', 'Ie', '(Io:', 'incidence', 'in', 'those', 'not', 'exposed', 'to', 'warfarin;', 'Ie:', 'incidence', 'in', 'those', 'exposed', 'to', 'warfarin).'], ['RRA:', '5,2%-', '2,2%=', '3=', '0,03.'], ['NNT:', '1/0.03=', '33.3.']]","[['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'], ['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'], ['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', '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'], ['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'], ['B-Claim', 'I-Claim', 'I-Claim']]"
645,,
57392,"[['QUESTION', 'TYPE:', 'NEUROLOGY'], ['CLINICAL', 'CASE:'], ['A', '75-year-old', 'woman', 'brought', 'for', 'consultation', 'by', 'her', 'family', 'because', 'they', 'have', 'been', 'finding', 'her', 'depressed', 'and', 'with', 'memory', 'lapses', 'for', 'months.'], ['They', 'are', 'concerned', 'that', 'she', 'may', 'have', ""Alzheimer's"", 'disease.'], ['The', 'patient', 'refers', 'that', 'she', 'does', 'not', 'think', 'anything', 'is', 'wrong', 'with', 'her', 'and', 'that', 'she', 'is', 'as', 'usual.'], ['In', 'what', 'order', 'do', 'the', 'following', 'symptoms', 'generally', 'occur', 'in', 'the', 'progression', 'of', ""Alzheimer's"", 'disease:'], ['1-', 'Mood', 'changes,', 'behavioral', 'symptoms,', 'cognitive', 'deficits.'], ['2-', 'Behavioral', 'symptoms,', 'motor', 'symptoms,', 'decline', 'of', 'functional', 'independence.'], ['3-', 'Mood', 'changes,', 'cognitive', 'deficit,', 'decline', 'of', 'functional', 'independence.'], ['4-', 'Behavioral', 'symptoms,', 'mood', 'changes,', 'motor', 'symptoms.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['I', 'answer', 'this', 'question', 'thinking', 'more', 'about', 'what', 'they', 'want', 'to', 'ask', 'than', 'what', 'they', 'are', 'really', 'asking.'], ['There', 'is', 'heterogeneity', 'in', 'the', 'development', 'of', ""Alzheimer's"", 'disease', 'symptoms.'], ['There', 'are', 'behavioral', 'variants,', 'but', 'in', 'the', 'MIR', 'they', 'usually', 'want', 'you', 'to', 'think', 'of', 'other', 'types', 'of', 'dementias', 'in', 'the', 'face', 'of', 'behavioral', 'symptoms.'], ['In', 'fact,', 'the', 'appearance', 'of', 'these', 'symptoms', 'in', 'early', 'stages', 'should', 'alert', 'us', 'and', 'open', 'the', 'range', 'of', 'diagnostic', 'possibilities.'], ['Therefore,', 'we', 'discard', '2', 'and', '4.'], ['Between', '1', 'and', '3,', 'I', 'choose', '3', 'for', 'the', 'same', 'reason', 'and', 'because', 'of', 'the', 'emphasis', 'on', 'the', 'decline', 'of', 'functional', 'independence', 'that', 'occurs', 'in', 'these', 'patients.']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', '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'], ['O', 'B-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'], ['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'], ['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'], ['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']]"
164123,"[['QUESTION', 'TYPE:', 'NEPHROLOGY'], ['CLINICAL', 'CASE:'], ['An', '80-year-old', 'patient', 'with', 'a', 'history', 'of', 'hypertension', 'and', 'on', 'treatment', 'with', 'enalapril', 'and', 'spironolactone', 'comes', 'to', 'the', 'hospital', 'with', 'asthenia', 'and', 'severe', 'muscle', 'weakness.'], ['Blood', 'pressure', 'is', '110/70', 'mmHg.'], ['In', 'the', 'ECG,', 'there', 'are', 'sharp', 'and', 'elevated', 'T', 'waves,', 'ventricular', 'extrasystoles', 'and', 'short', 'QT.'], ['What', 'is', 'the', 'most', 'likely', 'diagnosis?'], ['1-', 'Hypercalcemia.'], ['2-', 'Hyperkalemia.'], ['3-', 'Hypomagnesemia.'], ['4-', 'Hypocalcemia.'], ['5-', 'Hypernatremia.'], ['CORRECT', 'ANSWER:', '2'], ['The', 'correct', 'answer', 'is:', '2.'], ['Hyperkalemia.'], ['Spironolactone,', 'as', 'a', 'potassium-sparing', 'diuretic,', 'inhibits', 'the', 'action', 'of', 'aldosterone', 'at', 'the', 'renal', 'level,', 'being', 'responsible', 'for', 'a', 'decrease', 'in', 'potassium', 'excretion.'], ['Hyperkalemia', 'produces', 'repolarization', 'disturbances', 'that', 'result', 'in', 'the', 'installation', 'of', 'a', 'large,', 'symmetrical,', 'narrow-based', 'T,', 'visible', 'in', 'the', 'precordial', 'leads.'], ['The', 'QT', 'space', 'is', 'shortened.'], ['These', 'anomalies', 'appear', 'with', 'a', 'kalemia', 'of', 'around', '5.5', 'to', '6', 'mmol/l.'], ['Above', '6.5', 'mmol/L,', 'electrocardiographic', 'changes', 'are', 'constant,', 'and', 'are', 'dominated', 'by', 'conduction', 'disturbances', '(making', 'ventricular', 'extrasystoles', 'possible).']]","[['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'], ['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', 'B-Premise', 'I-Premise', 'O', 'B-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-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', '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'], ['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']]"
208183,"[['QUESTION', 'TYPE:', 'GYNECOLOGY', 'AND', 'OBSTETRICS'], ['CLINICAL', 'CASE:'], ['Woman', '40', 'weeks', 'gestation', 'in', 'labor', 'with', '6', 'cm', 'dilation.'], ['She', 'presents', 'a', 'decelerative', 'fetal', 'pattern', 'in', 'cardiotocographic', 'recordings,', 'so', 'it', 'is', 'decided', 'to', 'perform', 'a', 'fetal', 'blood', 'smear', 'to', 'assess', 'fetal', 'well-being.', 'Result', '7.22.'], ['The', 'correct', 'conduct', 'is:'], ['1-', 'Severe', 'acidosis.', 'Urgent', 'cesarean', 'section.'], ['2-', 'Pre-pathological', 'value', 'repeat', 'microtome', '15-20', 'minutes.'], ['3-', 'Moderate', 'acidosis.', 'Repeat', 'microtome', 'in', '1-2', 'hours.'], ['4-', 'Value', 'in', 'normal', 'limits,', 'leave', 'natural', 'evolution', 'of', 'labor.'], ['5-', 'Repeat', 'at', 'the', 'time', 'of', 'possible', 'error', 'in', 'obtaining', 'the', 'shot.'], ['CORRECT', 'ANSWER:', '2'], ['-', 'pH', 'less', 'than', '7.20', 'Pathological', 'value.'], ['Indication', 'for', 'fetal', 'extraction', 'by', 'the', 'quickest', 'route,', 'in', 'this', 'case', 'a', 'cesarean', 'section.'], ['-', 'pH', 'between', '7.20-7.25', 'Prepathological', 'value.'], ['Repeat', 'microtome', 'in', '15-20', 'min.'], ['-', 'pH', 'greater', 'than', '7.25.'], ['Value', 'within', 'the', 'limits', 'of', 'normality.', 'Observation.']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['O', 'O', 'O', 'O'], ['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'], ['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'], ['O', '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', '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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
232103,"[['QUESTION', 'TYPE:', 'HEMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '19-year-old', 'girl', 'with', 'no', 'medical', 'history', 'of', 'interest,', 'except', 'for', 'a', 'self-limited', 'case', 'of', 'influenza', '3', 'weeks', 'earlier,', 'who', 'comes', 'to', 'the', 'emergency', 'department', 'with', 'petechiae', 'and', 'ecchymosis', 'of', 'spontaneous', 'onset.'], ['On', 'physical', 'examination', 'the', 'patient', 'was', 'in', 'good', 'general', 'condition,', 'afebrile,', 'normotensive', 'and', 'oriented', 'in', 'time', 'and', 'space.'], ['There', 'were', 'petechiae', 'scattered', 'throughout', 'the', 'lower', 'extremities', 'and', 'abdomen', 'and', 'small', 'ecchymoses', 'in', 'decubitus', 'areas.'], ['No', 'lymphadenopathy', 'or', 'splenomegaly', 'were', 'palpated.'], ['Laboratory', 'tests', 'showed', 'the', 'following', 'findings:', 'Hb', '12.6', 'g/dL,', 'leukocytes', '5,500/mm3,', 'platelets', '7000/mm3.'], ['The', 'peripheral', 'blood', 'smear', 'showed', 'normal', 'erythrocyte', 'morphology,', 'normal', 'differential', 'leukocyte', 'count', 'and', 'the', 'planetary', 'count', 'was', 'concordant', 'with', 'the', 'autoanalyzer', 'figure', 'without', 'platelet', 'aggregates.'], ['Biochemistry', 'and', 'proteinogram,', 'beta', '2', 'microglobulin', 'and', 'LDH', 'are', 'normal.'], ['Which', 'of', 'the', 'following', 'do', 'you', 'think', 'is', 'the', 'most', 'appropriate', 'initial', 'treatment?'], ['1-', 'Platelet', 'transfusion.'], ['2-', 'Weekly', 'Rituximab.'], ['3-', 'Cyclophosphamide', 'in', '4-day', 'pulses', 'every', '21', 'days.'], ['4-', 'Daily', 'plasmapheresis.'], ['5-', 'Prednisone', 'at', '1', 'mg/day', 'for', '2-3', 'weeks.'], ['CORRECT', 'ANSWER:', '1'], ['Idiopathic', 'thrombocytopenic', 'purpura,', 'but', 'with', 'very', 'low', 'platelets,', 'so', 'replenishment', 'is', 'necessary.'], ['The', 'proposed', 'steroid', 'dose', 'is', 'too', 'low.']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', 'B-Premise', 'I-Premise', 'I-Premise', 'B-Premise', 'I-Premise', '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', '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', 'B-Claim', 'I-Claim'], ['O', 'B-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'], ['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']]"
64210,"[['QUESTION', 'TYPE:', 'ANATOMY'], ['CLINICAL', 'CASE:'], ['A', '42-year-old', 'woman', 'with', 'breast', 'cancer', 'has', 'metastases', 'at', 'the', 'level', 'of', 'the', 'intervertebral', 'foramina', 'between', 'the', '4th', 'and', '5th', 'cervical', 'vertebrae', 'and', 'between', 'the', '4th', 'and', '5th', 'thoracic', 'vertebrae.'], ['Which', 'spinal', 'nerves', 'will', 'be', 'injured?'], ['1-', 'Fourth', 'cervical', 'and', 'fourth', 'thoracic', 'nerves.'], ['2-', 'Fifth', 'cervical', 'and', 'fifth', 'thoracic', 'nerves.'], ['3-', 'Fourth', 'cervical', 'and', 'fifth', 'thoracic', 'nerves.'], ['4-', 'Fifth', 'cervical', 'and', 'fourth', 'thoracic', 'nerve.'], ['5-', 'Third', 'cervical', 'and', 'fourth', 'thoracic', 'nerve.'], ['CORRECT', 'ANSWER:', '4'], ['The', 'trick', 'to', 'this', 'question', 'is', 'that', 'there', 'are', '8', 'cervical', 'roots', 'for', '7', 'vertebrae,', 'therefore', 'the', 'C1', 'root', 'exits', 'ABOVE', 'the', 'atlas,', 'and', 'so', 'on', 'up', 'to', 'C8', 'which', 'exits', 'BETWEEN', 'C7', 'and', 'T1.'], ['The', 'thoracic', 'roots', 'come', 'out', 'respectively', 'below', 'the', 'vertebra', 'with', 'their', 'same', 'numbering', '(nerve', 'T1', 'under', 'T1,', 'T2', 'under', 'T2,', 'etc.).'], ['Therefore,', 'between', 'C4', 'and', 'C5', 'the', '5th', 'cervical', 'nerve', 'exits,', 'and', 'between', 'T4', 'and', 'T5', 'the', '4th', 'thoracic', 'nerve', 'exits.'], ['The', 'correct', 'answer', 'is', '4.']]","[['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'], ['O', 'O', 'O', 'O', 'O', 'O'], ['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'], ['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'], ['O', 'B-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', '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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
28032,"[['QUESTION', 'TYPE:', 'PATHOLOGICAL', 'ANATOMY'], ['CLINICAL', 'CASE:'], ['A', '59-year-old', 'woman', 'presents', 'with', 'chronic', 'watery', 'diarrhea', 'of', '4', ""months'"", 'duration.'], ['On', 'endoscopy,', 'the', 'mucosa', 'showed', 'no', 'relevant', 'features.'], ['In', 'particular,', 'no', 'ulcers', 'or', 'friable', 'areas', 'were', 'observed.'], ['A', 'biopsy', 'of', 'the', 'transverse', 'colon', 'was', 'performed.'], ['Histopathology', 'revealed', 'a', 'thickened', 'area', 'below', 'the', 'superficial', 'lining', 'epithelium,', 'which', 'was', 'more', 'evident', 'by', ""Masson's"", 'trichrome', 'technique', 'and', 'involved', 'epithelial', 'atrophy', 'and', 'denudation.'], ['There', 'was', 'also', 'a', 'clear', 'increase', 'in', 'intraepithelial', 'lymphocyte', 'density.'], ['The', 'diagnosis', 'of', 'the', 'intestinal', 'lesion', 'is?'], ['1-', 'Chronic', 'ulcerative', 'colitis.'], ['2-', 'Pseudomembranous', 'colitis.'], ['3-', 'Collagenous', 'colitis.'], ['4-', 'Fibrosing', ""Crohn's"", 'disease.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['Everything', 'we', 'are', 'told', 'in', 'this', 'case', 'is', 'typical', 'of', 'COLLAGENOUS', 'COLITIS.'], ['In', 'principle,', 'the', 'clinical', 'and', 'endoscopic', 'findings', 'may', 'leave', 'us', 'a', 'little', 'as', 'at', 'the', 'beginning,', 'but', 'histology', 'is', 'little', 'more', 'than', 'the', 'definition', 'of', 'this', 'pathology.'], ['The', 'specific', 'criterion', 'for', 'the', 'diagnosis', 'of', 'collagenous', 'colitis', 'is', 'the', 'additional', 'presence', 'of', 'an', 'irregular', 'band', 'of', 'collagen', 'just', 'below', 'the', 'surface', 'epithelium', 'of', 'the', 'colonic', 'mucosa', 'in', 'continuity', 'with', 'the', 'basement', 'membrane,', 'visible', 'with', 'trichrome', 'staining', '(stains', 'type', 'I', 'collagen', 'fibers),', 'which', 'traps', 'superficial', 'capillaries', 'producing', 'lesions', 'in', 'the', 'surface', 'epithelium.'], ['In', 'addition,', 'it', 'is', 'accompanied', 'by', 'a', 'chronic', 'inflammatory', 'infiltrate', 'in', 'the', 'lamina', 'propria,', 'composed', 'mainly', 'of', 'lymphocytes,', 'plasma', 'cells', 'and', 'eosinophils.']]","[['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'], ['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', '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', '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', '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', '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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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']]"
545122,,
25795,"[['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['In', 'a', '30-year-old', 'female', 'patient', 'a', 'calcium', 'level', 'of', '11', 'mg/dl', '(normal', 'less', 'than', '10.5', 'mg/dl)', 'is', 'found', 'during', 'a', 'routine', 'company', 'examination.'], ['PTH', 'determination', 'was', '45', 'pg/ml', '(VN', '10-55', 'pg/ml).'], ['The', 'history', 'is', 'unremarkable', 'except', 'for', 'the', 'fact', 'that', 'the', 'mother', 'and', 'paternal', 'grandfather', 'were', 'diagnosed', 'with', 'hyperparathyroidism', 'and', 'underwent', 'surgery,', 'although', 'they', 'remained', 'hypercalcemic.'], ['Which', 'test', 'is', 'most', 'useful', 'in', 'confirming', 'the', 'diagnosis?'], ['1-', '25-OH', 'D.'], ['2-', '1,25-OH', '2D.'], ['3-', 'Urine', 'calcium/creatinine', 'ratio.'], ['4-', 'Phosphate', 'tubular', 'reabsorption.'], ['5-', 'PTHrP.'], ['CORRECT', 'ANSWER:', '3'], ['Calcium/creatinine', 'urine', 'ratio.'], ['This', 'is', 'familial', 'hypocalciuric', 'hypercalcemia', 'or', 'benign', 'familial', 'hypercalcemia.'], ['Autosomal', 'dominant', 'disorder.'], ['Asymptomatic.'], ['Not', 'cured', 'after', 'surgical', 'treatment;', 'it', 'is', 'due', 'to', 'mutation', 'of', 'the', 'calcium-sensitive', 'receptor.'], ['Difficult', 'question', 'since', 'it', 'is', 'necessary', 'to', 'know', 'data', 'of', 'a', 'disease', 'that', 'is', 'not', 'usually', 'asked', 'in', 'the', 'MIR.']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-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'], ['B-Claim', 'I-Claim', 'I-Claim'], ['B-Premise'], ['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'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O']]"
548126,,
318140,"[['QUESTION', 'TYPE:', 'RHEUMATOLOGY'], ['CLINICAL', 'CASE:'], ['You', 'evaluate', 'a', '66-year-old', 'patient', 'with', 'groin', 'pain', 'accentuated', 'by', 'prolonged', 'standing', 'for', 'a', 'few', 'days', 'per', 'month.'], ['A', 'plain', 'radiograph', 'of', 'the', 'hips', 'shows', 'narrowing', 'of', 'the', 'femoroacetabular', 'joint', 'space,', 'sclerosis', 'and', 'ostephytes.'], ['1-', 'I', 'make', 'the', 'diagnosis', 'of', 'coxarthrosis', 'and', 'send', 'to', 'the', 'traumatologist', 'to', 'place', 'a', 'hip', 'prosthesis.'], ['2-', 'Start', 'treatment', 'with', 'weak', 'opioids', 'that', 'have', 'shown', 'evidence', 'in', 'stopping', 'the', 'progression', 'of', 'the', 'disease.'], ['3-', 'Treatment', 'with', 'paracetamol,', 'explaining', 'that', 'the', 'evolution', 'is', 'very', 'variable', 'and', 'the', 'surgical', 'indication', 'depends', 'on', 'the', 'functionality', 'and', 'pain', 'control.'], ['4-', 'Because', 'of', 'the', 'radiological', 'features', 'described,', 'I', 'need', 'a', 'hip', 'MRI', 'before', 'making', 'a', 'therapeutic', 'decision.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['It', 'is', 'a', 'coxarthrosis.'], ['The', 'surgical', 'criteria', 'depends', 'on', 'the', ""patient's"", 'symptoms', 'and', 'failure', 'of', 'medical', 'treatment.'], ['No', 'medication', 'slows', 'down', 'or', 'modifies', 'the', 'course', 'of', 'the', 'disease.'], ['An', 'MRI', 'is', 'not', 'necessary,', 'it', 'does', 'not', 'contribute', 'anything.'], ['Treatment', 'is', 'medical', 'and', 'sequential,', 'starting', 'with', 'the', 'first', 'analgesic', 'step', 'of', 'the', 'WHO.']]","[['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'], ['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', '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'], ['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'], ['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'], ['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']]"
147157,"[['QUESTION', 'TYPE:', 'PSYCHIATRY'], ['CLINICAL', 'CASE:'], ['A', '19-year-old', 'female', 'university', 'student', 'comes', 'to', 'the', 'clinic', 'accompanied', 'by', 'her', 'parents,', 'reporting', 'feeling', 'progressively', 'more', 'asthenic', 'in', 'the', 'last', 'two', 'months,', 'with', 'loss', 'of', 'appetite', 'and', 'weight', 'and', 'with', 'greater', 'difficulty', 'in', 'concentrating', 'on', 'her', 'studies.'], ['The', 'anamnesis', 'also', 'highlights', 'that', 'she', 'has', 'lost', 'interest', 'in', 'going', 'out', 'with', 'friends,', 'has', 'ideas', 'of', 'death', 'without', 'self-harming', 'ideation', 'and', 'pessimistic', 'cognitions', 'of', 'the', 'future.'], ['Her', 'weight', 'is', '90%', 'of', 'that', 'considered', 'ideal', 'for', 'age', 'and', 'gender.'], ['She', 'does', 'not', 'present', 'weight', 'phobia', 'or', 'body', 'image', 'distortion.'], ['The', 'most', 'appropriate', 'diagnosis', 'is:'], ['1-', 'Anorexia', 'nervosa.'], ['2-', 'Anxiety', 'disorder.'], ['3-', 'Borderline', 'personality', 'disorder.'], ['4-', 'Dysthymia.'], ['5-', 'Major', 'depressive', 'disorder.'], ['CORRECT', 'ANSWER:', '5'], ['As', 'soon', 'as', 'we', 'hear', 'about', 'weight', 'we', 'go', 'to', 'anorexia', 'nervosa,', 'but', 'anorexia', 'nervosa', 'has', 'three', 'features:', 'significant', 'self-induced', 'weight', 'loss,', 'body', 'image', 'distortion', 'and', 'amenorrhea.'], ['So', 'we', 'remove', '1.'], ['One', 'loses', 'weight', 'when', 'one', 'gets', 'sad,', 'worries,', 'etc...'], ['3', 'does', 'not', 'make', 'sense', 'in', 'the', 'MIR', 'because', 'of', 'the', 'clinic', '-in', 'reality', 'the', 'history', 'is', 'different', 'and', 'in', 'psychiatry', 'everything', 'is', 'evolution-.'], ['4', 'has', 'to', 'meet', 'temporal', 'criteria', 'that', 'are', 'not', 'met', 'here.'], ['So', 'we', 'are', 'between', '2', 'and', '5.'], ['Depression', 'or', 'anxiety?'], ['There', 'is', 'no', 'anxiety', 'clinic', 'and', 'she', 'also', 'meets', 'the', 'criteria', 'for', 'depression.'], ['The', 'poor', 'girl', 'has', 'been', 'diagnosed', 'with', 'depression.'], ['The', 'answer', 'is', '5', '(another', 'option', 'is', 'that', 'she', 'was', 'studying', 'the', 'MIR).']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-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'], ['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'], ['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'], ['B-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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O']]"
530167,"[['QUESTION', 'TYPE:', 'NEPHROLOGY'], ['CLINICAL', 'CASE:'], ['In', 'a', 'patient', 'with', 'known', 'advanced', 'chronic', 'kidney', 'disease', '(CKD', 'G4,', 'eGFR', '20', 'ml/min)', 'who', 'comes', 'to', 'the', 'emergency', 'department', 'for', 'general', 'weakness', 'and', 'is', 'found', 'to', 'have', 'severe', 'hyperkalemia', '(K', '7', 'mEq/l)', 'with', 'electrocardiographic', 'abnormalities.'], ['What', 'would', 'be', 'the', 'first', 'measure', 'to', 'take?'], ['1-', 'Administration', 'of', 'cation', 'exchange', 'resins.'], ['2-', 'Placement', 'of', 'a', 'catheter', 'to', 'initiate', 'dialysis.'], ['3-', 'Administration', 'of', 'intravenous', 'calcium', 'gluconate.'], ['4-', 'Administration', 'of', 'oral', 'furosemide.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['We', 'describe', 'the', 'case', 'of', 'a', 'patient', 'with', 'a', 'hyperkalemic', 'emergency', '(potassium', '>6.5', 'mmol/l', 'with', 'ECG', 'alterations).'], ['The', 'first', 'step', 'is', 'the', 'administration', 'of', 'iv', 'calcium', 'gluconate', 'to', 'counteract', 'the', 'cardiac', 'toxicity', 'of', 'hyperkalemia', '(option', '3', 'correct),', 'giving', 'us', 'more', 'time', 'to', 'initiate', 'hypokalemic', 'treatments', '(initially', 'saline', 'glucose', 'with', 'insulin,', 'salbutamol,', 'furosemide,', 'and', 'assessing', 'dialysis', 'if', 'there', 'is', 'no', 'good', 'response).']]","[['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'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['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'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-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', 'B-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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
494157,"[['QUESTION', 'TYPE:', 'HEMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '26-year-old', 'woman', 'consults', 'for', 'a', 'feeling', 'of', 'generalized', 'weakness', 'that', 'has', 'progressively', 'set', 'in', 'over', 'the', 'course', 'of', 'three', 'weeks,', 'becoming', 'particularly', 'intense', 'in', 'the', 'last', 'two', 'days.'], ['For', 'the', 'last', 'couple', 'of', 'years,', 'she', 'reports', 'episodes', 'of', 'joint', 'pain', 'in', 'the', 'hands', 'that', 'have', 'required', 'the', 'use', 'of', 'anti-inflammatory', 'drugs,', 'as', 'well', 'as', 'the', 'appearance', 'of', 'an', 'erythematous', 'lesion', 'of', 'unclear', 'cause', 'in', 'the', 'neckline', 'area,', 'mainly', 'in', 'summer.'], ['In', 'the', 'physical', 'examination', 'there', 'was', 'only', 'an', 'evident', 'cutaneous-mucosal', 'pallor', 'and', 'a', 'heart', 'rate', 'of', '100', 'bpm.'], ['The', 'hemogram', 'shows:', 'Hb', '6', 'gr/dL,', 'Hto', '27', '%,', 'MCV', '105', 'fL,', '3,420', 'leukocytes/mm3', '(2300', 'neutrophils/mm3,', '800', 'lymphocytes/mm3,', '250', 'monocytes/mm3,', '50', 'eosinophils/mm3,', '20', 'basophils/mm3),', 'platelets', '170,000/mm3.'], ['Biochemistry:', 'AST', '30', 'IU/L,', 'ALT', '35', 'IU/L,', 'GGT', '59', 'IU/L,', 'alkaline', 'phosphatase', '105', 'IU/L,', 'LDH', '490', 'IU/L,', 'urea', '20', 'mg/dL,', 'creatinine', '0.8', 'mg/dL.'], ['Taking', 'into', 'account', 'the', 'available', 'information,', 'indicate', 'which', 'of', 'the', 'following', 'additional', 'analytical', 'parameters', 'you', 'would', 'need', 'to', 'know', 'in', 'order', 'to', 'make', 'the', 'most', 'appropriate', 'immediate', 'decision:'], ['1-', 'Vitamin', 'B12.'], ['2-', 'Antinuclear', 'antibodies.'], ['3-', 'Direct', ""Coombs'"", 'test.'], ['4-', 'Anti-DNA', 'antibodies.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['They', 'comment', 'on', 'the', 'case', 'of', 'a', 'young', 'woman', 'with', 'symptoms', 'of', 'systemic', 'disease', 'of', 'probable', 'autoimmune', 'origin', '(lupus)', 'who', 'presents', 'with', 'macrocytic', 'anemia,', 'options', '2', 'and', '4', 'are', 'options', 'to', 'identify', 'the', 'autoimmune', 'disease', 'but', 'what', 'they', 'ask', 'us', 'is', 'what', 'to', 'do', 'to', 'treat', 'the', 'anemia,', 'so', 'we', 'should', 'suspect', 'that', 'the', 'anemia', 'is', 'secondary', 'to', 'the', 'autoimmune', 'disease', 'and', 'therefore', 'request', 'a', 'direct', 'Coombs', 'test,', 'since', 'if', 'it', 'is', 'positive', 'the', 'patient,', 'except', 'in', 'extreme', 'cases,', 'will', 'not', 'be', 'transfused', 'and', 'the', 'primary', 'cause', 'should', 'be', 'treated.'], ['It', 'also', 'speaks', 'of', 'rapid', 'onset,', 'which', 'in', 'the', 'case', 'of', 'vitamin', 'B12', 'is', 'more', 'progressive.']]","[['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', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', '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'], ['O', 'B-Claim', 'I-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', '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', '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', 'O', '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-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
117112,"[['QUESTION', 'TYPE:', 'INFECTOLOGY'], ['CLINICAL', 'CASE:'], ['A', '64-year-old', 'male', 'presents', 'with', 'fever,', 'cough,', 'dyspnea', 'and', 'right', 'pleuritic', 'pain', 'of', '1', ""week's"", 'evolution.'], ['Chest', 'X-ray', 'shows', 'a', 'loculated', 'right', 'pleural', 'effusion', 'occupying', 'two', 'thirds', 'of', 'the', 'hemithorax.'], ['During', 'thoracentesis,', 'a', 'yellowish', 'fluid', 'is', 'drawn', 'and', 'analysis', 'shows:', 'leukocytes', '15,000/uL,', '92%', 'neutrophils,', 'glucose', '30', 'mg/dL,', 'pH', '7,', 'lactate', 'dehydrogenase', '3500', 'U/L,', 'adenosine', 'deaminase', '45', 'U/L', 'and', 'absence', 'of', 'germs', 'on', 'GRAM', 'stain.'], ['What', 'is', 'the', 'most', 'appropriate', 'next', 'course', 'of', 'action', 'in', 'this', 'patient?'], ['1-', 'Intravenous', 'antibiotic', 'therapy.'], ['2-', 'Intravenous', 'antibiotic', 'therapy', 'and', 'repeat', 'diagnostic', 'thoracentesis', 'in', '24', 'hours.'], ['3-', 'Intravenous', 'antibiotic', 'therapy', 'and', 'repeat', 'diagnostic', 'thoracentesis', 'if', 'there', 'is', 'no', 'improvement', 'in', '48', 'hours.'], ['4-', 'Intravenous', 'antibiotic', 'therapy', 'and', 'evacuative', '(therapeutic)', 'thoracentesis', 'if', 'any', 'germ', 'is', 'isolated', 'in', 'the', 'pleural', 'fluid', 'culture.'], ['5-', 'Intravenous', 'antibiotic', 'therapy', 'and', 'placement', 'of', 'a', 'chest', 'tube', 'or', 'catheter', 'to', 'drain', 'all', 'pleural', 'fluid.'], ['CORRECT', 'ANSWER:', '5'], ['In', 'this', 'question', 'there', 'should', 'not', 'be', 'much', 'doubt', 'either', '(by', 'the', 'way,', 'I', 'think', 'it', 'is', 'more', 'of', 'Pneumology', 'than', 'mine,', 'but', 'well,', 'with', 'this', 'fever', 'my', 'friend', 'Emilienko', 'has', 'deviated),', 'since', 'the', 'clinical', 'picture', 'points', 'to', 'a', 'parapneumonic', 'pleural', 'effusion,', 'the', 'macroscopic', 'characteristics', 'of', 'the', 'fluid', 'seem', 'so', 'and', 'the', 'analysis', 'of', 'it', 'shows', 'us', 'that', 'the', 'effusion', 'is', 'also', 'complicated,', 'almost', 'on', 'the', 'verge', 'of', 'being', 'an', 'empyema', '(very', 'high', 'LDH,', 'cellularity', 'with', 'predominance', 'of', 'PMN,', 'glucose', 'consumption).'], ['In', 'addition,', 'with', 'this', 'pH', '(and', 'knowing', 'that', 'the', 'effusion', 'is', 'already', 'loculated),', 'the', 'endothoracic', 'tube', 'is', 'more', 'than', 'indicated.']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', 'B-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', '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', '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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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']]"
27203,"[['QUESTION', 'TYPE:', 'INFECTIOUS'], ['CLINICAL', 'CASE:'], ['A', '52-year-old', 'patient', 'is', 'admitted', 'to', 'the', 'Hospital', 'for', 'severe', 'pneumonia.'], ['With', 'appropriate', 'antibiotic', 'treatment,', 'the', ""patient's"", 'respiratory', 'symptoms', 'improved.'], ['After', '4', 'days', 'of', 'stay', 'in', 'the', 'ward,', 'his', 'evolution', 'is', 'complicated', 'by', 'the', 'appearance', 'of', 'a', 'severe', 'diarrhea.'], ['What', 'is', 'the', 'most', 'frequent', 'microorganism', 'responsible', 'for', 'this', 'condition?'], ['1-', 'Salmonella', 'enterica.'], ['2-', 'The', 'bacterium', 'itself', 'causing', 'pneumonia', 'that', 'has', 'become', 'resistant', 'to', 'the', 'antibiotic.'], ['3-', 'Campylobacter', 'jejuni.'], ['4-', 'Clostridium', 'difficile.'], ['5-', 'Yersinia', 'enterocolitica.'], ['CORRECT', 'ANSWER:', '4'], ['In', 'this', 'case,', 'given', 'the', 'antibiotic', 'treatment', 'given', 'and', 'the', 'severity', 'of', 'the', 'diarrhea,', 'it', 'seems', 'that', 'we', 'are', 'dealing', 'with', 'a', 'Clostridium', 'infection.'], ['Option', '2', 'is', 'not', 'very', 'credible,', 'in', 'fact,', 'as', 'much', 'as', 'patients', 'with', 'CAP', 'may', 'have', 'associated', 'diarrhea,', 'it', 'is', 'unlikely', 'that', 'a', 'bacterium', 'is', 'sensitive', 'to', 'an', 'antibiotic', 'at', 'the', 'beginning', 'of', 'the', 'picture', 'and', 'stops', 'being', 'so', 'after', '3', 'days.']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', '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'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-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', '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', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise']]"
471139,"[['QUESTION', 'TYPE:', 'ORTHOPEDIC', 'SURGERY', 'AND', 'TRAUMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '7-year-old', 'boy', 'brought', 'to', 'the', 'emergency', 'department', 'after', 'falling', 'off', 'a', 'swing', 'onto', 'his', 'right', 'hand.'], ['He', 'has', 'no', 'history', 'of', 'interest.'], ['He', 'presents', 'with', 'fork', 'dorsum', 'deformity', 'of', 'the', 'wrist', 'and', 'functional', 'impotence,', 'with', 'normal', 'distal', 'neurovascular', 'status.'], ['What', 'lesion', 'would', 'you', 'expect', 'to', 'find', 'on', 'the', 'urgent', 'x-ray', 'you', 'request?'], ['1-', 'Fracture', '-', 'dislocation', 'of', 'Monteggia.'], ['2-', 'Radial', 'head', 'fracture.'], ['3-', 'Epiphysiolysis', 'of', 'the', 'distal', 'radius.'], ['4-', 'Fracture', 'in', 'green', 'stem', 'of', 'ulna.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['With', 'the', 'deformity', 'and', 'pain', 'in', 'the', 'distal', 'radius,', 'we', 'expect', 'a', 'fracture', 'at', 'this', 'level,', 'so', 'we', 'mark', '3.'], ['However,', 'I', 'see', 'it', 'as', 'unquestionable,', 'given', 'that', 'it', 'could', 'also', 'have', 'a', 'concomitant', 'fracture', 'in', 'the', 'ulnar', 'green', 'stalk,', 'although', 'the', 'main', 'lesion', 'is', 'that', 'of', 'the', 'radius.']]","[['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-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', 'B-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', 'B-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', 'B-Marker', '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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
32781,"[['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['A', '30-year-old', 'woman', 'comes', 'to', 'the', 'clinic', 'reporting', 'anxiety,', 'weight', 'loss', 'of', 'about', '6', 'kg', 'and', 'a', 'feeling', 'of', '""nervousness""', 'in', 'the', 'last', 'three', 'months.'], ['In', 'the', 'physical', 'examination', 'she', 'has', 'tachycardia,', 'hyperreflexia', 'and', 'absence', 'of', 'goiter.'], ['In', 'the', 'blood', 'test', 'TSH', 'values', 'are', '<', '0.01', 'microU/mL,', 'T4', 'is', 'elevated', 'and', 'thyroglobulin', 'levels', 'are', 'low.'], ['A', 'scintigraphy', 'shows', 'an', 'absence', 'of', 'uptake', 'in', 'the', 'thyroid', 'region.'], ['What', 'seems', 'to', 'you', 'the', 'most', 'likely', 'diagnosis?'], ['1-', 'Factitious', 'thyrotoxicosis.'], ['2-', 'Hyperthyroidism', 'due', 'to', ""Graves'"", 'disease.'], ['3-', 'Ovarian', 'teratoma', '(ovarian', 'stromal', 'tumor).'], ['4-', 'Subacute', 'thyroiditis.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '1'], ['Answer', '2', 'incorrect:', ""Graves'"", 'disease', 'is', 'characterized', 'by', 'hyperthyroidism', 'and', 'one', 'or', 'more', 'of', 'the', 'following', 'features:', 'goiter,', 'exophthalmos', 'and', 'pretibial', 'myxedema.'], ['Answer', '4', 'incorrect:', 'The', 'most', 'obvious', 'symptom', 'of', 'subacute', 'thyroiditis', 'is', 'neck', 'pain.'], ['Sometimes,', 'the', 'pain', 'may', 'extend', 'to', 'the', 'jaw', 'or', 'ears.'], ['Painful', 'enlargement', 'of', 'the', 'thyroid', 'gland', 'can', 'last', 'for', 'weeks', 'or', 'months.'], ['And', 'you', 'usually', 'have', 'low', 'serum', 'thyroid', 'stimulating', 'hormone', '(TSH).'], ['High', 'serum', 'free', 'T4', 'level.'], ['High', 'serum', 'thyroglobulin', 'level.'], ['Incorrect', 'answer', '4:', 'Very', 'rare', 'tumor.']]","[['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'], ['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', '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', 'B-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', 'B-Claim', 'I-Claim'], ['O', 'O'], ['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'], ['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'], ['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'], ['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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
450154,"[['QUESTION', 'TYPE:', 'NEUROSURGERY'], ['CLINICAL', 'CASE:'], ['A', 'man', 'presents', 'on', 'neurological', 'examination', 'with', 'a', 'thermoalgesic', 'sensory', 'deficit', 'in', 'the', 'left', 'leg', 'associated', 'with', 'a', 'loss', 'of', 'vibratory', 'and', 'positional', 'sensitivity', 'in', 'the', 'right', 'leg.'], ['At', 'the', 'same', 'time', 'he', 'presents', 'with', 'clumsiness', 'and', 'loss', 'of', 'distal', 'strength', 'in', 'the', 'right', 'leg', 'and', 'a', 'right', 'plantar', 'cutaneous', 'reflex', 'in', 'extension.'], ['Which', 'of', 'the', 'following', 'statements', 'is', 'correct:'], ['1-', 'It', 'is', 'a', 'centromedullary', 'syndrome', 'type', 'syringomyelia.'], ['2-', 'It', 'is', 'a', 'hemimedullary', 'syndrome.'], ['3-', 'It', 'is', 'a', 'pattern', 'of', 'transverse', 'medullary', 'lesion.'], ['4-', 'It', 'is', 'a', 'pattern', 'of', 'lateral', 'bulbar', 'lesion.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '2'], ['They', 'describe', 'a', 'typical', 'hemisection', 'or', 'Brown-Sequard', 'picture.'], ['Ipsilateral', 'posterior', 'motor', 'and', 'chordal', 'involvement', 'with', 'contralateral', 'pain', 'and', 'temperature', 'involvement.']]","[['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', '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'], ['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'], ['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']]"
265137,"[['QUESTION', 'TYPE:', 'PNEUMOLOGY'], ['CLINICAL', 'CASE:'], ['65-year-old', 'man', 'with', 'a', 'history', 'of', 'pancreatic', 'neoplasm', 'undergoing', 'chemotherapy.'], ['What', 'diagnostic', 'test', 'is', 'more', 'cost-effective', 'to', 'confirm', 'the', 'diagnostic', 'suspicion?'], ['1-', 'D-dimer.'], ['2-', 'Magnetic', 'resonance', 'imaging.'], ['3-', 'Phlebography.'], ['4-', 'Venous', 'Doppler', 'ultrasound.'], ['5-', 'Helical', 'CT.'], ['CORRECT', 'ANSWER:', '4'], ['Dopler', 'ultrasound', 'is', 'the', 'most', 'accurate', 'test', 'and', 'allows', 'subsequent', 'non-invasive', 'monitoring', 'of', 'the', 'evolution', 'of', 'the', 'disease.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Diagnostics', 'I-Diagnostics'], ['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']]"
18971,"[['QUESTION', 'TYPE:', 'PEDIATRICS'], ['CLINICAL', 'CASE:'], ['A', '10-year-old', 'boy', 'with', 'brief', 'episodes', 'of', 'distractions', '(<', '1', 'minute)', 'in', 'which', 'he', 'does', 'not', 'respond', 'to', 'calls', 'and', 'blinks.'], ['An', 'EEG', 'shows', 'spike-wave', 'discharges', 'at', '3', 'cycles', 'per', 'second.'], ['First-line', 'elective', 'treatment', 'would', 'with:'], ['1-', 'Valproate.'], ['2-', 'Carbamazepine.'], ['3-', 'Phenytoin.'], ['4-', 'Gabapentin.'], ['5-', 'Clonazepam.'], ['CORRECT', 'ANSWER:', '1'], ['The', 'seizures', 'described', 'and', 'the', 'EEG', 'correspond', 'to', 'typical', 'absence', 'seizures', 'and', 'the', 'initial', 'treatment', 'of', 'choice', 'is', 'valproic', 'acid.']]","[['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', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim'], ['O', 'B-Claim'], ['O', 'B-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']]"
508148,"[['QUESTION', 'TYPE:', 'DIGESTIVE'], ['CLINICAL', 'CASE:'], ['A', '72-year-old', 'woman', 'with', 'no', 'past', 'history', 'of', 'interest.'], ['After', 'a', 'complicated', 'renal', 'colic,', 'a', '2', 'cm', 'cystic', 'lesion', 'in', 'the', 'tail', 'of', 'the', 'pancreas,', 'together', 'with', 'multiple', 'bilateral', 'renal', 'cystic', 'lesions,', 'is', 'found', 'by', 'chance', 'in', 'the', 'abdominal', 'CT', 'scan.'], ['Endoscopic', 'ultrasonography', 'shows', 'a', 'polycystic', 'lesion', 'formed', 'by', 'multiple', 'vesicles', 'with', 'central', 'calcification', 'in', 'the', 'tail', 'of', 'the', 'pancreas', 'with', 'no', 'connection', 'to', 'the', 'duct', 'of', 'Wirsung.'], ['Fluid', 'analysis', 'is', 'compatible', 'with', 'a', 'serous', 'cystadenoma.'], ['Of', 'the', 'following,', 'which', 'is', 'the', 'most', 'correct', 'attitude', 'regarding', 'the', 'management', 'of', 'this', 'patient:'], ['1-', 'Surgical', 'resection', '(corporocaudal', 'pancreatectomy).'], ['2-', 'Endoscopic', 'ultrasonography-guided', 'puncture', 'and', 'ethanolization', 'of', 'the', 'puncture.'], ['3-', 'Follow-up', 'of', 'the', 'lesion', 'by', 'MRI.'], ['4-', 'Kidney-pancreas', 'transplant.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['Serous', 'cystoadenoma', 'of', 'the', 'pancreas', 'is', 'a', 'benign,', 'often', 'polycystic', 'entity', '(also', 'called', 'microcystic', 'adenoma)', 'formed', 'by', 'collagen-producing', '(non-mucinous)', 'cells.'], ['It', 'is', 'usually', 'asymptomatic', 'and', 'is', 'discovered', 'as', 'an', 'incidental', 'finding.'], ['Given', 'its', 'benign', 'nature,', 'surgery', 'is', 'not', 'recommended,', 'and', 'is', 'reserved', 'only', 'for', 'symptomatic', 'patients', 'or', 'those', 'in', 'whom', 'the', 'nature', 'of', 'the', 'lesion', 'is', 'in', 'doubt', 'after', 'a', 'complete', 'study', 'with', 'CT,', 'MRI', 'and', 'echoendoscopy', 'with', 'biopsy.'], ['It', 'is', 'frequently', 'sporadic,', 'but', 'can', 'be', 'associated', 'with', 'Von-Hippel-Lindau', 'syndrome.']]","[['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', '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'], ['B-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', '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'], ['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'], ['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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
15170,"[['QUESTION', 'TYPE:', 'RHEUMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '25-year-old', 'female', 'patient', 'with', 'a', 'history', 'of', 'skin', 'rash', 'after', 'sun', 'exposure', 'and', 'occasional', 'polyarthritis', 'in', 'the', 'joints', 'of', 'the', 'hands,', 'controlled', 'with', 'non-steroidal', 'anti-inflammatory', 'drugs,', 'presents', 'with', 'general', 'malaise,', 'progressive', 'feeling', 'of', 'generalized', 'weakness', 'and', 'pallor', 'for', 'the', 'last', '15', 'days.'], ['Laboratory', 'tests', 'showed', 'hemoglobin', '7', 'g/dL,', 'MCV', '108', 'mm/h,', '150,000', 'platelets/mm3,', '3000', 'leukocytes/mm3,', 'elevated', 'LDH,', 'undetectable', 'haptoglobin.'], ['In', 'the', 'case', 'of', 'choosing', 'a', 'single', 'diagnostic', 'test', 'indicate', 'which', 'of', 'the', 'following', 'determinations', 'should', 'be', 'performed', 'first:'], ['1-', 'Direct', 'Coombs', 'test.'], ['2-', 'Antinuclear', 'antibodies', '(ANA).'], ['3-', 'Vitamin', 'B12.'], ['4-', 'Ferritin.'], ['5-', 'Folic', 'acid.'], ['CORRECT', 'ANSWER:', '1'], ['The', 'clinical', 'and', 'biological', 'picture', 'of', 'this', 'patient', 'raises', 'suspicion', 'of', 'hemolytic', 'anemia', 'in', 'the', 'context', 'of', 'systemic', 'lupus', 'erythematosus.'], ['If', 'we', 'have', 'to', 'choose', 'only', 'one', 'diagnostic', 'test,', 'and', 'this', 'should', 'be', 'the', 'first,', 'we', 'are', 'interested', 'in', 'confirming', 'the', 'presence', 'of', 'an', 'autoimmune', 'hemolytic', 'anemia', 'with', 'the', 'direct', ""Coombs'"", 'test', 'in', 'order', 'to', 'initiate', 'treatment.'], ['The', 'other', 'tests', 'can', 'wait...']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-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'], ['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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
404139,"[['QUESTION', 'TYPE:', 'OPHTHALMOLOGY', '(ECTOPIC)'], ['CLINICAL', 'CASE:'], ['A', '70-year-old', 'woman', 'with', 'a', 'history', 'of', 'anorexia,', 'weight', 'loss,', 'discomfort', 'in', 'the', 'musculature', 'and', 'proximal', 'joints', 'plus', 'pain', 'in', 'the', 'temporomandibular', 'region', 'who', 'comes', 'to', 'the', 'emergency', 'department', 'for', 'unilateral', 'loss', 'of', 'vision', '(hand', 'movement),', 'sudden', 'and', 'painless', 'onset', '(afferent', 'pupillary', 'defect).'], ['What', 'test', 'would', 'you', 'request', 'first', 'for', 'diagnostic', 'purposes?'], ['1-', 'Lumbar', 'puncture.'], ['2-', 'C-reactive', 'protein.'], ['3-', 'Magnetic', 'Resonance', 'Angiography.'], ['4-', 'Carotid', 'ultrasound.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '2'], ['This', 'is', 'a', 'woman', 'with', 'abrupt,', 'painless', 'and', 'severe', 'loss', '(she', 'only', 'sees', 'the', 'movement', 'of', 'the', 'hands)', 'of', 'vision', 'in', 'one', 'eye.'], ['She', 'does', 'not', 'give', 'us', 'much', 'information', 'from', 'the', 'ocular', 'examination,', 'only', 'that', 'there', 'is', 'an', 'afferent', 'pupillary', 'defect.'], ['We', 'have', 'to', 'rely', 'on', 'systemic', 'symptoms', 'to', 'diagnose', 'the', 'problem.'], ['This', 'is', 'an', 'elderly', 'woman', 'with', 'typical', 'symptoms', 'of', 'polymyalgia', 'rheumatica,', 'and', 'the', 'pain', 'in', 'the', 'temporomandibular', 'region', 'is', 'very', 'suggestive.'], ['It', 'is', 'giant', 'cell', 'arteritis', 'or', 'temporal', 'arteritis.'], ['The', 'most', 'common', 'ocular', 'manifestation', 'is', 'anterior', 'ischemic', 'optic', 'neuropathy.'], ['In', 'the', 'fundus', 'we', 'would', 'certainly', 'see', 'a', 'papillary', 'edema', 'of', 'that', 'eye,', 'with', 'a', 'gypsum', 'white', 'coloration.'], ['The', 'afferent', 'pupillary', 'defect', 'is', 'very', 'characteristic', 'of', 'these', 'severe', 'ischemic', 'optic', 'neuropathies.'], ['Suspecting', 'giant', 'cell', 'arteritis,', 'there', 'are', 'three', 'analytical', 'markers', 'that', 'are', 'characteristically', 'high:', 'CRP,', 'ESR', 'and', 'platelet', 'count.'], ['We', 'will', 'first', 'request', 'one', 'of', 'these', 'parameters', 'and', 'treat', 'it', 'often', 'without', 'waiting', 'for', 'biopsy', 'confirmation.'], ['Therefore,', 'option', '2', 'is', 'the', 'correct', 'one.']]","[['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'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-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', '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-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', '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', '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'], ['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'], ['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']]"
215106,"[['QUESTION', 'TYPE:', 'NEPHROLOGY'], ['CLINICAL', 'CASE:'], ['A', '68-year-old', 'patient', 'consults', 'for', 'edema', 'and', 'asthenia.'], ['Laboratory', 'tests', 'showed', 'creatinine', '5', 'mg/dL,', 'hemoglobin', '10', 'g/dL', 'and', 'marked', 'hypogammaglobulinemia', 'in', 'serum', 'at', 'the', 'expense', 'of', 'IgG,', 'IgA', 'and', 'IgM.'], ['A', 'urinalysis', 'reveals', 'the', 'presence', 'of', 'kappa', 'light', 'chains.'], ['What', 'is', 'your', 'diagnostic', 'suspicion?'], ['1-', 'Kappa', 'light', 'chain', 'deposition', 'disease.'], ['2-', 'Nephrotic', 'syndrome.'], ['3-', 'Amyloidosis.'], ['4-', 'IgA', 'myeloma', 'with', 'Bence-Jones', 'proteinuria.'], ['5-', 'Light', 'chain', 'myeloma.'], ['CORRECT', 'ANSWER:', '1'], ['This', 'question', 'is', 'mixed', 'hemato-nephro.'], ['It', 'is', 'complicated,', 'so', 'we', 'are', 'going', 'to', 'rule', 'out', 'options', 'one', 'by', 'one.'], ['Option', '2,', 'nephrotic', 'syndrome,', 'apart', 'from', 'being', 'broad', 'and', 'nonspecific,', 'would', 'not', 'be', 'assessable,', 'since', 'they', 'do', 'not', 'give', 'us', 'the', 'quantification', 'of', 'urine', 'protein', '(they', 'only', 'tell', 'us', 'that', 'urinalysis', 'reveals', 'the', 'presence', 'of', 'kappa', 'light', 'chains,', 'not', 'the', 'amount).'], ['Option', '3', 'would', 'be', 'unlikely;', 'in', 'amyloidosis,', 'the', 'light', 'chains', 'that', 'are', 'usually', 'deposited', 'are', 'of', 'the', 'lambda', 'type.'], ['Option', '4', 'also', 'seems', 'unlikely,', 'since', 'in', 'IgA', 'myeloma', 'we', 'would', 'expect', 'a', 'monoclonal', 'peak', 'of', 'this', 'Ig,', 'which', 'in', 'this', 'case', 'does', 'not', 'appear.'], ['The', 'doubt', 'that', 'arises', 'is', 'between', '1', 'and', '5;', 'I', 'would', 'opt', 'for', '1,', 'because', 'this', 'entity', 'fulfills', 'the', 'characteristics', 'described', '(absence', 'of', 'monoclonal', 'peak', 'in', 'most', 'cases,', 'acute', 'renal', 'failure', 'and', 'presence', 'of', 'kappa', 'chains', 'in', 'urine),', 'being', 'light', 'chain', 'myeloma', 'a', 'somewhat', 'broader', 'entity,', 'but', 'option', '5', 'could', 'also', 'be', 'considered', 'valid.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-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'], ['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-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', '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-Claim', 'I-Claim', '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-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', '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', 'B-Marker', 'B-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', 'B-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']]"
264135,"[['QUESTION', 'TYPE:', 'PNEUMOLOGY'], ['CLINICAL', 'CASE:'], ['A', '24-year-old', 'woman', 'is', 'found', 'lying', 'in', 'the', 'street', 'by', 'passers-by.'], ['On', 'arrival', 'of', 'the', 'emergency', 'team', 'she', 'was', 'found', 'with', 'an', 'oxygen', 'saturation', 'of', '88%', 'breathing', 'room', 'air', 'and', 'on', 'examination', 'with', 'pinpoint', 'pupils.'], ['She', 'was', 'transferred', 'to', 'the', 'emergency', 'room', 'of', 'the', 'nearest', 'hospital,', 'where', 'the', 'baseline', 'arterial', 'blood', 'gases', 'showed:', 'pH', '7.25,', 'PaC02', '60', 'mmHg,', 'Pa02', '58', 'mmHg,', 'bicarbonate', '26', 'mEq/1', 'and', 'base', 'excess', 'of', '-1.'], ['In', 'blood', 'sodium', 'was', '137', 'mEq/1', 'and', 'chloride', '100', 'mEq/1:'], ['1-', 'Partial', 'respiratory', 'failure.'], ['2-', 'Metabolic', 'acidosis.'], ['3-', 'Pure', 'respiratory', 'acidosis.'], ['4-', 'Respiratory', 'alkalosis', 'due', 'to', 'lack', 'of', 'chloride.'], ['5-', 'Blood', 'gases', 'can', 'only', 'be', 'venous', 'blood.'], ['CORRECT', 'ANSWER:', '3'], ['The', 'acidosis', 'with', 'elevated', 'PCO2,', 'hypoxemia', 'and', 'normal', 'bicarbonate', 'suggests', 'an', 'acute', 'respiratory', 'acidosis', 'of', 'rapid', 'onset', 'probably', 'due', 'to', 'drug', 'intoxication.']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['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', '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']]"
59480,"[['QUESTION', 'TYPE:', 'PEDIATRICS'], ['CLINICAL', 'CASE:'], ['A', '2-month-old', 'infant', 'with', 'an', 'upper', 'respiratory', 'tract', 'cold', 'of', '3', 'days', 'of', 'evolution,', 'who', 'begins', 'with', 'moderate', 'respiratory', 'distress', 'and', 'pulmonary', 'auscultation', 'with', 'expiratory', 'wheezing.'], ['Oxygen', 'saturation', 'is', '89', '%.'], ['Respiratory', 'syncytial', 'virus', 'is', 'isolated', 'in', 'the', 'nasopharyngeal', 'exudate.'], ['Which', 'of', 'the', 'following', 'treatments', 'do', 'you', 'consider', 'more', 'indicated', 'for', 'this', 'condition?'], ['1-', 'Oral', 'rivabirin.'], ['2-', 'Nebulized', 'salbutamol.'], ['3-', 'Supplemental', 'oxygen.'], ['4-', 'Intravenous', 'corticosteroids.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['We', 'are', 'presented', 'with', 'a', 'case', 'of', 'RSV-positive', 'bronchiolitis.'], ['According', 'to', 'current', 'recommendations,', 'it', 'would', 'be', 'indicated', 'to', 'initiate', 'supplemental', 'oxygen', 'therapy.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['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', 'B-Claim', 'I-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'], ['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']]"
236108,"[['QUESTION', 'TYPE:', 'HEMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '67-year-old', 'female', 'patient', 'on', 'ticlopidine', 'treatment', 'comes', 'to', 'the', 'emergency', 'department', 'with', 'headache,', 'asthenia', 'and', 'petechiae', 'in', 'the', 'lower', 'extremities.'], ['Laboratory', 'tests', 'showed', 'hemoglobin', '8.2', 'g/dL,', 'MCV', '100', 'fl,', 'platelets', '25000/ul', 'and', 'leukocytes', '7500/ul', 'with', 'normal', 'formula.'], ['The', 'reticulocyte', 'count', 'was', 'elevated', 'and', 'the', 'blood', 'smear', 'showed', 'numerous', 'schistocytes.'], ['Coagulation', 'studies', '(APTT,', 'PT', 'and', 'fibrinogen)', 'are', 'normal.'], ['The', 'biochemistry', 'shows', 'LDH', '2700', 'IU/l', 'and', 'bilirubin', '2.6', 'mg/dl.'], ['What', 'is', 'the', 'most', 'likely', 'diagnosis?'], ['1-', 'Autoimmune', 'thrombocytopenic', 'purpura.'], ['2-', 'Thrombotic', 'thrombocytopenic', 'purpura.'], ['3-', 'Bone', 'marrow', 'aplasia.'], ['4-', 'Drug-induced', 'thrombopenia.'], ['5-', 'Disseminated', 'intravascular', 'coagulation.'], ['CORRECT', 'ANSWER:', '2'], ['Typical', 'of', 'ticlopidine.'], ['Not', 'only', 'thrombocytopenia', 'but', 'also', 'headache,', 'schistocytes,', 'high', 'LDH', 'and', 'high', 'bilirubin.']]","[['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', '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'], ['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', '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', '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']]"