Prompt
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 17yo M presents with palpitations. Patient reports 3-4 months of intermittent episodes of ""heart beating/pounding out of my chest."" 2 days ago during a soccer game had an episode, but this time had chest pressure and felt as if he were going to pass out (did not lose conciousness). Of note patient endorses abusing adderall, primarily to study (1-3 times per week). Before recent soccer game, took adderrall night before and morning of game. Denies shortness of breath, diaphoresis, fevers, chills, headache, fatigue, changes in sleep, changes in vision/hearing, abdominal paun, changes in bowel or urinary habits. 
PMHx: none
Rx: uses friends adderrall
FHx: mom with ""thyroid disease,"" dad with recent heart attcak
All: none
Immunizations: up to date
SHx: Freshmen in college. Endorses 3-4 drinks 3 nights / week (on weekends), denies tabacco, endorses trying marijuana. Sexually active with girlfriend x 1 year, uses condoms.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad with recent heart attcak, mom with ""thyroid disease, chest pressure, intermittent episodes, episode, felt as if he were going to pass out, adderall, adderrall, adderrall, palpitations, heart beating/pounding, 3-4 months of, 17yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 Y/O M CAME TO THE CLINIC C/O HEART POUNDING. STARTED 2-3 MO AGO. IT STARTED SUDDENLY. DOES NOT RECALL ANY TRIGGERING EVENTS. IT COMES AND GOES, IT HAPPENED 5-6 TIMES SINCE IT STARTED. IT LASTS 3-4 MIN, AFTER THAN  JUST GOES AWAY. HE HAS ALSO EXPERIENCING SOB, PRESSURE ON HER CHEST WHEN HE HAS THIS ATTACK. HE IS A COLLEGE STUDENT, EXPERIENCING SOME STRESS RECENTLY. 
DENIES COUGH, CHEST PAIN.
ROS NEG EXCEPT AS ABOVE.
PMH NONE. MEDS ATEROL, FOR HIS STUDIES, SHARING W HIS ROOMMATE. NKDA.
PSH/ HOSP/ TRAVEL/ TRAUMA NONE.
FH MOM HAS THYROID PROBLEMS.
SH SEX ACTIVE W GIRLFRIEND, NO STDS, USING CONDOMS. SMOKE NONE. ETOH ONLY WEEKENDS. DRUG ONLY ONCE, 1 MO AGO..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]MOM HAS THYROID PROBLEMS, PRESSURE ON HER CHEST, COMES AND GOES, HAPPENED 5-6 TIMES, SOB, HEART POUNDING, STARTED 2-3 MO AGO, 17 Y/O, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Cleveland is a 17yo M who was consented by parents to be alone today and provide information.  He has no notable PMH and presented today with palpitations that have been occurring sporadically for 2-3 months.  He started college 7-8 months ago and described feelings of nervousness and anxiousness with starting school and exams.  He endorses using his roommates prescription adderall to study for tests and this coincides with the palpitations at times.  Nothing makes his palpitations worse or better when they occur.  ROS is negative except for light headedness and SOB.  He has not had any cold/heat intolerance, diarrhea, changes in voiding habits, or weight loss.  Worried about being able to play basketball.

Meds:  Adderall from his roommate
PMH:  none
PSH:  none
All:  NKDA
Family:  mom: thyroid issues, father: heart attack
social:  no tob, occ EtOH, no illicits
sex:  with gf, use condoms
diet:  good
exercise:  basketball.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father: heart attack, mom: thyroid issues, sporadically, light headedness, has not had any cold/heat intolerance, adderall, Adderall, SOB, palpitations, palpitations, palpitations, for 2-3 months, 17yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo M w/ no cardiac or arrhythmia PMH presents complaining of 3 months of episodic heart pounding.  Pt reports sensation of heart racing and pounding out of chest about 5-6 times total over the past 3 months.  THis last episode the patient experienced light headedness and had some shortness of breath.  Pt is a college student and has recently began to ""share"" his roommates prescribed aderall approx 2 tabs/week over this time.  Pt does not report any adverse effects of the aderall and reports it has helped him study.  No changes in weight, dizziness, changes in appetite, fevers or chills.  PMH none, PSH none, FHx Father MI, Mom thyroid problem.  Meds none accept aderall (not prescribed) Social: college student in philosophy, 2-3 alcoholic drinks/week, does not smoke, tried marijuana once.  Sexually active w/ 1 female partner uses condoms.  ROS negative accept above..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father MI, Mom thyroid problem, episodic, 5-6 times, light headedness, aderall, shortness of breath, heart pounding, heart racing, heart pounding, 3 months of, over the past 3 months, 17 yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: Dillon Cleveland is an otherwise healthy 17 year old male presenting due to rapid pounding heart rate for 2-3 months. He has never experienced these symptoms before. Comes on randomly, nothing makes it better. Lasts 3-4 minutes. Has happened 5-6 times over last 2-3 months.  
-Endorses light headedness, chest pressure the last time. 
-Intermittent tachycardia and pounding heart beat.
-Denies throat pain, headache, dizziness, loss of conciousness, chest pain, nausea, vomiting, changes in bowel and urinary habits
ROS: as per HPI
PMH: no medical issues, no allergies, takes friend's adderall (dose unknown)
SOC: No tobacco use, EtOH use 3-4 drinks per week, smoked ""pot"" once, full time student
FAM: Mom-thyroid problem, Dad-MI last year.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Dad-MI, Mom-thyroid problem, chest pressure, 5-6 times, light headedness, adderall, pounding heart, pounding heart, 2-3 months, 2-3 months, 17 year old, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 y/o M , Dillon Cleveland comes with c/o of palpitaions.  Palpitaions are sudden onset ond have been occuring for the last 3-4 months.  He has had 1-2 episodes of palpitaions every month. The last episode was accompanied by breathlessness and constricting pressure over chest which releived on its own. No aggravating or relieving factors. No h/o fever, pedal edema, cough, hemoptysis. no h/o of dyspnoea, orthopnoea. no h/o weight loss, tremors.
PMH; not allergic to any medications. no known allergies. No similar episode in hte past. 
Psh; no history
Family h/o; Mother has thyroid condition, father had acute MI last year. 
Social drinker . Sexaully active with girlfriend sincea a year. No h/o STD..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father had acute MI, Mother has thyroid condition, pressure over chest, 1-2 episodes, breathlessness, palpitaions, 3-4 months, 17 y/o, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo M college student comes to the clinic due to heart pounding.  He states the he has had episodes of heart pounding for the last 3-4 months.  Nothing makes it better or worse and it goes away on its own.  he denies any chest pain but does report chest pressure during some of the episodes.  He denies warmth or sweating, recent illness, abdominal pain or N/V, tingling in extremities, recent illness or trauma.  He is new to college and has been taking aderol a few times a week.  The last time he took aderol was 2 days ago, which was also the last time he had episode of palpitations.  
ROS: negative except for above
PMH, PSH: none, medications: aderol self administered.  knda, FH: Mother thyroid disease, father heart attach at 52 is okay now.  SH: no changes in weight or appetite, he is on the meal plan and tries to be healthy, he plays intermural soccer and runs, no smoking, alcohol hx.  Triend marijuanna, uses aderol. Stress college.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father heart attach, Mother thyroid disease, chest pressure, episodes, episodes, aderol, aderol, aderol, heart pounding, heart pounding, palpitations, for the last 3-4 months, 17 yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: Patient is a 17 yo m with a c/o of palpitations.  Palpitations began a few months ago. States that palpitations are sudden, unpredictable and feel like his heart is pounding fast/jumping out of his chest. Typically these episodes last 3-4 minutes and resolve on their own. His most recent episode was 2 days ago and lasted about 10 minutes. During this epsiode he felt lightheaded, Short of breath and had chest pressure located in the middle of his chest. Denies any sweating, changes in hair or bowel movements.
ROS: Negative except as stated above
PMH: None
Meds: Takes his roommates Adderall to help study
Allergies: NKDA
PSHx: None
FH: Mother has a thyroid problem, Father had a MI this past year at age 53
SH: denies to.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father MI, thyroid problem, Mother has a thyroid problem, chest pressure, episodes, lightheaded, Denies sweating, Adderall, Short of breath, palpitations, Palpitations, palpitations, heart is pounding, heart is fast, began a few months ago, 17 yo, m</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 17 y/o M w/ episodic feeling of ""heart pounding"" and ""jumping out of chest."" cannot identify a pattern, and seem to come and go without clear trigger..  Also notes some chest pressure during episodes.  Denies any tingling or numbness associated.  At times during these events he feels like he will pass out although denies oss of ocnsciousness. The episodes last 3-4 minutes. He does not note any undue stressors. 

PMHx: None
PSH: None  
FM: Mom has ""thyroid disorder,"" dad had recent MI. 
Social history: Notes trying some of his roommates adderral. Denies other drug use. Alcohol use socially. College freshman studying marketing.
Meds: None.
Hospitaliaitons: None.
Ros: Dizziness, lightheadedness during episodes. Denies tingling/numbness. Denies any feelings of dread or anxiety..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad had recent MI, Mom has ""thyroid disorder, chest pressure, come and go, lightheadedness, adderral, heart pounding, 17 y/o, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 y/o previously healthy male here with heart pounding. States a few months ago, he started having episodes of feeling like his heart is pound/jumping out of his chest. Denies any anxiety, sweating, shaking, or sense of impending doom during these episodes. States he also had shortness of breath with his last episode. Denies any temperature intolerance, jitteriness, chest pain, abdominal pain, GI symptoms, GU symptoms, or easy bruising/bleeding. States he drinks about 3-4 cups coffee/day and several energy drinks throughout the week. Denies any recent stressors in his life.
ROS: negative except for above
PMH, Surg hx, hospitalizations - none
Meds: occasionally take roommate's adderall
NKDA
FH: mom has thyroid problems, dad had heart attack last year
Social: started college 6-7 months ago, denies tobacco use, drinks 3-4 drinks/day on weekends (neg CAGE screening), tried MJ a few months ago. Sexually active with gf, no STD concerns.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad had heart attack, mom has thyroid problems, episodes, Denies any temperature intolerance, adderall, shortness of breath, drinks coffee, drinks energy drinks, heart pounding, heart is pound, few months ago, 17 y/o, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo M complains of heart pounding since 2-3 months. He had 5-6 episodes in the past 2-3 months. It is progressively worsening. No specific triggers noticed when these happen. No sweating/chest pain/N/B, SOB. The last episode was severe that he thought he would passout. Denies headaches/ blurry vision/cough/swelling of legs
ROS- negative except as above
PMH/Allergies/PSH- none
Meds- takes adderall since college 
FH- Mother has thyroid issues, Father has heart problem
SH-smoked pot once, nonsmoker, Etoh on weekends occasionally, college student, sexually active with girlfriend.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father heart problem, Mother thyroid issues, 5-6 episodes, episode, thought he would passout, adderall, heart pounding, since 2-3 months, in the past 2-3 months, 17 yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo m c/o palpitations for the last 3 months. Patient referred having 5- 6 episodes of palpitations in total that comes all of the sudden. He described the episodes as his heart is pounding and in the last episode had SOB and chest pressure. He is started college a few months ago and have no stressors except for recent MI of his father. Denies sweating, tingling, weakness, fear, changes in bowel  habits or skin, anxiety.
ROS: Negative excepts as above
PMH: None
Meds: Adderall from a friend's prescription since high school but have been taking it more now in college ( 2-4/ week) All: none
PSH: none
FH: Mother had thyroid disease, Father had MI at 50yo
SH: He is a college student, does not smoke, drink 3-4 beers in the weekend, marihuana once, monogamous with girlfiend, no STI in the past, use condoms regularly. Excercise by playing basketball and running, eat a healthy diet. Drinks 3-4 cups of coffee/day, 2-4 energy drinks/week..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]MI of his father, Father had MI, Mother had thyroid disease, chest pressure, episodes, episodes, Adderall, SOB, coffee, energy drinks, palpitations, palpitations, heart is pounding, for the last 3 months, 17 yo, m</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 27 yy/o male with consent from his mother to talk to physician about complaints of pounding heart beat. The palpitations have been occuring for the past 3-4 months 1-2 times perweeek. When experiencing this episodes the symptoms last for 3-14 mionutes. There are no alleviating or precipitatiing factors. He also endorses 1 episode of non radiating midsternal pressure with associated shortness of breath. He does not notice an increase of symptoms with exertion or alcohol. He denies any nausea, pallor, or diaphoresis. He has no PMHx or SHx. He endorses family history of thyroid disease in the mother and MI in the father. He has no allergies and is taking no medications. He endorses occasional alcohol use but denies the use of cigarretes. He endorses use of marijuana once and uses his friends Adderral a few times a week to prepare for exams. He is sexually active with his girlfriend and uses condoms. He is a college Freshman..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]MI in the father, family history of thyroid disease, midsternal pressure, uses Adderral, shortness of breath, pounding heart beat, palpitations, past 3-4 months, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dillon Cleveland is a 17yo otherwise healthy M presenting with 5-6 episodes of palpitations within the duration of past 3 months. 2 days ago, the patient also experience a chest tightness during basketball and was relieved by rest. Basketball seemed to have made the chest tightness come on, but the palpitations have no associated trigger, and both are relieved by rest and resolves on its own. Patient endorses using Adderall taken from a friend's bottle a few times/wk or more depending on the college work.

PMH: None
PSH: None
Meds: Adderall that is from a friend's bottle a few times a week; patient cannot recall the dosage or specific frequency
Allergies: NKDA
SH: Freshman in college as a 17yo majoring in Philosophy. Drinking on the weekends 3-4 beers. Denies use of marijuana and recreational drugs; denies smoking; has a girlfriend and are sexually active
FH: Mother with ""thyroid"" and father with heart attack recently.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father with heart attack recently, father with heart attack, Mother with ""thyroid"", chest tightness, chest tightness, using Adderall, palpitations, duration of past 3 months, 17yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 17 y/o male presenting with heart pounding. For last 2-3 months has sensation of heart jumping out of chest not necessariy associated with anything including activity. During the last episode he was playing basketball and also had SOB and chest pressure. Occasionally will feel light headed too. Denies palpitations, leg swelling, diaphoresis, headaches, changes to vision, joint pain, diarrhea/constipation, nausea, vomiting, abd pain, skin/hair changes, heat/cold inotlerance. No LOC. No psychiatric hx or hx of ADHD
FH: mom thryoid issues, dad MI in 50's. No hx of sudden death in childhood
PMH: None
Allergies/Meds: NKA, occasional aderol to help study and focus
SH: 1st year in college, not too stressful, no smoking or illiict drugs, alcohol 3-4 x two days out of the week, once tried marijuana.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad MI, mom thryoid issues, chest pressure, light headed, Denies hair changes, Denies heat/cold inotlerance, aderol, SOB, heart pounding, 2-3 months, 17 y/o, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 YO M C/O HEART POUNDING X 4 MONTHS
-ONSET DURING A SOCCER GAME, FELT AS IF HE WAS GOING TO LOSE CONSCIOUSNESS
-EPISODES OCCUR 1-2 TIMES EVERY MONTH, DESCRIBES THE SENSATION OF PRESSURE IN HIS CHEST
-COLLEGE FRESHMAN, OCCASIONALLY USES FRIEND'S PRESCRIPTION ADERALL TO HELP HIM STUDY
-DENIES ANY WEIGHT OR APPETITE CHANGES, DENIES ANXIETY AND NAUSEA, VOMITING, DIARRHEA OR CONSTIPATION
-DENIES FEVERS OR CHILLS
ROS: NEGATIVE EXCEPT AS ABOVE
PMH: NONE 
PSH: NONE
ALLERGIES: NKDA
MEDICATIONS: ADERALL (PRESCRIBED TO HIS FRIEND) TO HELP HIM STUDY
FH: MOTHER HAS A THYROID PROBLEM, FATHER HAD AN MI AT 52
SH: COLLEGE FRESHMAN, PLAYS SOCCER, DENIES SMOKING, DRINKS ETOH ON THE WEEKENDS,  SMOKES MARIJUANA OCCASIONALLY..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]FATHER HAD AN MI, MOTHER HAS A THYROID PROBLEM, PRESSURE IN HIS CHEST, OCCUR 1-2 TIMES EVERY MONTH, USES ADERALL, ADERALL, HEART POUNDING, X 4 MONTHS, 17 YO, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: PMHx: 17 yo male with episodic heart palpitations. episodes started 2-3 months ago, all of a sudden and would last 3-4 minute and go away on their own . but last episode lasted 10 minutes and was accompanied by chest pressure like sensation and shortness of breath. denies warning sign, confusion, LOC, head trauma, vision changes, SENSITIVIty to 
ALLERGIES:none
Meds: Addrell since high school. last pill was taken 2 days ago to focus on studies.
PSHx:none
FHx:mom has thyroid, dad had MI at age 52 and he is a smoker.
SSHx: he started college 7 months ago. denies smoking and recreational drug use. takes addrell from friend. takes 3-4 beers on weekends.smoked pot once in hight school but never again . sexually active with gf and uses condoms always. never tested for any STIs..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad had MI, mom has thyroid, chest pressure, episodic, episodes, episode, Addrell, addrell, shortness of breath, heart palpitations, started 2-3 months ago, 17 yo, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 17yo m with no PMH, presented with complaint of heart palpitation. Palpitation going on for 3-4 months, 5-6 episodes, last 3-4 min (comes and goes, self resolves). Last episode 2 days ago, had pressure, SOB, and lightheadness, no LOC. Hx of hyperthyroidism with mother, and heart disease in father similar symptoms and hx of MI. HX of using prescription drugs not prescribed to him, Adderol, for studying. DRinks 3-4 drinks, 3 times a week. Denies tobacco use. Marijuana use a few weeks ago. Sexually active with GF, condom use. 
ROS: Denies fever, chills, weight change, nausea, vomiting, abdominal pain. NKDA..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father hx of MI, Hx of hyperthyroidism with mother, 5-6 episodes, lightheadness, Adderol, SOB, heart palpitation, for 3-4 months, 17yo, m</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: The mother has given verbal consent for a history, physical examination, and treatment. 17 yo M comes to the clinic c/o intermittent heart pounding which started a few months ago, he reaclls between 2-3 months ago. He has had no prev episodes, not precipitated by anything, not allev or aggrav by anything. 2 days ago while playing basket ball he presented w/lightheadedness, SOB and chest pressure.
Denies LOC, falls, chest pain, numbness, tingling, changes in bowel habits and changes in urinary habits
ROS: none except for the above
PMH: none. Meds: non prescribed adderall, 1 pill a few times a week
HOSP/TRAUMA/SURG: none
FH: mother has thyroid condition, father had a heart attack
Social: college student, lives w/room mate in dorm, drinks 3-4 beers on weekends, CAGE:0/4, denies tobacco, denies other rec drugs.
Sexual: active w/gf, wears condom, monagomous, no stds.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father had a heart attack, mother has thyroid condition, chest pressure, intermittent, lightheadedness, adderall, SOB, heart pounding, started a few months ago, 2-3 months ago, 17 yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 Yo M c/o intermittent feeling of heart racing/palpitations for past 2-3 months. He says the episodes happen randomly sometimes during rest/sometimes during strenous activity and he doesnt notice a pattern, the last episode he felt some chest pressure and SOB that resolved after the episode. He has never had a syncopal episode and does not feel anxiety/panic/ or a sense of doom during or before the episode. He drinks 3-4 cups of coffee today, intermittently uses redbull and takes his friend's adderall intermittently to help with school. He did notice that he took an adderal the morning before the last episode of palpitations. No reported weight loss/cold and heat intolerance

Ros: - except what is mentioned
PMH: -
PSx: -
Med/Alg: NKDA, intermittently uses friends adderal
Fam: Mom has thyroid disease otherwise noncontributory
Soc: Freshman in college, uses firends adderal intermittently, otherwise no tobacco/drug use sparse etoh.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Mom has thyroid disease, chest pressure, intermittent, episodes, episode, No cold and heat intolerance, adderall, adderal, adderal, adderal, SOB, coffee, redbull, heart racing/palpitations, for past 2-3 months, 17 Yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: ""heart pounding episodes"" 
HPI: 17 yo M presents with 2-3 mo history of heart pounding with a total of 5-6 episodes. The episodes last about 3-4 min usually but last episode was 10 min and assoiciated with some SOB as well as chest pressure/discomfort. Last episode was brought on when playing sports with friends. Pressure/pain does not radiate elsewhere and there have been no similar prior episodes. He would rate the chest pressure a 4/10 severity. Denies any sweating, heat/cold intolerance, changes in bowel movements, nausea/vomiting, fever chills, weight loss or gain.
ROS: Negative except as above
Allergies: none 
Medications: taking roommate's adderall pills occasionally 
PMH: none 
SH: Drinks 3-4 beers or mixed drinks on weekends, 3-4 cups of coffee per day and 1-2 energy drinks per week, no tobacco use, or regular drug use
FH: Father had MI at 52, Mother has thyroid problems
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father had MI, Mother has thyroid problems, chest pressure, chest discomfort, 5-6 episodes, Denies heat intolerance, Denies cold intolerance, adderall, SOB, coffee, energy drinks, heart pounding, heart pounding, 2-3 mo, 17 yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17yo M with ""heart pounding"" for few months. Feels like heart is racing. Usually comes out of nowhere, happens when just sitting. Happens 1-2x/month. Last episode was during soccer game, felt chest pressure, light-headed, thought was going to pass out. Does not notice association with any activities, time of day, or activities. Additionally, drinks 3-4 cups of coffee/night and 3-4 energy drinks per week. Has had some increased anxiety since starting college recently, does not have trouble sleeping. Otherwise feels well, no additional symptoms. Has been able to play soccer. 

PMH: none
Meds: uses friends adderal few x per week
Allergies: none
FH: father with MI at age 52
SH: does not smoke, drinks 3-4 alcoholic beverages/week, no illicit drugs.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father with MI, chest pressure, Happens 1-2x/month, light-headed, adderal, drinks coffee, drinks energy drinks, heart pounding, heart is racing, for few months, 17yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17yo M presents with 2-3month history of ""heart feeling like it is going to beat out of my chest"". Feeling comes and goes, has happened a total of 5-6 times, lasts 3-4min per time, can occur at any time of day, and is not alleviated or exacerbated by anything. Never had palpitations in past. Also reports feeling of pressure in center of chest 2 days ago described as ""someone sitting on me"", lasting 10min as well as SOB during episode. Stressed with recently starting college, and taking roommate's adderall 2x/week. Denies diaphoresis, nausea, vomiting, skin or hair changes, weight changes, and appetite changes.
ROS: negative except as above
PMHx, allergies, surgeries: none
Meds: adderall (see HPI)
SH: EtOH: 3-4 on weekends (negative CAGEx4), marijuana once at party, denies tobacco, sexually active with girlfriend, uses condoms
FH: mother with thyroid disease, father with MI last year.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father MI, mother thyroid disease, pressure in chest, comes and goes, Denies hair changes, adderall, adderall, SOB, heart feeling like it is going to beat out of my chest, 2-3month history, 17yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: 17 yo M c/o heart pounding
HPI: Patient complains of episodes of heart punding, that happen once or twice monthly, that come and go, usually lasting 3-4 minutes, sudden. During the last episode he felt chest pressure, shortness of breath and felt like passing out, it happened during a fottball game. Between the episodes, he is assymptomatic.
ROS: none
PMH: none
PSH: none
med: takes alterol - medicine for enhancing concentration that his roomate gives him
allergies: none
FH: father had heart attack at age 52, mother has thyroid problem.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father had heart attack, mother has thyroid problem, chest pressure, episodes, happen once or twice monthly, episodes, felt like passing out, shortness of breath, heart pounding, heart punding, 17 yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 17yo previously healthy male who presents with heart pounding. Pt states first began having episodes of heart pounding 2-3 months ago, first time while sitting/watching TV. No associated pain, nausea or vomiting. Two days ago, did feel pressure on his chest with SOB. Episodes are sporadic, with no apparent trigger, and self-resolve within 2-3 min. Pt has not tried any medications. No syncopal episodes. No hx of travel. No hx of preceding illness/URI. He exercises and eats varied diet. No hx of congenital heart defects.
ROS: as per HPI
PMH, PSH: -
Meds: -
Fam Hx: Mom w/ thyroid issue. Dad had heart attack recently (due to poor diet). Sister healthy. No hx of heart issues or sudden cardiac death.
Social: Studying philosophy, living on college campus. Sexually active in monogamous relationship w/ gf (uses condoms). Denies tobacco or drug use (tried marijauana once few mo ago). Drinks socially on weekends. 
Allergies: -.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Dad had heart attack, Mom w/ thyroid issue, pressure on his chest, SOB, heart pounding, 17yo, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dillon Cleveland is a 17yo male with a 3-4 month history of heart pounding. These palpitations come on suddenly and last four 3-4 minutes each. The most recent episode was accompanied by a pressure sensation in the chest and shortness of breath. The patient denies headache, chest pain, pallor, dizziness, diaphoresis, weight changes, heat/cold intolerance, hair loss. The patient drinks 3-4 cups of coffee per night and 1-2 energy drinks during the week to keep up with studying. He has also been taking his roommates prescribed Adderall, most recently twice in one day at which may have been associated with eps.
Past Medical Hx: None
Past surgical hx: None
Medications: Adderall
Social Hx: Patient is a freshman in college. He drinks 3-4 drinks over the weekend, denies smoking hx, endorses marijuana use in last month as well as a roommate's Adderall a few times a week.
Family Hx: Thyroid disease - mother, Heart attack 1 year ago - father.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Heart attack 1 year ago - father, Thyroid disease - mother, pressure sensation in the chest, denies heat/cold intolerance, denies hair loss, taking Adderall, Adderall, Adderall, shortness of breath, drinks coffee, drinks energy drinks, heart pounding, 3-4 month history, 17yo, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 y/o M complains of increased heart rate for the last 3 months. The sensation of increased heart rate has occured 5-6 times and the last episode has been the worst. Pt says the sensation goes away on its own and is not aware of what makes it worse. Pt notes episode at basketball game with exertion as well as notes an episode at rest. Pt admits to using college roomates prescription amphetimine to increase study performance on exams. Pt also admits to increased consumption of high caffine energy drinks. Additionally Pt denies any changes in weight, heat intolerance or any changes in mood sleep or urinary or bowel habits. 
ROS (-) except above 
PSH/PMH - nc
MED- adderall 
ALL - NKDA
SSH - no tobacco, tried marijuana once, drinks EtOH socially
FH - father heart attack 52, mother thyroid problem.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]ather heart attack, mother thyroid problem, occured 5-6 times, denies heat intolerance, amphetimine, adderall, consumption caffine, increased heart rate, increased heart rate, last 3 months, for the last 3 months, 17 y/o, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 17 YO M C/O PALPITATIPN X 2-3 MONTHS AGO. IT'S INTERMITTENT ( 5-6 EPISODES/2-3 MONTHS) , LAST ABOUT 1 MIN, AND IT'S NOT PROGRESSIVE. ALLEVIATED AND AGGRAVATED BY NOTHING. HE TOOK ADDERRAL 1 PILL/LAST WEEK DUE TO SUDYING FO FINAL EXAM. HE DENIES CHEST PAIN, SOB,  SWEATING, COUGH, EDEMA IN LEGS, NAUSEA, VOMITING, FEVER, FATIGUE, NIGHT SWEAT, CHANGES IN SKIN/HAIR, CHANGES IN WEIGHT OR APPETITE. NO TRAUMA, RECENT INFECTION OR TRAVEL. HE USED POT 1 TIME LAST MONTH IN FRIEND'S PARTY. HIS MOOD AND SLEEP IS NL. HE IS NOT WORRY ABOUT FUTURE  EPISODES. NO ANXIETY.
ROS: NEG EXCEPT AS ABOVE.
NKDA. MEDS: ADDERRAL.
FH: MOTHER HAS THYROID DISEASE. FATHER HAD MI.
SSH: SEXUALLY ACTIVE WITH GIRLFRIEND. USES CONDOMS. NO SMOKING.  USED POT 1 TIME LAST MONTH. ETOH OCCASIONALLY. FULL TIME STUDENT, NO STRESS OR RECENT CHANGES IN LIFE..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]FATHER HAD MI, MOTHER HAS THYROID DISEASE, INTERMITTENT, EPISODES, DENIES CHANGES IN HAIR, ADDERRAL, ADDERRAL, PALPITATIPN, X 2-3 MONTHS, 17 YO, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 17 yo M presenting with 3-4 months of intermittent heart pounding and beating fast. Patient report that the symptoms have been getting worse. Episodes would last 3-4 minutes but the most recent episdoe 2 days ago during a soccer match lasted 10 minutes with associated chest tightness. Does not notice a pattern to the symptoms. Denies headache, vision changes, LOC, n/v, orthostatic hypotension, recent illness. Reports feeling behind with college and use of adderall to manage workload
PMH: n/a
PSH: n/a
meds: adderall from a friend few times/week
Allergies: n/a
Family hx: mother with thyroid issue; father had heart attack at 52 years old last year; no hx of unexpected deaths in family; no hx of other heart problems in family
social hx: denies tobacco use. Drinks 3-4 drinks/week. counceled on drinking and adderall use. tried marijuana in college.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father heart attack, mother thyroid issue, chest tightness, intermittent, Episodes, adderall, adderall, adderall, heart pounding, heart beating fast, 3-4 months of, 17 yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17-year-old male presenting with heart palpitations for the past few months. He endorses that these episodes occur randomly are not associated with any particular activity. The episodes last 3-4 minutes and occur once-twice/month. He denies alleviating and provoking factors. His most recent episode occurred two days ago and he also experienced chest pressure that lasted for 10 minutes and a sensation that he was going to pass out when he was playing goalie in a soccer game, which resolved spontaneously. He denies headache, vision changes and weakness. He denies a family history of sudden cardiac death. 
ROS: negative except as noted above
PMH: none
PSH: none
Meds: uses friend's adderoll before tests
All: NKDA
FHx: mother with hypothyroidism, father had an MI at 52 and is now fine/quit smoking
SHx: freshman in college studying marketing, lives with roommate, no alcohol, other drug use, sexually active with girlfriend, uses condoms.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father had an MI, mother with hypothyroidism, chest pressure, episodes occur randomly, uses adderoll, heart palpitations, past few months, 17-year-old, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 y.o. male presents with 2-3 month history of heart pounding. The heart pounding and chest pressure occurs for about 3-4 minutes and has happened 5-6 times since the first episode. Last episode was 2 days ago, he felt significant pressure in the chest, SOB, and light headedness. The episodes can occur while sitting down (most times) or while active. Pt denies any recent stressors, weight change, nausea/vomiting, diaphoresis.
PMHx: No hospitalizations, chronic medical conditions, trauma or surgeries
Meds: NKDA, no prescription meds, no OTCs or vitamins
FHx: Heart attack in father, denies any family history of sudden death of syncope
PSHx: 1st year college student. 3-4 beer on weekend socially, Sexually active with 1 partner(girlfriend), Denies smoking or tobacco history. Used marijuana 1x. Takes friends adderal 3-4x per week. Has been doing so fo1 year. Pt is active on his basketball team, this is not associated with his symptoms..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Heart attack in father, chest pressure, pressure in the chest, happened 5-6 times, light headedness, Takes adderal, SOB, heart pounding, heart pounding, 2-3 month history, 17 y.o., male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: A 17 YO M COLLEGE STUDENT C/O HEART POUNDING X 2-3 MONTHS
- INTERMITTENT, NOT PROGRESSIVE, NOTHING MAKES IT BETTER OR WORSE
- ASSOCIATED WITH SOB X 2 DAYS
- DENES CHEST PAIN, LOC, FATIGUE, ANXIOUS, SWEATING, NECK SWELLING, HEAT INTOLERANCE, RASH, LEG SWELLING, SLEEP DISTURBANCE, EXCESSIVE CAFFEINE INTAKE, HEADACHE AND CHANGES IN BOWEL MOVEMENT
ROS: NEGATIVE EXCEPT ABOVE
ALLERGY: NKDA
MEDS: ADDREALL FOR STUDY
PMH & PSH: NONE
FH: MOTHER HAD THYROID DIEASE AND FATHER HAD HEART ATTACK
SH: NO SMOKING, USED MARIJJANA 1 MONTH AGO, 2-4 DRINKS/WEKEND, SEXUALLY ACTIVE WITH GIRLFRIEND, NO STI, PERSISTENT CONDOM USED.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]FATHER HAD HEART ATTACK, MOTHER HAD THYROID DIEASE, INTERMITTENT, DENES HEAT INTOLERANCE, ADDREALL, SOB, HEART POUNDING, X 2-3 MONTHS, 17 YO, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Cole is a 17 m with c/o heart pounding. He has had 5-6 episodes of his heart ""jumping out of his chest"". These episodes last 3-4 mintues normally, but the last one lasted 10 mintues. He also felt chest pressure, SOB, and lightheaded with the last episode. It has happened while exercising and while sitting around. Of note, this last episode occurred after he took some of his friends adderrall for a test. He has not had any pain, pounding elsewhere in the body, vision changes, appetite changes, weight loss, abdominal pain, or bowel movement changes.  
ROS: negative unless in HPI
Meds: adderrall 2 per week, no allergies
Med Hx: none
Surg Hx: none
Family Hx: MI at 52 for father, mother healthy
Social Hx: at college, lives in dorms, feels safe. No tobacco use, drinks 3-4 beers per weekend. Smoked marijuana once. Sex with girlfriend, use condoms..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]MI at 52 for father, chest pressure, 5-6 episodes, episodes, episode, lightheaded, adderrall, adderrall, SOB, heart pounding, heart ""jumping out of his chest, 17, m</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 17 yo m presents with episodic palpitation for the past 2 - 3 months. It is progressive worsening, 5-6 times over 3 months, lasting for 2-3 minutes, and with no exacerbating or alleviating factors. He reports SOB , lightheadedness and chest pressure with last episode. He denies any weight loss, tremors, hot intolerance, recent stress, numbness, tingling, diarrhea, wheezing, and cough.
ROS: Negative except as above
PMH: None
Med: amphetamine
PSH: None
Allergy: NKDA
FH: mother has hypothyroidism, father has MI
SH: no smoking,used illicit drug once, sexually active with his girlfriend.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father MI, mother hypothyroidism, chest pressure, episodic, lightheadedness, denies hot intolerance, amphetamine, SOB, palpitation, for the past 2 - 3 months, 17 yo, m</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: Dillon Cleveland is a 17 yo M with a 3-4 month history of heart pounding. He feels his heart beating quickly like it's coming out of his chest. These episodes occur 1-2x/month with no provoking factors or specific pattern and resolve on their own in 3-4 minutes. Last episode was 2 days ago during a soccer game and was associated with chest pressure, SOB, and lightheadness. He has never passed out or lost consciousness. He notes starting college recently was hectic but he was able to transition well.
ROS: no weight changes, diarrhea, tremors, heat intolerance, anxiety
PMH: negative
Medications: takes his roommate's Addral a few times/wk
Allergies: NKDA
FHx: mom - thyroid problem, dad - heart attack last year
Social: freshman in college, lives with his roommate; denies tobacco use, drinks occasionally, tried marijuna a few times, no other drug use, drinks 3-4 cups of coffee/day, sexually active with one F partner,uses condoms
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad - heart attack, mom - thyroid problem, chest pressure, lightheadness, no heat intolerance, Addral, SOB, drinks coffee, heart pounding, 3-4 month history, 17 yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yr old m comes in with CC of ""heart beating/pounding too fast"". For the past month has been having random episodes of tachycardia that last 3-4 minutes at a time. Patient denies LOC, sweating, palpitations, tremors, chills, fever, numbness or tingling. He has never experienced this before. Pt is a freshmen in college and has been using adderall to keep up with his studies. Last use was 3 days ago, last episode of tachycardia was 2 days ago. States he feels light headed duing these episodes.  Patient denies cold intolerance,weight loss, diarrhea, urinary changes, headaches and nausea.
ROS: negative except above.
Meds: occasionally takes adderall. NKDA
PMH: none
FH: mother has thyroid disease, Father had an MI 1 year ago
Social: freshmen in college. does not use tobacco. drinks 3-4 beers on the weekend. No Illicits. Adderall. Exercise: runs a few miles a week, no relation to tachy..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father had an MI, mother has thyroid disease, random episodes, light headed, denies cold intolerance, using adderall, takes adderall, Adderall, heart pounding, tachycardia, 17 yr old, m</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dillon is a 17 yo M with no PMH c/o heart pounding. he has had 1-2 episodes a month for the last 3- 4 months and have been lasting longer. The episodes typically last 3-4 minutes and self resolve, there is no consistent percipitating factor. The last episode was 2 days ago during a soccer match where the patient felt SOB and lightheaded. He has not had any syncopal episodes,  dizziness, N/V, Chest Pain, diarrhea, abdominal pain, headaches, sleep changes, sweating, sense of doom or vision changes.  

PMHX: none
surgical: none
Family: mom has thyroid issues, dad had MI
med: occasionally uses friends adderal
SHX: does not smoke, alcohol 3-4 drinks a weekend smokes marijuana occasionally
exercise: plays soccer for school
Caffeine- 3-4 cups of coffee a night, 1-2 red bulls/energy drinks a week
sexual: sexually active with gf uses condoms.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad MI, mom has thyroid issues, episodes, episodes, episode, lightheaded, has not had sweating, adderal, SOB, Caffeine, coffee, energy drinks, red bulls, heart pounding, for the last 3- 4 months, 17 yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: Heart pounding
HPI: The patient is a 17-year-old male who presents with intermittent episodes of heart pounding. This has occurred 5-6 times over the last 2-3 months with each event lasting 3-4 minutes. There is nothing that brings them on and they resolve on their own. During the last event 2 days ago, he had associated chest pressure, SOB, and light-headedness. No diaphoresis or syncope during this event.
ROS: Negative for headache, sore throat, chest pain, nausea, vomiting, constipation, diarrhea.
PMH: Negative
Rx: None
All: NDKA
Sx: None
FMH: Father-recently had an MI. Mother-has thyroid problems
Soc: Is a full-time student. Denies tobacco use. Drinks 3-4 beers on weekends (0/4 CAGE). Reports using his friend's Adderall a few times per week with his last use being 3 days ago. He also reports smoking marijuana a month ago..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father-recently had an MI, Mother-has thyroid problems, chest pressure, intermittent episodes, occurred 5-6 times, light-headedness, Adderall, SOB, Heart pounding, heart pounding, over the last 2-3 months, 17-year-old, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Cleveland is a 17yoM presenting with palpitations. Started 2-3months ago, getting worse, intermittent episodes with sudden onset and no triggers. Nothing makes better or worse. Episodes happen during exertion and rest, last 3-4min, self resolve. Most recent was 2 days ago, with SOB, chest pressure (at midline chest), and lightheadedness while playing basketball. States never had those symptoms before. Endorsed adderol use this morning prior to episode. Denies relation of palpatations to adderol usage. Denies other chest pain, SOB, cough, Headache, fatigue, fevers, weight change, appetite change, or body pains. 
PMX: none
meds: none
allergies: none
surgeries: none
family: father has heart issue and had MI at 52yo. Mom has thyroid issue.
substances: never smoker, drinks 3-4x/week, adderol started 6-7 months ago, uses occassionally, most recently prior to episode stated above. Also marijuana used once.
Social: goes to school..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father had MI, Mom has thyroid issue, chest pressure, intermittent episodes, lightheadedness, adderol, adderol, SOB, palpitations, 2-3months ago, 17yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: Mr. Cleveland is a 17yo M who presents with 2-3 months of heart pounding. Was sitting and watching TV when it first started. Sensation has been stable and unchanging since onset. Episodes last 3-4 minutes, self-resolve. Occurs randomly, no alleviating or aggravating factors. Had one episode 2 days ago during basketball game with midline chest pressure and lightheadedness. No loss of consciousness. He has a basketball game tomorrow and is worried the symptoms may return.
ROS: No headache, vision changes, cold/heat sensitivity, abdominal pain, diarrhea, constipation, nausea, vomiting, urinary symptoms, weight changes, appetite changes, fever, chills
PMH: None
PSH: None
Medications: Adderall 2-3 weekly 
Allergies: NKDA
Fam Hx: Mom with thyroid disease, Dad 
Soc Hx: college student, sexually active with girlfriend, regular condom use, drinks 3-4 beers each weekend 0/4 CAGE, no tobacco or other drug use, tried marijuana once.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Mom with thyroid disease, chest pressure, Occurs randomly, lightheadedness, No cold/heat sensitivity, Adderall, heart pounding, 2-3 months, 17yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI- 17 YO M WITH C/O HEART PALPITATIONS FOR 3 MONTHS WHICH WAS SUDDEN IN ONSET, INTERMITTENT AND PROGRESSIVE. HE HAD A SEVERE EPISODE 2 DAYS AGO WHERE HE HAD CHEST TIGHTNESS AND SOB. HE IS STRESSED OUT ABOUT COLLEGE AND IS  TAKING ADY WHICH HIS FRIEND PROVOIDED TO HIM.  HE ALSO CONSUMES 3 TO 4 CUPS OF COFFEE EACH DAY. DENIES FEVER, CHEST PAIN, SLEEP CHANGES COUGH,  SKIN CHANGES, CHANGES IN WEIGHT OR APPETITE, TREMORS, SOB ON EXERTION, CHANGES IN URINARY OR BOWEL HABITS.
PMH/PSH- NONE
ALLERGIES- NKA
MEDS- NONE
FH- MOTHER HAS THYROID PROBLEMS AND FATHER HAD MI
SH- DRINKS 3 TO 4 BEERS/WEEKEND, DENIES TOBACCO, SMOKED POT ONCE, PLAYS BASKETBALL AND DOES EXERCISE. 
SEXUAL- MONOGAMOUS AND USES CONDOMS..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]FATHER MI, MOTHER THYROID PROBLEMS, CHEST TIGHTNESS, INTERMITTENT, EPISODE, SOB, CONSUMES COFFEE, COFFEE, HEART PALPITATIONS, FOR 3 MONTHS, 17 YO, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 17 yo M presents with c/o heart pounding. Started 2 months ago and has experiences 5-6 episodes each lasting 3-4 minutes
-Describes pain as substernal pressure and denies radiation of presure.
-Most severr episode occurred 2 days ago. reported chest pounding and SOB
-ROS: Denies LOC, observed seuizure like activity, change with position, relation to food. Denies bowle or bladder incontinence
-PMH: none
-Meds: Uses roomates Adderall a few times a week 
-All: NKDA
-PSH: none
-SHx: College student studying philosophy. Lives on campus. Drinks 3-4 beers on weekends. Tried marijuana 1x. Denies use of other ilicit drugs. Denies personal stressors. Sexually active with one female partner
-FH: Dad- alive, MI @ 55 yo. Mom- alive, Hyperthyroid
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Dad MI, Mom Hyperthyroid, substernal pressure, 5-6 episodes, Uses Adderall, SOB, heart pounding, chest pounding, Started 2 months ago, 17 yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17yo male. presents with paroxysmal episodes of ""heart pounding"". onset of symptoms 2-3 months ago. was sudden onset while watching television at home. has had 5-6 episodes in total. episodes last 2-3 minutes and are self-remitting. no identifiable triggers. last episode was 2 days ago. episode 2 days ago was accompanied by light-headedness, shortness of breath and central chest pressure. 
No recent illnesses. no sick contacts. no travel. no pets. no infective symptoms. no weight changes
ROS: no syncopal events. 
        no cough or wheeze. no haemoptysis
        no headaches or altered mentation. no diaphoresis
MHx: nil
Medications: nil prescribed, however takes his friend's adderall for studying. takes these a few times per week since highschool. 
nil known allergies. 
Social Hx: nonsmoker. drinks 3-4stds/weekend. smoked cannabis once a few months ago. denies other drug use.
FHx: mother - thyroid issue. father - heart issue..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]mother - thyroid issue, chest pressure, 5-6 episodes, light-headedness, takes adderall, shortness of breath, 2-3 months ago, 17yo, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 y.o male p/w 2-3 month history of intermittent episodes in which patient has the sensation his heart is 'pounding' and 'racing'. These episodes have occured 5-6 times over the interval and have lasted for ~3-4 minutes. The most recent episodes two days ago was also associated with SoB and occured several minutes into a game of basketball. Otherwise the patient does not attribute these episodes to any particular activity. Notably, the patient is a college freshman and reports taking street-adderal several times a week and has been doing so for the past two years. No other pertinent PMH, surgical, family, or social history. Pt denies LOC, HA, N/V, chest pain, and SOB only in the most recent episode. Paitient was counseled to avoid adderal and other stimulants, and to avoid strenuous physical activity until next clinic appointment..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]intermittent episodes, 5-6 times, adderal, SoB, SOB, ""heart is pounding"", heart racing, 2-3 month, 17 y.o, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: Heart Pounding 
HPI: Episodes of heart pounding that began a few months ago and last for 4-5mins at a time. The episodes occurr every couple weeks and have recently been accompanied by some mild lighheadeness. Patient states he needed to sit down on the last episode which happened while he was playing basketball. Patient denies chest pain but has been having some heaviness on his chest during the episodes. Denies any feelings of dread or panic, but has had some SOB. He has been recently trying adderall from his roommate every couple days, but there doesn't seem to be a relation to the drug use. He has never had syncope. 
PMH: none
PSH: None
Meds: Aderall
allergies: none
Social: Sexually active wears condom every time, no tobacco use, only drug use is the aderall and one time tried THC. Never Cocaine or PCP. He is full time student who just started 
ROS: No cough or congestion, no fatigue or diarrhea
FM: Dad had MI at 52yr.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Dad had MI, heaviness on his chest, Episodes, episodes, episodes, lighheadeness, adderall, Aderall, aderall, SOB, Heart Pounding, heart pounding, began a few months ago</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17yo M with cc palpitations for the past 2-3 months, palpitations have occurred 5-6 times in total, denies history of palpitations prior to this. pt reports lightheadedness, sob and chest pressure with last episode. episodes last about 3-4 min and resolve on their own. denies alleviating or aggrevating factors. denies N/V, diarrhea, constipation, weight changes, cold or heat intolerance or hair loss, denies changes with appetitie or sleep difficulty. denies allergies or medication use. 

ROS: negative except for above
PMH: denies
FH: mother-thyroid problem, father-MI at 52yo 
SH: denies tobacco use. tried cannabis once a few months ago. drinks socially on weekends with friends. is in his first year of college and becomes stressed with the workload. pt admits to taking adderrall from a friend to stay away. denies any drug use. pt drinks excessive amounts of coffee, red bulls and 5hr energy drinks in other to stay away..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father-MI, mother-thyroid problem, chest pressure, episode, episodes, lightheadedness, denies cold or heat intolerance, denies hair loss, adderrall, sob, coffee, red bulls, 5hr energy drinks, palpitations, palpitations, past 2-3 months, 17yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dillon Cleveland is a 17 yo M who presents to the clinic for pounding heart. He states it seems to be unprovoked and has been happening for the last 2-3 months. He is has been in college for the last 7-8 months and is generally doing well with his mood and his grades. He did not one episode of heart pounding where he felt SOB and light headed while playing basketball. He denies any flushing, sweating, excessive worrying, recent illness, or allergies. He does not take any medications. No recreation drug other than 1 time with marijuana, he has taken non-prescribed adderall a couple times a week during exam times. Maximimun EtOH consumption is 3-4 beers or mixed drinks on the weekends only. Family history is positive for an MI in his father at age 52, and his mother has thyroid problems. He was never hospitalized or told he had heart problems in the past..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]MI in his father, mother has thyroid problems, light headed, taken adderall, SOB, pounding heart, heart pounding, 2-3 months, 17 yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: Mr. Cleveland is a 17 yo m that presents with intermittent palpitations for the last 2-3 months.  He notes that the last one was 2 days ago while playing basketball and after taking adderal.  This episode was worse than those prior.  They go away on their own with no alleviating or aggravating factors.  Associated factors possibly include exercise and adderall use.  He has had 5-6 episodes over the last 2 months.  
PMH: None. No surgeries
Allergies: NKDA
Medications: Adderal during test season
ROS: Endorses SOB and lightheaded.  Denies fever, chills, nausea, vomiting, chest pain, headache, dizziness, change in weight, or diaphoresis
FH: Mother thyroid issue. Father MI
Social Hx: Denies tobacco use. Social drinker 3-4 drinks on weekend.  Experiment with marijuana once. Safe at home and in relationships. Student
Sexual Hx: Sexually active monogamously and uses condoms.  No STI Hx
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father MI, Mother thyroid issue, intermittent, episode, episodes, lightheaded, adderal, adderall, Adderal, SOB, palpitations, or the last 2-3 months, over the last 2 months, 17 yo, m</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 17 year old male presenting with heart palpitations, he state it has been going on for the past 2-3 months and it comes and goes. nothing makes it better or worse. It has happened 5-6 times the past. nothing particualary triggers it. Pt is stressed with college that he started in the fall and has consumed redbull once a week coffee every once and a while. He also states he takes his friends adderal every once and while. last used was 2-3 days ago He has never had this happen to him in the past. he had shortness of breath about 2 days ago. Pt deneies headache, no vision change, no bowel issue, no temperature intolerance.

PMHX: none
medication: none exepect for friend adderal 2/3 days ago
phx: na
allergy: NA
fHX: father heart issue mother: thyrid
Shx: college student, does not smoke, drinks on weekends 2-3 beers, tried marijwana once but does not use it. Sexually active with one female partner and uses condoms consistently.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]comes and goes, happened 5-6 times, no temperature intolerance, adderal, adderal, shortness of breath, consumed redbull, coffee, heart palpitations, past 2-3 months, 17 year old, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Cleveland is a 17 yo M presenting with epidosidic heart racing. This started 2-3 mos ago and he has had 5-6 episodes of tachycardia during this time. It doesn't seem to be related to exercise or public speaking. During the last episode he had SOB and felt lightheaded, but did not pass out. He also had chest pressure during this episode. Denies diaphoresis, headaches, vision changes, wt changes, fatigue, hair changes, heat or cold intolerance, changes in bowel or urinary habits, and chest and abdominal pain. No PMHx. Takes friend's adderal occassionally. No allergies. No surgeries. Dad had MI at 52; mom has thyroid disease. No tobacco or drug use. Occassionaly drinks on weekends. Sexually active with girlfriend and uses condoms..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Dad had MI, mom has thyroid disease, chest pressure, 5-6 episodes, felt lightheaded, Denies heat intolerance, Denies cold intolerance, adderal, SOB, heart racing, 2-3 mos ago, 17 yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: pt 17y/m c/o palpitation since 2-3 months, episodes come and go, last for 3-4 minutes, no precipitating or releiving factors. last episode happened while playing basketball, pt felt chest pressure, and felt like almost passed out. pt has no chest pain, nause or vomitting, no tremors, no heat or cold intolerance, no changes in bladder or bowel habits. no changes in diet or polydypsia pt had changed college 7-8 months back, and has trouble adjusting to it, no rashes. pt has been taking 3-4 cups of coffee every day and red bull 4-5  in a week.
no mood changes, no anxiety or panic attack
ROS - nothing significant except as above
allergy - none
medication - pt takes aderral multiple times, last 2 days ago.
PMH - none
PSH - none
SH - no smoking, occasional marijuana 5month ago, sexually active with girlfriend, uses condom, no STI
FH - father had problems with heart and mother has hyperthyroid 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father had problems with heart, mother has hyperthyroid, chest pressure, episodes come and go, felt like almost passed out, no heat intolerance, no old intolerance, takes aderral, coffee every day, taking red bull, palpitation, since 2-3 months, 17y, m</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dillon Cleveleand 17yoM with 2-3 months of intermittent episodes of cardiac palpitations. Episodes 3-4min and self resolve, happened 5-6x at rest and while active. Recently lightheadedness and SOB. Between these episodes denies any symptoms. ROS: Denies CP, dizziness, abdominal pain, dysuria, rash, edema, appetite change, weight change, change in BM.
PMH: Denies. vaccines UTD
PSH: Denies
Meds: uses friends adderall 1-2x/week since starting college
Fam hx: Mom with ""thyroid problem;"" Dad with ""heart attack"" last year
Social: first year college student studying philosophy, 3-4 beers/week, denies tobacco use, used marijuana 1x last month. Sexually active only with girlfriend, denies STI testing. Healthy high fibe diet, runs and plays basketball 3-4x/week..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Dad with ""heart attack, Mom with ""thyroid problem, intermittent episodes, happened 5-6x, lightheadedness, uses adderall, SOB, cardiac palpitations, 2-3 months, 17yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 years old m presents  with c/o heart pounding X 2-3 months. it starts suddenly and is getting worse since then no aggra/alleviating factors. he had 5-6 episodes in last 3 motnhs and each lasted for 3-4 mins. it is associated with sob. pt drinks 5-6 drinks of coffee and red bull and he also takes aderrol 2-3 times/week from past 7-8 months.  denies any changes in the weight, tremors, heat intolerenace, fever, chest pain and cough.
ros: neg exp above
pmh/psh:na
meds: adderrol X 7-8 months, last use : in last week.
allergies/hosp:na
travel/trauma:na
fh: mother -thyroid 
ssh: denies smoking or illicit drug use, uses  alcohol occassionally.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]mother -thyroid, episodes, denies heat intolerenace, aderrol, adderrol, sob, coffee, red bull, heart pounding, X 2-3 months, last 3 motnhs, 17 years old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo M c/o heart racing
- Episodes have been going on for the past 2-3 months
- Episodes last for 3-4 minutes
- Random with no precipating event. 
- Pt. denies sweating , vision changes, sleep changes.
FHx: Mother had some thyroid issue, Father had some heart issue.
SH: Student. Drinks 3-4 drinks on weekends, Used Pot once. Uses unprescribed Adderal as study aid which he aquires from friend.
Allergies: NKDA.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Mother had some thyroid issue, Episodes Random, Adderal, heart racing, past 2-3 months, 17 yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Cleveland is a 17 yo otherwise healthy male that presents with 3 months of heart palpitations. He states that he has had 5-6 episodes in total and that they do not seem to be associated with anything, including stress or activity. He does however note that he has been taking his friend prescription aderall in order to help him study. He started this in high school but since starting college he has been taking them more often. He has not had any chest pain but he did have one instance of non-radaiting chest pressure that was accompanied with shortness of breath that lasted 15 mimutes 1 week. No fevers, headaches, weight changs, sweating, n/v, diarrhea, constipation, abdominal pain, urinary changes, skin changes, joint pains. No past medical history or surgical history. No meds beyond taking his friend's adderral. No smoking or illicit drugs. 3-4 beers on the weekend. Family hx: Father had MI last yar at 52 yo. Mom has thyroid disease.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father had MI, Mom has thyroid disease, chest pressure, 5-6 episodes, No sweating, aderall, adderral, shortness of breath, heart palpitations, 3 months, 17 yo, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI:17-year-old male, 2 months ago 6 episodies of heart pounding, the last whit shortness of breath, 4 to 6 minutes of duration , self imited, no sincope , no chest pain , no temperature problems ,no alliviating o , no worsering, no exercise asociation ,no gain or loss weight

ROS: Negative except as above

PMI:Neg,Meds:Neg;PSH:Neg;All:Neg;Hx:Neg
FH: Mom Thyroid problem, Dad MI last year
SH: Drinks: Weekend whit friends;Smoke: Neg;Drugs weed 1 episode;Sexually active  1 parner , uses condoms
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Dad MI, Mom Thyroid problem, 6 episodies, no temperature problems, shortness of breath, heart pounding, 2 months ago, 17-year-old, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo previously healthy male who presents  with a 2-3 month history of heart pounding. He says that he has had 5-6 episodes of this sensation where his heart feels like its beating faster and harder since his first episode. Each episode last about 3-4 minuts each and goes away with rest. He has not noticed anything that couses the episodes to occur and no relieving factors other than rest. His lat episode had associated feeling of pressure in his chest like someone was sitting on it and it lasted 10 minutes. No associated chest pain, shortness of breath, or changes to urinary or bowel habits, no changes to vision. Endorses regular use of adderall a few times week to help in study for which he has been taking for the last year. 
ROS Negative except as above 
Family history: Mom thyroid disease, Dad: Heart problem
Social: Full time student. No Tobacco or recreational drugs. drinks 3-4 beers on weekends.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Dad: Heart problem, Mom thyroid disease, pressure in his chest, 5-6 episodes, use of adderall, heart pounding, heart feels like its beating faster, 2-3 month history, 17 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo M who presents with 3 months of episodic ""heart beating out of my chest."" He endorses 5-6 episodes over the last few months that last approx. 3 min and resolve spontaneously. THe last episode happened while he was playing basketball and he felt SOB and lightheaded. The pain doesn't radiate anywhere and hasn't progressed in severity. He is concerned given paternal FH positive for a recent heart attack. Patient also endorses taking 1-2 Adderrol pills per week to help with school work, which he is taking without prescription. Denies cough, wheezing, changing in vision, changes in hearing, skin/nail changes, tremor, or cold/heat intolerance.

FH: Father- MI; Mother-""Thyroid problem""
PMH: None
PSH: None
Medications: Per HPI
Allergies: NKDA
SH: ETOH-3-4 on weekends. Beer and/or mixed drinks. Tried Marijuana once. No illicit drug use or tobacco..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]FH positive for a recent heart attack, Father- MI, Mother-""Thyroid problem, episodic, episodes, episode, lightheaded, Denies nail changes, Denies cold/heat intolerance, Adderrol, SOB, heart beating out of my chest, 3 months of, over the last few months, 17 yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Cleveland is a 17yo male , to office with heart pounding for 3-4 months at epi region of chest. He states ""it feels like my chest is going to jump out"". He states it is getting worst and pain is at the center or chest. Non radiating. He states mom has thyroid issues and he is concerned. He had a previous episode that went away on its own. He denies vomit, nausea or abdominal pain. He cosumes roommates prescription Aldereol on several occasions.  He states everyone is using it.Sleeps well.  Pain comes and goes without notice.
ROS: Neg, except as per HPI
PHM:None
PSH:None
Allergies:None
Meds:None
FH: Mom has thyroid issues , dad has cardiac issues
Sh; Coolege student lives swith roommate, He consume 3-4 beers on weekend, Has previously used marijuana and presciption Alderol.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad has cardiac issues, mom has thyroid issues, Mom has thyroid issues, Aldereol, Alderol, heart pounding, feels like my chest is going to jump out, for 3-4 months, 17yo, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: worried heart racing will interfere with sports
HPI: Mr. Cleveland is a 17 yo male with complain of heart pounding. He states his heart has been racing for the past 2-3 months, each episode last 3-4 minuts, he has had 5-6 episodes and there is no pain associated. Sometimes it is associated with exercise and sometimes laying down. Has had SOB. It goes away on its own and is random. 4/10 bothersome in life. No change in weight, no cold or heat intolerance, no sweating or chest pain. Of note, he has been using friends prescription aderrall.

PMH: No chronic illnesses, no prescription medications of his own, NKDA, no hx of hospitalizations
FH: mom has thryoid problem, dad had MI last year
SH: no tobacco use, drinks occassionally on weekends, tried marijuana once a few months ago. Goes to college, lives in dorms iwth roommate, no travel outside of US, sex. active w/ GF uses condoms.
ROS: negative except as noted per HPI..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad MI, mom thryoid problem, episode, episodes, no cold or heat intolerance, aderrall, SOB, heart racing, heart pounding, heart has been racing, past 2-3 months, 17 yo, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo male with 2-3 months of intermittent heart racing/pounding episodes. No recent anxiety or stress about college and no recent changes in activities. Episodes come out of the blue with no warning, heart pounds for 3-4 min then resolves. Recent episode associated with chest pressure, light headedness and shortness of breath. No diaphoresis. Uses roommates adderall a few times a week for concentration at school. No tremors, skin changes, or weight changes.
PMH: none
PSH: none
Meds: roommate's adderall, few times per week. No other meds. 
Allergies: NKDA
Family: dad with recent heart attack, mom with thyroid disorder 
Social: freshman in college, lives in dorms, no cigarette smoking. Has smoked pot in the past. Drinks alcohol on weekends, 3-4 beers, no driving under influence. Sexually active with girlfriend of 1 year, uses condoms but wants to switch to OCPs, states they are monogamous..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad with recent heart attack, mom with thyroid disorder, chest pressure, intermittent, episodes, Episodes, episode, light headedness, adderall, adderall, shortness of breath, heart racing, heart pounding, heart pounds, 2-3 months of, 17 yo, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: 17 yo M c/o heart pounding. The pt reports episodic heart pounding over the last 2 months. They occur randomly and last 3-4 minutes. There have been 5-6 in that time. There are no alleviating or aggrevating factors. No previous episodes. The last episode he experienced pressure in his chest and SOB. He reports taking adderoll (w/o a prescription)3-4x wk since in college. 
ROS: Negative except as above.
Allergies: NKDA.
Meds: adderoll
PMH: None.
PSH: None.
Prenatal hx: None. Birth Hx: NSVD
SH: College student lives dormatory. Sexually active with girlfriend, uses condoms. Tried ""pot once"", no other rec drugs. No tobacco hx. EtOH 3-4 beers xwk.
FH: Mother thyroid ""problem"". Father MI 1 yr ago..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father MI, Mother thyroid ""problem, pressure in his chest, episodic, episode, adderoll, adderoll, SOB, heart pounding, heart pounding, over the last 2 months, 17 yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 YO M in student heatlh clinic c/o sudden onset heart pounding x few mo. No precipitating factor, describes heart jumping out of the chest, worsening, intermittent, last 3-4 mins, 1-2 episode in a mo. no allev/aggrav. A/w chest pressure, and SOB, 3-4 cup of coffee a day, 1-2 energy drink a week. No previous episode in the past. Denies fear of having other episode, cough, dizziness, tiredness, tremor, change in skin/hair, change in weight/appetite, change in sleep, weakness/tingling/numbness, change in BM/urine.
Ros neg except as above
PMH none, Meds takes aderal from his roomate, NKDA
PSH/hosp/travel/trauma none
FH father heart disease, mother has thyroid disease
SH student, lives w roommate, denies smoking, occ ETOH, tried pot 1 time in a party, healthy diet, plays soccer and walk few miles, sexually active w GF, 1 partner in the past 6 mo. sometimes use condoms w her. He preffer the pill and no condom use, no STDs in the past.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]mother has thyroid disease, chest pressure, intermittent, 1-2 episode in a mo, takes aderal, SOB, 3-4 cup of coffee a day, 1-2 energy drink a week, heart pounding, heart jumping, x few mo, 17 YO, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Dillon is a 17yo mM otherwise healthy presenting with 3-4 month history of intermiitent, palpiations, tachycardia; regular adderol use from roomate; 2 days ago while playing soccer, experienced chest pressure, SOB, resolved on its own. Denies chest paion, diaphoresis, changes in bowel habits.
PMH:
non, NKA
SH: P is a freshman in colleg, plays soccer and runs regularly. Drinks 2-3 beers on the weekends, tried marijuana, denies smoking. Healthy diet.
FH: father- MI at 5yo, Mother- thyroid issues.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father- MI, Mother- thyroid issues, chest pressure, intermiitent, adderol, SOB, palpiations, tachycardia, 3-4 month history, 17yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC : 17 yo M presenting for ""heart pounding.""
HPI: Going on 3-4 months. Has 1-2 episodes a month. Last episode was a week ago while playing soccer, he stated he also felt chest throbbing in center of chest and light headedness which is different from previous episodes. There is nothign that he associates with onset of these episodes. Lasts 3-4 minutes originally and last one lasted 10 minutes. Endorses shortness of breath with episodes. Denies diaphoresis, dizzinses, changes in vision, changes in hearing, radiation of pain, loss of sensation, weakness, anxiety. Endorses using roommates adderall prescription.
PMH: none; PSH: none; meds: vitamins; allergies: none
FH: father - MI (no known heart disorder); mother: thyroid problem
SH: student, doign marketing, active playing soccer and running, denies tobacco use, etoh 3-4 on weekend (CAGE 0/4), adderall use, sexually active with girlfriend uses condoms
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father - MI, mother: thyroid problem, chest throbbing, 1-2 episodes a month, light headedness, adderall, adderall use, shortness of breath, heart pounding, 3-4 months, 17 yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo male presents for 3-4 months of intermittent palpitations. He first noticed when he was just sitting. They happend 1-2x/month and last for 3-4 minutes. Nothing makes it better and it goes away on its own. Nothing seems to make it worse. No associated chest pain, but did note substernal chest presure associated with SOB 2 days ago. Denies fevers, chills, diaphoresis, sleeping problems, tremor, diarrhea, or constipation. He has a normal mood but admits to some stress starting college 5-6 months ago. Now feels well-adjusted. Majoring in marketing.
Denies PMHx and PSHx and allergies
FHx: Father with MI at age 52, mother with thyroid problem
Denies tobacco use, alcohol 3-4 drinks on weekend
Drugs: Tried pot a few months ago
Meds: Roommate shares Rx Adderall a few times a week before exams (started about a year ago)
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father with MI, mother with thyroid problem, substernal chest presure, intermittent, 1-2x/month, Adderall, SOB, palpitations, 3-4 months, 17 yo, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 YO M Pt c/o racing heart x 2-3 months. Random onset, lasting 3-4 mins. No chest pain or SOB, No dizziness, or LOC. No aggrevating/alleviating factors. He mentions 2 days ago he had an epsiode of palpitations while playing basketball which was accompanied by SOB, lightheadedness, and pressure in the center of his chest. This lasted for 10 mins and went away on its own once he sat down. He did not fall or hit his head. He denies any changes in his bowel habits, appetite, weight or skin. No fever, chills, or visual changes. Pt admits to taking his roomates Adderal since high school. He has been taking 1 pill a few times a week. 

PMH/PSH: none
Medications: as mentioned above
SH: Lives with roomate, is a fulltime student. Denies smokin, Drinks ETOH on the weekends. Occasionally uses Marijuana. 
FH: Father had possible MI last year and has ""Heart issues"", Mother has ""Thyroid Issues"".
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father had possible MI, Mother has ""Thyroid Issues, pressure in the center of his chest, epsiode, lightheadedness, Adderal, SOB, racing heart, palpitations, x 2-3 months, 17 YO, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dillon cleaveland is a 17 yo M presenting for heart pounding. He noticed this 2-3 mo ago. He has had 5-6 episodes of this over that timeframe. No kown triggers, nothing stops them. He gets lightheaded during them. He feels like his heart is bearting really fast "" beating out of my chest"". They last for 3-4 minutes. Yesterday was the worst of these episdoes. it lasted for 10 minutes, and in additon to the pounding, he has pressure in the middle of his chest that didn't radiate, he was also SOB that that time. Those symtpoms resolved after the pounding went away. He does endorse a historyof taking his friend's adderall prescription but hx does not coincide with symtpoms. No headache, vision changes, diarrhea, fever, chills, or temperature issues.
PMH: none- born at term, immunizations complete, growth curve normal
med: adderall
allergiesl none
FH: mom-thyroid problem, dad, heart attack-52
SH: no smoking, alcohol 3-4drinks, drug- MJ.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad, heart attack, mom-thyroid problem, pressure in the middle of his chest, episodes, episdoes, lightheaded, No temperature issues, adderall, adderall, SOB, heart pounding, heart is bearting really fast, beating out of my chest, noticed this 2-3 mo ago, 17 yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 17 year old male no PMH complaining of rapid heart beating in his chest. He has felt this for many months, 1-2 times per week, 3-4 minutes per episode. He is unsure of what brings them on or stops them. The most recent episode occurred 2 days ago while playing soccer and was associated with pressure in the center of his chest, non-radiating, as well as lightheadedness, after which he sat down and it stopped in ten minutes. In the past year, he has used his roommate's adderall frequently. He drinks 3-4 cups of coffee per night and 1-2 energy drinks per week. Denies recent heat intolerance, sweating, anxiety, weight loss. 
Meds: None
Allergies: None
PMH: None
FH: Mom has ""thyroid problems"", dad had a heart attack at age 52 and is still alive.
SH: Uses roommate's adderall frequently. 3-4 beers per weekend day, CAGE 0/4. Marijuana once months ago. Currently freshman in college..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad had a heart attack, Mom has ""thyroid problems, pressure in the center of his chest, 1-2 times per week, lightheadedness, Denies heat intolerance, adderall, Uses adderall, drinks coffee, drinks energy drinks, rapid heart beating, many months, 17 year old, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dillon Cleveland is a 17 year old male presenting with a chief complaint of ""heart pounding."" He has had 6 episodes over the last 2-3 months, all lasting about 3-4 minutes and then self-resolving. The episodes occur at rest and with exercise, although the last one during a basketball game was associated with a dull chest pressure, shortness of breath, and presyncope. He denies any radiation of the pressure. He denies any aggravating or alleviating factors.

PMH/PSH: none

FH: Father had an MI at 52; Mother has ""thyroid issue""; No known history of hypertrophic cardiomyopathy or atrial fibrillation, or other ""heart rhythm"" disorders

SH: Slightly more stressed; tried marijuana once but no other recreational drugs; alcohol 3-4 drinks on the weekend; no tobacco products. Plays basketball

ROS: no nausea or vomiting, weight changes, dairrhea, constipation, hair loss.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father had an MI, Mother has ""thyroid issue, chest pressure, episodes, episodes, presyncope, no hair loss, shortness of breath, heart pounding, over the last 2-3 months, 17 year old, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Dillon Cleveland is a 17 year old male who presents for heart pounding. 
- Started occuring 3 months ago, with 3-4 minute episodes of heart racing and pounding.
- Nothing seems to specifically bring on the episodes, relieving factors include resting in a sitting position for a few minutes
- He denies sweating, nervousness, anxiousness, heat intolerance
- Of note, he was playing in a basketball game recently and acutely felt lightheaded like he was going to pass out. He required rest to resolve this issues.
Past medical history and surgical history and allergies to medications was all negative
Family history: Mother: thyroid problem; Father: Myocardial infarction at 51 years old
Medications: Adderal 2-3 times a week (not prescribed to patient), coffee and caffeine 3-4 times a week
Social: Patient is a college student studying philosophy, drinks 3-4 beers on the weekend, 0-4 CAGE questions, does not smoke, and rare marijuana.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father: Myocardial infarction, Mother: thyroid problem, lightheaded, denies heat intolerance, Adderal, coffee, caffeine, heart pounding, heart racing, heart pounding, Started 3 months ago, 17 year old, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: This is a 17 year old male presenting with palpitations. Began 2-3 months ago, described as ""heart pounding"". States symptoms occur randomly and may happen at rest or with activity, lasts about 15 minutes at a time
-One episode recently included shortness of breath while playing basketball, patient had difficulty catching his breath which resolved on its ownHe denies any syncope but complains of some dizziness during a recent episode during. Has not taken anything for his symptoms, nothing makes them better or worse, symptoms usually resolve ""on their own""
-denies any weight loss, fatigue, changes in bowel habits
-He states he has been taking adderall from his friends perscription for several years a few times a week, denies any other drug use
PMH:
-No medical problems, no surgery
-Takes adderall from friend 2-3x per week

Family Hx:
-Thyroid disease in mother
-CAD in father
Social - drinks occasionally on weekends, no drug
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]CAD in father, Thyroid disease in mother, occur randomly, episode, dizziness, adderall, adderall, shortness of breath, difficulty catching his breath, palpitations, heart pounding, Began 2-3 months ago, 17 year old, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Case of a 17 yo male that comes due to chest palpitations since 3 months ago. He states he has had around 6 episodes total. They come completely at random with no particular inciting event and end rather quickly. Patient refers no improving or worsening factors. He does refer they have been progressing, with the last episode (about 2 days ago) having additional features of chest pressure, SOB, and lightheadedness. He denies: nausea, vomiting, fever, bowel or urinary pattern changes, abdominal pain, chest pain, hair loss, feelings of anxiety, tremors, or sweating. 
PMHx: unremarkable
All.: NKDA
PSHx: none
FMHx: mother has a thyroid disease. Father suffer an MI at age 52.
Social Hx: He is a full time college student. He drinks 3 - 4 weeks a week. Denies smoking. Admits drug use only once (marijuana) with no similar complaints. He refers a healthy and active lifestyle. Currently sexually active and uses condoms. No STDs.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father suffer an MI, mother has a thyroid disease, chest pressure, 6 episodes, lightheadedness, SOB, chest palpitations, since 3 months, 17 yo, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 YO M C/O RACING OF HEART FOR 3 MONTHS, EPISODIC,  LAST EPISODE 2 DAYS BACK WHEN PLAYING BASKET BALL ASSOCIATED WITH SOB, LIGHTHEADEDNESS. HE ALSO REPORT TAKING CAFFENATED DRINKS (4-5 DRINKS PER DAY), AND ADDERAL( LAST INTAKE WAS 2 DAYS BACK). HE HAS NO HISTORY OF PASSING OUT, OR HAS NOT NOTICED ANY SKIP BEATS.
DENIES CHEST PAIN, N/V, SKIN CHANGES, TEMPERATURRE INTORELANCE, CHANGE IN BOWEL OR BLADDER HABIT, NO CHANGE IN SLEEP
ROS: NEGATIVE EXCEPT ABOVE
FH: FATHER HAD HEART ATTACK
ALLERGIES/PSH/PMH: NONE
MEDS: ADERRAL
SH: NO SMOKE, DRINK IN WEEKEND 3-4 BEER, SEXUALLY ACTIVE WITH GIRLFRIEND, NO OTHER DRUGS BESIDE ADDERRAL.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]FATHER HAD HEART ATTACK, EPISODIC, LIGHTHEADEDNESS, DENIES TEMPERATURRE INTORELANCE, ADDERAL, ADERRAL, SOB, CAFFENATED DRINKS, RACING OF HEART, FOR 3 MONTHS, 17 YO, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo pat. presents with heart pounding and racing. Symptoms began 2-3 months ago and have occured 5-6 times during this period. Two days ago the patient had an episode that was also accompanied by chest pressure and dyspnea. No cough, fever, N/V, angina, abdominal pain, changes in bowel or urinary habits. No rashes or edema. Pat. uses roommates Aderol 2-3 times/wk as a study aid. 
ROS: neg. except as above. 
PMH/PSH/Hospitalisations: none
Meds: Roommate's aderol 1-2x/wk
NKDA
EtOH 3-4 beers/weekend, no tobacco, Drugs: marijuana once, no reg. consume
FH: Mother thyroid problem, Father had a MI one year ago. 
No travel or sick contacts
SH: student, lives in dorms
Excercise: basketball adn running 3-4x/wk
Sexual hx: active with girlfriend, condoms, 1 partner/past year, no prior STI, last screening negative..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father MI, Mother thyroid problem, chest pressure, occured 5-6 times, Aderol, dyspnea, heart pounding, heart racing, Symptoms began 2-3 months ago, began 2-3 months ago, 17 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 y/o M in student clinic c/o heart pounding x 2-3 months. Started suddenly, the palpitations are wosening, occurs 5-6 times in last 2-3 months. Last episode was 2 days ago precipitated by taking Adderall to concentrate. A/w stress in school, pressure like discomfort in chest, 5-6/10 in intensity, non radiating. The palpitations resolve spontaneously. Denies LOC, dizziness, fainting, cough, colds, association of discomfort to inspiration/exertion, hot/cold intolearance.
ROS Negative except as above
PMH/PSH/Hosp/Trauma None, Meds Adderrall since high school, currently takes it 2x/week, Last intake 2 days ago in AM; NKA
FH Mom had thyroid problems, Dad had heart attack at age 52
SH college student, has good grades but has been stressed in school, no smoking, drinks 3-4 beers/weekend, took Potts once months ago, sexaully active with girlfriend only, no STDs, uses protection regularly
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Dad had heart attack, Mom had thyroid problems, pressure like discomfort in chest, 5-6 times, Denies hot/cold intolearance, Adderall, Adderrall, heart pounding, palpitations, palpitations, x 2-3 months, in last 2-3 months, 17 y/o, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 17 yo M who presents with heart pounding and racing x3-4 months. He reports these events occur about 1-2/month and last for about 3-4 minutes before resolving spontaneously. His most recent episode occured 2 days ago, and he had associated chest pressure and SOB and notes that he felt he may pass out. Of note, he had taken a dose of his friends' adderal the night prior and the morning of the episode. He is unsure of any other preceding events that have caused prior episodes. He denies any recent fevers, chills, fatigue, weight loss, heat intolerance, cough, or changes in bowel habits. 

ROS: Neg other than HPI
PMH: None
PSH: None
Allergies: None
Meds: Adderall a few times a week. Borrows from friend.
SH: Freshman student in college. Lifetime non-smoker. Drinks 3-4 beers at parties on weekends. Tried marijuana in past but no recent recreational drug use. 
FH: Mother - ""thyroid problem"" (pt unsure). Father - MI at age 52.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father - MI, Mother - ""thyroid problem, chest pressure, occur about 1-2/month, adderal, Adderall, SOB, heart pounding, 3-4 months, 17 yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 year old male presenting with heart pounding and racing. This has happened 5-6 times over the past 2-3 months. Endorses some stress from college. Reports taking his friend's Addirall to help him study and 2-3 cups of coffee per day. The most recent episode was 2 days ago, when he also had substernal chest pain and felt lightheaded. ROS: denies cold/heat intolerance, constipation/diarrhea, energy changes, headache during episodes, weight change, sleep problems. 

PMH: none
PSH: none
meds: Taking his friend's Addirall a few times a week to help with studying. Willing to schedule f/u appointment to discuss this further. 
FH: mom with thyroid problem, father with herat attack one year ago (smoker)
SH: college student. Alcohol 3-4 beers per night on the weekend. Tried marijuana 1x. Denies other drug use. Sexually active with girlfriend, always use condoms. Feels safe in relationships..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father with herat attack, mom with thyroid problem, chest pain, happened 5-6 times, episode, lightheaded, denies cold/heat intolerance, Addirall, Addirall, coffee, heart pounding, heart racing, over the past 2-3 months, 17 year old, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo male presents with 3 months of heart palpitations. He states that they occur without association to any activity or time of day. Each event is associated with sob and last about 3-4 minutes. nothing makes it better or worse. 2 days ago he had a severe episode that lasted 10 minutes and was accompanied by chest pressure and lightheadedness while playing basketball. He mentions that he started college 8 months ago and has started taking his roommates adderal 2xweek to aid in studying for the last 7 months. denies any diarrhea, weightloss, appetite changes, or diaphoresis. 

ros: neg except for hpi
pmhx: none
pshx: none
fhx: mother with ""thyroid problem"" and father with MI at 57yo
medications: adderal (no prescription)  
social hx: started college no declared major yet, lives with roommate in doorms, drinks 3-4 beers or mixed drinks on weekends, no smoking, sexually active with girlfriend of one year. uses condoms. no stds..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father with MI, mother with ""thyroid problem, chest pressure, lightheadedness, adderal, adderal, sob, heart palpitations, 3 months, 17 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 17yo,m,c/o palpitations,started suddenly,intermittent,5-6times in a week,nothing makes it better or worse.He drinks a few cups of coffee in a week,he also has dyspnea in his last episode of palpitations.He denies fever/urinary problems/changes in his appetite/weight changes/bowel changes/skin changes/chest pain/loss of consciousness/tremors/sweating/eye problem/temperature intolerance.Mood is good, no stress recently
ROS: Neg apart from the above symptoms
PMh : No similar symptoms,No other medical problems,Allergy: NKDA,NKA
Meds: Adderall for exam, 1 pill a week
Hospitalization : no ill contact/surgery/trauma
FH: father has heart problem,mother has thyroid problem
SH : No smoking/EtOH/rec drugs - used Pop, last 2 mos ago at a party, work : college student, Sexually active with girlfriend, uses condomas.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father has heart problem, mother has thyroid problem, intermittent, denies temperature intolerance, Adderall, dyspnea, drinks coffee, palpitations, palpitations, 17yo, m</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 y.o. M presents with a few months history of episodes of palpatations and dyspnea. the episodes have been getting worse. the worst episode occured 2 days ago during which he felt presyncopal, he was also short of breath and had pressure in his chest. He denies any Loss of consciousness, headache, dizziness, tremor, heat intolerance, bowel or urinary symptoms.
ROS: negative except as above
PMH: none
PSH: none
FH: mother has a Thyroid problem, father had an MI
SH: nonsmoker, drinks on the weekends, has tried marijuana, sexually active with his girlfriend and uses condoms. Sometimes uses adderall which he gets from him friend.
Meds: none
Allergies: NKDA
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father had an MI, mother has a Thyroid problem, pressure in his chest, episodes, episodes, episode, presyncopal, denies heat intolerance, adderall, short of breath, palpatations, few months history, 17 y.o, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI
Pt is a 17 yo M presenting with 2 months of intermittant palpitations. Reports 5-6 episodes of palpitations that last 3-4 minutes and resolve spontaneously. Reports most recent episode was at a basketball game where he had chest pressure, dyspnea, and lightheadedness. Normaly, these episodes have no palpitations, chest pain, shortness of breath, loss of conciousness, syncope. symptoms have never happened before. Denies any chest pain, or abdominal pain. No known precipitant. 
ROS -neg unless above
Med/surg hist - none
Med- took a couple pills of roommates adderall
allergies -none
SocialH-no tobacco, 3/4 drinks of alcohol a week, tried marijuana once, lives with roomate in college.
Sexhist-1 partner, wheres condoms, never tested for STDs, denies hist of STD symptoms.
fam hist- Dad had heart attack at 52, mom has hypothyriod.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Dad had heart attack, chest pressure, intermittant palpitations, 5-6 episodes, lightheadedness, mom has hypothyriod, adderall, dyspnea, palpitations, 2 months, 17 yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo M c/o heart pounding.
Reported 5-6 episodes heart pounding in 2-3 months, last 3-4 mins each episode, but last episode lasted almost 10 mins, associated chest tightness, mild SOB during baskerball game. Denies dizziness, intolerance to heat, diaphoresis, hand tremor, change of bowel movements. No severe change in life but in new semester in college. 
PMH:none
PSH?hospitalization:none
Meds: Adderral, and ponds once 
NKDA
FH: father had heart disease, mother had diarrhea related disease
SH: No smoking, social drinker, Adderal use and last dose 2 days ago. 
Sexually active with GF only, with condom and pills protection..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father had heart disease, chest tightness, 5-6 episodes, Denies intolerance to heat, Adderral, Adderal use, SOB, heart pounding, heart pounding, 2-3 months, 17 yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yr Old M comes to clinic with c/o Heart Pounding, which started 2-3 Months. Symptoms comes and goes and last 3-4 min. Pt had 5-6 episodes so far and goes away on its on. Also feeling chest pressure which is in center x 2 days and difficulty in breathing x 2 days. Denies headache, diaphoresis, loss of consciouness, flushing, diarrhea, constipation, hair and skin chages. Diet and Appetite is normal. Pt is on Health plan for diet and eats fruits, veggies and protein meal.
ROS negative except above
PMH None Meds  Takes addrall from room mate, NKDA
PSH none   Hospital none   No trauma
FH Mother had thyroid condition, Father has heart problem
SH student, No smoking, ETOH occasional, Recreational drugs Pot one time
SEX H Active with GF, Use condom and NO STD..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Mother had thyroid condition, chest pressure, Symptoms comes and goes, 5-6 episodes, Denies hair chages, Takes addrall, Heart Pounding, started 2-3 Months, 17 yr Old, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC"" ""My heart has been pounding""
HPI: Mr. Cleveland is a 17 year old male with no PMH who presents for the sensation of his heart pounding. For the past 3-4months he has had episodes of feeling as if his heart is racing. They happen sporadically and self resolve within 3-4 minutes. There is no recognizable trigger, including stress or exertion. The most recent epsidoe happened while playing soccer and was assciated with a midsternal pressure type pain that was non-radiating. They are not associated with dizziness or sweating.  He has not had any recent unexplained weight loss. 
PMH: none
Meds: none persribed
Family hx: mom has thyroid issues, dad had a heart attack at 52
SH: 3-4 beers on weekend, non smoker, does take roommates adderall (took some the night before and morning of the last episode that had associated chest pain).
Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad had a heart attack, mom has thyroid issues, midsternal pressure, happen sporadically, adderall, My heart has been pounding, heart pounding, heart is racing, past 3-4months, 17 year old, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Cleveland is 17 year old Male who came to student health clinic for complaints of chest pounding that has been going on for about 5 or 6 months and states that he feels the episodes are getting worse. He states that the episodes seem to be random but when further questioned he admits to taking his roommates adderall on occasion. He admits that the last episode occurred on the same day that he took some adderall. He denies palpitations but endoreses some chest pressure and SOB.
ROS: all other ROS negative unless stated above. 

PMHx: none
Medication: none
SurgHx: none
FamHx: father MI at age 52, mother has a thyroid disorder
SocialHx: patient drinkds 3-4 mixed drinks or beer on weekends, smoke marijuana once at a party, endorses occassional non perscription aderall use
Allergies: none.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father MI, mother has a thyroid disorder, chest pressure, episodes random, adderall, took adderall, SOB, chest pounding, 5 or 6 months, 17 year old, Male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr Cleveland is a 17 yo male c/o heart punding. It happened yesterday, started suddenly, lasted for 3-4 minutes and went away by itself. It has been about 3 months he has been having such episodes, for a total of 5-6. In this last episode he also felt dizzy, short of breath and had some chest pressure. He finds that the last episode might have been linked to aderol intake. Denies loss of consciousness, any nausea or vomit. Denies any sweating. 
ROS: as per HPI. 
PMH: none. PSH: none. NKA. Meds: he has been taking aderol before tests to improve his performance. No hospitalizations, injuries or surgeries. Immunizations up to date. FH: mother has thyroid problems, father had a MI recently. SH: college student, denies any smoke, occasional drinking on the weekends, has tried pot once. Sexually active with his girlfriend, regular condom use..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father MI, mother thyroid problems, chest pressure, episodes, Denies any sweating, aderol, short of breath, heart punding, 3 months been having, 17 yo, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dillon Cleveland is a 70 yo male with no pertinent pmh who is presenting with 2-3 mo of irregular heartbeat/ pounding in his chest. It has happened 5-6 times over the past 2-3 months. Doesn't radiate. Feels like heart is going to jump out of his chest. 6/10 in  severity. Unsure if anything makes it better or worse. No sugeries, hospitalizations, trauma. Up to date on immunizations. No sick contacts. Student at UH undeclared major; states transition to college was stressful and takes lots of tests at school (has coping measures and good support system). Alcohol on weekends (3-4 beers/ mixed drinks). No tobacco. Tried marijuana in past. Denies recreational drugs (ex. cocaine). No RX medications; uses friends adderall 2-3 times a week. No allergies. Takes protein supplements; no pre-workout. Eats healthy. Mom hx of thyroid (unsure hyper or hypo). Dad hx MI at 52. ROS otherwise negative (denies SOB, fever, chills, nausea, vomitting)..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Dad hx MI, Mom hx of thyroid, 5-6 times, adderall, irregular heartbeat, pounding in his chest, heart is going to jump out of his chest, 2-3 mo, 2-3 months, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 17 YO M CAME WITH SUDDEN ONSET OF EPISODIC PALPITATIONS FOR THE PAST 2 MONTHS. HE HAS HAD 5-6 EPISODES WITHOUT AGGRAVATING OR RELIEVING FACTORS. LAST EPISODE WAS ASSOCIATED WITH CHEST PRESSURE, AND SOB. HE DENIES SWEATING, COUGH, FEVER. HE DRINKS 3-4 CUPS OF COFFEE/DAY AND 2 ENERGY DRINKS/WEEK. HE RECENTLY JOINED A NEW COLLEGE AND HAS SOME STRESS IN HIS COLLEGE IN ADJUSTING TO NEW ENVIRONMENT. HE IS MILDY WORRIED ABOUT HAVING NEXT EPISODE. HE DENIES SKIN/HAIR CHANGES, TEMPERATURE INTOLERANCE, CHEST PAIN. NORMAL MOOD, SLEEP, WEIGHT, BLADDER AND BOWEL HABITS.
ROS: AS PER HPI.
PMH/PSH/ALLERGIES: NONE
MEDS: NONE
FH: FATHER HAS HEART PROBLEM, MOTHER HAS THYROID PROBLEM
SH: USES ADERRAL TWICE A WEEK/7 MONTHS; NO SMOKING; OCCASIONAL ETOH INTAKE; SEXUALLY ACTIVE WITH GIRLFRIEND; USES CONDOMS.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]FATHER HAS HEART PROBLEM, MOTHER HAS THYROID PROBLEM, CHEST PRESSURE, EPISODIC, EPISODES, DENIES TEMPERATURE INTOLERANCE, DENIES SKIN/HAIR CHANGES, ADERRAL, SOB, COFFEE, ENERGY DRINKS, PALPITATIONS, FOR THE PAST 2 MONTHS, 17 YO, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Dillon Cleveland is a 17 y/o boy with no significant pmh presenting with 5-6 episodes of palpitations over the last few months. Most recently this occurred a few days ago while he was playing basketball. At that time it was associated wtih lightheadedness, shortness of breath, and chest pressure. Previously also had palpitations when resting quietly. This would last 3-4 minutes and subside spontaneously. IT was not associated wtih any activities or time of day. Of note, pt takes friends' adderall prescription 3x/week for extra focus while studying. baseline he denies difficulty concentrating.
ROS: denies chest pain, cough, abdominal pain, N/V/D/bloody/black stools/dysuria, and all otherwise negative
PMH: none, takes no medications other than friends' adderall non-prescribed, no allergies
SOC: studies philosophy in school, drinks up to 3-4 drinks/week, sexually active weith girlfriend, uses condoms.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]chest pressure, 5-6 episodes, lightheadedness, takes adderall, shortness of breath, palpitations, palpitations, over the last few months, 17 y/o, boy</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dillon Cleveland is a 17 year old male with no significant past medical history who presents for evaluation of episodic palpitations, chest pressure, and light headedness. He reports that these issues started after he started taking adderall given to him by a friend to help with studying at college. He also drinks energy drinks from time to time. He reports that his mood is good and college has been fine but a little hectic. He has not noted any particular triggers. Denies recent weight changes or changes to hair and skin.
No prior surgeries or hospitalizations.
Meds: Adderall from a friend. Denies others.
Allergies: NKA
FmHx: Father- MI at 52
Mother; Thyroid issue
SHx: College student for 1 year. Living on campus. School is ""hectic""
High risk: Denies smoking. Drinks 3-4 drinks per weekend. Tried marajuana once. Denies other drugs..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father- MI, Mother; Thyroid issue, chest pressure, episodic, light headedness, Denies changes to hair, adderall, Adderall, energy drinks, palpitations, 17 year old, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo male with no PMH presents with 3-4 months of palpitations
-episodes occur randomly, no associated with activity, associated with shortness of breath and pre-syncope
-no sweating, feeling of impending doom, anxiety with episodes, no diarrhea
-takes adderall a few times that is prescribed to friend, however has been taking this for a year now
-no history of thyroid problems
PMH: none
Meds: adderall (not prescribed)
FamHx: Mom- ""thyroid problem""; dad- heart attack at 52
Social: lives with roomate; 3-4 alcoholic beverages/week, no durgs, sexually active w girlfriend and uses condoms.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]dad- heart attack, Mom- ""thyroid problem, episodes, adderall, adderall, shortness of breath, palpitations, 3-4 months of, 17 yo, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: MR clevland is a 17 year old male ho presetn wth episodes of his heart pounding and racing, they hve happended 5-6 times in the past 3 months, nothing seems to set the episodes off or make them go away, he felt short of breath in one episode while he was playing basketball, there is no pain. there are no asosiated syptoms such as headaches, lightheadenss, consistant shortness of breath, feelings of impending doom, fear, 

PMHx- no medical diagnosis, healthy
Meds- admits to taking friends prescription adderal for study usage, no othe meds
Allegeries- nka
Surg hx- none
Fam hx- mom has some thyoid disorder he is unsure of, father had heart attack last year
Social- doesnt smoke, drinks with friends on weekends 3-4 beers, uses a Designated Driver, tried pot once but hasnt since then, no IVD use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father heart attack, mom thyoid disorder, episodes, 5-6 times in the past 3 months, adderal, short of breath, heart pounding, heart racing, past 3 months, 17 year old, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: History: The patient is a 17-year-old male presenting with chief concern that his heart is pounding. His episodes started 3-4 months ago without any identifiable stressor, occuring intermittently 1-2 times per month at rest or while exercising. They go away on their own afer 3-4 minutes and are associated with a pressure sensation in the center of the chest. His most recent episode occured 2 days before presentation during a soccer game, lasted for 10 minutes, and was associated with shortness of breath + lightheadedness. No , unexpected weight loss, chest pain.
ROS: Negative except HPI
PMH: N/A
PSHx: N/A
Allergies: N/A
Medication: Takes friend's adderal a few times per week 
FH: mother with ""thyroid"" condition; father (52) with heart attack 
SH: Student. Drinks 3-4 drinks per week (CAGE = 0 for all questions); no tobacco use; tried marijuana once not using. Vaginal intercourse w/ monogamous female; uses condoms; no hx STIs.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father with heart attack, mother with ""thyroid"" condition, pressure in chest, occuring intermittently, 1-2 times per month, lightheadedness, Takes adderal, shortness of breath, heart is pounding, 3-4 months ago, 17-year-old, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo male with no significant PMH presenting with 3-4 months of episodes where his ""heart is pounding and going to jump out of my chest."" The episodes each last 3-4 minutes, and he has had 1-2 espisodes per month. he has not noticed a pattern or trigger. they resolve on their own, nothing makes them better or worse. the last time it occured, also had chest pressure and felt that he couldn't catch his breath (during a soccer game) and felt that he was going to pass out, though didn't. has not experienced lightheadedness, dizziness, LOc, otherwise. Reports taking his roommate's adderall ""a few times per week"" for the past year. Also drinks 3-4 cups of coffee per night, plus 1-2 energy drinks a few times per week also. No PMH. no PSH, NKDA, no recent travel, no recent illness. No other meds. no smoking, drinks 3-4 drinks alcohol on weekends, sexually active with one partner, no recent STD testing. Dad had MI age 52. Mom has thyroid dz.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Dad had MI, Mom has thyroid dz, chest pressure, episodes, episodes, 1-2 espisodes per month, felt that he was going to pass out, adderall, ""couldnt catch his breath"", coffee, energy drinks, heart is pounding and going to jump out of my chest, 3-4 months of, 17 yo, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo M who presents with episodes of heart palpitations. He has had 2-3 episodes per month for the past 2 months. Most recent episode was yesterday. Episodes last 3-4 minutes, and he reports no known triggers, can occur at rest or with exercise. Patient denies chest pain, dyspnea, sweating, dizziness, or LOC. Denies fevers, diarrhea, constipation. Patient reports using friend's Adderall 2-3 times weekly to help him focus. Last use was yesterday. Drinks 3-4 beers on weekends. Tried marijuana use, denies other drug use. Nothing known to alleviate or exacerbate symptoms.

PMH: none
Meds: none
Allergies: none
SH: ETOH and substance use above, lives in dorm at school, sexually active with girlfriend only
FH: mother has thyroid condition, father had MI 1 year ago.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father MI, mother thyroid condition, 2-3 episodes per month, Adderall, heart palpitations, past 2 months, 17 yo, M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo CC palpitation 
-Started 3 months ago, , has experienced 5-7 episodes wich last 3-4 minutes, sudden onsent, no precipitations factor, no alleviating or aggravating factor 
-Do not has any visual disturbances, sweating. has has episodes during rest and exertion. has been progressively worsened. 
-Last episode associated SOB no chet pain 
-No changes in bowel movement, no heat intolerance, no skipped meals, no fever. No mood changes, no weigth loss
-Good relationship with friends, good school grades. 
-ROS: Negative except above
PMH: None 
AllergiesNKDA-NKA
Meds: Nones
FH: Mother hx of thyroid disease, Father IM at 52 
SH: College student, live with roomates, no tobacco, drinks socially,  One use of marijuana and stopped. Sexually active 1partner last yr, +Condoms. Exercises regualrly Healthy diet.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Mother hx of thyroid disease, 5-7 episodes, no heat intolerance, SOB, palpitation, Started 3 months ago, 17 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: dillon cleveland is a 17yo male with no PMH that comes in with palpitations. the last time he felt them, about 2 days ago, he also felt short of breath and some chest pressure, and like he was going to ""pass out"". he denies sweating, loss of consciousness, he says these palpitations happen a couple times a month and have been going on for a few months. he does not associate any pattern with when the palpitations happen. the only medication he takes is adderall a few times a week that he gets from his roommate. his family history consists of his mother with a thyroid problem and his father who had a heart attack at age 52. he does not smoke, drinks 3-4 beers on the weekends, and used marijuana once..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father heart attack, mother hyroid problem, chest pressure, felt ike he was going to ""pass out"", denies sweating, adderall, short of breath, palpitations, going on for a few months, 17yo, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Cleveland is a 17 yo male who presents with a chief complaint of heart pounding. Patient has experienced this sensation for the past 2-3 months, 5-6 times total, roughly 2x/month. The last episode was 2 days ago while playing basketball. Patient describes heart racing, pressure, shortness of breath, and light headedness. Episodes have occured variably, some while exercising, some while resting. He reports the use of a friend's adderall roughly 2x/week for the past 7 months to help with concenctration. He also endorses drinking 3-4 cups of coffee/day and energy drinks as well. Patient is a freshman in collee, sexually active with his long term girlfriend, uses condoms, but denies use of tobacco products and ilicit drugs. He reports drinking 3-4 alcholoic drinks on weekends. Family hx is positive for thyroid dx in his mother and a MI in his father. He has no significiant medical/surgical hx. No allergies or weight/appetite changes..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]MI father, thyroid dx mother, pressure, 5-6 times, Episodes, light headedness, adderall, shortness of breath, drinking coffee, drinking energy drinks, heart pounding, heart racing, for the past 2-3 months, 17 yo, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: Dillon Cleveland is a 17 year old male with a 2-3 month history of chest palpitations 

Dillon has had chest palpitations for the last two to three months. He has not found anything that has made them worse or given him relief at this time. The palpitations usually self resolve. Dillon had a particularly bad episode during a basketball game yesterday with strong shortness of breath. Dillon has had no changes in weight, sweating, nausea vomiting or diarhea at this time. Particularly chest fluttering  in particular due to the fact his father had a heart attack last year. Dillon is taking two adderal per week since starting school.

NKDA.Patient takes no medications other than the two adderal from his roommate per week, Patient is a college student living in the dorms. Drinking 3-4 drinks per week. Remote use of marijuana, no tobbacco, advised to not play basketball for now, Mother thyroid issues.Father MI. Sexually active w/gf,use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father MI, father had a heart attack, Mother thyroid issues, adderal, shortness of breath, chest palpitations, chest palpitations, 2-3 month, 17 year old, male</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 y/o F c/o abdominal pain  
5/10. from last 10 hours.
dull and ache.,cramping pain in the right lower quadrant.
no radiation.
walking makes it worse.took ibuprofen but not much help.
no fever chills,no discharge,no dysuria,no blood in the urine.
pat h/o of similar episodes 3-4 in the last 6 months..not allergic .no medicines other than ibuprofen..no hospitalisation trauma or surgeries .no past illness.
family h/o not significant..
lmp 2 weeks ago.regular 28 days lasts for 4 days.moderare flow.age of menarche 13.
last sexual encounter 9 months ago with boy friend always uses condoms..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]no discharge, last sexual encounter 9 months ago, 20 y/o, similar episodes 3-4 in the last 6 months, pain in the right lower quadrant, no dysuria, lmp 2 weeks ago, last 10 hours, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo F c/o abdominal pain
HPI : onset 8-10 hours, RLQ abd pain, achy and crampy, PS 5/10, no radiated, getting worse, better with ibuprofen, worse with walking, poor appetite, + diarrhea 2-3 d, loose and watery stool, 4-5 times a day, no blood in stool, no mucus.
neg Vaginal discharge, dysuria, fever, headache, nausea, vomiting

+previous similar episodes in the past, same site, characteristic, didnot see a doctor, went away spontaneously
PMH/PSH : neg
neg smoking/ alcohol/ ilicit drug
no sexual intercourse for 9 months
FHX none
no previous hospitallised
normal.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]neg Vaginal discharge, no sexual intercourse for 9 months, diarrhea, loose and watery stool, 20 yo, no blood in stool, +previous similar episodes in the past, RLQ abd pain, neg dysuria, poor appetite, onset 8-10 hours, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo female presents with RLQ pain for the past 10 hours. Pain is 5/10, dull and crampy. She has assoicated nausea and loss of appetitie since the pain started. She has had 3-4 similar episodes in the past 6 months. She notes intermittent diarrhea for the past 6 months with or without association with pain. Bowel movements do not improve pain. Pain does not radiate or change with position. Ibuprofen has helped some. Walking makes the pain worse. She has noticed that her clothes fit looser over the past 6 months.
ROS: denies chills, sweats, vomiting, or recent infection
PHM: none
Meds: ibuprofen as needed
NKA
SH: lives alone, family is in California, not sexually active for past 9 months
OB/GYN: last period 2 weeks ago, regular cycles.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]clothes fit looser, not sexually active, diarrhea, 20 yo, 3-4 similar episodes in the past 6 months, RLQ pain, loss of appetitie, last period 2 weeks ago, pain for the past 10 hours, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Suzanne Poweltor is a 20 yo F with no significant PMHx who presents with a cc of abdominal pain. She states that the pain began about 8 hours ago and is located in her RLQ. The pain began there and has presisted there since. She describes it as a dully, achy pain that worsens with walking. The patient has had this happen before. She states that it has resolved in the past on its own. She reports having nonbloody diarrhea today and a decreased appetite. She denies any chills, chest pain, dyspnea, nausea/vomiting, dysuria, hematuria, or concerns for STIs. She has tried taking ibuprofen and states that it has helped with the pain. 

PMHx - None
PSurgHx- None
Meds - Ibuprofen prn
Allergies - NKDA
FamHx - None
SocHx- Drinks alcohol 2x/month. No tobacco or recreational drug use.

Menstrual Hx - Last period was 2 weeks ago. Regular cycles. Last sexually active 9 months ago. Last STI check was 1 year ago..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Last sexually active 9 months ago, diarrhea, 20 yo, nonbloody diarrhea, patient has had this happen before, RLQ, denies dysuria, denies hematuria, decreased appetite, Last period was 2 weeks ago, began about 8 hours ago, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 year old woman presenting for RLQ abdominal pain which started 8-10 hours ago and woke her up from sleep. The pain in 5/10 in severity, does not radiate, dull and aching in nature, constant, not relieved by ibuprofen, exacerbated by walking. No nausea or vomiting. Has had diarrhea for the past few days, loose stools that are nonbloody nonmucoid.
She reports having similar but milder abdominal pains 3-4 times in the past 6 months that resolve spontaneously as well as diarrhea, but not concomitantly. No joint pain or skin rashes. 

Past medical and surgical hx: none
Meds: ibuprofen for the abdominal pain
Allergy: NKDA
Family hx: noncontributory
OBGYN: regular cycles, LMP 2 weeks ago, last sexual activity 9 months ago
Social: biology premed student, no smoking, occasional alcohol.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]last sexual activity 9 months ago, diarrhea, loose stools, diarrhea, 20 year, stools nonbloody, abdominal pains 3-4 times in the past 6 months, RLQ abdominal pain, LMP 2 weeks ago, started 8-10 hours ago, woman</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: PT 20 YO F C/O PAIN IN RLQ  x 8-10 HOURS SUDDEN IN ONSET, DULL, 5/10, AGGRAVATES WITH WALIKING AND RELIEVED PARTIALLY BY TAKING IBUPROFEN A/W DIARRHEA x 2D(BROWN IN COLOR, WATERY, CONTAIN NO BLOOD) , FEVER. PT HAS PMH OF 3 4 EPISODES OF SIMILAR PAIN EPISODES ASSOCIATED WITH DIARRHEA BUT NOW THE PAIN IS WORSE THAN EVER BEFORE.PT ALSO REPORTS DECREASE IN APETTITE, WEIGHT(NOT MEASURED) FOR PAST ONE MONTH. PT EATS HEALTHY DIET.
PT DENIES EATING OUTSIDE , NAUSE , VOMITING , ANY CHANGE IN URINARY HABITS. PT ALSO DENIES ANY PREVIOUS H/O KIDNEY STONES.
ROS: -VE EXCEPT AS ABOVE
PMH: AS PER HPI
MED: IBUPROFEN FOR PAIN
PSH/HOSP: NONE
ALL: NKA
FH: N/C
SSH: NO SMOKING/ETOH/DRUGS. HAD SEX WITH HER BOY FRIEND 9 MONTHS AGO USING CONDOMS.
OBGY: LMP 2 WEEKS , REGULAR PERIODS 4-5/28.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]DECREASE IN WEIGHT, SEX 9 MONTHS AGO, DIARRHEA x 2D, 3 4 EPISODES OF DIARRHEA, 20 YO, DIARRHEA NO BLOOD, 3 4 EPISODES OF SIMILAR PAIN, PAIN IN RLQ, DENIES CHANGE IN URINARY HABITS, DECREASE IN APETTITE, LMP 2 WEEKS, 8-10 HOURS SUDDEN IN ONSET, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 20 y F complains of sudden onset right lower quadrant pain for 8-10 hours, states pain is aching and cramping, non-radiating and about a 5/10 on severity. Not relieved by ibuprofen, aggravated by walking. Associated with diarrhea that began 3/7 ago, contains no mucus or blood, has 3-4 episodes a day. Denies fever, vomiting or ill-contacts. Of note, patient gives history of 3-4 episodes of right lower quadrant in the past year of similar characteristics but states that this pain is worse.  Admits to decreased appetite, and last meal was last night. Denies vaginal discharge or bleeding. 
OBGYN: LMP 2/52 ago. Regular 28 day cycle, uses 4-5 tampons on first day but decreases over 5 days of menses. Not currently sexually active. Last sexual encounter 9/12 ago with a male. 
PMH: Nil 
Allergies: Nil 
FH: Nil
SH: No smoking. Drinks alcohol twice a month. No recreational drug use. Student, studying biology. Normal diet and exercise..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Denies vaginal discharge, Not currently sexually active, Last sexual encounter 9/12 ago, diarrhea that began 3/7 ago, 20 y, diarrhea no blood, 3-4 episodes of right lower quadrant in the past year, right lower quadrant pain, decreased appetite, LMP 2/52 ago, pain for 8-10 hours, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI : a 20 yo f , complains of right lowe quadrant pain for 10-12 hr ago , pain is constant , non radiating , 5/10 in severity , increase with walking , decrease a little bit with ibuprofen , patient reports diarrhea since couple of days , watery brown loose stool , with no blood , no mucus , no nausea or vomiting , patients reprots no feeling of hotness , has decreased appetite , and seems to be loosing weight , but not sure how much , patients reports no urinary changes , and pain not related to food , she has regular periods evey 28 days , and LMP was 2 weeks ago , patient has a good sleep . 

ros : negative except as above 
allergies : NKDA 
meds : none 
pmh : none 
psh : none 
sh : no smoke , drinks wine occasionally ,work as student , sexually active with her boyfriend uses condoms eveytime she has sex . 
fh : non contributory 

.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]loosing weight, reports diarrhea, 20 yo, stool , with no blood, right lowe quadrant pain, no urinary changes, decreased appetite, LMP was 2 weeks ago, for 10 ago, f</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 20 year old female who presents with abdominal pain. Pain is a constant dull ache of 5/10 in severity, is located in the RLQ, started suddenly 8-10 hours ago and awoke the patient from sleep. Endorses non-bloody diarrhea for the past 3 days and loss of appetite since last night. Denies nausea, vomiting, chills. Last PO intake was dinner last night. Pt experienced similar episodes 3-4x in the past 6 months which resolved spontaneously. Ibuprofen helps the pain, walking worsens the pain. 
ROS negative except as above. 
PMHx: none. LMP 2 weeks ago, 28d cycle, lasts 4 days, moderate flow. 
Allergies: NKDA
Surghx: none
FH: noncontributory
SH: lives alone, biology student, 1 beer 2x/month, denies tobacco or drug use. No recent travel. Sexually active, only male partners, most recent activity 9 months ago, uses condoms consistently..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]most recent activity 9 months ago Sexually active, diarrhea for the past 3 days, 20 year, non-bloody diarrhea, similar episodes 3-4x in the past 6 months, Pain RLQ, loss of appetite, LMP 2 weeks ago, 8-10 hours ago, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Suzanne Powelton is a 20y/o female with no PMH who presents to the ED for abdominal pain. 
-pain located in right lower quadrant.
-progressively worsening pain rated 5/10 and described as dull, achy
-she has had diarrhea the last few days with no blood in the stool
-she has had a few episodes like this in the past 6 months that have resolved spontaneously
-she tried ibuprofen without much relief
-LMP 2 weeks ago
-has not been sexually active for 9 months
-no previous surgeries
-no nausea, urinary frequency, urinary urgency, discharge.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]no discharge, has not been sexually active, has had diarrhea, 20y/o, no blood in the stool, few episodes like this in the past 6 months, abdominal pain right lower quadrant, abdominal pain. right lower quadrant, no urinary frequency, no urinary urgency, LMP 2 weeks ago, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo Suzanne Powelton presents to ED with complaints of sudden onset of ABD pain. The pain is in RLQ, started 8-10 hr back, dull and achy in character, does not radiate anywhere, constant and seems to be worsening. The pain is aggravated with walking but relieved a little with ibuprofen. It is 5/10 in severity. The patient also complains of having diarrhea for few days back with nausea or vomiting present. The diarrhea is watery, no blood present. There was no sense of incomplete evacuation or alernating diarrhea and constipation.
Temp: 100.8F
HR: 88bpm
BP: 126/78
Allergies: NKDA
Meds: Ibuprofen
PMH: None
Obs/Gyn: Menarche 13 yr of age, LMP 2 weeks ago, Regular cycle with 4/28 days, 4 tampons/day, no vaginal discharge or spotting present, PAP Smear negative
SH: sexually active 9 months back but not anymore, used condoms, alcohol twice a month,.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]no vaginal discharge, sexually active 9 months back, diarrhea, diarrhea, 20 yo, diarrhea no blood, pain is in RLQ, LMP 2 weeks ago, started 8-10 hr back</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Suzanne Powelton is a 20 YP F complaining of abdominal pain. Pain is in right lower quadrant and is dull/achey like a bad cramp. 5/10 on pain scale. Does not radiate, worse with walking, IBU helps. Decreased appetite since yesterday has not eaten. Patient says she has had 4 similar episodes, but none of this severity and length. No nausea, vomiting, or constipation, Diarrhea past few days nonbloody 5x/day. No sick contacts. 
PMH: none, Allergies: none, meds: ibuprofen for pain, surgeries: none, family: none
ob/gyn: never had pap or STD, LMP was 2 weeks ago and she is regular, experiences moderate cramps, last time sexually active 9 months ago
social: no smoking or drugs. alcohol 2x/month, lives by herself, full time student..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]sexually active 9 months ago, Diarrhea past few days, 20 Y, Diarrhea nonbloody, similar episodes, abdominal pain right lower quadrant, Decreased appetite, since yesterday has not eaten, LMP was 2 weeks ago, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Powelton is a 20 year old female presenting to the clinic with right lower abdominal pain. For the last 8-10 hours she has had constant right lower badominal pain. SHe has had 3-4 similar episodes over the last 6 months. the pain is dull and achy. She has not noticed any activities or foods that bring on her pain. The pain does not radiate anywhere. Walking makes her pain worse. She has trie ibuprofen with no relief. She has had diarrhea for the last 4 days, with 4-5 large volume stools per day. SHe has not noticed blood in her stool. Her last mestrual period was 2 weeks ago and normal for her. She is sexually active wit hone partner and uses condoms for contraception. Denies nausea, vomiting, fevers, chills, palpitations, shortness of breath, and dizziness. She has no chronic medical conditions and has never had surgery. She does not take any medications, supplements, or herbals. Family history noncontributory..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]diarrhea, 20 year, has not noticed blood in her stool, 3-4 similar episodes over the last 6 months, right lower abdominal pain, right lower badominal pain, last mestrual period was 2 weeks ago, For the last 8-10 hours, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20yo otherwise healthy F presents to ED with RLQ pain x10 hrs. Woke her up from sleep this morning. Dull achy pain, 5/10 in severity. Ibuprofen helped a little. Worse with walking. She has had 4 similar episodes over the past 6 mo, each resolved with in 2 hours. She has had no appetite this morning but ate yesterday. No vomiting. Has had diarrhea x 2 days, watery, no blood, no melena. Good PO intake of water. Has had several episodes of diarrhea over past 6 months that lasted 2 days and resolved spontaneously. Last was sexually active 9 months ago. Sexually active with men. Always uses condoms. No h/o STI. LMP 2 weeks ago.
ROS: denies f/c, CP, SOB, back pain, HA, hematuria, dysuria
No PMH, PSH, FHx
SH: Lives alone, biology premed student, EtOH 2x/mo, no other drug use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Last was sexually active 9 months ago, diarrhea x 2 days, 20yo, diarrhea no blood, no melena, similar episodes over the past 6 mo, several episodes of diarrhea over past 6 months, RLQ pain, denies hematuria, denies dysuria, no appetite, LMP 2 weeks ago, pain 10 hrs, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms Powelton is an otherwise healthy 20 yo F presenting with an 8-10 hour history of right lower quadrant abdominal pain. The pain woke her up from sleep. She states that it is constant dull, aching cramps that is a 5/10 pain. She has had 3-4 similar episodes in the past, which only lasted for a couple hours. She has also noted 4-5 days of watery diarrhea, which does not contain blood. Her LMP was 2 weeks ago and she has not been sexually active for 9 months. She believes she has lost some weight, because her clothes are fitting looser. She denies any other symptoms..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]lost some weight, clothes are fitting looser, has not been sexually active for 9 months, diarrhea, 20 yo, diarrhea, which does not contain blood, 3-4 similar episodes in the past, right lower quadrant abdominal pain, LMP was 2 weeks ago, 8-10 hour history, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Suzanne Powelton is a 20yo f with no pmhx who presents to the ED with abdominal pain. She states that the pain started 8-10 hours ago. She has a dull aching, like a bad cramp. It does not radiate. It is constant. She has had 3-4 siminlar episodes over the past 6 months. She has had diarrhea without blood for the last couple of days. She has 5-6 stools per day. Ibuprofen helped a bit but is not helping anymore. She does not feel hungry but has no nausea or vomiting. She denies fevers or chills, but states that her clothes ""fit looser"". She has no other meds than ibuprofen. She has no known allergies. She has no known family history. No past surgical or medical history. She denies smoking or illict drugs. She drinks 2 beers twice a month. She last had sex 9months ago with condoms. She is worried that she does not have her family close by, and would like us to contact her friends nearby.

ROS negative unless noted above.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]clothes ""fit looser"", last had sex 9months ago, diarrhea, 20yo, diarrhea without blood, 3-4 siminlar episodes over the past 6 months, does not feel hungry, started 8-10 hours ago, f</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 20yo female without PMH who presents to ED with abdominal pain. Pain is in the RLQ, 5/10, achey/crampy, no radiation. Pain began ~8-10 hrs ago. Patient was sleeping and awoke with pain. No N/V. some appetite loss. Pain is better but not releived with ibuprofen. worse with walking. Patient still has her appendix. Denies hx of inflammatory bowel disease, irritible bowel syndrome.  Patient was last sexually active approximately 9 months previously. Used condoms for protection. Denies any vaginal discharge or bleeding. Patient is concerned because she has no family close by. Does have good friends that are close. Has not eaten since last night.
PMH: still has appendix. no medical conditions. no meds. no surgeries. NKA
FHx: parents alive and healthy
SHx: no tobacco use, social drinker, no illicit drug use. full-time student studying biology.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Denies any vaginal discharge, last sexually active approximately 9 months previously, 20yo, Pain is in the RLQ, some appetite loss, Pain began ~8-10 hrs ago, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 20 yo F compains of abdominal pain for 8-10 hrs. She had abdomonal pain in her RLQ and it is getting worse. It is not raleated to any food and she has no vomitting or nausea, no cough and chest pain,palpitation,denies fevers and chills. She has no change in her urinary habits. she had a diarrhea for 2 days, watery stool , brown and no blood in it, without any odors.  
PMH: None.
PSH: None.
Alergies: NDKA.
Meds: None.
OB/GN: LAP 2 weeks ago, no spotting during periods.
SH: student, sexually active with boyfriend, use condoms rugularily.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]diarrhea, 20 yo, stool no blood, abdomonal pain in her RLQ, no change in her urinary habits, LAP 2 weeks ago, pain for 8-10 hrs, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: S.P. is a 20 y/o female who px to clinic w/ abdominal pain. pt states pain is in RLQ & started 8-10hrs ago when she woke up from sleep. [ain is dull & achy. pt has had few sim eps in past but not as severe.  ibuprofen has heloed pain & walking makes it worse.  pt has had some recent wt loss & no appetite for 1 day. pt has had diarrhea for 2-3 ds w/ no blood/mucous. pain not relived by BM. no recent travel, or illbness, no trauma. no fatigue. pain does not radiate but ibuprofen improved it slightly. 
ROS; no dyspnea, no urinary changes, no numbness or tingling, no wt loss. no vomitting
PMH: healthy. NKDA. no meds/hosp/surgeris. family healthy. 
soc: student who lives alone. no smoking or durgs. ETOH 2x/wk. exercises & healthy diet
sex/gyn: sexually acitve last 9 mnths ago.  w/ 1 male partner in past yr. uses protection. STI negative few mnths ago. Menacrh @ 13, regular periods lasting 4 ds w/ normal flow.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]recent wt loss, no wt loss, sexually acitve last 9 mnths ago, diarrhea, 20 y/o, diarrhea no blood, pain is in RLQ, no urinary changes, no appetite, started 8-10hrs ago, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 year old female presents to the clinic with acute pain in her rlq quadrant. The pain is constant, ""dull an achy"" and a 5/10 in intenstity that does not improve with ibuprofen. The patient endorses similiar symptosm in the past (2-3x in last 6 months), and has had diarrhea for the last 2 days as well. Nothing improves or worsens the pain. The patients LMP was 2 weeks ago, and has had no recent irregularities. She denies nausea and vomiting. Endorses no appetie, last meal was dinner last night. 

ROS - as above 
PMH/PSH - none
Allergies - none
Medications - none
hosptializations - none
Family - parents and 2 siblings healthy
OBgyn- no children, LMP 2 weeks ago, 3-4/28 day cycles. no history of pap smears 
Social - Denies smoking, drinks approximately 2x per month, studying biology pre-med, sexual active with male 9 months ago.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]sexual active with male 9 months ago, diarrhea, 20 year, similiar symptosm in the past (2-3x in last 6 months, rlq quadrant, no appetie, LMP was 2 weeks ago, LMP 2 weeks ago, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo F previously healthy with no pass medical history presents with worsening abdominal pain. It began 8-10 hrs prior to presentation while she was sleeping. Describes the pain as dull, achy, crampy and mainly localize in the right lower quadrant. Does not radiate. She also reports of recent diarrhea. No skin changes or heat/cold intolerance. No drug use. No fever. She took ibuprofen but it did not help and became concerned.

Meds: ibuprofen
SHx: sexually active. Last sexual activity 9 months ago. Use contraceptive all the time..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Last sexual activity 9 months ago, recent diarrhea, 20 yo, pain right lower quadrant, abdominal pain began 8-10 hrs, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: cc: abdominal pain 
hpi: Suzanne Powelton, a 20-year-old female, has come to the emergency department today because of abdominal pain.  Pain began 8-10 hours ago woke her up from sleep, she says the pain is achy and crampy and has been constant through, alleviated by ibuprophen only and aggravated by walking.  She also complaints of diarrhea and loose watery bowel movments for the last couple days, denies any blood, mucus. She denies any nasuea, vomit , changes to her diet, recent infections, pain with urination, or painful defecation. She denies hisotry of sted, or past similar symtpoms.
allergies: nkda
pmh: none 
meds: ibuprophen
sh: drinks ocacionally , no smoke
obgy: crampy periods,  regular. lmp 2 weeks ago, uses 4-5 pads daily , not sexually active for 9 months since she broke up.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]not sexually active, loose watery bowel movments, diarrhea, 20-year, bowel movments denies any blood, denies pain with urination, lmp 2 weeks ago, Pain began 8-10 hours ago, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 YR O  F WITH RLQ PAIN - 10 hrs acute on radiating  cramping intensity  5/10 aggrevated by walking nreliieve by ibuprofen hx of fever ,h no heatburns or related to food x of diarrhoe  watery / loose non blooody no nausea or vomuting no headache no  LMP- 2 WEEK AGO NO MISCURIAGES no child 
pmh- none
meds ibuprofen
fh- no contributary
social- 1-2 /month.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]diarrhoe, 20 YR, diarrhoe   non blooody, RLQ PAIN, LMP- 2 WEEK AGO, PAIN - 10 hrs acute, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: 20yoF c/o ABD pain
HPI:  20yoF c/o ABD pain, RLQ pain began 8-10 hours ago, woke from sleep, worsening, 5/10, dull/achy, ibuprofen does not alleviate, walking exacerbates. Pt endorses lose fitting clothes. Pt also endorses diarrhea for 2 day, 4-5x, denies blood, constipationj. Denies fever, chills, nausea, vomiting, headache, SOB, chest pain, urinary habit changes,
PMH: denies
Meds; denies
All: NKDA
Imm: UTD
Soc: student, does pilates 2x/wk, run/walks 2-3x/wk, balanced diet, denies toxic habits
Sex: last 9m ago with male partner, used condoms
OBGYN: LMP 2wk, cycle 28d for 4 days, menarche at 13.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]lose fitting clothes, Sex: last 9m ago, diarrhea, 20yo, 20yo, diarrhea denies blood, RLQ pain, Denies urinary habit changes, LMP 2wk, began 8-10 hours ago, F, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 20 yo F c/o abdominal pain.
-Location: RLQ. No radiation.
-Onset 6 months ago, episodic (3-4X last 6 months, current episode worst ever), rates 5/10, getting worse, constant, walking aggrivates, ibuprofen minimally relieved.
-Associated Sx: diarrhea 4-5X per day for last 2-3 days, decreased appetite.
ROS: denies fevers, chills, n/v, back pain, numbness, parasthsias, chest pain, SOB.
PMHx: None. Meds: ibupfrofen 200 mg 3 tablets prn for pain. Allergies: NKDA. No prior hospitalizations, trauma, surgeries. FMHx: None.
Sexual Hx: last sexual encounter 9 months ago, men only, uses barrier protection, 1 partner over last year, no h/o STIs.
Obstetrics: No prior pregnancies. LMP 2 weeks ago (normal). Moderate flow every 30 days for 4-5 days.
SHx: never smoked, no other tobacco or recreational drugs. Drinks 1-2 beers with friends a few times a month (CAGE 0/4)..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]last sexual encounter 9 months ago, diarrhea or last 2-3 days, 20 yo, episodic 3-4X last 6 months, abdominal pain RLQ, decreased appetite, LMP 2 weeks ago, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 YO F C/O PAIN RLQ SINCE 10 YRS, WORSENING. 5/10 INTENSE, DULL, ACHING PAIN, ALLEV ON IBUPROFEN AND AGGRV ON WALKING, H/O SIMILAR 2-3 EPISODES SINCE 3 MONTHS.ASSO WITH DIARRHEA COUPLE OF DAYS, 3-4 /DAY, LIGHTBROWN , WATERY, NO BLOOD OR MUCPS. ASSO WITH REDUCED APPETITE AND LOOSENING OF CLOTHERS
DENIES FEVER, CHILLS, FATIGUE, LAD, YELLOWISH DISCOLORATION OF URINE, VAGINAL DISCHARGE
ROS NEGATIVE
PMH NONE, MEDS IBUPROFEN, NKDA
PSH NONE, TRAUMA/ TRAVEL/ ILL CONTACT NONE
FH NON CONTRIBUTORY
SH STUDENT, DRINKS ALCOHOL OCNL, SEUXUAL ACTVITY 9 MONTH BACK,
OBG LMP 2 WEEKS BACK, REGULAR, MODERATE FLOW WITH CRAMPY PAIN.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]DENIES VAGINAL DISCHARGE, LOOSENING OF CLOTHERS, SEUXUAL ACTVITY 9 MONTH BACK, DIARRHEA COUPLE OF DAYS, 20 YO, DIARRHEA NO BLOOD, SIMILAR 2-3 EPISODES SINCE 3 MONTHS, PAIN RLQ, REDUCED APPETITE, LMP 2 WEEKS BACK, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Powelton is a 20 y/o female with history of diarrhea and recurrent abdominal pain who presents for 5/10 dull pain in the right lower quadrant. The pain started 8-10 hours ago and is worst with walking. Ibuprofen has not been very helpful. She says that she has had 3-4 similar episodes of RLQ pain and diarrhea (4-5 times daily) that have occurrd over the last 6 months. The diarrhea is normal in color. She has not had intermittent constipation.  She denies any lightheadedness, nausea or vomiting, trauma, or recent infections. She does not smoke cigarettes, does not drink alcohol, anddrinks alcohol twice monthly at parties. Her last menstrual period was 2 weeks ago, and they are regular, moderate flow. She has not been sexually active for 9 months. She has never had a pap smear. She denies dysuria. She is concerned that her family does not live nearby and would like access to support resources if needed. She is a premed student..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]has not been sexually active for 9 months, has not been sexually active, diarrhea, diarrhea, diarrhea, 20 y/o, 3-4 similar episodes of RLQ pain, diarrhea (4-5 times daily) that have occurrd over the last 6 months, abdominal pain right lower quadrant, denies dysuria, last menstrual period was 2 weeks ago, pain started 8-10 hours ago, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 20yo F w/ no PMH c/o crampy dull RLQ pain for the past 8-10 hrs. Pt states ibuprofen 200mg relieves the pain somewhat while walking exacerbates pain. Pain is 5/10 in severity and pt also c/o dec appetite and diarrhea x2 days. Pt hasn't been sexually active in 9 months and denies recent travel hx or fevers.
ROSS: denies fevers, HA, cp, SOB, changes in urination, or weight loss

PMH: none
A: NKDA
meds: ibuprofen 200mg 2x daily
FH: none
OB: G0 menarche at 12yo, LMP 2 wks ago, periods regular lasting 4 days and 28 day cycles
SH: social drinker, denies tobacco use or illicit drug use, not sexually active in 9 months; biology student
denies surgical hx of hospitalizations.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]""hasnt been sexually active in 9 months"", not sexually active in 9 months, diarrhea x2 days, 20yo, RLQ pain, denies changes in urination, dec appetite, LMP 2 wks ago, past 8-10 hrs, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yF presenting with RLQ pain. Pain started 8-10 hours ago, waking her up from sleep. Described as dull/achy/crampy pain. Constant, progressively worsened from 4/10 to 5/10 currently. Moving seems to make pain worse. Tried ibuprofen for pain (600 mg) without improvement, and nothing else seems to make pain better. 2-3 days ago also had onset of diarrhea. Having 4-5 watery BMs/day. No blood or mucous in stool. Has had episodes of similar pain and diarrhea 3-4 times in last 6 months, no always occuring together. Has noticed some weight change, clothes fitting looser. 
PMH: none
Meds: none
PSH: none
FH: no hx of IBD, parents healthy 
SH: non-smoker, infrequent alcohol use (1-2 beers 1-2x month), no drug, last sexual encounter 9 months ago with known partner, wears condoms consistently, LMP 2 weeks ago
ROS: no nausea, vomiting, arthralagias, rash, mouth sores, fever/chills,urinary symptoms, vaginal discharge/bleeding.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]no v discharge, weight change, clothes fitting looser, last sexual encounter 9 months ago, 2-3 days ago diarrhea, episodes of similar diarrhea in last 6 months, 20 y, No blood in stool, episodes of similar pain in last 6 months, RLQ pain, no urinary symptoms, LMP 2 weeks ago, 8-10 hours ago, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo F with h/o LRQ abdominal pain for the past 8-10 hours, 5/10 serverity, dull-achy cramp, worsened by walking, progressive. Reduced appetite, watery diarrhea past 2 days, clothes fitting looser. No nausea, vomiting, fevers, chills, night sweats, travel history, hematochezia, light stools, urinary changes. LMP 2 weeks ago, no pap smears, G0P0, menses 28 day cycle, last 4 days, changes 4 tampons/day.

PMHx, surgeries, hospitalization: none
Allergies: NKDA
Meds: advil for abd pain
FHx: noncontributory
SH:
Student at northwestern, lives off campus
Sexual activity with men, last 9 months ago, uses condoms always, no illicit drugs, tobacco, EtOH 2 times/month
exercise with pilates 2 times/week, regular diet.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]clothes fitting looser, Sexual activity last 9 months ago, diarrhea past 2 days, 20 yo, LRQ abdominal pain, No urinary changes, Reduced appetite, LMP 2 weeks ago, past 8-10 hours, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Suzanne is an otherwise healthy 20 yo female coming in with 5/10 dull and achy RLQ pain that started 8-10 hours ago. Suzanne has had a similar pain 3-4 times over the last 6 months.
-Positive symptoms include anorexia, fever, episodic diarrhea, and clothes fitting more loosely 
-Denies constipation and fatigue
GYN Hx: last menstrual period 2 weeks ago; normally regular
PMH/PSH: none
Meds/allergies: none
FH: denies FH of autoimmune conditions
SH: student stuyding pre-med; EtOH use 2x monthly, denies tobacco or other illicit drug use; last sexually active 9 months ago and always uses condoms
ROS: positive for looser fitting clothing, diarrhea, anorexia and RLQ pain; denied N/V, fevers, change in bowel habits or blood in stool.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]clothes fitting more loosely, looser fitting clothing, last sexually active 9 months ago, diarrhea, diarrhea, 20 yo, denied blood in stool, similar pain 3-4 times over the last 6 months, RLQ pain, RLQ pain, anorexia, anorexia, last menstrual period 2 weeks ago, started 8-10 hours ago, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Powelton is a 20 yo F coming in with abdominal pain. It is located in the RLQ of her abdomen and started about 8-10 hours ago. She describes it as a dull/achy pain, would rate it a 5/10, and says that it has been worsening. Walking makes it worse. Ibuprofen hasn't helped significantly. No nausea, vomiting, fever, urinary changes, chest pain, SOB, sore throat or chills. Reports some diarrhea and a decreased appetite. Has had 3-6 episodes of similar pain in the past that has resolved on their own.
ROS: negative except where stated in HPI.
PMH: none
PSH: none
Meds: none
Allergies: NKDA
Family Hx: non-contributory
Social Hx: drinks 1-2 beers a few times per month, no cigarettes or other drug use. Eats a balanced diet and exercises regularly. Last sexually active 9 months ago. No h/o STIs. LMP was 2 weeks ago. They are regularly 28 days with 4 days of flow..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Last sexually active 9 months ago, diarrhea, 20 yo, 3-6 episodes of similar pain, abdominal pain RLQ, No urinary changes, decreased appetite, LMP was 2 weeks ago, started about 8-10 hours ag, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: This is a 20 yo female with no significant past medical history presenting to the emergency department for abdominal pain. The pain began 8-10 hours ago and is located in the RLQ. She describes it as dull and achy. She rates it as a 5/10. The pain is constant and worsening. The pain is associted with decreased appetitie. She also notes 2-3 days of loose watery stools. She took motrin with mild relief. The patient says she has had several episodes of abd pain and diarrhea over the past 6 months but this episode is more severe. No blood in stool. The patient denies urinary symptoms.
medical and surgical history: none
Medications: motrin
NKDA
ROS per HPI
Family history: none
Social history: lives alone. premed student. away from family but has friends in the area. Denies tobacoo or drug use. drinks 1-2 beers twice a month
Sexual activity: last intercourse 9 months ago. uses condoms. no pregnancies. No prior STDs.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]last intercourse 9 months ago, 2-3 days of loose watery stools, diarrhea over the past 6 months, 20 yo, No blood in stool, episodes of abd pain over the past 6 months, abdominal pain RLQ, denies urinary symptoms, decreased appetitie, pain began 8-10 hours ago, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: Suzanne Powelton is a 20 year old female with dull, achy, abdominal pain for the past 8-10 hours.  The pain is constant, but increases with walking or bumps in car ride.  She rates the pain as 5/10.  The pain improves slightly with ibuprofen and worsens with walking. She had diarrhea for the past 2 days, the stool has been brown, loose and watery without blood.  There has been no nausea or vomiting, no fever, no fatigue.  Her appetite has been decreased since last night.  She has no sick contatcts and has no exposure to high risk food.   
PMH:  As above
Medications:  Ibuprofen
PSH: None
Allergies:  NKDA
FH:  None
SH:  Patient does not smoke, drinks occassionally (2x/month), last drank 3 weeks ago, does not use illicit drugs
Menstraul:  LMP 2 weeks.  Regular cycle, 4 days, 4 pads per day.  Every 28 days.  No pregnancy.  Last sex 9 months ago.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Last sex 9 months ago, diarrhea for the past 2 days, 20 year old, stool without blood, appetite has been decreased, LMP 2 weeks, pain for the past 8-10 hours, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 Y O F C/O RLQ PAIN X 8-10 HRS SUDDEN ONSET,PROGRESSIVE,CONSTANT,5/10 IN INTENSITY,DULL CRAMPY IN QUALITY,AGGRAVATED BY WALKING ,NO ALLEVIATING FACTORS AND ASSOCIATED W NON BLOODY WATERY DIARRHEA (3-4 EPISODE /DAY) X 3-4 DAYS . SHE REPORTS HX OF ABD PAIN AND DIARRHEA ON AND OFF X 6MONTHS AND HAVE TO RUSH TO REST ROOM TO PASS STOOL . SHE REPORTS SHE NOTICED SOME WEIGHT LOSS AND DECREASE IN APPETITE X FEW MONTHS
SHE DENIES FEVER,RASH,N/V,SOB,HEADACHE,FLU,BLADDER CHANGES .
ROS: NEG EXCEPT AS ABOVE
ALL: NKA
PMH/MED: N/C
PSH/HOSP: N/C
FH: N/.C
GYN/OBS: LMP 4/29,REGULAR
SH: NON SMOKER,OCC EtOH/ILLICT DRUG.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]WEIGHT LOSS, DIARRHEA X 3-4 DAYS, DIARRHEA X 6MONTHS, 20 Y O, NON BLOODY DIARRHEA, HX OF ABD PAIN X 6MONTHS, RLQ PAIN, DENIES BLADDER CHANGES, DECREASE IN APPETITE, PAIN X 8-10 HRS SUDDEN ONSET, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Powelton is a 20yo f with no PMH, presenting w right lower quadrant abdominal pain that started 8-10 hours ago. The pain is a dull ache that feels like a ""bad cramp"". She has had 3-4 similar episodes over the past 6mo. Ibuprophen makes the pain a little better, walking makes the pain worse. It does not radiate and is 5/10. LMP was 2wk ago. Last sexually active with male partner 9mo ago, regularly uses condoms. No previous pregnancies. Cycle is regular, 28 day intervals, 4 days of bleeding, uses 4 tampons first day, then decrease. ROS: + dec appitite, diarrhea (no blood - brown and watery, not associated with food). Neg: fever, chills, nausea, vomiting, constiptation. No pain/blood w urination. no blood in stool. No surgeries. EtOH socially, no smoking/illicit drugs. Family is healthy. Meds: ibuprophen PRN pain. NKDA.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Last sexually active 9mo ago, diarrhea, 20yo, diarrhea no blood, no blood in stool, 3-4 similar episodes over the past 6mo, right lower quadrant abdominal pain, No pain w urination, No blood w urination, + dec appitite, LMP was 2wk ago, pain that started 8-10 hours ago, f</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms.Powelton is a 20yo F presenting to the ED with RLQ abdominal pain. The pain started 8-10 hours ago. She describes it as constant, dull and achey, 5/10 in severity, without radiation. She has had no nausea or vomiting, but has had a decrease in appetite. Walking makes the pain worse. Nothing seems to make the pain better. She has had non-bloody diarrhea today. She notes that she has had 3-4 episodes of this RLQ pain in the past 6 months, but not as severe as it is today. She has had intermittent non-bloody diarrhea with the abdominal pain over the past 6 months as well. She notes increased stress due to her course load as a premed student.
OB/Gyn: G0, LMP 2 weeks ago, 28 day cycles with 4 days of moderate bleeding, last had sex with male partner 9 months ago, uses condoms consistantly, no history of STIs
Meds: none
PMH/PSH: none
FH: non-contributory
SH: alcohol 1-2 per month, no tobacco or illicit drug use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]last had sex with male partner 9 months ago, diarrhea, diarrhea past 6 months, 20yo, non-bloody diarrhea, non-bloody diarrhea, 3-4 episodes of this RLQ pain in the past 6 months, RLQ abdominal pain, decrease in appetite, LMP 2 weeks ago, pain started 8-10 hours ago, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 year old female with no significant past medical history presenting with 8-10 hour history of worsening right lower quadrant pain. Patient reports several days of diarrhea and decreased appetite. Her last meal was dinner last night and she does not currently feel hungry but has been drinking water. She rates her pain as a 5 out of 10. Ibuprofen helped minimally. Patient denies nausea, vomiting, fever, and headaches.

Patient has no significant medical or surgical history. Her menstrual history includes regular periods with LMP starting 2 weeks ago. She was last sexually active with a partner about 9 months ago. She tested negative for STDs about 1 year ago. Patient denies smoking and illicit substance use and endorses social alcohol use. Parents are healthy..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]last sexually active about 9 months ago, several days of diarrhea, 20 year old, right lower quadrant pain, decreased appetite, last meal was dinner last night, does not currently feel hungry, LMP starting 2 weeks ago, 8-10 hour history of pain, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Suzanne is a 20yo F who present with right lower quadrant pain. It came on suddenly 10 hours ago at a 5 out of 10, and has been getting worse. Ibuprofen helps with the pain. It does not radiate. Has had right lower quadrant pain in the past, but not as severe. Associated with diarrhea over the past couple of days. She noticed some weight loss over the past 2 weeks. Denies vaginal discharge or bleeding. 
ROS: Denies, chills, chest pain, nausea/vomiting, dysuria or hematuria
PMH: none; PSH: none
Meds: Ibuprofen; NKDA
FH: none
OBGYN: First period at 13, regular every 28 days, 4 tampons/pads per day on first few days, no dysmenorrhea. LMP 2 weeks ago. 
SHx: Not currently sexually active. Drinks alcohol 'at parties', no tobacco or illicit drugs..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Denies vaginal discharge, weight loss, Not currently sexually active, diarrhea, 20yo, Has had right lower quadrant pain in the past, right lower quadrant pain, Denies dysuria, Denies hematuria, LMP 2 weeks ago, came on suddenly 10 hours ago, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Powelton is a 20 year old female who presents to the ED complaining of right lower quadrant pain for the last 8-10 hrs. She says the pain is  a dull achy pain rated as a 5/10 and feels similar to a menstrual cramp. she took ibuprofen which has helped only slightly. walking makes the pain worse. She has had 2-3 days of diarrhea 4-5x/day. she has been drinnking fluids well but hasnt had an appetite today. she denies fever, chills, sweats, fatigue, n/v, urinary symptoms.

ROS: negative except per hpi
PMH: none
PSH: none
Ob/Gyn: LMP 2weeks ago, 28day cycle, lasts 4 days, never pregnant, does not use contraception
meds: ibuprofen
allergies: none
SH: lives alone, no tobacco use, alcohol 2x/month, no elicit drug use, not currently sexually active
FH: noncontributory.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]not currently sexually active, diarrhea, 20 year, right lower quadrant pain, denies urinary symptoms, hasnt had an appetite, LMP 2weeks ago, last 8-10 hrs, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: A 20 yo F c/o progressive, sudden, persistent, dull-achy RLQ abdominal pain in the last 8-10 hours, 5/10 in severity. Exacerbated by walking and alleviated by Ibuprufen. She refers non-bloody, brownish, watery diarrhea in the last couple of days. She also refers anorexia since yesterday.
She denies constipation, N/V, fever, infection, vaginal discharge, vaginal spotting,  joint pain or food relation to pain. She also denies SOB, palpitations, headache or urinary changes.
OBs/GYN : LMP was 2weeks ago and reular.
ROS :Neg except as above, Allergies : NKDA, Meds : none
PMH : none, PSH : none 
FH : non-contributory
SSH : no smoking, occasionally EtOH, no illict drugs, not sexually active in the last 9months. Full-time student.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies vaginal discharge, not sexually active, diarrhea, 20 yo, non-bloody diarrhea, RLQ abdominal pain, denies urinary changes, anorexia, LMP was 2weeks, last 8-10 hours, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Suzanne Pomelton is a 20 y/o female who presents with 10 hours RLQ abdominal pain. She reports a dull, achy pain of 5/10 intensity that does not radiate. It is aggravated by walking and mildly allevaited by ibuprofen; she has taken 3 doses of 200 mg ibuprofen since the pain started. Ms. Pomelton states that pain began when she was sleeping. She reports 3-4 similar, previous episodes of pain, which resolved on their own, but states this is the worst she has ever had. She also reports having loose, watery diarrhea for the pat 2 days.

PMH: none
PSH: none
Rx: ibuprofen 200 mg PRM
Allegies: none
OB/GYN: LMP 2 weeks ago; regular 28-day cycle with 4 days of flow.
Health maintenance: UTD
FH: non-contributory
SH: Student; lives alone. Denies tobacco use; occasional EtOH approximately every 2 months, denies CAGE.
ROS: watery diarrhea.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]diarrhea, diarrhea, 20 y/o, 3-4 similar, previous episodes of pain, RLQ abdominal pain, LMP 2 weeks ago, with 10 hours, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 20 YO F C/O ABOMINLA PAIN 
-STARTED SUDDNELY , 8-10 H AGO , ON THE RLQ , STEADY , NO RADIATION, GETTING WORSE, CRAMPY , ALLEV BY IBUPROFEN , AGRRAV BY WALKING, REPORT NAUSEA, NO VOMITTING. 
- DENIES ANY FEVER, ASSOCIATION TO FOOD , VAGINAL DISCHARGE, VAGINAL BLEEDING, HAVE NOT DONE PAP SMEAR BEFORE, LMP 2 WEEKS AGO, REGULAR.
ROS: NEG EXECPT ABOVE 
PMH: DAIRRHIA FOR THE PAST FEW DAYS , LOOSE , NO BLOOD. 
PSH: NONE 
MEDS:IBUPROFEN .  ALL: NKDA 
FH:BOTH PARENTS HEALTHY   SH: NO CIG/DRUG USE, ETOH OCCASIONALLY.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]DENIES VAGINAL DISCHARGE, DAIRRHIA FOR THE PAST FEW DAYS, 20 YO, DAIRRHIA NO BLOOD, ABOMINLA PAIN RLQ, LMP 2 WEEKS AGO, 8-10 H AGO, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: a 20-year-old female, has come to the emergency department today because of abdominal pain. 
- start 8-10 hours ago, constant and getting worse., the pain located at lower right quadrant.
- The pain is 5/10 in severity, dull in quaility, no radiation
- The pain is exacerbated by movement, walking and relived by Ibuprofen.
- The patient reports that she has similar episodes. 3-4 episodes over the last few months. The pain during these episodes is less severe
- Has a brown diarrhea over the past month
- Has weight loss but no change in appetites
ob/gyn: Menarche at age 13. Last menstrual perior 2 weeks ago and regular q 1month, last of 4 days. Sexually active 9 months ago, use condom consistency. No history of sexual transmitted disease
Allergies: NKDA
Medication: none
PMH: none
PSH: none
SH: no smoking. occasional EtOH. Students. Good diet
FH: none contributory.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]weight loss, Sexually active 9 months ago, brown diarrhea past month, 20-year, reports similar episodes, 3-4 episodes last few months, pain located at lower right quadrant, Last menstrual perior 2 weeks ago, start 8-10 hours ago, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Complaint: Abdominal pain
HPI: This is Suzanne Powelton, a 20 year old female Biology student with a complaint of RLQ abdominal pain for the past 8-10 hours
> (+) anorexia since last night
> Fever 100.8 F
> describes pain as dull aching and cramping pain, non-radiating, rated 5/10 on pain severity scale
> denies nausea or vomiting 
> had 3 episodes of diarrhea
> Pt has had similar hx of crampy abdominal pain usually relieved with Ibuprofen 
PMH None
SurgHx : None pertinent 
LMP ; 2 weeks ago
Soc Hx : Biology student , denies any recent travel, no recent ill contacts
> denies use of tobacco or drugs, drinks alcohol 1-2 drinks 1-2 times per month
ROS : Negative except as above
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]diarrhea, 20 year, similar hx of crampy abdominal pain, RLQ abdominal pain, (+) anorexia, LMP ; 2 weeks ago, for the past 8-10 hours, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI - A 20 yo f presents with rlq pain that started 8-10 hours ago while she was sleeping. It started suddenly, is getting worse and she rates it has 5/10. It it is slightly relieved with ibuprofen and walking makes it worse. Her last mentrual period was 2 weeks ago, her periods are regular. Her last sexual encounter was 9 months ago. She has had diarrhea since 2-3 days. Her apetite has decreased and her clothes are getting lose.

ROS - No nausea, no vomiting, no headaches or subjective fever

PMHx - None
PSHx - None
Allergies - None
Meds - None
FHx - Noncontributory
SH - No tobacco, Occational Etoh, No illicit Drug use, Last sexual encounter 9 months ago, Student.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]clothes are getting lose, last sexual encounter was 9 months ago, Last sexual encounter 9 months ago, diarrhea, 20 yo, rlq pain, apetite has decreased, last mentrual period was 2 weeks ago, started 8-10 hours ago, f</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Powelton presents today with 8-10h of crampy/achy lower R quadrant abdominal pain. It is 5/10 severity and associated with diarrhea for the last few days (4-5 episodes/day). Pain is worse with walking and ibuprofen is not helping. She has had 3-4 episodes of similar pain in the last 6 months. Pain is not related to food, stress or menses. 
ROS - denies HA, fever, chills, N/V, constipation, HA, sweating, palpitations, or ill contacts. 
PMH - none
OB/Gyn Hx - LMP 2 weeks ago. 28 day cycle with 4 days of moderate bleeding and slight cramps. No previous pregnancies, miscarriages or abortions. No hx of STIs. Never had a pap smear.
PSH - none
Meds - ibuprofen
NKDA
FH - neg
SH- pre-med student. Denies tobacco or drug use. Drinks alcohol socially 1-2x/month. Last time being sexually active was 9 months ago. Always uses condoms. 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Last time being sexually active was 9 months ago, diarrhea for the last few days, 3-4 episodes of similar pain in the last 6 months, lower R quadrant abdominal pain, LMP 2 weeks ago, 8-10h</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 20 yo female c/o abdominal pain with onset 8-10 hours ago. Pain awoke pt from sleep and is ""mild-moderate"" intensity without radiation and ""achy"", constant since onset, no variation with position. It is associated with watery diarrhea 4-5x/daily for the past several days. No hemotochezia, melena, pain with defecation. No n/v. Pt endorses several episodes of similar pain and diarrhea over past 6 mos, each of which resolved spontaneously. Present episode is more severe. No known food triggers for episodes.
ROS: Positive for decreased appetite. Negative for malodorous stool, urinary frequency/pain/urgency, vaginal bleeding
PMH: None
Soc: College student, lives alone. Never smoker, no drugs, occasionally 1 beer at parties 1-2 x monthly. Sexually active with 1 male partner, uses condoms every time for BC.
GYN - G0, LMP 2 weeks ago, regular cycles. 
Meds - Tried ibuprofen for current pain with no effect. O/w no meds. NKDA..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]diarrhea for the past several days, diarrhea over past 6 mos, 20 yo, No hemotochezia, No melena, several episodes of similar pain over past 6 mos, Negative urinary frequency, Negative urinary pain, Negative urgency, decreased appetite, LMP 2 weeks ago, onset 8-10 hours ago, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Suzanne Powelton is a 28 yo F who presents with right lower quadrant abdominal pain. Her pain started 8-10 hours ago, while she was sleeping. It has since gotten progressively worse and she rates it at a 5/10 severity. Describes as a dull achy crampy pain that does not radiate. Ibuprofen helped a little, walking makes it worse. Really bothering her and so she came in right away to get it addressed. Endorses associated loss of appetite and diarrhea for past few days. Diarrhea has also worsened, going about 4-5 times a day but no blood or mucus in the stool. Tried to take KOpectate which did not help. Denies any recent travel or camping, no new foods, no nausea/vomiting, no constipation. Last menstrual period was 2 weeks ago and normal. 
PMHx/PSHx: none 
Meds: ibuprofen
Allergies: none 
FHx: parents in good health 
SHx: 2 drinks/month, never smoker, no drug use, student, sexually active 9 months ago with condoms, no STIs
ROS: HPI.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]sexually active 9 months ago, diarrhea, Diarrhea, no blood n the stool, no blood tool, right lower quadrant abdominal pain, loss of appetite, Last menstrual period was 2 weeks ago and normal, Last menstrual period was 2 weeks ago, pain started 8-10 hours ago, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo F with no PMH presenting with Right lower quadrant abdominal pain for 8-10 hours. The pain happened after she woke up from sleeping and is progressive. Described as dull, crampy pain and does not radiate. Endorses decreased appetite but denies any nausea or vomiting. She has been feeling feverish as well. Has had loose brown stools (diarrhea) for past 2-3 d that occur 4-5x/day. Reports drinking plenty of fluids
PMH/PSH- none
Allergies- none
OBH- regular periods last 4 d, 28 d cycle. Last MP- 2 wk ago Sex 9 mo ago with male.
Fam Hx- none
Sochx- does not smoke. drinks alcohol 2x/mo.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Sex 9 mo ago, diarrhea for past 2-3 d, 20 yo, Right lower quadrant abdominal pain, decreased appetite, Last MP- 2 wk ago, 8-10 hours, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 F C/O RLQ PAIN THAT STARTED SUDDENLY 10 HOURS AGO AND WOKE HER UP FROM SLEEP. PAIN IS CONSTANT, SHARP AND COLICKY, NON RADIATING, 5/10 IN INTENSITY, AGGRAVATED WITH WALKING, RELIEVED TO SOME EXTENT WITH IBUPROFEN. SHE ALSO REPORTS OCCASIONAL WATERY  DIARRHEA FOR SEVERAL MONTHS, ASSOCIATED WITH UNDOCUMENTED WEIGHT LOSS. SHE DENIES ANY BLOOD IN STOOLS, DIFFICULTY FLUSHING THE STOOLS, NAUSEA, VOMITTING, BACK PAIN. SHE HAD 3 EPISODES LIKE THIS IN THE PAST 6 MONTHS BUT THEY REESOLVED ON THEIR OWN. 
DENIES ANY SOB, PALPITATIONS, LOSS OF APPETITE
ROS: WNL EXCEPT ABOVE
PMH: NONE
PSH: NONE
ALLERGIES: NONE
FH: NON CONTRIBUTIORY
SH: DENIES SMOKING, ALCOHOL AND ILLICIT DRUGS. LAST SEXUAL INTERCOURSE WAS 9 MONTHS AGO.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]WEIGHT LOSS, LAST SEXUAL INTERCOURSE WAS 9 MONTHS AGO, DIARRHEA, 20, DENIES ANY BLOOD IN STOOLS, 3 EPISODES LIKE THIS IN THE PAST 6 MONTHS, RLQ PAIN, LOSS OF APPETITE, STARTED SUDDENLY 10 HOURS AGO, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo F c/o abdominal pain since 8-10hrs ago 
-sudden, worsening, constant, RLQ, no radiation, 5/10, dull and aching, aggrav by walking, allev by ibuprofen, different nature with previous abdominal pain 
-recurrent RLQ pain (3-4times/6months) 
-reports diarrhea, weight loss (unmeasured), poor appetite
-denies nausea, vomiting, fever, change in urinary habit 
ROS: neg except above 
PMH/All/PSH/FH: none, Meds: ibuprofen
OBGY: G0P0, LMP 2weeks ago, regular q28days lasting 4days, no vaginal spotting
SH: no cig/EtOH/illicit drug, student, not sexually active since 9months ago, no h/o STDs.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]weight loss, not sexually active since 9months ago, diarrhea, 20 yo, recurrent RLQ pain (3-4times/6months), abdominal pain RLQ, denies change in urinary habit, poor appetite, LMP 2weeks ago, since 8-10hrs ago sudden, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo F complains of RLQ, 5/10, dull, achy pain that started 8-10hrs ago and woke her up from the sleep . It is non-radiating and is somewhat alleviated by Ibuprofen and egzacerbated by walking. Pain is not accompanied by nausea or vomitting. Patient denies fever,chills or change in urination. She does not have apetite and says her pants are fitting little looser than usual.  She report 3 day history of watery diarrhea but denies any mucus or blood in her stool. The last episode of diarrhea was today.
ROS: None except above
OB/GYN: LMP 2 weeks ago, regular cycles 4-5/28 days, 3 pads/day. Menarcha at age 13. No vaginal spotting, vaginal discharge or history of STDs. 
Allergies. NKDA
Medications: Ibuprofen
PMH: None.
PSH: None.
FH: Noncontributory.
SH: does not smoke or use ilicit drugs, has 1-2 beers at party. Is sexually active, her last intercouse was 9 months ago. Constant use of condoms..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]No vaginal discharge, pants are fitting little looser, last intercouse was 9 months ago, diarrhea, diarrhea, 20 yo, denies blood in her stool, RLQ pain, denies change in urination, does not have apetite, LMP 2 weeks ago, started 8-10hrs ago, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo female presenting with new onset right lower quadrant pain. Started 8-10 hours ago. Walking makes it worse. Ibuprofen makes it better. Described as dull cramping pain. Pain does not radiate. Has been constant since start. Similar episodes 3-4 times in past 6 months. Pain not associated with eating. Denies nausea, vomitting. Endorses diarrhea for past few hours. No blood in stool. 

ROS: negative except for above. 
OB/GYN: Menarche at 13. No vaginal discharge. Normal periods every 28 days, last 4 days. GOPO. LMP 2 weeks ago. 
Pmed: none
Psurg: none 
Meds: Ibuprofen PRN
Allergies: none 
FH: not pertinent 
SH: Denies smoking and drugs. Social alcohol use 2-3X/month. Is a student. Not sexually active currently, last sexual encounter was 9 months ago. Always uses condoms..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]No vaginal discharge, Not sexually active, last sexual encounter was 9 months ago, Similar episodes 3-4 times in past 6 months, diarrhea, 20 yo, No blood in stool, Similar episodes 3-4 times in past 6 months, right lower quadrant pain, LMP 2 weeks ago, Started 8-10 hours ago, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 year old F with RLQ
- Started 8-10 hours ago. Worse with walking. Better with Ibuprofen. 
- Has had 3-4 similar episodes in the past, but not this bad. Feels dull and achy like a cramp. Came on suddely, no radiation. 5/10 in severity. 
- Associated with diarrhea, fever, chills, weight loss, decreased appetite, 
- No vomiting, nausea. No back pain 
PMHx: none. No medications other than tylenol. No allergies. 
PSHx: None
LMP was 2 weeks ago and was normal (28 day cycles, lasts 4 days, uses 4 tampons/pads per day until it gets lighter). 
FamHx: noncontributory.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]weight loss, diarrhea, 20 year, had 3-4 similar episodes in the past, RLQ, decreased appetite, LMP was 2 weeks ago, Started 8-10 hours ago, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 YO F CAME WITH PAIN IN RIGHT LOWER ABDOMEN FOR 8-10 HRS. IT IS DULL,ACHY KIND OF PAIN. SHE SCORES IT 5/10 ON INTENSITY, THERE IS NO RADIATION OF THE PAIN. IT AGGRAVATES ON WALKING AND RELIEVES FOR A WHILE BY IBUPROFEN. SHE HAD EPISODES OF DIARRHOEA FOR COUPLE OF DAYS RECENTLY. IT OCCURED 4-5 TIMES PER DAYS, IT WAS BROWN IN COLOR, NO BLOOD WAS SEEN IN IT. SHE HAS NO FEVER,NO BURNING URINATION,NO BACK PAIN,NO ANY VAGINAL DISCHARGE, HER APPETITE HAS DECREASED TODAY. SHE HAS NOTICED LOOSENING OF HER CLOTHES LATELY. THERE IS NO RECENT TRAVEL HX,NO HIKING. NO SLEEP CHANGES.NO CHANGE IN DIET.
ROS-NONE EXCEPT ABOVE
PMH/PSH-NONE
ALLERGIES-NONE
MEDS-IBUPROFEN FOR PAIN
SH-LMP WAS 2 WEEK AGO,SHE HAS NORMAL REGULAR CYCLE OF 4 DAYS EVERY 28 DAYS,NO HX OF STI,NOT SEXUALLY ACTIVE SINCE 9 MO,SHE IS A STUDENT.SHE DRINK ALC OCCASIONALLY.
FH-NONE.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]NO VAGINAL DISCHARGE, LOOSENING OF HER CLOTHES, NOT SEXUALLY ACTIVE SINCE 9 MO, DIARRHOEA FOR COUPLE OF DAYS, 20 YO, DIARRHOEA NO BLOOD, PAIN IN RIGHT LOWER ABDOMEN, NO BURNING URINATION, APPETITE HAS DECREASED, LMP WAS 2 WEEK AGO, 8-10 HRS, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 year old female comes to the ED for worsening RLQ abdominal pain.  The pain began 8-10 hours ago while she was sleeping and she describes it as a constant 5/10 dull ache in the RLQ.  It does not radiate.  The pain is worse while walking and is dimished by ibuprofen.  She also notes having a few episodes of diarrhea over the past 2 days which is described as loose and brown, no blood.  She has had no nausea, no vomiting, no fever/chills, and no changes in urinary habits.  She was last sexually active 9 months ago with a condom.  Her LMP was 2 weeks ago.  She has never had an STI and STD and denies vaginal bleeding and discharge.

ROS:  negative except as above
Allergies:  None
PMH, Meds, PSH, FH: None
SH:  Student, no alcohol, recreational drugs, or tobacco..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies vaginal discharge, last sexually active 9 months ago, diarrhea, 20 year, diarrhea no blood, RLQ abdominal pain, pain RLQ, no changes in urinary habits, LMP was 2 weeks ago, pain began 8-10 hours ago, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms Powelton 20 yo F college student, c/o of RLQ abdominal pain of 8-10 hours duration, constant, getting worse, dull aching, no radiation , associated with watery brown diarrhea for the past few days,, increased by walking, slightly decreased by Ibuprofen, 5/10 in severity. She has had decreased apetite since yesterday, and thinks she might have lost some weighty recently. Patient denies any fever, N/V, chest pain, urinary changes, recent travel or infection. No hx of STD or STIs. LMP was 2 weeks ago, usually regular every 28 days, changes 4 tampons and bleeding for 4 daysn no intermenstrual spotting.
ROS: negative other than per HPI
PMH: none
PSH: None
FH: both parents healthy
Meds: as per HPI
SH: non smoker, occasionaly wine 2 per month, no illicit drug use, sexually active with partner, last sexual activity 9 months ago, always uses condoms..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]lost some weighty, last sexual activity 9 months ago, diarrhea, 20 yo, RLQ abdominal pain, denies urinary changes, decreased apetite, LMP was 2 weeks ago, 8-10 hours duration, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: This patient is a 20 year old female presenting to the ED with complaints of RLQ pain. Pt reports she was awoken from sleep with RLQ pain that seems to be getting progressively worse, constant rating 5/10 in severity and described as a dull aching pain. She notes associated diarrhea that has occured the last 2-3 days 4-5 times per day with loose, watery stool. Denies any blood in her stool. No other ill symptoms or urinary symptoms preceding this illness. LMP was 2 weeks ago and was normal. She was last sexually active 9 months ago with her partner. She had no history of pregnancy or previous STI.
PMH: None
NKDA
Surgical Hx: None
Social: Student studying pre-med biology, does not smoke, drinks alcohol about 2 times per month, denies recreational drug use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]last sexually active 9 months ago, diarrhea, loose, watery stool, 20 year, Denies any blood in her stool, RLQ pain, RLQ pain, No urinary symptoms, LMP was 2 weeks ago, awoken from sleep, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 20 yo F, c/o lower quadrant pain for the last 10 hours. It started when she was sleeping, and it is constant, dull and achy quality, 5/10 intensity and getting worse. It is aggravating with walking, ibuprofen helped a little. She had similar symptoms 3-4 times in the last 6 months. The pain hapenning randomly, no activity related. She also has diarrhea, 4-5 times a day, no blood in it. It is watery brown.
She has no appetite, and she didn't check her weight but her clothes getting loose. She is on a healthy diet. No travel outside the country recently. 
OB/GYN: last menstraul period was 2 weeks ago. sometimes cramps with her menses
ROS: negative
PMH: none
allergies: NKDA
Med: ibuprofen
PSH: none
FH: noncontributary
SHx: no smoking, no illcit drugs, no EtOH, she is a student. She is not sexually active
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]clothes getting loose, not sexually active, diarrhea, 20 yo, diarrhea no blood, similar symptoms 3-4 times in the last 6 months, no appetite, last menstraul period was 2 weeks ago, pain for the last 10 hours, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20-year-old female complaining of abdominal pain. The pain is in the LRQ and started 8-10 hours ago, it is about a 5/10 dull aching cramp that does not radiate. She has had watery non-bloody diarrhea/loose stools for the past 2 days with 4-5 stools per day. She denies sick contacts or recent travel. Ibuprofen helped moderately with pain. Pain is worse with walking. Not currently sexually active. regular menstrual periods every 28 days. Denies Nausea/vomiting. Loss of appetite since last night. 
No known allergies.
No PMH or surgeries/hospitalizaitons
Meds: ibuprofen 
FH: none
SH: not sexually active
EtOH: 1 beer monthly
Tobacco: no
Illicit drugs: no.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Not currently sexually active, not sexually active, diarrhea/loose stools for the past 2 days, 20-year-old, non-bloody diarrhea, pain is in the LRQ, Loss of appetite, pain started 8-10 hours ago, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 y/o F here for LRQ abdominal pain that started 8-10 hr ago when she was sleeping. She pain is dull and a 5/10, but does not radiate. It is a constant pain and has progressed over the past few hours. Ibuprofen alleviated the symptoms some what, and walking aggrevates it. She denies nausea, vomiting, constipation. She has had diarrhea for the past 2-3 days. She says she has had 4-5 BM/day, up from 2x/d normally. She denied blood, mucous or pain with defacation. She denies pelvic pain, vaginal d/c or pain, cp, sob, headache, fatigue, or fever. She is not as hungry and has noticed some weight loss as her clothes are fitting loser. LMP 2 weeks ago with moderate pain. Last sexual partner 9 mo ago with condom no OCP. Menarche at 13. No pregnancies. No dyspareunia. 
ROS neg except for above
PMH neg 
Meds ibuprofen 
all nka
surgreies none 
fh: noncontributory 
sh: student who lives alone no tobacco/drug use, occasional EtOh use..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies vaginal d/c, weight loss, clothes are fitting loser, Last sexual partner 9 mo ago, diarrhea, 20 y/o, denied blood with defacation, LRQ abdominal pain, not as hungry, LMP 2 weeks ago, pain started 8-10 hr ago, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 20 year old woman who presents with 8 hours of right lower quadrant pain. Pain started suddenly this morning, feels dull and achy. Does not radiate, has not moved. Associated with diarrhea the past few days and no appetite since last night. Pain 5/10. Has occured 3-4 other times the past 6 months, this time is the most painful. Took ibuprofen, helped a bit. Episodes usually last a couple hours and resolve on own. No known triggers, occurs seemingly randomly. Worse with walking. Endorses weight loss with no chnage in diet. Denies consptipation, bloody stool, pain with defication, urinary changes, nausea/vomitting, lightheadedness, joint pain, rashes. 

ROS: negative except above
Med hx: none 
meds: ibuprofen today 
Surgery: none 
Family hx: none 
Soc: drinks 2x a month, no tobacco or drug use. Goes to school as a pre-med
Allergies: none.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]weight loss, diarrhea the past few days, 20 year old, Denies bloody stool, occured other times the past 6 months, right lower quadrant pain, Denies urinary changes, no appetite, 8 hours started suddenly, woman</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: Ms Powelton is a 20yo female coming for abdominal pain. it has been present for 8-10 hours and has been getting worse. The pain is constant and the patient rates it 5/10 in intensity. It is located in the Right lower quadrant of the abdomen, does not radiate anywhere. The patient has no appetite, has not eaten since the pain started, denies any vomiting. The has had diarrhea for the past few days. The patient took 3 Ibuprofen tablets which seemed to relief the pain. Movement and walking make the pain worse. No additional associated symptoms, no fever, headache, change in urination. 
ROS: negative except as above
PMH: none
PSH: none
Allergies: NKDA
Meds: no medication
OB gyn - regular periods, every 28 days, moderate flow for 4 days. last sexual contact was 9 months ago with boyfriend.
Social: patient is a student, does not use illicit drugs, alcohol twice per month socially, no tabacco
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]last sexual contact was 9 months ago, diarrhea, 20yo, Right lower quadrant of the abdomen, No change in urination, no appetite, for 8-10 hours, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Powelton is a 20yo F with no sig PMHx who presents to the ED with 8-10 hour of RLQ abdominal pain. Pt describes this pain as dull/alchy, without radiation. Patient does endorse similar episodes ~3/4 times though with less severeity. Pt endorses decreased appetite, diarrhea of 2 days without hematochezia or melena. Pt denies subjective fever, chills, nausea, vomitting. Patient denies dysuria. Patient has 28 day menstrual cycle with 4 days of moderate flow, last one was 2 weeks ago. Patient is currently no on contraceptive, and was last sexually active with a male partner 9 months ago, using condom consistently.
PMHx: Negative, uses ibuprofen for pain currently
Past Surgical Hx: negative
FHx: healthy parents
SHx: does not smoke, drinks EtOH a couple times a month, does not use illicit drugs, has not travelled anywhere recently.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]ast sexually active 9 months ago, diarrhea, 20yo, without hematochezia, without melena, similar episodes ~3/4 times, RLQ abdominal pain, denies dysuria, decreased appetite, menstrual cycle last one was 2 weeks ago, 8-10 hour of pain, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Suzanne Powelton is a 20 yo F presenting with abdominal pain.
-Started 8-10 hours and is localized to the right lower quadrant, was never periumbilical in nature.
-Pain is constant, dull, achy, crampy, and was preceded by 2 days of diarrhea with 4-5x bowel movements a day
-Walking aggravates the pain, ibuprofuen did not alleviate the pain. Pain is getting worse with time.
-Patient reports no appetite.
-Patient denies any nausea or vomiting
-LMP was 2 weeks ago and sexual history is negative for intercourse in the last 9 months and negative for history of STIs. 
-PMHx and FHx are non-contributory.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]sexual history is negative for intercourse in the last 9 months, preceded by 2 days of diarrhea, 20 yo, abdominal pain right lower quadrant, no appetite, LMP was 2 weeks ago, pain Started 8-10 hours, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo F presents w 5/10 dull, achy abd. pain in the RLQ for 8-10 hrs. She has had intermittent 3 or 4 episodes over the past 6 mo. but they dont last this long. It is progressing. She tried ibuprofen, with no relieve.  no alleviating factors, exacerbated by walking. it is limiting her school schedule and it is causing her incr. stress.  Pain is non radiating. Reports watery non bloody diarrhea over the past couple of days. decappetited and looser fitting clothing. Denies: radiating pain, blood in stools, change in stool colo, association with food. Nausea, vomitting, fevers or chills. 
OB: sexually active last time 9 mo ago. 2 M partners, cons. condom use. no other contraception. LMP: 2 weeks, menarche: 13 yo. periods are regular associated w som light cramping in between. no spotting in between. No vaginal discharge, itching, pain today. Never pregnant. 
 SIGECAPS 0/7
PMH: none, PSH: none, meds: ibuprofen, FH: none. SH: no tob. ETOH.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]No vaginal discharge, looser fitting clothing, sexually active last time 9 mo ago, diarrhea over the past couple of days, 20 yo, non bloody diarrhea, Denies blood in stools, 3 or 4 episodes over the past 6 mo, abd. pain in the RLQ, LMP: 2 weeks, for 8-10 hrs, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 20 F c/o of RLQ abdominal pain that suddenly started while she was sleeping 8 hours ago. The pain is constant and has progressively gotten worse. Pain is ranked as 5/10 in severity, is an aching, cramping pain that does not radiate. Ibuprogen relieves the pain while walking makes the pain worse. The RLQ pain is a/w diarrhea. She has had past episodes of diarrhea 2-3 times with both increase in frequncy of bowel movement as well as volume. The diarhea is nonbloody, watery, and brown in color.  She has noticed some weight loss w/ clothes fitting looosely and has had decreased appetite despite a balanced, regular diet. She denies travel, sick contacts, energy changes, constipation. 
ROS negative as above 
PMH noncontributory, MEDs ibupren NKA no surgeries or hospitalizations  FH noncontributory 
SH drinks occ twice a month, does not use tobacco or rec drugs. exerices w/ pilates, diet balanced 
SX sex active bf, no stds.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]weight loss, clothes fitting looosely, diarrhea, past episodes of diarrhea, 20, diarhea is nonbloody, RLQ abdominal pain, RLQ pain, decreased appetite, suddenly started 8 hours ago, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo F presents to the ED with right lower quadrant pain started 8-10 hours ago.
-5/10 constant dull and achy pain. better with ibuprofen and worse with walking. 
-Previous episode: happened 3-4 times in the past, gradual onset, dully ache

-diarrhea started 2-3 days ago. 4-5 times/day, no blood in the stool. 
-denied similar illness in the household, no recent ill contacts
OB Hx:G0 menarche age of 13. no vaginal discharge. 4/28, 3-4 pads/day.  slight cramping, no intermenstrual period bleeding or postcoital bleeding. Sexually active 9 months ago.
PMH: none
PSH: none
Allergies: NKDA
Medications: Ibuprogen 200mg X3 times a day
FM: noncontributory
SH: no smoking, social drinker, no illicit drugs. exercise regularly 2-3/week. Regular diet.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]no vaginal discharge, Sexually active 9 months ago, diarrhea, 20 yo, no blood in the stool, happened 3-4 times in the past, ight lower quadrant pain, started 8-10 hours ago, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 20yo F c/o 5/10 dull and achy constant nonradiating RLQ pain that started 8-10 hours ago and was preceded with diarrhea. Patient tried to use ibuprofen, but it wasn't helpful, nothing ,makes worse. She said that she has low appetite and she didn't eat anything since last dinner (salad, icecream). Patient denies any sensation of hottness, chills, rashes, pain anywhere else.
OB/Gyne: LMP 2w ago, menarche 13y, every 28d amd lasts 4d
PMH/PSH: she had similar pain in the same place for a while, which happens every 6w and not related to menses
Medications: ibuprofen 
Allergies: NKDA
FH: noncontributory
SH: no smoking, elicit drug use, EtOH occasionally, last sexual intercourse was 9mo ago and she have never had an STD..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]last sexual intercourse was 9mo ago, preceded with diarrhea, 20yo, similar pain in the same place for a while, RLQ pain, low appetite, ""didnt eat anything since last dinner"", LMP 2w ago, pain that started 8-10 hours ago, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 20 yo otherwise healthy female presenting to the ED with 8 hours of non radiating RLQ abdominal pain and fever. Sudden onset while sleeping, progressively worsening. Not associated with eating. Has had 3-4 similar episodes in the past that resolved on their own. Has taken ibuprofen which has helped minimally. Movement makes pain worse. It is dull and aching. Patient denies subjective fever, chills, N/V. Admits loss of appetite and potentially mild weight loss recently. Has had diarrhea for 2 days, non bloody. LMP was 2 weeks ago. Has not had sex in over 9 months. No STD history. No abdominal surgeries.
ROS: aside from mentioned in HPI, no changes in urination or vision, no chest pain, no SOB, no weakness
PMHx: none
Hospitalizations: none
PSHx: none
Social: non smoker, rarely drinks alcohol, no recreational drugs, pre med student.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]weight loss, Has not had sex in over 9 months, diarrhea for 2 days, 20 yo, diarrhea non bloody, Has had 3-4 similar episodes in the past, RLQ abdominal pain, no changes in urination, loss of appetite, LMP was 2 weeks ago, 8 hours of pain, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: Suzanne Powelton is a 20-year old female presenting with a chief complaint of ""lower right quadrant abdominal pain"". She states the pain awoke her from her sleep 8-10 hours ago. It has progressively worsened. Dull, achy pain. Rated 5/10. Took ibuprofen, helped some. Walking worsens pain. Does not radiate. Diarrhea for past couple of days. No nausea or vomiting. LMP was 2 weeks ago. Last sexual intercourse was 9 months ago. 
PMH: None
PSH: None 
Meds: Ibuprofen PRN
Allergies: None 
Family: No pertinent history 
Social: Drinks 1-2 beers 2x a month. No recreational drugs or tobacco use. Has history of sexual activity with multiple male partners; used condoms. Has been tested for STDs in past. In college, biology major..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Last sexual intercourse was 9 months ago, Diarrhea for past couple of days, 20-year old, lower right quadrant abdominal pain, LMP was 2 weeks ago, pain awoke her 8-10 hours ago, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Chief Complaint: Right Lower Quadrant Pain
Suzanne Powelton is a 20 y.o. F presenting w/ RLQ pain. This pain started suddenly about 8-10 hours ago and has been getting worse since. Pt states the pain doesn't radiate and describes it as dulll and achey. She rates it a 5 of 10. She has had no ververs or chills. No nausea or vomiting but has had no appetite. Pt states that she has had diarrhea for the past cople of days. She denies blood in her stools. She reports stooling 4-5 times a day and describes them as loose or watery. She denies travel out of the country, recent sick contacts or change to diet. She denies any vaginal bleeding or pain w/ urination. Walking makes the pain worse pt has tried ibuprofen w/ minimal response.  Pt's last menses was 2 weeks ago. Cycle is regular

PMHx: None. No surgeries 
Medications: None
SocHx: Occasional alcohol use. No tobacco or drug use. Last intercourse 9 months ago
FamHx: Non contributory.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Last intercourse 9 months ago, diarrhea, stooling 4-5 times a day loose or watery, 20 y.o, denies blood in her stools, Right Lower Quadrant Pain, RLQ pain, denies pain w/ urination, no appetite, last menses was 2 weeks ago, pain started suddenly about 8-10 hours ago, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo F c/o abdominal pain
onset: 8-10 hrs ago, right lower quadrant, dull and achy and cramping pain, no radiation, 5/10 severity, constant progressive pain, no precipitating factor
worse with walking, better with ibuprofen but now doesn't work
no nausea, no vomiting, no fever sense,
diarrhea (+) since 2-3 days ago, brownish non bloody stool
PMHx: none
no surgery history, no allergies, no hospitalization, no recent travel history, no ill contact
FMHx: none
SHx: student, no smoking, social alcohol drinking, no recreational drug, currently not sexually active since 9 MA
OBGY: LMP 2 weeks ago, regular period, no pain between periods, no STD history, no pregnancy history.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]not sexually active, diarrhea (+) since 2-3 days ago, 20 yo, non bloody stool, abdominal pain right lower quadrant, LMP 2 weeks ago, onset: 8-10 hrs ago, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: This is 20 year old female with RLQ abdominal pain.  Patient reprot that pain started 8-10 hours a go.  It woke her up from sleep. She have similar symptoms before 3-4 times each month over the last 6month. She describes the pain as dull ache pain. She reprot walking make her symptoms worse.  She denies fever, chills, trauma, urinary symptoms. She reprot having brown color diarrhea. She had similar diarrhea before.  
Allergy:
Med: 

Family history: both family are health
Social history:  she is sexual active with one pattern.  She does not smoke or or do illicity drugs. She drink occasional on the weekend.  LMP 2 weeks a go. 

.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]similar diarrhea before, 20 year old, similar symptoms over the last 6month, RLQ abdominal pain, denies urinary symptoms, LMP 2 weeks a go, started 8-10 hours a go, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Suzanne Powelton is a 20 y/o F who presents with abdominal pain. Patient notes RLQ pain that started 8-10 days ago, constant, dull, achy cramping pain. No precipitating events. No radiation of pain. 5/10 severity. Pain is worse with walking; Ibrofen no longer helps with pain. No fever, chills, nausea, or vomiting. No recent illness.
ROS: low appetite, as noted in HPI
PMH: No history of STDs/STIs. 
PSH: none
OB hx: Last  menstural period 2 weeks ago. 28 day cycle, 4 day duration, regular
Meds: none
Allergies: none
Family hx: none
Social hx: No smoking, EtOH, drugs. Occupation: student, studying biology/pre-med. Sexually active with male partner, use condoms..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20 y/o, abdominal pain RLQ pain, low appetite, Last  menstural period 2 weeks ago, started 8-10 days ago, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo F comes with pain in LLQ for the last 8-10 hours. Pain is constant ,crampy, non radiating ,achy ,5/10 , relived by ibuprofen and aggravated by walking . h/o similar pains for last 6 months. she has been having diarrhea for 2 days with 4-5 episodes per day. the stool is watery brown with no blood in it. h/o diarrhea multiple episodes in the past also. no h/o painful joint fever rash . c/o no appetite fr 1 day and weight loss (undocumented).no nausea or vomiting. pain and diarrhea r not related to food. no changes in urination.
ROS: as above
PMH: noncontributory
FH: noncontributory
OBGYN: LMP 2 wks ago menstrual cycle regular with crampy pain during menstruation. no c/o discharge
SS: non smoker occasional alcohol drinks no illicit drug use. had sexual intercourse 9 months ago. always use condoms..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]no c/o discharge, weight loss, had sexual intercourse 9 months ago, diarrhea, stool is watery brown, diarrhea multiple episodes, diarrhea, 20 yo, stool no blood, similar pains for last 6 months, no changes in urination, no appetite, LMP 2 wks ago, pain last 8-10 hours, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: hpi:20 y old female presented with complains of rlq abdominal pain. pain started about 8-10 hours ago. it is dull aching crampy in nature, 5/10 on intensity, has been bcoming worse and is constant in nature. ibuprofen relives it mildly and walking makes it worst.  she also had  4/5 episodes of episodes of diarrhea per day starting from 2/3 days back. stools are loose and watery and do not contain blood.
ros: denies nausea vomiting, denies loc, dizziness, denies any urinary complains. no ill contacts rcently. no history of travel.
pmh: none
allergies: nkda
meds: ibuprofen
psh: none
occupation: student
sh: occasional etoh twice a month, no smoking, no recreational drugs
obgyn: lmp 2 weeks ago, regular cycles(28 days, last for 4 days, normal flow). last sexually active 9 months ago. G0P0.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]last sexually active 9 months ago, diarrhea, 20 y, stools do not contain blood, rlq abdominal pain, denies any urinary complains, lmp 2 weeks ago, started about 8-10 hours ago, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo, f, presents with abdominal pain since 8-10 Hours ago, pain was on the RLQ, dull and crampy in nature, non radiating, constant, getting worse, alliviated with Ibuprofen, exacerbated with walking, pain is 5/10 in severity, accompanied with Diarrhea, 4-5 times in the last few days, which was loose and watery, no blood noticed, patient reports cloths to be loose, patient reports decrease in appetite, exercises regularly, 2-3 times per week, regular diet.
OBGYN: LMP= 2 weeks ago, regular and lasted for 4 days with a 28 day cycle, have never had any previous pregnancies.
PMH: healthy. PSH: non. Allergies: non.
SH: drinks alcohol once every 2 months, does not smoke, does not use illicit drugs.
occupation: student..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]cloths to be loose, Diarrhea, 20 yo, Diarrhea no blood, pain RLQ, decrease in appetite, LMP= 2 weeks ago, since 8-10 Hours ago, f</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 ye F presenting to ED with abdominal pain that began 8-10 hours ago. no precepitating events. has been constant and progressively worsening. it is dull. achy, and crampy rated 5/10. does not radiate similar episodes 3-4x over past 6 months lasting only a cuople hours in duration. worse with walking. improved with Ibuprofen. associated with diarrhea. denies recent flu, fever/chills, chest pain, sob, problems with urination. 
PMH/surgeries: none
Meds: Ibuprofen for this pain
Allergies: NKDA
OB/GYn: last sexually active 9 months prior with partner, condoms for protection, LMP 2 weeks ago and is regular, no previous pregnancies.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]last sexually active 9 months prior, associated with diarrhea, 20 ye, similar episodes 3-4x over past 6 months, denies problems with urination, LMP 2 weeks ago, abdominal pain that began 8-10 hours ago, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: This is a 20 year old F who presents complaining of right lower abdominal pain for the past 8-10 hours. The pain is described as dull/achey; patient unable to quanitfy 1-10 how bad it is but states that here has been minimal improvement with Ibuprofen. No exacerabting factors. She has had 3-4 similar episodes of pain over the past 6 months but states this is the worst it's been. She reports her last LNMP was 2 weeks ago. Has regular 28 day cycles. 4-5 pads/tampons first day of period which gradually tapers off over a few days. No previous cramping history with periods. Denies vaginal pain, discharge, bleeding. No STD history. Last sexually active 9 months ago. 
ROS: as above and negative for chills, fever, nausea, vomiting, . Positive for diarrhea for 2 days. Positive for loss of appetite
-No PMHx/PSHx. No medications other than PRN Ibuprofen
-alcohol twice a month. No tobacco or drug use..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Denies discharge, Last sexually active 9 months ago, diarrhea for 2 days, 20 year old, 3-4 similar episodes of pain over the past 6 months, right lower abdominal pain, loss of appetite, LNMP was 2 weeks ago, past 8-10 hours, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: patinet is a 20 yO f COMPLANING OF rlq ABDOMINAL PAIN THAT STARTED 8-10 HOURS AGO, the pain is 5/10 in intensity, dull/aching in nature, nonradiating, gets worse with walking, partially relieved by ibuprofen, it is associated with diahrrea 4-5 times a day, no pain or tenesmus. had similar pain before. No nausea or vomitting, no jaundice or heart burn. She hasn't noticed any hotness and hasn't been in contact with anyone ill. She feels like she has lost weight, and has a reduced appetite. Her LMP was 2 weeks ago, every 4 days lasting 4 days. no change in menstrual flow, no dysmenorrhea or vaginal discharge.
ROS: negative except as above.
PMH: negative
Allergies: NKDA.
Medications: ibuprofen,
PSH: none.
FH: negative
SH: last sexually active 9 months ago withprevious partner, uses condoms, previously tested for STDs but were negative, NO tobacoo, EtOH, or illicit drugs..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]no vaginal discharge, lost weight, last sexually active 9 months ago, associated with diahrrea, 20 yO, similar pain before, rlq ABDOMINAL PAIN, reduced appetite, LMP was 2 weeks ago, STARTED 8-10 HOURS, f</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 y/o F presenting with lower RUQ pain. Pain started 8-10 hours ago, in bed, 5/10, dull, achy, was sleeping, worse with walking, better with ibuprofen. Reports watery diarrhea for past 3 days, brown, no blood in stool. Can drink water, cannot eat since pain started last night. No fever, chills, leg pain, N/V, vaginal discharge, constipation.
PMHx - none, NKDA, takes ibuprofen for pain, no other meds, No surgeries, trauma, accidents, hospitaliations, FHx - noncontributory,
OB/GYN - LMP 2 weeks ago, 28 between, 4 days.
Sexual - sexually active 1 partner, male, last 9 mos ago, use condoms, no STI, HIV history
Social - uses alcohol 2x/mo - 1 beer socially, no tobacco, rec drug use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]No vaginal discharge, sexually active last 9 mos ago, diarrhea, 20 y/o, no blood in stool, cannot eat, LMP 2 weeks ago, started 8-10 hours ago, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: Patient is a 20 yo female who presents with constant, achy, 5/10 right lower quadrant pain of 8 hours duration. This pain woke her from sleep and she does not define a clear trigger.The patient has also been having diarrhea and anorexia associated with this episode of pain. Ibuprofen has helped alleviate the pain. Walking exacerbates the pain. She has had 3-4 similar episodes in the past 6 months that have not been as painful. She denies nausea, vomiting, fevers, and chills.

ROS: Negative except for above
Allergies: None
Medications: Occasionally ibuprofen for pain.
PMH: None
FHx: None, parents are both healthy
Surgical history: None
Social history: Never smoked. Drinkings about 2 beers twice a month. No other drugs. Reports last being sexually active 9 months ago..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]last being sexually active 9 months ago, diarrhea, 20 yo, 3-4 similar episodes in the past 6 months, right lower quadrant pain, anorexia, pain of 8 hours duration, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Suzanne Powelton is 20 yo F w/ chief complain of ""Abdominal pain."" Pain is located in RLQ. Started 8-10 hrs ago while she was sleeping. Describes pain as ""dull, achy, like bad cramp."" Pain is constant and does not radiate. Describes as low-moderate pain 5/10. Ibuprofen helps with pain a little but not enough. Walking makes the pain worse. Her menstraul periods are normal, last one was 2 weeks ago. She describes menstrual pain as moderate and denies having heavy menstrual cycles. She has had pain similar to this 3-4 times over last 6 months and pain usually last a couple hours and goes away. Denies irregular bleeding. Denies N/V or fever. 

Denies any allergies, meds, PMH, PSH, and PFH. 
Social: Student studing biology and pre-med. Likes going for coffee and movies.
Sexual Hx: Not sexually active in 9 months. Last STD test was 1 year ago and was negative.
Alcohol: drinks socially a 'couple' times/month
Tobacco and Drug use: denies.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Not sexually active in 9 months, 20 yo, has had pain similar to this 3-4 times over last 6 months, Pain is located in RLQ, menstraul periods 2 weeks ago, Started 8-10 hrs ago, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: RLQ pain for 8-10 hours
HPI: patient is a 20 year old female who presents with right lower quadrant abdominal pain for the last 10 hours. She states it is dull and achy and does not radiate. This pain has occurred 3 to 4 times in the past 6 months and resolved iwthout intervention. Ibuprofen helps a little, while walking makes it worse. She also notes watery diarrhea without blood occuring 4-5 times in the last couple of days, as well as a loss of appetite and loose-fitting clothing. She denies any recent trauma, fever or constipation.
ROS: negative except as above
PMH: no medical conditions
Medications: ibuprofen
Allergies: none
Surgeries: none
OB/GYN: G0P0, first period age 13, last period 2 weeks ago, periods regular
SH: works as a student, drinks a beer 2x/month, no tobacco or recreational drug use, last sexually active 9 months ago, uses condoms every time
FH: no medical conditions run in family, mom and dad healthy.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]loose-fitting clothing, last sexually active 9 months ago, diarrhea in the last couple of days, 20 year old, diarrhea without blood, occurred 3 to 4 times in the past 6 months, RLQ pain, right lower quadrant abdominal pain, loss of appetite, last period 2 weeks ago, 8-10 hours, for the last 10 hours, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20YO F WITH ACUTE ONSET OF RLQ ABDOMINAL PAIN STARTED 8-10HOURS AGO.
*PAIN IS DESCRIBES AS DULL, ACHE, CONSTANT, NO RADIATION, WORSENING, AND 5/10 INENSITY.
* RECENT ONSET OF WATERY BROWN DIARRHEA, 4-5 BM/DAY, AND URGENCY.
*SHE REPORTS SHE HAD SIMILAR PAIN 3-4 EPISODES IN THE PAST 06 MONTHS.
*UNINTENTIONAL SUBJECTIVE WT LOSS, POOR APPETITE.
DENIES: CHILLS, SWOLLEN GLANDS, N/V, PRIOR CONSTIPATION, BLOOD IN DIARRHEA, TENESMUS, TREMORS.
ROS: NEG EXCEPT AS ABOVE.
ALL: NKDA, MED: IBUPROFEN
PMh: AS PER HPI
PSH: NONE
FH: NC.
SH: DENIES TOXIC HABITS BESIDE OCCASIONAL ETOH, SEXUALLY ACTIVE, REGULAR USE OF CONDOMS.
LMP: 2WK, REGULAR..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]WT LOSS, DIARRHEA, 20YO, DENIES BLOOD IN DIARRHEA, SIMILAR PAIN 3-4 EPISODES IN THE PAST 06 MONTHS, RLQ ABDOMINAL PAIN, POOR APPETITE, LMP: 2WK, REGULAR, STARTED 8-10HOURS AGO, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo female presents with acute crampy RLQ abdominal pain that began 8-10 hours ago. Endorses history of similar pain in the past however, this time pain is more severe and is lasting longer. Previously pain would subside in 2-3 hours. Described as a constant crampy pain of 5/10. Endorses 2 episodes of diarrhea today. Denies changes in urination, recent sexual partners, nausea, vomitting, mouth ulcers, night sweats, chills, fever. 

ObGyn: LMP 2 weeks ago. Started mensis at age 13. Cycles are regular 28 days for 4 days with mild cramping requiring at max 4 tampons. Not currently sexually active. Last partner was 9 months ago. Had negative STI testing since. 
PMHx and PSurgHx: none
Meds: none
Allergies: NKA
FH: healthy
SH: currently a full time student studying biology. Denies tobacco or recreational drug use. EtOH 1-2 x/month socially..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Denies recent sexual partners, Not currently sexually active, Last partner was 9 months ago, diarrhea today, 20 yo, similar pain in the past, RLQ abdominal pain, Denies changes in urination, LMP 2 weeks ago, pain that began 8-10 hours ago, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo female presents with RLQ abdominal pain. Nonradiating. Dull and constant pain for the past 8-10 hours. Ibuprofen does not help. Walking makes the pain worse. 3-4 previous peisodes in the past 6 months that resolved spontaneously. Associated with watery diarrhea without blood or mucus. Decrease in appetite. Potential weight loss with clothes fitting looser. No recent travel, sick contacts, or eating bad food.
ROS: denies fever, chills, SOB, nausea, vomiting, chest pain, numbness, tingling, changes in urinary habits, back pain
PMHx: none
Surg hx: none
Meds: ibuprofen
Allergies: none
Ob/gyn: LMP 2 weeks ago, 28 day cycle, lasts 4 days, uses 4 tampons
FH: none
SH: Family lives far away, denies tobacco and recreational drug use, drinks 2x per month
Sex hx: sexual active, last time was 9 months ago, uses condoms consistently.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Potential weight loss, clothes fitting looser, sexual active, last time was 9 months ago, diarrhea, 20 yo, diarrhea without blood, 3-4 previous peisodes in the past 6 months, RLQ abdominal pain, denies changes in urinary habits, Decrease in appetite, LMP 2 weeks ago, pain for the past 8-10 hours, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo F came the the ED c/o RLQ abdominal pain for 8 hours today. The pain was sudden, dull and achy in nature, and 5/10. Pain does not radiate, she took Ibuprofen with minimal relief and nothing makes it worse. She has had similar episodes in the past but this time it is the worst. Reports diarrhea since yesterday, brown watery without blood. Also reports decresed appetitie and some weight loss. Denies any nausea, vomiting, or changes in urinary habits. LMP 2 weeks ago, normal flow and menstrual cycles, 4 weeks / 4 days. 
ROS as per HPI
PMH none, Meds: Ibuprofen, NKDA
PSH none
FH noncontributory
SH: Pre-med college student, sexually active no histroy of STDs. No smoking, occasional EtOH. No illicit drug use..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]weight loss, diarrhea since yesterday, 20 yo, diarrhea without blood, similar episodes in the past, RLQ abdominal pain, Denies changes in urinary habits, decresed appetitie, LMP 2 weeks ago, for 8 hours pain was sudden, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20yo F is complaining of an achy bad crampy pain in the lower right quadrent. The pain is constant, does not radiate and began suddenly. The worsening pain is 5/10 and started 8-10hrs ago. 5/10 pain. She was asleep when it happened and the pain woke her up. This pain has occurred 3-4x in the past month. She does not feel better with Ibprofen use (3 tablets/day 200mg), and she feels worse with walking. She noticed some weight loss with clothes feeling looser. She reports loose, watery, brown diarrhea a couple days ago. She hasn't felt hungry today and her last meal was last night. LMP 2 weeks ago, regular, no discharge. Denies changes in urination, redness, swelling, rashes, constipation. SHx: Studies biology in college, drinking EtOH 2x/mo, no tobacco, under stress with exams coming, and drinks 4-5cups/day of coffee. No rec drugs. SexHx: Last sexually active 9mo ago but broke up with boyfriend. No Hx of STI
PMH, FHx non contributory.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]weight loss, clothes feeling looser, Last sexually active 9mo ago, diarrhea, 20yo, pain has occurred 3-4x in the past month, pain in the lower right quadrent, ""hasnt felt hungry"", LMP 2 weeks ago, started 8-10hrs ago, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Suzanne Powelton is an otherwise healthy 20 y.o. female presenting to the ED with RLQ abdominal pain. The pain awoke her from sleep 8-10 hours ago. It is a 5/10, dull and achey, nonradiating pain. The pain has progressed since onset and was not relieved with ibuprofen. She has had diarrhea for 2 days and anorexia since last night. She has not eaten since last night. She has had episodes of similar but less severe pain 3-4 times in the last 6 months, lasting about 2 hours and then self-resolving. She has also had intermittent nonbloody diarrhea in the last 6 months, sometimes with the pain. She denies nausea, vomiting, dysuria, urinary frequency, vaginal discharge, vaginal bleeding. LMP was 2 weeks ago. 
Past medical history: none
Meds: ibuprofen
NKDA
Social: Never smoker. Drinks 1-2 beers socially twice per month. No drug use. Last sexual activity 9 months ago with male partner. No history of STI. 
Family history: none significant.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies vaginal discharge, Last sexual activity 9 months ago, diarrhea, diarrhea, 20 y.o, nonbloody diarrhea, pain 3-4 times in the last 6 months, RLQ abdominal pain, denies dysuria, denies urinary frequency, anorexia, LMP was 2 weeks ago, 8-10 hours ago, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 YO F, C/O RLQ PAIN, PAIN IS ACUTE AND PROGRESSIVE STARTED 8-10 H AGO, DULL AND ACHING IN CHARACTER WAS 4/10 AND PROGRESSED TO 5/10 IN INTENSITY. PAIN IS INCREASED WITH WALKING AND PARTIALLY RELIVED WITH IBUPROFEN. PATIENT ALSO COMPLAINS OF DIARRHEA STARTED 2 DAYS AGO, 4-5 BOWEL MOVEMENTS/DAY (VS PREVIOUS 2-3/DAY) DIARRHEA IS MODERATE IN AMOUNT, NONBLOUDY, NO MUCOID, WATERY BROWN DIARRHEA. PATIENT DENIES ANY FEVER, CHILLS, NAUSEA OR VOMITING BUT METIONS A POOR APPETITE SINCE YESTERDA (LAST MEAL WAS DINNER).DENIES ANY VAGINAL DISCHARGE, DISURA, OR HX OF KIDNEY STONES
ROS (-) EXCEPT AS ABOVE
OBGYN: MENARCH 13 Y, REGULAR MENSES 4 DAYS/28 MODERATE FLOW(4 TAMPONS/DAY), NO STD HX 
PMH/PSH: NEGATIVE
MEDICATIONS: IBUPROFEN 
FH: BOTH PARENTS ARE HEALTHY
SEXUAL: ACTIVE LAST INTERCOURSE WAS 9 MONTHS AGO WITH BOYFIRNED, ACTIVE WITH MEN ONLY, CONSISTENT USE OF CONDOMNS
SOCIAL: STUDENT, NONSMOKER, ETOH 2 S/MONTH, NO RECREATIONAL DRUG USE.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]DENIES ANY VAGINAL DISCHARGE, LAST INTERCOURSE WAS 9 MONTHS AGO, DIARRHEA STARTED 2 DAYS AGO, 20 YO, DIARRHEA NONBLOUDY, RLQ PAIN, DENIES DISURA, POOR APPETITE, PAIN IS ACUTE STARTED 8-10 H AGO, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo F without significant PMH presenting with RLQ abdominal pain, which started 8-10 hours ago. First noticed it when she was sleeping. Rated at 5/10 for pain. No radiation. Pain has been localized at RLQ and has noted it has gotten worse overnight. Walking makes it worse. Ibuprofen with minor help. Has had 3-4 similar episodes in the past 6 months. Some of which have had diarrhea (4-5x/day). No association with foods. Does report decreased appetite since last night. Denies blood or tarry black stools.
ROS: denies headaches, n/v, vision changes, recent illnesses
PMH: none or in HPI
Surgical: none
Meds: ibuprofen for pain
All: none
FH: noncontributory; healthy family
Social: student, lives alone; non-smoker, 2 drinks of alcohol/month. Not sexually active; last partner 9 mo ago. consistent condom use; no hx of STDs.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Not sexually active, diarrhea, 20 yo, Denies black stools, Denies blood stools, 3-4 similar episodes in the past 6 months, RLQ abdominal pain, Pain RLQ, decreased appetite, started 8-10 hours ago, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 year old female complains of a dull, achy pain in the RLQ. Onset of 8-10 hours ago which woke her up from sleep. She rates it a 5/10 in intensity, and has progressively gotten worse since the pain began. No radiation of the pain, ibuprofen tends to alleviate the pain, while walking makes it worse. Denies vomiting, but states that she has had diarrhea without blood for the last 3 days. Patient has had similar episodes to this over the last 6 months, but has progressively gotten worse every time. Last sexual encounter was 9 months ago, and has never had a pap smear

Ob/Gyn: LMP 2 weeks ago, 28 day cycles, 4 days each. Menarche at age 13.
ROS: Negative except as above
Allergoes: None
Meds: ibuprofen
PMH: None
PSH: None
SH: Student in school, drinks alcohol socially, denies illicit drug use and tobacco use
FH: Noncontributory.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Last sexual encounter was 9 months ago, diarrhea for the last 3 days, 20 year old, diarrhea without blood, similar episodes to this over the last 6 months, pain in the RLQ, LMP 2 weeks ago, pain Onset of 8-10 hours ago, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Suzanne Powelton is a 20 year old female who presents with RLQ abdominal pain. This has been bothering her for the past 8-10 hours. She has had 3-4 similar episodes in the last 6 months that remitted on their own. She describes a dull aching pain in the right lower quadrant that does not move. She also has had several bouts of watery, non-bloody diarrhea lasting a few days in the past 6 months, not associated with her abdominal pain. Bowel movements do not relieve the pain. Menarche was at age 13 and she has regular menstrual cycles, the last being 2 weeks ago. It was not abnormal for her, and the abdominal pain is not associated with menses. No recent travel or hiking. No unual foods eaten. Vaccines up to date.

Med Hx: none
Surg Hx: none
Meds: none
Fam Hx: Parents in good health
Allergies: NKA
Soc Hx: Last sexual activity 9 months ago. NO smoking. Occassional alcohol. No illicit drug use..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Last sexual activity 9 months ago, diarrhea lasting a few days in the past 6 months, 20 year old, non-bloody diarrhea, 3-4 similar episodes in the last 6 months, RLQ abdominal pain, pain right lower quadrant, menstrual cycles 2 weeks ago not abnormal, past 8-10 hours, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HOPI: A 20 yo F c/o constant right lower quadrant pain, started 8-10 hours ago while sleeping , dull,achy and crampy in quality, 5/10 in intensity, non radiating, tried ibuprufe, not very relieved, walking exacerbates the pain. She also complains of being nauseated, but denies vomiting. She has been having diarrhoea for the past 4-5 days, with 4-5 stools/day, watery brown, no blood or pus or peculiar odor to it. She has been noticing unintenttional weight loss for past coupkle of months, no change in appetite. She denies any ill ciontacts, recent travel, or food association to diarrhoea. She denies LOC, fever, dizziness, cold/heat intolerance.
ROS:negative except as above
PMH/PSH:none
ALLERGY: NKDA
MEDS:Ibuprufen
OBS/GYN: LMP 2 weeks ago, Menarche 13 yrs. Regular cycles, no dysmenorrhoea.
FH:Noncontributory
SH: Sjhe is a student, occasional alcohol 2/month. Denies smoking or illicit drug use. ! sexual partner last year, usues con.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]weight loss, sexual partner last year, diarrhoea for the past 4-5 days, 20 yo, diarrhoea f no blood, right lower quadrant pain, LMP 2 weeks ago, pain, started 8-10 hours ago, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 y/o f c/o RLQ PAIN X8-10 HOURS AGO. STARTED SUDDENLY WHEN THE PATIENT WAS SLEEPING(WOKE HER UP), IS DULL ACHY IN NATURE, 5/10 IN INTENSITY, NON RADIATING, AGGRAVATED BY MOVEMENT AND NO RELIEVING FACTORS. SHE ALSO HAS HAD DIARRHEA FOR FEW DAYS WHICH IS WATERY SHE HAD 4-5 BOEWL MOVEMENTS IN A DAY USUALLY HAD 1-2 PER DAY, NO BLOOD OR FOUL ODOR IN STOOLS. SHE ALSO FEELS LIKE SHE HAS LOST WEIGHT THOUGH DIDN'T DOCUMENT IT. SHE HAS DECREASED APPETITE SINCE YESTERDAY NIGHT.
PATIENT DENIES ANY NAUSEA/VOMITING, PREVIOUS STI'S, URINARY CHANGES, BURNING MICTURITION, PALPITATIONS, COUGH, SOB, CHEST PAIN, TRAUMA TO ABDOMEN.
ROS-NEGATIVE EXCEPT ABOVE
PMH/PSH/MEDS/ALLERGIES-NONE
FH-N/C
SH-DRINKS ALCOHOL OCCASIONALLY, NO TOBACCO/ILLICIT DRUG USE, LAST TIME SEXUALLY ACTIVE WAS WITH PARTNER 9 MONTHS AGO/NO PREVIOUS STI'S.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]LOST WEIGHT, 9 MONTHS AGO LAST TIME SEXUALLY ACTIVE, DIARRHEA FOR FEW DAYS, 20 y/o, NO BLOOD IN STOOLS, RLQ PAIN, DENIES URINARY CHANGES, DENIES BURNING MICTURITION, DECREASED APPETITE, 8-10 HOURS AGO STARTED SUDDENLY, f</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: The patient is Suzanne Powelton, 20 yo female coming in for abdominal pain. The patient has right lower quadrant pain described as dull, aching, 5/10 in severity, non-radiating that started 8-10 hours ago and has prgressively worsened. Pain is associated with anorexia and is partially relieved by ibuprofen and aggravated by walking. She has also been having diarrhea in the past 2 days with soft, watery, non-bloody stools. No fever.
ROS: No headache, cough, nausea, vomiting, dysuria, bloody urine, urinary changes, menstrual changes, DOB, chest pain
PMH: none
Allergies: none
Medications: none
FMH: none
PSH: Patient does not smoke, drinks alcohol occasionally 2x/month, does not use illicit drugs; She does pilates and walking 2x/week. She is a student.
Gyne: LMP 2 weeks ago, occuring every 28 days, lasting 4 days, 4ppd. No Pap smear in the past, no STI..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]diarrhea in the past 2 days, soft, watery stools, 20 yo, non-bloody stools, right lower quadrant pain, No dysuria, No bloody urine, No urinary changes, anorexia, LMP 2 weeks ago, started 8-10 hours ago, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 20 yo F c/o RLQ pain for past 10 hrs. 5/10, constant, no radiation, progressively woresening, dull and achy in nature. Similar sx for 3-4 episodes in the past 6 months. Allev. with ibuprofen, aggrav. with walking. Pos for diarrhea for past couple of days. No mucus in diarrhea. Abd pain not alleviated with defecation. Pos for weight loss (recently pants feel loose) and loss of appetite. Neg for fever, chills, nausea, vomiting, jaundice, constipation. LMP was 2 wks ago. last sexual intercourse was 9 months ago.
PMH: None
NKDA.
Meds: ibuprofen 
no h/o hospitalizations, injuries, and surgery.
FH: parents both alive and well. non-contributory.
OBGYN: LMP 2wks ago. 0G0P
Sexually active with only men. last sexual intercourse was 9 months ago. 
SH: student. EtOH+  (2 times/month), Tobacco -, recreational drugs -.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]weight loss, pants feel loose, last sexual intercourse was 9 months ago, last sexual intercourse was 9 months ago, diarrhea for past couple of days, 20 yo, Similar sx past 6 months, RLQ pain, loss of appetite, LMP was 2 wks ago, LMP 2wks ago, 10 hrs, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: 44 yo female c/o irregular periods
HPI: x 3 years has had irregular periods they vary in the amount of blodd each time. Her LMP was 2 months ago and was regular. She first began to notice periods at age 14. She had flu like symptoms one week ago with nausea and vomiting. No clots during her periods. She has to use 2-3 pads when they are light and 5-6 when they are heavy. Nothing makes it better or worse. She has been experiencing hot flashes, sweating and vaginal dryness which she uses lubricant for. She also complains of dyspareunia. No fever or chills. No abdominal pain, diarrhea, constipation or urinary symptoms. 
PMH: HTN on HCTZ, No PSHx, No allergies,  Two vaginal births without complications. 
FH: Mother has osteoarthritis and HTN
Social: Does not smoke or use drugs drinks occasionally.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]vaginal dryness, dryness which she uses lubricant for, irregular periods, irregular periods, one week ago with nausea and vomiting, flu like symptoms one week ago, female, LMP was 2 months ago, hot flashes, vary in the amount of blodd each time, has to use 2-3 pads when they are light and 5-6 when they are heavy, x 3 years, sweating, 44 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 44 F in office c/o irregular periods x 3 yrs. Started suddenly. LMP was 2 mo's ago, menarche was 14 yo, periods last from 2-6 days, are irregular, uses 2-6 pads/tampons per day depending on flow rate, no N/V, spotting, cramping, light-headedness. 2 pregnancies resulting in 2 SVD's at term with no complications. A/w hot flashes, vaginal dryness and extra sweating. No h/o STD's or abortions or h/o dilation and curretage. Denies emotional lability, HA, CP, burning when urinating, frequency, vaginal discharge, weight gain, changes in bowel or urinary habits.
ROS: negative exc as above
PMH: HTN, Meds: HCTZ, NKDA
PSH /Hosp / Travel / Trauma: none
FH: NC
SH: works as office manager, lives with husband and 2 sons, feels safe in relationship, no smoking, rare EtOH, no drugs, sexually active w/husband, no protection, no h/o STD's or abortions or dilation and curretage
OB: 2 pregnancies, 2 SVD's at term, no complications.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]sexually active, vaginal dryness, irregular periods, periods are irregular, F, ""LMP was 2 mos ago"", hot flashes, uses 2-6 pads/tampons per day, last from 2-6 days, x 3 yrs, sweating, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 yo F, G2P2A0, c/o irregular periods. Last menstrual period was 2 months ago. Menarche at age 14. Patient states that she has night sweats. Last pap smear was a year ago and it was normal. Patient denies any headaches, fatigue, visual changes, joint pain, abdominal pain, or SOB. Patient took a pregnancy test and it was negative.
ROS- negative except for above
Allergies- NKDA
Meds- HCTZ
PMH- HTN
PSH- none
SH- 1 glass of wine socially, no tobacco, no illicit drugs
FH- mother with osteoarthritits and over-weight.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]pap smear a year ago, irregular periods, F, Last menstrual period was 2 months ago, night sweats, 44 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms Dolores Montgmery, 44 yo F c/o Irregular menstruation that has been occuring since 3 yrs ago. Last mentruation was 2 months and was irregualar and associated with night sweats, hotflashes, and heavy flow. Pt denies cramping and clotting. On ROS - pt denies heat/cold intolerance, weight gain/loss, chest pain, headache, blurry vision or gait dysfunction.
Phmx - HTN tx with HCTZ
Allergy  none
Fhx - Mother OA and sister HTN
Surg/Hosp - none
Obgyn - P2G2A0, Irregular menses no defined start dates, uses 2 to 6 pads at the heaviest flow, no cramping or clots or foul discharges
Shx - Office manager, No tabbacco, sociall drinker, healthy diet, and no rec drug.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Irregular menstruation, F, Last mentruation was 2 months, hotflashes, 2 to 6 pads at the heaviest flow, menses no defined start dates, occuring since 3 yrs ago, night sweats, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 F with HTN here for irregular menses of 3 year, stating her menses come without a pattern, lasts 2-6 days, can involve minimal to heavy bleeding, no pain. She also noticed that 1 week ago she had nausea and NBNB emesis that has since resolved. She states she had hot flashes for 1 year, and 1 episode of night sweat 1 week ago, and vaginal dryness for which she uses lubricants. She took 2 home pregnancy tests, both were negative. ROS neg.

LMP 2 months ago, menarche 14, regular, lasts 5 days, 2-3 tampons/day, mild cramping, denies fibroids/cyts, last Pap 1 year normal
G2T2P0A0L2

PMHx: HTN
PSHx: none 
Hospitalized for 2x vaginal deliveries
Med: HCTZ
NKDA
FHx: Mother obesity, OA; Brother HTN
SHx: never smoker, occasional drinker, no recreational drug use. Office manager, lives at home with husband & 2 sons, not stressed at home/work. Low fat & salt diet. Exercise moderately. Sexually monogamous with husband, no hx of STIs.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]last Pap 1 year, Sexually monogamous, vaginal dryness, irregular menses, 1 week ago she had nausea and NBNB emesis, F, LMP 2 months ago, hot flashes, menses come without a pattern, lasts 2-6 days, minimal to heavy bleeding, of 3 year, night sweat, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Montgomery is a 44 YOF G2P2002 with Hx of HTN here with cheif complaint of irregular periods.
-Irregular periods last 3 years with cycles between 3 weeks and 4 months
-Vaginal dryness, occasional hot flashes, no changes in weight
-Other symptoms: episode of drenching night sweats last week, two days of N/V last week as well, no headaches, changes in vision, dysuria, diarrhea, or constipation
-Meds: HCTZ
-Allergies: none
-Surgeries: none
-FHx: mom with OA, brother with HTN
-Gyn: started periods at age 14, been on copper IUDs for 20 years, last one place 4 years ago, regular 28-29 day periods up until 3 years ago
-SocHx: denies smoking, reports occasional social drink at events, denies recreational drug use; sexually active only with her husband of 14 years; has 2 kids and is an office manager at an investment firm; no increased stressors
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]regular 28-29 day periods up until 3 years ago, IUDs, sexually active, Vaginal dryness, irregular periods, F, hot flashes, cycles between 3 weeks and 4 months, last 3 years, drenching night sweats, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 44 yo F with co irregular mentrual cycles for the past 3 years used to have her periods reularly ever 28d/5d with moderate flow and light PMS, now between 3 weeks and 4 months with very heavy to very light flow for 2-6 days. Menarche at age 14. recently started having hot flashes and excessive sweating. woke up drenched in sweat last night. uses lubricant against vaginal dryness, menarche at age 14, 2P2G, last PAP 1 y ago normal, no Hx of abnormal PAP smears. no abdomninal pain, no vaginal discharge, no weight change, no change in appetite, no change in bowel movements, no fatigue
OBGYN as per HPI
ROS negative except as above
Allergies: NKDA
FH: noncontributory
PSH: none
PMH: hypertension
Meds: HCTZ
SH: lives with husband and 2 sons, works as office manager, sexually active with husband only, uses IUD for contraception, excersis 3-4 times a week.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]used to have her periods reularly, used to have her periods ever 28d, used to have her periods ever 5d, used to have her periods with moderate flow, PAP 1 y ago, IUD, sexually active, vaginal dryness, irregular mentrual cycles, F, hot flashes, now between 3 weeks and 4 months, with very heavy to very light flow, for 2-6 days, for the past 3 years, for 3 years, sweating, drenched in sweat, woke up drenched, 44 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Montgomery 44 yo F who presents w/ irregular periods for 3 yrs. States that they are unpredictable with no pattern; lasts 2-6 days with light or heavy menstraution. LMP was 2 months ago. Patient does endorse having a copper IUD, non hormonal; last pap smear was 1 year ago and was normal. Patient denies having any abdominal pain, or changes in bowel/bladder habits; denies fevers, chills, nausea, vomiting, no changes in diet or recent sick contacts, no vaginal odors or discharge. Patient does endorse one episode of night sweats one week ago, has not had a repeat episode since then..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]last pap smear was 1 year ago, IUD, irregular periods, periods are unpredictable, periods with no pattern, Ms, F, LMP was 2 months ago, lasts 2-6 days, with light or heavy menstraution, for 3 yrs, night sweats, 44 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: irregular periods
HPI: 44 y/o F G2T2P0A0L2 presents w/ 3 years of irregular periods lasting 2-6 days in length. periods are variable in length and flow, varies between light or heavy. she has had hot flashes and sweating for the past year. LMP 2 mo ago. Last saw OB/GYN 3 yrs ago, last pap smear 1 yr ago, was wnl. she has also had vaginal dryness for 1 yr, uses lubricant.
ROS: denies headache, lightheadedness, fatigue, weight gain/loss, vaginal discharge/spotting, vaginal pain, NVD
PMHx: HTN
Meds: HCTZ
Allergies: none
Hospitalizations: only for birth of 2 children
FHx: mom has osteoarthritis and obesity. brother has HTN. 2 healthy children.
SHx: works as office manager, ""loves it"", married to husband, monogamous. exercises and eats healthy diet. no tobacco or drugs, social EtOH. 2 pregnancies, both term, no history o STI. uses IUD for contraception..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]last pap smear 1 yr ago, IUD, vaginal dryness, irregular periods, F, LMP 2 mo ago, hot flashes, varies between light or heavy, variable in flow, variable in length, 3 years of, sweating, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dolores Montgomery is a 44 y.o. G2P2 presenting to the clinic today for irregular periods starting 3 years ago. LMP was 2 months ago. Periods previously regular, now up to 4 months apart with 2-6 d of bleeding. She experiences no pain with these periods and flow can range between heavy and light. She is sexually active and monogamous with her husband. She uses a copper IUD for contraception. She does not have increased fatigue but does report night sweats (with one particularly bad episode last week), hot flashes, and vaginal dryness that began a year ago. Denies diarrhea, constipation, heart racing, and states mood is ok today. She had flu like symptoms last week which have resolved. Births were SVD, no complications.

PMH: HTN, on HCTZ
Surgeries: None
FH: Mom osteoporosis, Brother HTN; no hx early menopause
SHx: Office manager, no current/former tobacco use, no drug use, no travel hx, occasional wine, sexually active w/ husband.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Periods previously regular, IUD, sexually active, monogamous, sexually active, vaginal dryness, irregular periods, flu like symptoms last week, LMP was 2 months ago, hot flashes, now up to 4 months apart, with 2-6 d of bleeding, flow can range between heavy and light, starting 3 years ago, night sweats, 44 y.o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dolores Montgomery is a 44yo G2P2 female presenting with irregular periods. Periods used to be regular at 28-29 days with moderate flow. Now they range from 3 weeks to 4 months and are ""consistently inconsistent"" in timing, and her flow ranges from light to heavy. She reports hot flashes and sweating recently, and a bout of PMS a few days ago with breast tenderness. She denies fatigue, headache, changes in diet or exercise. She does not have any vaginal discharge. She reports vaginal dryness over this period of time and is now using lubricant. She is monogamous with her husband and has no history of STIs. She denies urinary, bowel, digestive symptoms.
PMH: HTN
Meds: HCTZ
Allergies: NKDA
FHx: older brother HTN, mom osteoarthritis
SHx: no smoking, 1 glass of wine sparingly, no drugs. Works as office manager in investment firm. denies increased stress.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Periods used to be regular, monogamous with her husband, vaginal dryness, irregular periods, female, hot flashes, range from 3 weeks to 4 months and are ""consistently inconsistent"" in timing, flow ranges from light to heavy, sweating, 44yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44yo F who presents with 3 years of increasingly irregular periods. Reports no pattern to her period, the interval between periods can be up to 8 weeks. When they occur, they can be either heavy or light. Previously, her periods occured montly, lasted 2-3 days and she used approximately 3 pads per day. Now, when bleeding is heavy, she uses around 5-6 pads. She also has been experiencing occasional hot flashes that last 1-2 minutes, they primarily occur during the day. She has noted vaginal dryness, for which she uses lubricant during sexual activity. One episode of night sweating. No vision 

OB/GYN: G2P2, vaginal deliveries. Menarche at 14

PMH: hypertension
FH: mother with osteoarthritis and obesity, unsure when she went through menopause. Father alive and well, brother with hypertension
PSH: no surgeries
SH: no tobacco, no illicit drug use, occl EtOH at celebrations. Sexually active with husband, uses lubrication
MEDS: HCTZ.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Previously periods occured montly, Previously periods lasted 2-3 days, Sexually active, sexual activity, vaginal dryness, uses lubricant during sexual activity, Sexually active uses lubrication, irregular periods, no pattern to her period, F, hot flashes, interval can be up to 8 weeks, can be either heavy or light, 3 years of, night sweating, 44yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms Montgomery is a 44F who presents with irregular periods. She reports that over the last 3 years her periods have become irregular and she has had variable amount os bleeding. She got her first period when she was 14 and had 28 day cycles with 3-4 days of moderate bleeding (3-4 pads/day) with mild cramping. She has had two pregnancies. Her LMP was 2 mongs ago and lasted 4 days with moderate flow. She reports that her periods over the last 2 years have been variable in flow. She notes that she has had occasional hot flashes/sweating episodes as has had one night sweat recently. She does not notice any changes in her mood. Doesn't know when her mom got her period, doesn't know sister's menstrual history
PMH: HTN, meds: HCTZ
SH: no drugs, occasional glass of wine, lives with husband and two kids
FH: no cancer known, older brother with HTN
ROS: no change in bowel habits, no change in urination, no change in mood, no headaches.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]had 28 day cycles with 3-4 days of moderate bleeding, periods have become irregular, irregular periods, F, LMP was 2 mongs ago, hot flashes, had variable amount os bleeding, periods have been variable in flow, over the last 3 years, sweating episodes, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 yo F presenting with a 3 year histpry of irrgular periods. Her periods had previously been regular, every 4 weeks lating 4-5 days, with moderate bleeding, using about 3-4 pads a day. In the last 3 years, it had been irregular, ranging from a light period to a heavy bleed, requiring 5-6 pads a day. Her LMP was 2 months ago, with moderate bleeding. Denies any other symptoms. No excessive fatigue, double vision, changes in bowel movements, breast changes. 
No dysuria or dyspareunia. No abnormal vaginal discharge. Does endorse vaginal dryness, relieved with ointment. No changes in mood or irritabillity. No hot flashes. 
ROS otherwise negative. 
PMH: HTN
PSH: None
Meds/allergies: HCTZ
Obgyn: G2P2. Normal vaginal deliveries, with no pre pr post partum compllication. Menarche at 14. regular periods until recently. Has sex with her husband. Uses IUD for protection. No dyspareunia. Endorses vaginal dryness, relieved with ointments
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]periods previously every 4 weeks, periods previously lating 4-5 days, periods had previously been regular, periods previously with moderate bleeding, regular periods until recently, IUD, Uses IUD, sex with her husband, Has sex with her husband, vaginal dryness, vaginal dryness, Does endorse vaginal dryness, irrgular periods, it had been irregular, F, 44 yo F, LMP was 2 months ago, Her LMP was 2 months ago, ranging from a light period to a heavy bleed, requiring 5-6 pads a day, 3 year histpry of, In the last 3 years, 3 year histpry, 44 yo, 44 yo F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: A 44 F presents with irregular periods for the past three years. She states that there is no pattern; they can last from 2-6 days and can be heavy and light reuqiring as little as 1-2 tampons or 5-6 tampons. She describes having hot flashes and sweating. She denies visual changes, nipple discharge or mood changes. Her LMP was 2 months ago and sge described it as regular (3-4 tampons a day for 4 days)
Ob: Her first period was at the age of 14, her periods would occur every 28 days, last 4 days and would require 3-4 tampons per day. She also had back pain, breast tenderness, cramps. She currently denies vaginal discharge. She has vaginal dryness. She currently has an IUD. 
PMH: HTN on HCTZ 12.5 
Sexual history: no STIs, monogamous with husband
Social history: 1-2 glasses of wine. NO drugs/ smoking/ lives with her husband and son
FH: osteoperosis for mom/ HTN for brother
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]periods would occur every 28 days, periods would last 4 days, periods would require 3-4 tampons per day, described it as regular (3-4 tampons a day for 4 days), IUD, monogamous, irregular periods, periods there is no pattern, F, LMP was 2 months ago, hot flashes, last from 2-6 days, can be heavy and light, reuqiring 1-2 tampons or 5-6 tampons, for three years, sweating, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms Montgomery is a 44 yo female who presents with a 3 year history of irregular periods. There is no pattern, the longest she has gone without a period is 4 months. Bleeding lasts 2-6 days and can be heavy or light, not related to the elapsed time between periods. Up until 3 years ago, her periods were very regular. She has noticed vaginal dryness that has been relieved with lubricant. She has also noticed hot flashes and sweating. She had one episode of drenching night sweats last month. She denies spotting between the periods, weight change, dyspareunia, and fatigue. She rarely even feels her normal PMS symptoms with periods (cramps, breast tenderness). Mood is good.
Gyn history: two vaginal deliveries, no abortions, last PAP 1 year ago, normal, menarche at age 14.
ROS: negative except as above
Meds: HCTZ
Allergies: none
PMH: HTN, no surgeries
SH: sexually active with husband, has IUD. Never smoker, rare EtOH, no drugs
FH: HTN.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]until 3 years ago, periods were regular, PAP 1 year ago, IUD, sexually active, vaginal dryness, dryness relieved with lubricant, periods no pattern, irregular periods, Ms, female, hot flashes, gone without a period is 4 months, Bleeding lasts 2-6 days, can be heavy or light, 3 year history of, sweating, drenching sweats, 44 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 44F who presents with irregular periods for the past 3 years. Her last menstrual period was 2 months ago, with moderate flow (2-3 pads or tampons per day) and lasted 4-5 days. Prior to 3 years ago, she had regular periods every 28 days, which lasted 4-5 days. Her first menstrual period was at age 14. Reports hot flashes, weating and vaginal dryness and night sweats (1 week ago). Reports nausea and vomiting (nonbloody, unsure color) 1 week ago. Denies weight changes, dysmenorrhea, or spotting in between periods. Sexually active with husband with IUD as only contraception. 2 prior pregnancies, both normal sponataneous vaginal births with no complications. 
PMH: hypertension (diagnosed 6 years ago)
PSH: none
Meds: HCTZ: 12.5 mg/day
NKDA
FH: mom with osteoarthritis, overweight, brother: HTN
SH: lives with husband and 2 sons, feels safe at home. Occupation: office manager. Alcohol: 1 glass of wine socially. Drugs/smoking: never..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Prior had regular periods, Prior periods every 28 days, Prior periods lasted 4-5 days, IUD, Sexually active, vaginal dryness, irregular periods, nausea 1 week ago, vomiting 1 week ago, F, last menstrual period was 2 months ago, hot flashes, for the past 3 years, for 3 years, weating, night sweats, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dolores Montgomery is a 44 year old female who presents with a history of irregular periods. She noticed a change 3 years ago; before this time she had regular 28 day cycles that had moderate flow (of note, before each menstruation she had low back pain and breast tenderness). Over the last 3 years her periods are ""unpredictable"" happen every 3 weeks to 4 months, last 2 to 6 days, and the flow is anywhere from light to very heavy. She has also had occasional hot flashes and night sweats- the other day she woke up covered in sweat and decided it was time to see a doctor. 
She has an IUD in place- put 4 years ago. Last pap smear was 1 year ago. Denies fatigue, chest pain, SOB
PMH- HTN, only hospitalization was for her 2 childbirths, no surgeries
Medications- IUD, HCTZ 
allergies-none 
Family history- dad healthy, mom osteoarthritis (not sure when she started menopause)
Social- no smoking, rare drinker, no illicit drug use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Last pap smear was 1 year ago, IUD, irregular periods, happen every 3 weeks to 4 months, periods are ""unpredictable"", female, hot flashes, flow is anywhere from light to very heavy, last 2 to 6 days, Over the last 3 years, 3 years ago, night sweats, covered in sweat, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dolores Montgomery is a 44yoF presenting with irregular periods. For the past 3 years, she has experienced periods that can last 2-6 days, occur every 3 weeks to 4 months, and are sometimes light and sometimes heavy. She endorses hot flashes and vaginal dryness for 1 year, and 1 episode of night sweats last week. She has a copper IUD and is sexually active with her husband. She took 2 pregnancy tests last week and both were negative. Her old periods were predictable lasting 4 days and occuring every 28-29 days. She denies vaginal discharge. Denies dizziness, lightheadedness, changes in hair, cough, chest pain, shortness of breath, recent travel, weight gain, or weight loss. 
PMHx: Hypertension
Surgical history: None
Meds: HCTZ
Allergies: None
FamHx: Mother - osteoarthritis, brother - HTN, father healthy
SocHx: Works as an office manager. No new stressors. No smoking. Drinks occasionally at celebrations. No drugs. 
ROS: Above.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]old periods were predictable, old periods lasting 4 days, old periods occuring every 28-29 days, IUD, sexually active, vaginal dryness, irregular periods, F, hot flashes, occur every 3 weeks to 4 months, sometimes light and sometimes heavy, last 2-6 days, For 3 years, night sweats, 44yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: This is a 44 year old female with a past medical history of HTN (taking HCTZ, presenting today with a 3 year history of irregular bleeding.  Patient states that periods are unpredictable lasting any where from 2-6 days and sometimes the bleeding is light and sometimes it is heavy.  Periods were regular prior to 5 years ago with moderate bleeding.  Patient does endorse some vaginal dryness, some day time sweating, and one episode of drenching night sweat.  She denies weight changes, fatigue, appetite changes, fever, nipple dischartge, bleeding after sex, or skin changes.  Patient also denies abdominal fullness, pain or bloating.  No nausea or vomiting.

OBGYN:  Pap smear was 1 year ago was normal.  She has had two uncomplicated vaginal pregnancies. has IUD.
PMH:  HTN, HCTZ, no sugeries, no allergies
Family:  Mom has osteoarthritis and is overweight, dad is fine
social:  no tobacco, drinks rarely, walks 4-5 times a day, and no drug
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Periods were regular prior to 5 years ago, Pap smear was 1 year ago, IUD, vaginal dryness, irregular bleeding, periods are unpredictable, female, lasting any where from 2-6 days, sometimes the bleeding is light and sometimes it is heavy, a 3 year history, sweating, drenching night sweat, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 y/o F comes in due to irregular periods that being going on for the past 3 years. She states that her periods use to be every 28 days that will ast 5 days. But now her periods range between 3 weeks to 4 months lasting between 2-6 days. She states that she also has menstraul cramping. She states that she has nausea for 48 hours with the color being her food she eat before. Pt feels hot with some sweating, but denies feeling cold. She states she experiences hot flashes. 
ROS: negative except above
OBGYN: P2A0P2- no complications during pregnacy
SH: married, has intrauterine device. sex with husband. drinks Etoh 1/3 months. denies smoking and recreational drug use. pt exercises 3/week. diet consist of meats and fruits
OBGYN; G2/A0/P2.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]periods use to be every 28 days, intrauterine device, sex with husband, irregular periods, now her periods range between 3 weeks to 4 months, F, hot flashes, feels hot, going on for the past 3 years, sweating, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI:
Dolores Montgomery is a 44 year old female with a history of hypertension who presents with 3 years of irregular menstrual periods. She relays that the interval between periods is irregular, and they last between 2-6 days, sometimes heavier with 6-7 pad changes/day, and sometimes lighter. She denies any pain or fullness in the pelvis. She has occassional breast tenderness before her periods. She denies any change in vaginal discharge or fevers. She also denies any headaches, visual changes, galactorhea, constipation, diarrhea, abdominal pain, fatigue, or cold/heat insensitivity. No significant change in weight or exercise habits.

FH: HTN and obesity

PMH: HTN- takes HCTZ
no other meds or over the counter supplements.

OB/GYN: menarche at 14 with regular periods until 3 years ago. G2P2 with 2 vaginal deliveries.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]regular periods until 3 years ago, irregular periods, female, sometimes heavier sometimes lighter, sometimes with 6-7 pad changes/day, and sometimes lighter, interval is irregular, last between 2-6 days, 3 years of, 44 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Montgomery is a 44yo female presenting with irregular periods for the last 3 years. These range from 2-6 days in length with her cycles lasting from 3 weeks to 4 months. Her menstrual flow can be either heavy or light ranging fro 2-3 pads/day to 5-6 pads/day. Her periods are not painful. She has also had night sweats and hot flashes during this time period. She has not experienced dizziness, palpitations, intermentrual bleeding or vaginal discharge. She is sexually active with her husband (monogamous) and has no dyspurinia but does experience some vaginal dryness which she uses lubrication for. 1 weeks ago did have some nausea and vomitting for a day which resolved on its own. 
Denies changes in mood or energy.
PMHx: HTN, takes HCTZ, no surgeries
FMHX: OA, obsesity in mom and HTN in brother.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]sexually active, (monogamous), vaginal dryness, irregular periods, 1 weeks ago have nausea and vomitting, female, hot flashes, range from 2-6 days, lasting from 3 weeks to 4 months, flow can be either heavy or light, ranging fro 2-3 pads/day to 5-6 pads/day, for the last 3 years, night sweats, 44yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Dolores Montgomery is a 44yo F with h/o HTN presenting with 3 years of irregular periods. She had menarche at age 14 and had regular periods every 28-29 days with moderate flow lasting 5 days until three years ago. She has noted recent discomfort with sex due to vaginal dryness, as well as the occasional hot flashes accompanied by sweating. Her last period was 2 months ago and lighter than usual. She does have an IUD in place - this is her third IUD and she did not have any problems with the previous two. Unknown age of mother's menopause. Has had regular pap smears with no irregular results.
ROS: no changes in weight, appetite, fevers or chills.
- no skin dryness, hair loss, constipation
Gyn Hx: 2 vaginal deliveries
PMH of HTN, treated with hydrochlorothiazide; no PSH
FHx: no known h/o fibroids, early menopause
SHx: sexually active with husband.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]had regular periods, had periods every 28-29 days, had periods with moderate flow, regular periods until three years ago, periods every 28-29 days until three years ago, periods lasting 5 days until three years ago, IUD, sexually active, with sex, vaginal dryness, irregular periods, F, last period was 2 months, hot flashes, 3 years of, until three years ago, sweating, 44yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44yo G2P2 F with irregular menses. Patient reports 3 years of irregular menses. She reports that prior to 3 years ago her menses were regular, but now they have no pattern. They last from 2-6 days, occur every 3wks-4mos, and range from heavy to light bleeding. Patient reports decreased menstrual cramps. Patient denies abdominal pain, but did have some nausea and vomiting last week, thought to be food poisoning. She took two at home pregnancy tests that were negative. Patient also reports hot flashes and diaphoresis. Patient denies increased hair growth, palpitations, breast tenderness.
ROS:  as above
meds:  HCTZ; NKDA
PMHx: HTN; PSHx:  none
OBGYN:  G2P2002; uncomplicated vaginal deliveries 10 and 14 years ago; sexually active with husband, patient has an IUD (placed 4 yrs ago)
FH:  mom- osteoarthritis
SH: investment manager; rare alcohol use, no tobacco or drug use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]prior menses were regular, reports that prior to 3 years ago her menses were regular, IUD, patient has an IUD, sexually active, sexually active with husband, irregular menses, now they have no pattern, nausea and vomiting last week, decreased menstrual cramps, reports decreased menstrual cramps, F, G2P2 F, hot flashes, also reports hot flashes, They last from 2-6 days, occur every 3wks-4mos, range from heavy to light bleeding, last from 2-6 days, 3 years of, prior to 3 years ago her menses were regular, Patient reports 3 years of irregular menses, diaphoresis, also reports diaphoresis, 44yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 year old G2P2 female with a history of HTN who presents with irregular periods. She has had irregular periods for the past 3 years. They have become unpredictable with no pattern, lasting from 2-6 days with an unpredictable flow. Previously, she had her period every 28-29 days, lasting 5 days, with moderate flow, with 2 days of PMS symptoms directly preceeding each period. First period at 14 yo. She has not had PMS symptoms for 3 years but with her most recent period 2 months ago, had them again. She has hot flashes with sweating 1-2 times per month and vaginal dryness. No nipple discharge. Last week, she also notes 48 hours of some kind of illness (nausea/vomiting) and woke up drenched in sweat. Other, ROS is negative.
PMH: HTN
PSH: None
Meds: HCTZ
Allergies: None
FH: brother with HTN, mother with obesity and osteoarthritis and unknown when she had menopaus
SH: no smoking, no drinking, social alcohol use (a few times a year).
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Previously, she had her period every 28-29 days, vaginal dryness, irregular periods, irregular periods, unpredictable with no pattern, Last week, she also notes 48 hours of some kind of illness (nausea/vomiting), She has not had PMS symptoms, female, most recent period 2 months ago, hot flashes, for the past 3 years, sweating, drenched in sweat, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Dolores Montgomery is a 44 year female who presents with irregular periods. Notes it began 3 years ago with bleeding that ranged from 2-6 days in length and from light to heavy periods. 1 year ago she started to experience hot flashes and sweating that continues to persist. Denies weight changes. and trauma She also notes vaginal dryness and discomfort during sex. Denies stressors and changes in visual fields. 

PMH: HTN, well controlled 
GH: Non-contributory 
Meds: HCTZ
Allergies: None
SHX: sexually active with her husband- 1 partner 
Social History: Office Manager, lives with husband and 2 sons 
OB/Gyn History: 2 Vaginal deliveries.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]sexually active, vaginal dryness, irregular periods, Mrs, female, hot flashes, ranged from 2-6 days, from light to heavy periods, began 3 years ago, sweating, 44 year</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Montgomery is a 44 yo G2P2 female ho presents for evaluation of irregular periods. Pt reports 3 yrs of irregular periods, occurring at upredictable times and lasting 2-6 days with light to heavy bleeding. She has also experiences hot flashes and sweating mostly during the day but once at night in the past year. LMP was 2 months ago lasting 4 days and associated w/ mild menstrual cramps. Previous periods were regular every 28-29 days, last 5 days with mod flow. Periods were associateed with mild PMS sx - breast tenderness, back pain, mild menstrual cramps. She is concerned about hot flashes. 
ROS: No fever/chillls, weight loss, headache/visual changes, nipple discharge, intermenstrual bleeding. Denies palpitations, skin and hair changes, and diarrhea/constipation. 
PMH: HTN. 2 vag deliv no compl, no surg
FHx: HTN brother, obesity/osteoporosis mother. No cancer.
SHx: 
Meds: HCTZ, All: NKDA
SHx: No smoking, EtOH, drugs. 2 kids.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Previous periods were regular, Previous periods were every 28-29 days, Previous periods last 5 days, Previous periods with mod flow, irregular periods, irregular periods, Ms, female, LMP was 2 months ago, hot flashes, hot flashes, occurring at upredictable times, lasting 2-6 days, with light to heavy bleeding, 3 yrs of, sweating, 44 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dolores Montgomery is a 44 yo F presenting with irregular periods. this began 3 years ago with no precipitating factors. Her periods occur between every 3 weeks and 4 months lasting anywhere from 2 to 6 days, sometimes her flow is heavy other times it is light. Her last LMP was 2 months ago. prior to these episodes her periods were regular. She denies any remedies that make her periods more or less regular. She admits to nausea and vomiting for two days as well as hot flashes and diaphoresis for 1 year. She denies any weight gain or loss, irritability, or intermenstrual bleeding. 
ROS: denies headaches, vision changes, chills, CP, SOB abd pain, changes in bowel or bladder habits.
allergies: NKDA
meds: HCTZ x 6yrs
pmhx: HTN x 6 yrs
psurghx: none
fhx: mother has OA and is overweight, brother has HTN
shx: nonsmoker, 1 glass of wine on occasion, no drugs, office manager high stress, sexually active, no STI hx. G2P2.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]prior periods were regular, sexually active, irregular periods, nausea and vomiting for two days, F, LMP was 2 months ago, hot flashes, occur between every 3 weeks and 4 months, lasting from 2 to 6 days, sometimes flow is heavy other times it is light, began 3 years ago, diaphoresis, 44 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Montgomery is a 44 year old female complaining of irregular periods. The change is her periods began approximately 3 years ago, and they have been unpredictable in terms of their onset and duration. Her last menstrual period was 2 months ago. When they do occur, they range from 2-6 days and range from low to high flow. In the past, she has had menstrucal cramps and breast tenderness, but has not had these symptoms consistently over the last few years. but they did occur during her last period. She denies any weight change, nipple discharge, or mood changes., but endorses experiencing hot flashes, sweating, and an episode of night sweats.
Sexual history: 2 prior pregancies, full term, with no complications. Has Intrauterine device for contraception.
Denies discharge
Med hx: HTN, controlled with HCTZ
Family hx: no pertinent family history
No prior surgeries, or allergies
No drug, tobacco use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Intrauterine device, irregular periods, change is her periods, periods have been unpredictable, had menstrucal cramps and breast tenderness, but has not had these symptoms, Ms, female, last menstrual period was 2 months ago, hot flashes, periods unpredictable in terms of their onset, periods unpredictable in terms of their duration, range from 2-6 days, range from low to high flow, began 3 years ago, sweating, night sweats, 44 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dolores Montgomery is a 44yo F with hx of irregular periods for 3 years. 
- Menstrual history: Menarche at 14yo. Cycle 28-29 days. Mentrual period would typically last for 5 days, require 2-3 pads daily. With mild PMS symptoms including cramps, breast tenderness, low back pain.
- In the past 3yrs, menstrual periods have occurred without pattern, from 3wks apart to 4mo apart. Flow is very light to heavy, lasting 2-6 days. Now without PMS symptoms except for in the most recent period. LMP 2 months ago.
- Also with occassional hot flashes and sweating
- Denies palpitations, hair loss, weight changes, fevers, chills
- IUD in place
ROS: as per HPI
PMH: HTN
Meds: HCTZ
NKDA. No prior surgeries. Hospitalizations for childbirth x2. 
FHx: Brother with HTN. Mom overweight, with osteoarthritis.
SocHx: Office manager. Never smoker. Rare alcohol use. Denies recreational drugs. Sexually active with husband only.
Normal mammogram last year.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Cycle 28-29 days, period would typically last for 5 days, period would typically require 2-3 pads daily, IUD, Sexually active, irregular periods, periods occurred without pattern, without PMS symptoms, F, LMP 2 months ago, hot flashes, from 3wks apart to 4mo apart, Flow lasting 2-6 days, Flow light to heavy, for 3 years, In the past 3yrs, sweating, 44yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Montgomery is a 44 yo F who presents w/ 3 years of irregular periods. She began menses at 14 years old and was regular (menses q.28-29 days, lasting 5 days, moderate flow with 3-4 pads and mild PMS sxs including breast tenderness, lower back pain and mild pelvic cramping without mood changes). However, over the past 3 years, her periods became irregular, beginning unpredictably, and ranging from light to heavy relative to her baseline moderate flow. She has had one episode of her normal PMS sxs over the past 3 years and that was prior to her LMP which was 2 months ago. Endorses occasional hot flashes and diaphoresis that begin and conclude spontaneosly
ROS: no changes in skin, hair, bowel habits, weight, appetite, energy levels since her menstrual irregularities began. No CP, SOB. PMHx: HTN, G2P2. Meds: Copper IUD in place, HCTZ. NKDA. Sexual hx: monogomous w/ husband. Family hx: HTN in her brother, mother: obesity, osteoarthritis.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]menses was regular, menses q.28-29 days, menses lasting 5 days, menses moderate flow with 3-4 pads, baseline moderate flow, IUD, monogomous, irregular periods, periods became irregular, menstrual irregularities, Ms, F, LMP was 2 months ago, hot flashes, beginning unpredictably, ranging from light to heavy, 3 years of, over the past 3 years, diaphoresis, 44 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 yo F c/o irregular menstrual period 3 yrs PTA-less flow LMP:3 yrs ago
- OB/GYN: LMP 3 yrs ago, previously regular 5 days*28-29 days, G2P2, no complication, vaginal delivery, vaginal dryness->dyspareunia-needs lubrication
-Reports: cramps with menstruation, back pain, sleeping 
-Denies:irritable mood, edema, constipation, diarrhea, palpitation, vaginal dis
-PMH: HTN 6 yrs ago on HCTZ, no Sx
-FH:noncontributory, cannot recalls mother menopause age
SH: works as an office manager in invesment firm, occasional EtOH, no illicit drug use, no smoking, monogamous with husband, healthy diet, regular exercise
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]previously regular, previously 5 days, previously *28-29 days, monogamous, vaginal dryness, dyspareunia-needs lubrication, irregular menstrual period, F, 3 yrs PTA, 44 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44F with HTN presesing for irreuglar periods for past  3yrs. They occur every 3wk-4mo and she bleeds 2-6d (heavy or light). previously they occured every 28-29d and lasted 5d. LMP was 2 months ago whcih was normal and she has no spotting since then. Endorses hot flashes and vagnal dryness with sex for one year. Had one episode of night sweats last week and also had nausea and vomiting for a few days.  Denies weight loss, fevers or chills, headaches, bowel changes or urinary changes. No STDS in past. G2P2. took home pregnance test whishcwere negative. Denies vaginal discharge, breast discharge. 
pmh- HTN
psh- none
med- HCTZ
all- none
fh- mop- OA, brother htn
SH- lives at home with husband and 2 children, rare drnker, deneis drugs or tob.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]previously occured every 28-29d, previously lasted 5d, previously they occured every 28-29d and lasted 5d, with sex, vagnal dryness, Endorses vagnal dryness, irreuglar periods, presesing for irreuglar periods, nausea and vomiting for a few days, F, 44F, LMP was 2 months ago, hot flashes, Endorses hot flashes, occur every 3wk-4mo, bleeds 2-6d, bleeds (heavy or light, lasted 5d, for 3yrs, irreuglar periods for past  3yrs, night sweats, Had one episode of night sweats, 44, 44F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44yo Female presents with irregular period.
-Menarche has irregular pattern. Started 3 years ago. Menarche last 2-6 days, irregular flow and consistency.
-Pt also experiences hot flashes and sweating.
-Pt denies hair loss, hair gain, heart palpitation, cold/heat intolerance, fever, and chills, abdominal pain, stool changes.
PMH: HTN
NKDA, meds include HTCZ
Hospitalize for childbirth 10 and 14 years ago.
Pt works in office Finance investing.
LMP was 2 months ago. Requires 3-4 pads.
No changes in urination/defaction/diet/weight. Sleep changes wakes up early past 3 months.
FMh: Older Brother has HTN, mother is overweight and has osteoporosis.
No tabacco, rarely drinks, no drugs
Sexually active with husband. Pt has IUD..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]IUD, Sexually active, irregular period, Female, LMP was 2 months ago, hot flashes, irregular flow and consistency, Started 3 years ago, sweating, Sleep changes, wakes up early, 44yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 year old female c/o irregular periods. Patient states that she has a history or regular periods since menarche at age 13 up until 3 years ago when she began having unpredictive, irregular periods. Menstraution last 2-6 days and can be heavy to light flow. Patient does report hot flashes throughout day for the past year and a recent episode of nt seats last week. She denies any weight changes, hirsutism, cold intolerance, changes in hair, dysmenorrheapalpitations or change in energy
OBGYN: G2P2. Mearche at age 13, LMP 2 months ago. Previously regular periods till about 3 years ago.
ROS: Negative except for above
Medications: HCTZ
Alllergies: None
PMH: HTN, treated with HCTZ and DASH diet
PSH: None
SH: Occasional EtOH, no tobacco or illicit drug. Lives with Husband. Eats a healthy balanced diet and walks 3-4 times a week.  Monogomous with husband.
FH: Mother obese and oseteoarhtrits.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]regular periods since menarche, Previously regular periods, Monogomous with husband, irregular periods, female, LMP 2 months ago, hot flashes, heavy to light flow, last 2-6 days, 3 years ago, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 year old female who presents with 3 years of irregular periods. Previously regular, her periods are now anywhere from 2-6 days, light to heavy. She is now experiencing hot flashes and sweating. Has had PMS symptoms for the first time in 3 years to include breast tenderness, low back pain, and menstrual cramping. Also last week had 48 hours of flu-like symptoms to include nausea and vomiting. No changes in bowel or bladder habit. She is sexually active her husband, but has a copper iud that was placed 4 years ago with no change in periods at that time. Has a PMH of HTN for which she takes HCTZ. No history of surgeries. Hospitalized twice for the birth of her 2 sons. No abortions or miscarriages. No family history of irregular periods, blood disorders or thyroid disorders. Denies tobacco use or recreational drugs. Drinks very infrequently 1 glass of wine at a time..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Previously regular, iud, sexually active, irregular periods, last week had 48 hours of flu-like symptoms, female, hot flashes, anywhere from 2-6 days, light to heavy, 3 years of, sweating, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dolores Montgomery is a 44 yo F c/o irregular periods for the past 3 years. They vary from every 3 weeks to every 4 months. She has had associated night sweats, trouble sleeping, and hot flases well during this time. She denies chest pain, vaginal discharge, vaginal bleeding, palpitation, sensitivity to cold, skin changes, decreased libido, vision changes, dysuria, hair thinning/loss, and weight changes. 
ROS: negative except for above
Ob/Gyn: 2 uncomplicated pregnancies. Vaginal deliveries. Has a copper IUD in place for contraception. Last pap smear was 1 year ago. Has had normal pap smears throughout life.
PMH/PSH: HTN. had gastroenteritis that caused N/V but resolved on its own within 48 hrs. 
Allergies: NKDA
Meds: HCTZ
FH: Arthritis in mom and brother with HTN
Sexual hx: monogamous with husband. no hx of STD's
SH: never smoked, denies illicit drug use. Rarely drinks alcohol. Feels safe at home..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Last pap smear was 1 year ago, IUD, Sexual hx: monogamous with husband, irregular periods, had gastroenteritis that caused N/V but resolved on its own within 48 hrs, F, hot flases, vary from every 3 weeks to every 4 months, for the past 3 years, sweats, trouble sleeping, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44yo F with HTN who presents for evaluation of 3 years of irregular periods. Pt reports that her periods have been unpredictable, lasting 2-6 days, with variable flow. Prior to the irregularity, her periods were regular, lasted 5 days, with moderate flow and mild pain. She denies any pain with intercourse but states that she has experienced vaginal dryness for about a year. One week ago, she woke up drenched in sweat. She also reports that a week ago, she experienced nausea and vomiting for 2 days. Pt has been using copper IUD for 20 years, last replaced 4 years ago. No hx of STDs or HIV. Normal pap smear 1 year ago.
ROS negative other than HPI
PMH: HTN
Meds: HCTZ
NKDA
PSH: none
FH: mom with osteoarthritis and overweight, brother with HTN
SH: lives with husband and 2 sons (ages 10 and 14), works as office manager, no smoking/alcohol/drugs, low fat low salt diet, walks 3-4x/week.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]periods were regular, pap smear 1 year ago, IUD, vaginal dryness, irregular periods, periods have been unpredictable, a week ago, she experienced nausea and vomiting, F, with variable flow, 3 years of, drenched in sweat, 44yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 YO F IN CLINIC C/O IRREGUALR PERIOD X 3 YO. SUDDEN ONSET. HER LMP   2 MO AGO, 4 - 2 MO INTERVAL , SOMETIMES 3 WK INTERVAL , LASTS FOR 2 -6 D, FLOW HEAVY TO LIGHT . MENERCHE AT 14.A/W VAGINAL DRYNESS, SLEEP DIFFICULTY, SHE WAKES UP EARLY IN A.M. SHE HAS SOME  STRESS . DENIES IRRITABILITY, MOOD CHANGE , FEVER. NO WEAKNESS, URINARY OR BOWEL HABIT CHANGE.
PMH FLU LIKE ILLNESS 1 WK AGO, HTN X 6 YO , NKDA, MEDS HCTZ X 6
PSH / HOSP / TRAVEL / TRAUMA NONE
FH N/C
OB / GYN HER LMP   2 MO AGO, 4 - 2 MO INTERVAL , SOMETIMES 3 WK INTERVAL , LASTS FOR 2 -6 D, FLOW HEAVY TO LIGHT . MENERCHE AT 14., G2P2
SH OFFICE MANAGER, NO TOBACCO / REC DRUG, ETOH OCC
SEXUALLY ACTIVE W/ HUSBAND.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]SEXUALLY ACTIVE, VAGINAL DRYNESS, IRREGUALR PERIOD, FLU LIKE ILLNESS 1 WK AGO, F, HAS SOME  STRESS, LMP   2 MO AGO, LMP   2 MO AGO, LASTS FOR 2 -6 D, FLOW HEAVY TO LIGHT, LASTS FOR 2 -6 D, FLOW HEAVY TO LIGHT, X 3 YO, SLEEP DIFFICULTY, WAKES UP EARLY, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dolores Montgomery, a 44-year-old female, c/o irregular periods. LMP 2months ago, lighter/shorter duration than previously, previously q28days. Associated with vaginal dryness, breast tenderness, dysmennorhea. Pt eats healthy and exericies. 
ROS: Denies postcoital bleeding, dysparenuia, hirtuisum, cold/hot intolerence, change in BM, abdominal pain, change in weight/appeitie, change in urination, skin changes, 
OBGYN: G2P2, SVD, no complication, IUD 4years ago, menarche 14
PMH: HTN, well controlled
Meds: HCTZ
PSH:none
Allergies: NKA
SHx: EtOH occacionally, denies smoking, illicit drug use, officer manager, sexualy active with husband only
FH: Brother HTN, Mother osteoarthritis.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]previously q28days, IUD, sexualy active, vaginal dryness, irregular periods, female, LMP 2months ago, lighter/shorter duration than previously, 44-year-old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: PT IS A 44 Y/O f W/ CHIEF COMPLAINT OF IRREGULAR PERIODS. PT STATES THAT FOR THE PAST 3 YEARS SHE HAS BEEN EXPERENCING UNPREDICTABLE PERIODS. PT STATES PREVIOUSLY SHE HAD REGULAR PERIODS EVERY 28 DAYS WITH 5 DAYS OF LIGHT BLEEDING. Now, pt is experiencing irregular periods w/ bleeding lasting 2-6 days sometimes bleeding through multiple pads, sometimes light. Pt is also experiencing what she describes at hot flashes and sweating. Pt denies nipple discharge or headaches.
OBHX G2P2 woman with 2 healthy kids born at full term via normal spontaneous vaginal delivery, no complications. Pt is sexually active w/ husband, no concern for STDS, no hx of stds, last PAP 1 year ago no abnormalities. No pain with intercourse. Pt complains of vaginal dryness and discomfort which she treats with lubricant.
PMH: HTN PSH: none allergies: none Meds: HCTZ
FH: mother: osteoarthritis
Social: lives at home with husband no complaint
-ETOh, -T.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]PREVIOUSLY SHE HAD REGULAR PERIODS, HAD REGULAR PERIODS EVERY 28 DAYS, sexually active, vaginal dryness, IRREGULAR PERIODS, irregular periods, f, hot flashes, UNPREDICTABLE PERIODS, bleeding lasting 2-6 days, sweating, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 3 year history of irregular menses. Pt has a copper IUD for 4 years, non hormonal. Periods last 2-6 days and are at intervals of 3wks-4months. Flow ranges from heavy to light.  No pattern or associations between length of periods and flow. She does not usually have symptoms of cramping, back pain, or breast tenderness, but she had these before her most recent period 1 week ago. 2 children, vaginal deliveries at age 30 and 34, no problems during pregnancy. Sexually active with husband only. No vaginal discharge, itching or pain. Occasional vaginal dryness. No history of STIs.Denies dyspareunia, dysuria, or bowel changes. Denies headache or fever. 2 days of vomiting last week associated with abdominal cramping. Denies abdominal pain. No hospitalizations or surgeries.
PMH: hypertension Meds: HCTZ
FHx: no family history of early menopause or painful menses
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]IUD, Sexually active, vaginal dryness, irregular menses, does not usually have symptoms of cramping, Periods last 2-6 days, are at intervals of 3wks-4months, Flow ranges from heavy to light, No pattern flow, No pattern length of periods, 3 year history</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 year old female presenting with chief complaint of irregular periods
- ongoing for the past 3 years, reports irregular periods, coming at unpredictable times, lasting anywhere from 2 to 6 days, flow is variable ranging from light to heavy
- reports nothing has made her symptoms better or worse; have been stable in unpredictablility over the 3 years
- last period 2 months ago
- periods prior to 3 years were normal
Review of systems: no fevers, chills, chest pain, shortness of breath, abdominal pain, diarrhea/constipation, dry skin, dysuria
PMH: hypertension, no surgeries
Medications: HCTZ
NKDA
Social: office manager, rarely drinks alcohol, no drug use or smoking, sexually active with husband 20+ years
ObGyn: menarache at 14, regular periods every 28-29 days, lasting 5 days, moderate flow, would also get breast tenderness, cramps with periods, G2P2 (two sons 10, 14)
no oral contraceptive use, no hormone replacement therapy.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]periods prior to 3 years were normal, sexually active, irregular periods, irregular periods, female, last period 2 months ago, flow is variable ranging from light to heavy, coming at unpredictable times, lasting anywhere from 2 to 6 days, ongoing for the past 3 years, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: irregular periods
HPI: 44 yo F presenting to the clinic with irregular periods since 3 years. Menstrual cycles have lasted various lengths of times. Associated sx include hot flashes, breast tenderness, PMS, and one episode of lower back pain. Pt has not seen any clots in her menstruation. Pt currently is using an IUD which was placed by her gynecologist but is currently seeing her primary care for her GYN care. Mammograms and Pap smears have been all normal. Denies headaches, dizziness, chest pain, SOB, abdominal pain, dysuria, NVDC, fevers, night sweats, weight loss.
PMH: HTN
PSH: None
Meds: HCTZ
Fam: Brother has HTN, mother has osteoarthritis
Allergies: NKDA
Social: Pt is happily married and lives with her family. Drinks wine only on social occasions. Denies smoking, illicit drug use, recent travel. Sexually active with husband and she uses an IUD.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]IUD, IUD, Sexually active, irregular periods, irregular periods, F, hot flashes, lasted various lengths of times, since 3 years, night sweats, 44 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dolores Montgomery is a 44 yo F with irregular periods for the past 3 years.  She describes them previously as very regular 28-29 days, medium flow, lasting 5 days, preceded by breast tenderness, lower back soreness and cramps.  3 years ago, these became unpredictable with no pattern, 2-6 days in length, bleeding could be light to heavy, without typical PMS symptoms until once recently. She notes 1 year hot flashes, sweating, vaginal dryness needing lubricant, 1 night last week of drenching night sweats.  
No changes to energy, weight, appetite. Rest of ROS neg
PMHx: HTN diagnoses 6 years ago, well controlled
PSHx: None
Medications: HCTZ. IUD in place
Allergies: None
FH: Older brother HTN, mom overweight osteoarthritis.
SH: Office manager.  Lives with husband and 2 sons, feels safe at home, sexually active, IUD replaced 4 years ago, used for 20 years. No prior STIs. No tobacco, illicit drugs. EtOH extremely rarely, 1-2 drinks/mos.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]previously regular, previously 28-29 days, previously medium flow, previously lasting 5 days, IUD, IUD, sexually active, vaginal dryness, dryness needing lubricant, irregular periods, became unpredictable, without PMS symptoms, F, hot flashes, 2-6 days in length, could be light to heavy, for 3 years, 3 years ago, sweating, night sweats, drenching sweats, 44 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 44 year old female presenting with a three year history of irregular menstruation. Patient's last menstrual period was two months ago. Periods last 2 - 6 days, however patient reports that this varies. Also reports using 5 to 6 pads when periods are regular but fewer than this during light periods. Patient reports hot flashes and sweating along with vaginal dryness. Has two previous pregnancies (spontaneous vaginal delivery). Menarche 14y. Reports nausea and vomiting one week ago. Reports that she took a pregnancy test which was negative
ROS: no cramps, no vaginal discharge, no history of STIs no weight gain, no appetite changes, no visual disturbance. 
Allergies: none
Medications: HCTZ (compliant with medications)
PMH: HTN for six years
PSH: no surgeries
FH: mother had oesteoarthritis
SH: works as an office manager, ETOH (glass of wine) on special ocassions, no tobacco or drug use, sexually active with husband only..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]sexually active, vaginal dryness, irregular menstruation, female, last menstrual period was two months ago, hot flashes, Periods last 2 - 6 days, reports using 5 to 6 pads when periods are regular but fewer than this during light periods, a three year history of, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Montgomery is a 44 yo F w/ irregular periods. She has been having irregular periods for the past 3 years. Periods have been very unpredictable with no consistent pattern. When she has periods, she can bleed for 2-6 days and the flow may be light or heavy. Her last menstrual period was 2 months ago, and she had some pain menstrual cramping for 2 days prior. She has also been having nausea with 3 episodes of non-bloody non-bilious vomiting last week, vaginal dryness, discomfort during sex, hot flashes, diaphoresis and 1 episode of night sweats last week.
PMH: HTN diagnosed 6 years ago
PSH: None
Allergies: NKA
Medications: Hydrochlorothiazide
FH: Brother: HTN, Mom: Obesity, arthritis, Dad: Healthy
SH: Works as office manager, sexually active with husband, rare EtOH use, no history of tobacco or drug use
ROS: + Nausea, vomiting, vaginal dryness, hot flashes, diaphoresis, night sweats
NO Irritability, chest pain, SOB, headache.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]sexually active, vaginal dryness, vaginal dryness, irregular periods, Periods have been very unpredictable, vomiting last week, F, last menstrual period was 2 months ago, hot flashes, hot flashes, can bleed for 2-6 days, flow may be light or heavy, for the past 3 years, diaphoresis, night sweats, diaphoresis, night sweats, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 yo F with a history of controlled HTN here with irregular periods for 3 years. Periods have been irregular and unpredictable, with menses lasting 2-6 days with variable light to heavy flow. Menarche was at age 14, and menses were previously regular every 28-29 days with moderate flow and predictable premenstrual symptoms (abdominal pain, bloating). No history of sexually transmitted infections. 
ROS: Endorses episode of night sweats, vaginal dryness x 1 year. Denies headaches, vision changes, tremors, abdominal pain, peripheral edema, breast pain, discharge
PMH: HTN, controlled.
PSH: None
FH: No known menstrual irregularities. Mother's age of menopause unknown. Brother has HTN. Mother was overweight , OA.
Meds: HCTZ 12.5 mg/d x 6 years
Allergies: None
SH: Never smoker, rare alcohol consumption, never illicit drug use, walks 3-4 times per week. Healthy low fat, low salt diet. Has 2 childrenNo change in mood. No acute stressors.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]menses were previously regular, previously every 28-29 days, previously with moderate flow, vaginal dryness, irregular periods, Periods have been irregular, Periods have been unpredictable, F, menses lasting 2-6 days, variable light to heavy flow, for 3 years, night sweats, 44 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 44 yo female with increasingly unpredictable periods. Her periods were regular, occurring every 28 days, lasting 5 days with moderate abdominal cramping. Her periods are now irregular and lasts 4-6 days with light to heavy bleeding. She is experiencing hot flashes and sweating and some discomfort due to vaginal dryness that is relieved with lubrication. She has no significant gynecological history, has had 2 prior pregnancies with no complications. She is experiencing no joint pain or fatigue. She has had no weight loss or gain. 

Allergies: NKA
Meds: HCTZ
PMH: HTN
PSH: none
FH: older brother with HTN, mom with osteoarthritis
SH: works as an office manager, does not smoke or use illicit drugs. Drinks rarely 1-2 glasses a month. Exercises by walking 3x a week. Is sexually active with husband. 

.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]periods were regular, periods were occurring every 28 days, periods were lasting 5 days, sexually active, vaginal dryness, unpredictable periods, periods are now irregular, female, hot flashes, periods with light to heavy bleeding, sweating, 44 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 YO F with 3 years of irregular periods. Patient reports getting her period at age 14 and having regular periods up until 3 years ago when they became unpredictrable. Periods now last from 2-6 days, her flow has alternated. She had one epidose of cramping and premenstrual symptoms on her last period. She has regular pap-smears and they have always been negative for any abnormalities. She is G2P2, both vis SVD without any complications, she is seually active only with her husband. Patient recalls having a few episodes of night sweats and hot flshes, but denies any changes in her mood or ability to concentrate. No urgency, frequency or dysuria. 

PMHx: Hypertension
PSHx: None
FH: Brother with hypertension, mother with osteoarthritis.
Meds: HCTZ
Allergies: NKDA
Gyn: G2P2.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]regular periods up until 3 years ago, seually active, irregular periods, they became unpredictrable, F, hot flshes, flow has alternated, last from 2-6 days, 3 years of, night sweats, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI= 44yo F c.o irregular period, x 3yrs, worse w/nothing, better w/ nothing. Before 3yrs ago, Her cycle was 25-28days, duration was range from 4-5days, with moderate flow.
Current cycle range from 3weeks- 2mos, duration range from 2-6days, flow range from light to heavy. On a heavy days, she uses 6-7pads/day.
She also has vaginal discomfort during sex, so that she uses lubricant.  She has PMS symptom, Lower back pain, SOB, Hot flashes, sweating 1-2x /mos. 
She is sexually active with her husband.
She denies spotting/ mood change/ dyspareunia/ STD hx/ weight change/ breast discharge. 
ROS= negative except as above
PMH= no similar episode,  HTN x6yrs.     
Allergy= NKDA
Meds= HCTZ x6yrs.     
FH= mother overweight, father healthy
Ob/Gyn as in HPI  G2P2A0
 SH= no cigs. Etoh 2,3times/year.  no rec drugs..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Before cycle was 25-28days, Before cycle range from 4-5days, Before cycle with moderate flow, during sex, sexually active, vaginal discomfort uses lubricant, irregular period, F, Hot flashes, Current range from 3weeks- 2mos, duration from 2-6days, flow range from light to heavy, x 3yrs, sweating, 44yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Montgomery is a 44 y.o F that presents with irregular preiods for the past 3 years. She has always had regulr periods in the past (28-29 day interval, moderate flow, mild cramps, breast tenderness, LBP a few days before) but since 3 years has had unpredictable patterns 2-6 days flow from light to heavy periods. Last period was 2 months ago and had premenstrual symptoms then as well.  She also had hot flashes, sweating symptoms recently and last obgyn vist was a year ago with nml papsmear and no STDS in the past. She has a stomach flu symptoms 2 days last weeks with associated vomiting and went away on its own. Denies any feverm n, vomiting bowel bladder issues, cold/heat intolerance. 
Meds: HCTZ/ allergies
Allergies: none
Fhx: Father has HBP, mother obestiry and OA
Shx: Married 20 years, 2 kids, in home
PMH: 2 pregancies both baginal 

.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]always had regulr periods in the past, a year ago papsmear, irregular preiods, has a stomach flu symptoms 2 days last weeks, F, Last period was 2 months ago, hot flashes, has had unpredictable patterns, 2-6 days, flow from light to heavy, for the past 3 years, since 3 years, sweating, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 yo R presenting with irregular periods for 3 years. LMP was weeks ago, gets period in irrgeular intervals, lasts 2-6 days, sometimes heavy (5-6 pads/day) or light. Not associated with pain. Of note, sexually active exclusively with husband, uses copper IUD as contraception, 2 negative pregnancy tests at home last week. Last PAP smear last year that was normal. Last seen by OBGYN 3 years ago. No PMH of fibroids, cysts, polyps, bleeding disorders, endocrinopathies, GYN malignancy. No FH of bleeding disorders, GYN malignancy. Unsure of age of menopause in women of family..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]IUD, sexually active, irregular periods, gets period in irrgeular intervals, lasts 2-6 days, heavy or light, for 3 years, 44 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 y/o female with history HTN who prsents with irregular bleeding over the last several years. Her periods are irregular with no predictable pattern, sometimes heavy or light, last from 2-6 days. Last period 2 months ago, normal. Menarche age 14, regular at that time. 2 sons aged 14 and 10, no pregnancy complications, vaginal birth. Hasn't seen gynecologest for 3 years as they retired. Also noticed drenching night sweats last week, vaginal dryness requiring lubricant for intercourse, hot flashes, early morning wakenings several times over the last several months. Denies vaginal discharge, pain with urination or intercourse. Sexually active with husband only. She does note an illness 1 week ago with nausea and vomiting that lasted two days. Family history significant for overweight, hypertension. No weight changes, changes in mood, changes in bowel habits, abdominal pain..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Sexually active, vaginal dryness, requiring lubricant for intercourse, irregular bleeding, periods are irregular, periods with no predictable pattern, 1 week ago with nausea and vomiting, female, Last period 2 months ago, hot flashes, sometimes heavy or light, last from 2-6 days, over the last several years, night sweats, drenching sweats, early morning wakenings, 44 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: The patient is a 44 yo F who came in due to irregularity in her menstruation. This started 3 years ago and the pattern has been unpredictable and irregular. Flow varies from light (1-2 pads a day), moderate (3-4 pads a day) or heavy (up to 6 pads a day). The patient has experienced one episode of menstrual cramps. There is associated hot flashes, sweating, sleeping problem (wakes up early and unable to fall back to sleep) and vaginal dryness for the past few months. Her last menstrual period was 2 months ago. She denies any mood changes, changes in her skin or hair, chest pain, headache, dyspnea,changes in bowel movement or urination.
OB hx: G2P2. Both vaginal deliveries with no complications
ROS: Neg except as above
PMH: HTN for 6 years
PSH: None
Meds: HCTZ
FH: Mother has osteoarthritis. Brother has HTN.
SH:Office manager.Drinks occasionally.No smoking and drugs. Low fat low salt diet.Sexually active with husband. Uses lubricant.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Sexually active, vaginal dryness, irregularity in her menstruation, pattern has been unpredictable, pattern has been irregular, F, last menstrual period was 2 months ago, hot flashes, Flow varies from light moderate or heavy, Flow varies from 1-2 pads a day 3-4 pads a day up to 6 pads a day, started 3 years ago, sweating, sleeping problem, wakes up early, wakes and unable to fall back to sleep, 44 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dolores Montgomery is a 44 year old previously healthy female who presents to clinic to discuss irregular periods. States this has been going on for the past 3 years. LMP was 2 months ago and lasted 4 days. Describes tenderness, low back pain, and cramping prior to this period. Also endorses hot flashes, sweating, and vaginal dryness over the past year. Dryness has improved with estrogen cream. Denies hx of STDs. Is sexually active with her husband. Has Copper IUD which was placed 4 years ago. Denies weakness, weight changes, fevers, chills, lower extremity edema, or cardiac problems. 

MEds: HCTZ 
Allergies none
PMH HTN
PSH none
OB 2 pregnancies normal vaginal delivery
FH: does not know family menstrua hx
SH: Office manager. Lives w/ husband. 
Denies smoking, drug use. occassional champagne.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]IUD, sexually active, vaginal dryness, irregular periods, female, LMP was 2 months ago, hot flashes, for the past 3 years, sweating, 44 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 yof with history of irregular menstrual bleeding. Last period 2 months ago. lasted 4 days and used 2-3 pads daily. Before that last period was 3 weeks before and lasted 5 days with 5-6 pads daily. And before that last period was nother 4 months. Before irregular periods started, patient normally had period every month lasting 5 days and used 2-3 pads daily. She denies any headache, fever, chills, vision changes, fatigue, galactorrhea, pain with sex (although mentions vaginal dryness). Meds: HCTZ. No known drug allergies. FH. mom w/ osteoarthritis nad brother with hypertension. Social Hx: Denies tobacco, social alcohol, no recreational drug use. Surgical history: 2 vaginal deliveries. PMH: hypertension. 
Denies any history of STDs, abortion, is sexually active with jsut her husband, and this has never happened before.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Before normally had period every month, Before normally had period lasting 5 days, Before normally had period used 2-3 pads daily, with sex, sexually active, vaginal dryness, irregular menstrual bleeding, irregular periods, f, Last period 2 months ago, 44 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dolores Montgomery is a 44 yof c/o irregular periods. Meses in past have been regular every 28-29 days, lasting 5 days with moderate flow, mild PMS symptoms of breast tenderness, back pain, and mild cramping. Menses for past 3 years have become unpredictable in pattern lasting 2-6 days with light to heavy flow. Patient has also been experiencing hot flashes and sweating, vagina dryness, and discomfort during intercourse during past year and woke drenched in sweta for 2 days last week. Denies weight change, fatigue, palpitations, abdominal/pelvic pain, vaginal discharge, skin changes, or hair growth. 
OBGYN: G2P2 normal pregnancies full term.
ROS: otherwsie negative
Allergeis: none
Meds: HCTZ
PMH: HTN
PSH: none
FH: older bother HTN, mother osteoarthritis, overweight
SH: lives with husband and 2 sons, monogmaous sexually active with husband, rare alcohol, no tobacco,no recreational drugs. works as office manager..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Meses in past have been regular every 28-29 days, sexually active, vagina dryness, irregular periods, yof, hot flashes, lasting 2-6 days, light to heavy flow, unpredictable in pattern, sweating, drenched in sweta, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 YO G2P2 female with irregular periods
- patient reports a 3 year history of irregular periods (no pattern to occurence, 2-6 days in length when they do occur, light-heavy flow) 
- her previous menstrual history was regular, every 28-29 days, and moderate flow
- she also experienced occasional breast tenderness, mild cramps before her periods which disappeared when her periods became irregular but returned last week
- does not know when mother had menopause

- LMP: 2 mo ago, has a copper intrauterine device placed 4 yo ago w/o complications, had 2 uncomplicated term pregnancies
- patient is sexually active with her husband and does not use condoms
- does not smoke and uses alcohol socially, no other drugs 
- takes HCTZ for hypertension, NKDA

- in addition, she reports occasional hot flashes/sweats which interrupt her sleep, menstrual cramps, and nausea
- she denies any diarrhea, irregular uterine bleeding, chest pain.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]previous menstrual history was regular, previous menstrual history was every 28-29 days, previous menstrual history was moderate flow, intrauterine device, sexually active, irregular periods, irregular periods, periods (no pattern, breast tenderness, mild cramps before her periods disappeared when her periods became irregular, female, LMP: 2 mo ago, hot flashes, 2-6 days in length, light-heavy flow, 3 year history of, sweats, interrupt her sleep, 44 YO</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dolores Montgomery, a 44-year-old female, has come to the doctor's office today to discuss her irregular periods.
- Has been having irregular periods for the past three years
- periods have been unpredicatble , they have been heavy and light, last two to six days
- two months ago has experienced hot flashes with sweating
-has been getting up earlier 4-5x in the past three months
- currently sexually active with husband, no barrier protection, has iud
- has hypertension
-has had breast tenderness, back pain and one episode of menstrual cramps
-no skin changes.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]iud, sexually active, irregular periods, irregular periods, periods have been unpredicatble, female, hot flashes, they have been heavy and light, last two to six days, for three years, sweating, has been getting up earlier 4-5x in the past three months, 44-year-old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 y/o F w/ 3 year h/o irregular periods. Patient previously had regular 28-day periods w/ regular flow onset of menses at age 14. No h/o pelvic pain, abnormal bleeding before. Patient c/o irregular flow (heavy/light) and hot flashes, sweating, and one episode of night sweats. She also endorses 1 episodes of N/V. She denies and F/C, recent travel, abnormal exposures, or h/o STDs. She is sexually active w/ husband only.

PMH: HTN
PSH: none
Meds: HCTZ
All: none
FHx: none
SHx: no smoking, social drinker

ROS: as per HPI, o/w neg

Women's health:
Regular PAP, most recent 1 year ago, all normal
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]previously had regular periods, previously had 28-day periods, previously had regular flow, PAP 1 year ago, sexually active, irregular periods, F, hot flashes, irregular flow, flow (heavy/light, w/ 3 year h/o, sweating, night sweats, 44 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dolores Montgomery is a 44yo F coming in for irregular periods of 3yr duration. Periods occur anywhere from 3 weeks-4 months apart, and last for 2-6 days, with variable bleeding from 1-6 pads per day. No triggers. She has had 2 pregnancies with uncomplicated vaginal deliveries. She used to have pain/cramping when she had regular periods but does not have any pain with periods anymore. She reports hot flashes and sweating. Her menarche was at 14, LMP 2 months ago. Mother's age at menopause is unknown. Has used IUD for 20 years, last insertion was 4yo. 
PMH: HTN on HCTZ. No hospitalizations other than childbirth. No surgeries, no allergies
Family hx: Mother has osteoarthritis, obesity. Brother has HTN. 
Social: lives with husband and 2 children, works as office manager. 
Sexual: active with husband. Birth control is IUD. No hx of STIs. Reports dyspareunia and vaginal dryness, uses lubricant. Never smoker, alcohol rarely, no drugs.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]when she had regular periods, IUD, IUD, Sexual: active, vaginal dryness, irregular periods, does not have any pain with periods, F, LMP 2 months ago, hot flashes, occur 3 weeks-4 months, last for 2-6 days, variable bleeding, from 1-6 pads per day, of 3yr, 3yr duration, sweating, 44yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44-year-old female, has come to the doctor's office today to discuss her irregular periods. Periods have been irregular for 3 years, lasting between 2-6 days, alternating between heavy and light changing 5-6 pads for heavy days with no spotting between periods and no pain. Menarchy was at age 14, periods were regular 28 day cycles with 2-3 days of moderate flow for 5 days changing 2-3 pads. Patient reports hot flashes, and one episode of night sweating. She also reports vaginal dryness during sex for which she uses lubricant. No recent weight changes, skin changes, trauma, infections. No masses/lumps in the neck. No feelings of sadness or fatigue. 2 pregnancies to term, no abortions/misscarages.
ROS: negative except above
PMH: HTN
NKDA
Meds: HCTZ - no side effects
Fx: Osteoarthritis in mother
Patient eats healthy and exercises several times weekly. 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]periods were regular 28 day cycles, vaginal dryness, irregular periods, Periods have been irregular, female, hot flashes, lasting between 2-6 days, alternating between heavy and light, for 3 years, night sweating, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44yo WF c/o irregular periods for the last 3 years. Periods last 2-6 days every 3w to 4 months and are light to heavy. Pt also reports hot flashes and sweeting 1-2x/months and vaginal dryness. Terminal insomnia since a few months not associated to any worries.  No pattern. No spotting, no vag discharges, no itching. Nothing precipitates symptoms. 
G2P2 2 vaginal deliveries. 
ROS : No hair changes or skin changes. No bowel changes, no urinary complaints. No headaches.  
Last week had nausea and vomitting for 2 days but everything resolves spontaneously. 
PMH : HTN diagnosed  6 years ago
PSH None
Meds : HCTZ
NKDA
FH : Brother has HTN, Mother has obesity and osteoarthritis
Office manager 
No EtOH, tabacco or rec drugs
Sex active with husband only. 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Sex active, vaginal dryness, irregular periods, Last week had nausea and vomitting for 2 days, WF, hot flashes, Periods last 2-6 days, every 3w to 4 months, are light to heavy, for the last 3 years, sweeting, Terminal insomnia, 44yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms Montgomery G2P2 44 yo f here c/o irregular periods for the past 3 years. Her periods are totally unpredictable for 3 years now. Can come in 3 weeks or in 4 months. Can last 2 days or 6 days. She also gets hot flashes in the last year, and woke up drenched in sweat recently. Previosly her menses were always regular, 5d/29d with 2/3 tampons/pads per day. Denies HA, vision/hearing changes, SOB, CP, abdominal pain, dizziness, weakness, numbness or tinglings. 
ROS negative except above 
ObGyn menarche 14 yo, regular 5d/29d with 2/3 pads per day, Pap smear last year normal, never abnormal Pap smear, no abortions or miscarriages, G2P2, no abnormal discharges
PMH HTN 6 yrs Meds HCTZ Allerg NKA
PSH none
FH mom osteoarthritis, dad well
SH denies tobacco, EtOH, drugs, and STIs, sexually active with husband only.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Previosly her menses were always regular, Pap smear last year, sexually active, irregular periods, periods are totally unpredictable, f, hot flashes, Can come in 3 weeks or in 4 months, Can last 2 days or 6 days, for the past 3 years, for 3 years now, drenched in sweat, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 YO F IN CLINIC C/O IRREGULAR PERIODS, WAS INITIALLY EVERY 28D, LASTING 5D OF FLOW, NOW 2-6D, SOMETIMJES HEAVY OR LIGHT, A RANGE OF 5-6 PADS NOW FROM 2-3 PADS. LMP 2 MO AGO. MENARCHE WAS 14Y, A/W VAGINAL DRYNESS, G2P2, NO HX OF ABORTIONS OR MISCARRIAGES, PAP SMEAR DONE NORMAL 2MO AGO. A/W HOT FLASHES, SWEATING, VAGINAL DRYNESS. DENIES VAGINAL ITCHING, DISCVHARGE, BREAST TENDERNESS/FULLNESS, CHANGES IN VOICE/ WTR/ SKIN/ HAIR/ VISION, HA, MOOD, COLD INTOLERANCE, BM/URINARY HABITS, FEVER, CHILLS,,LAD,M ABD PAIN, HIRSIUTISM. SEX ACTIVE WITH HUSBAND, USES IUD X 20Y, CHANGES 4 YA. 
ROS NEG EXCEPT AS  ABOVE
PMH HTN X 6Y MED HCTZ NKDA 
PSH/HOSP/TRAVEL/TRAUMA NONE
FH BROTHER HAS HTN, MUM OSTEOATHRITIS, DOESNT RECALL MUM MENOPAUSAL AGE
SH LIVES WITH HUSBAND AND KIDS, ,INVESTMENT MANAGER. DRINKS ETOH RARELY, DENIES SMOKING, REC DRUGS, EXERCISE REG, HEALTHY DIET.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]INITIALLY EVERY 28D, INITIALLY LASTING 5D, IUD, SEX ACTIVE, VAGINAL DRYNESS, VAGINAL DRYNESS, IRREGULAR PERIODS, F, LMP 2 MO AGO, HOT FLASHES, NOW 2-6D, SOMETIMJES HEAVY OR LIGHT, RANGE OF 5-6 PADS NOW FROM 2-3 PADS, SWEATING, 44 YO</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 yo F with chief complaint of irregular periods. The patient states that three years ago her periods became very irregular. They are unpredicatable, there is no longer a regular cycle, the duration varies from 2-6 days. Sometimes the bleeding is very light, sometimes heavy requiring 5 or 6 pads a day. Prior to this she had regular periods every 28 days, lasting about 5 days, requring 2 or 3 pads a day. Menarche was 14. She is G2P2, both deliveries were vaginal. She is sexually active with only her husband, does not use condoms. Has a copper IUD, placed 4 years ago. She follows with an OBGYN and, she had a normal pap smear last year. Denies any urinary frequency, urgency, or dysuria. No changes in bowel habits. No history of STD.

ROS: nause and vomitting last week for a few days
Meds: HCTZ
Allergy: NKA
PMH: HTN
PSH: none
FH: mother-osteoarthritis, brother-HTN
SH: rarely drinks, never smoker, no illicit drugs, sex with husband.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Prior to this she had regular periods, pap smear last year, IUD, sexually active, sex with husband, irregular periods, They are unpredicatable, nause and vomitting last week for a few days, F, periods became very irregular, Sometimes the bleeding is very light, sometimes heavy, duration varies from 2-6 days, three years ago, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dolores Montgomery is a 44 year old female with PMH of HTN who presents for 3 years of irregular periods. Pt reports that 1st period was at 14 yo and have been 28 day cycles, 5 days periods with moderate bleeding and mild cramping until 3 years ago when periods started to be irregular with 3 weeks up to 4 months between periods. Denies spotting between periods. Her flow is light and there are no cramps. She has hot flashes 2 amonth and vaginal dryness (treated with lubricant for intercourse).  She is G2P2, with two living children both normal vaginal deliveries. No hx of STIs, monogamous with husband. No change in libido. Last pap nl (no hx of abnormal), last mammo normal. Denies weight changes, palpitations, diarrhea, dry skin, change in hair growth.
ROS: negative except for above
PMH: HTN
Meds: copper IUD and HCTZ
Surgeries:no
social: no tobacco, social ETOH, no recreational drugs.works as office manager. 
Allergies: none.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]have been 28 day cycles, IUD, vaginal dryness, irregular periods, female, hot flashes, 3 weeks up to 4 months between periods, for 3 years, until 3 years ago, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 y/o G2P2 no pmh here for chronic worsening amenorrhea for the last 3 years with episode of recently drenching the clothes. nl menarche age 14 with 28 day cycles and period lasting for 5 days. now unpredictable, lmp 2 months ago. Sexually active no protections. episode of nausea and vomiting last week that resided.  No fever, cough, chest pain, change in bowel movement, urinary frequency, discharge or abd pain. No bruising or masses. No sick contatcs. 
ROS- as per hpi 
ph- none 
meds- HCTZ no allergies 
fh- noncontributory 
sh- nonsmoker, non alchohol, no drugs, unprotected sex with partner..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]nl menarche age 14 with 28 day cycles and period lasting for 5 days, Sexually active no protections, 28 day cycles and period lasting for 5 days, now unpredictable, G2P2, lmp 2 months ago, here for episode of recently drenching the clothes, 44 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 yo female c/o irregular menstruation x 3 years.  She has associated breast tenderness, lower back pain, vaginal dryness.  She reports mild associated dysnmenorrhea. There is no vaginal discharge, weight changes, cold insensitivity, headache. She has an IUD since 4 years ago. She reports no trouble falling asleep, but has had episodes where she wakes up at night.
Menarche 14 years old, usually lasts 2-6 days, pad consumption varies with flow 
ROS: As per HPI, the rest are negative
ALLERGIES: none
MEDICATONS: HCTZ
PMH: Hypertension x 6 years ago
PSH: No previous surgeries
FH: Older brother with hypertension
Sexual Hx: Sexually active with husband 
SH: works as an office manager, denies smoking tobacco, rarely drinks alcohol on special occasions,.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]IUD, Sexually active, vaginal dryness, irregular menstruation, female, lasts 2-6 days, x 3 years, wakes up, 44 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Montgomery is a 44 yo female presenting today with chief complain of irregular menstrual periords for the  past 3 years.  Her periods last 2-6 days and occur anywhere from 3 weeks to 4 months apart.  Her last menstrual period was 2 months ago.  She experiences 2 day day course of nausea and vomitting 1 week ago which resolved on its own. 

She denies weight change, fevers, but reports hot flashes
Denies lumps in her throat.
Denies vaginal discharge, dyspyruneia, dysuria. 
VS: WNL
PMH: HTN
Allergies: none
Medications: HCTZ
FamHx: Noncontributory. 
Obstetric: Last Papp smear three ayears ago. Normal. No h/o abnormal Papp. Last mammorgram one year ago; normal. Previously normal periods since menarche at age 14.
Social: Married. Two sons. denies smoking and illicit drug use.  Sexually active with spouse. Copper IUD for contraception. Inserted 4 years ago. 

.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Previously normal periods, IUD, Sexually active, irregular menstrual periords, nausea and vomitting 1 week ago, Mrs, female, last menstrual period was 2 months ago, hot flashes, periods last 2-6 days, occur anywhere from 3 weeks to 4 months apart, for 3 years, 44 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: The patient is a 44 year old female who presents with irregular periods. Her last period was 2 months ago. Over the past 3 years her periods have been ""unpredictable,"" with various amounts of bleeding and frequency of menstrual cycles. She also endorses vaginal dryness, discomfort with intercourse, hot flashes, and nausea and vomiting last week. She has an IUD x 4 years. She typically has mild cramps and breast tenderness with periods. Menarche was age 14, first pregnancy age 30, second pregnancy age 34. Both pregnancies uncomplicated. Patient denies HA, chest pain, SOA, abdominal pain. Denies dysuria, hematuria. Denies seeing blood in her stool. Denies unintentional wt loss, weight gain, dry skin. No breast discharge. 

PMH: HTN 
PSH: none 
Medication: HCTZ
Allergies: none 
FH: unremarkable 
SH: no tobacco, ETOH rare, no drugs. Sexually active with husband only. Feels safe at home. IUD in place. 
ROS otherwise negative 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]IUD, IUD, Sexually active, vaginal dryness, irregular periods, have been ""unpredictable,"", female, last period was 2 months ago, hot flashes, various amounts of bleeding, various frequency, Over the past 3 years, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 y/o female presents with 3 year history of irregular periods. Periods have been irregular for 3 years and may occur 2-3 months and lasting 2-6 days. She has had cramping abdominal pain assoc with last menstrual cycle. Pt also compains of vaginal dryness and has been using lubricant that helps. 

PMHx: HTN dx 6 y/o using HCTZ and compliant; no side effects. 
GYN/Sexual Hx: G2P2; currently sexually active with husband, no barrier contraception
Social Hx: lives with husband and 2 sons. Feels safe at home with good suppport system Pt denies ever smoking. alcohol rarely.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]sexually active, vaginal dryness, irregular periods, Periods have been irregular, female, lasting 2-6 days, 3 year history of, for 3 years, 44 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: Patient is a 44 years old female, complaining of irregular periods for the past 3 years, stating previously as regular, eveyr 28-29 days, lasting 5 days, regular flow (3-4 pads a day). Currently very irregular, with no specific pattern, ranging from 3 weeks to 4 months, light to heavy flow and last 2-6 days, Last mentrual perior 2 months ago. Patient also copmlains of Hot flashes en excessive sweating, with no change in mood or behaviour.  
ROS: negative except as explained above
PMH: HTN diagnosed 6 years ago, treated with HCTZ, with daily compliance
surgery hx: negative
FH: father alive and in good health, Mother alive and overweight with osteoporosis, older brother alive with HTN
SH: works as office manager, drinks 1 glass of whine very sporadically, no smoking, no illicit drugs, diet low on fat and salt, walks 3-4 week
obgyn: g2p2a0, currently sexualy active with husband, birthcontrol with UID., last pap smear 1 yr,normal.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]previously as regular, previously eveyr 28-29 days, previously asting 5 days, previously regular flow, last pap smear 1 yr, UID, sexualy active, irregular periods, Currently irregular, Currently no specific pattern, female, Last mentrual perior 2 months ago, Hot flashes, ranging from 3 weeks to 4 months, ranging from light to heavy flow, ranging from last 2-6 days, for the past 3 years, excessive sweating, 44 years old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 y-o F c/o irregular perios over the last 3 years
- previously regular periods, each 28 days, lasting 5 days, moderate flow, no clots
- since the last 3 years, periods have been irregular, unpredictable, lasting 2 to 6 days, no cramps, no spotting between them
- refers hot flashes and change in sleep pattern (sleeping less, awakes at 4 am and can not sleep again)
- denies change in libido, tremor, or weight change
GYN/OB: G2P2 at ages 30 and 34; vaginal deliveries; no OCP; menarche at age 14
Allergies: NKDA
Medications: HCTZ
PMH: hypertension
FH: mother has ostheoarthritis; father is healthy
SH: no smoking, EtOH socially, sexually active with husband only
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]previously regular periods, previously periods, each 28 days, previously periods lasting 5 days, previously periods moderate flow, sexually active, irregular perios, periods have been irregular, periods have been unpredictable, F, hot flashes, lasting 2 to 6 days, over the last 3 years, since the last 3 years, change in sleep pattern, sleeping less, awakes at 4 am, 44 y-o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 yo F, irregular periods x3 years. There is no pattern, can be every 3 weeks to every 4 months. They typically last 2-6 days and can sometimes be heavy requiring 5-6 pads or light requiring 2-3 pads. There is no pain associated. LMP was 2 months ago and lasted for 4 days. Menarche was at age 14. Her periods were regular before 3 years ago. She reports a recent illness of nausea and vomiting last week for a few days for which she took some peptobismal and it resolved. She also woke up one night last week drenched in sweat. Denies any abdominal pain, diarrhea, constipation, hematochezia, dysuria, hematuria, incontinence, vaginal discharge or itching, fevers, chills, cold intolerance, or palpitations. Has cooper IUD.
pmhx: HTN
meds: HCTZ
social hx: No tobacco, rare alcohol use, no drus. Sexually active with husband. No hx STIs. Walks 3-4 times a week for 30-45 minutes. Has 2 boys, 14 and 10 yo. No miscarriages or abortions..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]IUD, Sexually active, irregular periods, periods no pattern, recent illness of nausea and vomiting, nausea and vomiting last week, nausea and vomiting for a few days, F, LMP was 2 months ago, every 3 weeks to every 4 months, last 2-6 days, can be heavy or light, can requiring 5-6 pads or requiring 2-3 pads, x3 years, 44 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 3 years of irregular periods. LMP 2 mo. ago. Frequency of menses ranges from 3 weeks to 4 months. Menarche at age 14 - until age 41, had regular menses every 28-29 days, lasting 4 days, and associated with breast tenderness, cramping and back pain. Associated menstrual symptoms have resolved over the past month. Has been having night sweats, hot flashes. Describes vaginal dryness with sexual intercourse. No weight loss or gain. No fevers. No skin/hair changes. No change in bowel movements, or mood.
Normal pap smear, mammogram 1 yr ago.
OBGYN Hx: 2 uncomplicated pregnancies. Normal pap and mammogran 1 y
PMHx: Hypertension, well-controlled with no recent changes in meds. No prior STIs
PSH: None
Meds: HCTZ, daily. Full complicance. 
Allergies: none
Fhx: maternal osteoporosis. paternal HTN
SHx: sexually active with husband.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]until age 41 menses every 28-29 days, until age 41 menses lasting 4 days, until age 41, had regular menses, had regular menses, pap 1 y, pap smear 1 yr ago, Normal pap 1 y, sexually active, sexual intercourse, vaginal dryness, irregular periods, menstrual symptoms have resolved, Associated menstrual symptoms have resolved over the past month, LMP 2 mo. ago, hot flashes, Has been having hot flashes, Frequency of menses ranges from 3 weeks to 4 months, 3 years of, night sweats, Has been having sweats</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 y/o G2P2 F complains of irregular period over the past 3 years. Her periods were last regular 3 years ago. Her periods no occur anywhere from 3 weeks to 4 months, 2-6 days of bleeding, and her periods are heavy or light. She also notes hot flashes and sweating for the past year. She did note 1 night last week she awoke drenched in sweat. She complans of vaginal dryness, but denies vaginal discharge, HA, fatigue, or recent STDs. Her last pap smear was 1 year ago and normal. She denies any anormal pap smears in the past. She denies heat or cold intolerance, hair loss, change in her weight, or nipple discharge. She denies dysparunia, dysuria, or dysmenorrhea. 
ROS: no CP, N/V, SOB, abd pain, rashes, msk pain
PMH: HTN for 6 years
Medication: HCTZ
FH: osteoarthritis in mother, HTN in brother
SH: office manager, no tobacco use, occasional alcohol use, no illicit drug use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]periods regular 3 years ago, Her periods were last regular 3 years ago, pap smear was 1 year ago, Her last pap smear was 1 year ago, vaginal dryness, She complans of vaginal dryness, irregular period, complains of irregular period, F, G2P2 F, hot flashes, She also notes hot flashes, periods occur from 3 weeks to 4 months, periods 2-6 days of bleeding, periods are heavy or light, Her periods no occur anywhere from 3 weeks to 4 months, 2-6 days of bleeding, and her periods are heavy or light, 2-6 days of bleeding, occur anywhere from 3 weeks to 4 months, over the past 3 years, complains of irregular period over the past 3 years, sweating, drenched in sweat, She also notes sweating, 1 night awoke, 44 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Dolores Montgomery 44 yo F presenting today due to irregular periods for the last 3 years. They were very regular before this time but have recently been irregular and random. Can be 3 weeks apart to 4 months apart. She also notes some hot flashes and sweating at random times over the last few years about 1-2 times per month. She notes vaginal dryness and discomofort on intercourse with husband as well during this time. She uses 3-4 pads per day usually, but sometimes experiences slightly heavier periods now as well. She notes one episode of PMS symptoms with breast tenderness, cramps, and low back pain that was mild before the last period. She denies vaginal discharge, no vision changes, no HA, no nipple d/c
PMH: 2 vaginal deliveries, normal; last Pap 1 year ago, normal; Menarche at 14; hx of HTN 6 yrs, has IUD
Meds: HCTZ
Allergies: NKA
FH: Non-contributory
SH: Happy home, works in office, social drinker, never smoked, never drugs.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]were regular before, Pap 1 year ago, IUD, on intercourse, vaginal dryness, irregular periods, recently been irregular, recently been random, F, hot flashes, Can be 3 weeks apart to 4 months apart, for the last 3 years, for 3 years, sweating, 44 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Montgomery os a 44 y.o G3P3 female with PMH of HTN who presents with 3 years of irregular periods. Prior to three years has had regular periods every 28 days with normal flow. she also complains of occasional hot flashes and sweating along with vaginal dryness. she denies any abdominal pain or changes in bowel or urinary habits. First had her period when 14. she has had two uncomplicated pregnancies.
PMH: HTN
Meds: HCTZ
FH: Mother has OA, father with HTN
SH: None
Allergies: None
SH: Never smoked, drinks ocassionally, no recreational drug use. sexually active with husband does not use barrier contraception. No history of prior STI..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Prior to three years has had regular periods, every 28 days with normal flow, sexually active, vaginal dryness, irregular periods, female, hot flashes, presents with 3 years of, sweating, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 yo with PMH of HTN, presents w/ irregular periods.  Reports that she used to have regular periods, but for the past three years has had periods that range from 2-6 days in length, and that can be light to heavy bleeding.  She is not sure how many periods she has had in the past 12 months, but she has not had a period every month.  Her LMP was 2 months ago.  She has also been exerpiencing vaginal dryness and hotflashes several times a month.   1 week ago, she woke up in a drenching sweat, which is what prompted her to come to the doctor today.  She used to have pre-menstrual cramps regularly but had not had them recently until her LMP.  She has no family history of endometrial/ovarian or breast cancer.  She is unsure when her mother went through menopause.  She denies smoking and drinks infrequently.  she denies abdominal pain or changes in urination.  She denies recent weight loss..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]used to have regular periods, vaginal dryness, irregular periods, LMP was 2 months ago, hotflashes, periods that range from 2-6 days in length, can be light to heavy bleeding, for the past three years, drenching sweat, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44yo F presents with menstrual irregularities which began 3 years ago. She state they are getting unpredictable and she is getting worried. LMP was 2mo ago, menarche at 14, period last about 4 days and are irregular. denies vaginal discharge, cramping, spotting, and her last pap smear was normal last year. She is sexually active with husband, and has a copper IUD in place. no history of STIs. Denies abdominal pain, headache, edema, problems with urination or deffication.
ROS: Neg except as per HPI
PMH: HTN  Meds: HCTZ  SH: none  FH: brother has HTN
Social: Lives at home with 2 kids and husband. Sex with husband, drinks on occasion, no smoking or drugs..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]last pap smear last year, IUD, sexually active, Sex with husband, menstrual irregularities, period are irregular, they are getting unpredictable, F, LMP was 2mo ago, began 3 years ago, 44yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44yo F patients comes complaining of irregularity in her periods that has been going on for 3 years. Periods range between 2-6 days and they happen in a range every 3 weeks-4 months. She also complains of hot flashes, sweating, and vaginal dryness. Denies mood changes, no skin dryness and her cramps are less prominent. Also wakes up earlier than usual
ROS: negative except as above/
PMH: high BP treated with ace inhibitors
A:NKDA
PSH: none
FH:mother with osteoarthritis, brother high BP
SH: lives with husband and kids. Office manager, drinks champane in special ocassions, No smoke no illicits.
OBGYN: LMP: 2 months ago, P2G2 normal vaginal deliveries. Last PAP smear normal.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]vaginal dryness, irregularity in her periods, F, LMP: 2 months ago, hot flashes, Periods range between 2-6 days, happen in a range every 3 weeks-4 months, going on for 3 years, sweating, wakes up earlier than usual, 44yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 yo F has C/O irregular periods. Her periods have been irregular for the last 3 years. She states that the periods last anywhere from 2-6 days, can be either heavy or light. and has no timeframe for when they appear. She says she has hot flashes 1-2 times a month and night sweats last week. She denies any blurry vision, fatigue, feelings of cold,  chest pain, abdominal pain, changes in bowels and weight gain. Patient denies any feelings of sadness or depression.  

ROS: Negative except those stated in HPI
PMH: HTN
Allergies: None
Medications: HZTZ
Hospitalizations: Vaginal delievey. 
Fhx: Mother has osteoarthritis, brother has high blood pressure. 
OBGYN: Mechanice at age 14. Periods were regular till 3 years ago, used 2-3 pads. No vaginal discharge
SH: no smoking, no etoh, no history of stds. Sexual active with husband, monogomous
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Periods were regular, Sexual active, monogomous, irregular periods, periods have been irregular, F, hot flashes, last from 2-6 days, can be heavy or light., has no timeframe for when they appear, for 3 years, till 3 years ago, night sweats, 44 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 yr old f w/ 3 yrs irregular menstrual bleeding
-notes no pattern to her perioeds
-notes it feeling crampy
-nothing makes it better or worse
-Notes hot flashes, sweating, nausea, vomit, early morning waking
No previous episodes. No allergies. Takes HCTZ for hypertension. No trauma, or surgeries. ROS neg except for above.
OBGYN: LMP 2 months ago, menarchy at age 14, period used to last 6 days but now unpredictable, uses 6 tampons a day, notes vaginal dryness, G2P2. Sex hx: active w/ husband, uses IUD, no hx of STDS. Soc hx: lives w/ family, she is a manager at a company, no unusual stress. Occasional wine, denies tobacco, and recreational drugs..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]period used to last 6 days, IUD, Sex hx: active, vaginal dryness, irregular menstrual bleeding, no pattern to her perioeds, period now unpredictable, f, LMP 2 months ago, hot flashes, w/ 3 yrs, sweating, early morning waking, 44 yr old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 44 year old G2P2 female with irregular menses for 3 years. Menarche age 14, regular menses 28 days for 5 days with moderate flow (3-4 pads a day) and premenstrual sx breast tenderness, lower back pain, mild menstrual cramps. Periods became unpredictible over last 3 years, duration 2-6 days ranging light (1-2 pads/day) to heavy (6 pads/day) with frequency ranging 3 weeks to 3 months. LMP 2 months ago for 4 days, moderate flow (prior was 3 weeks), accompanied with premenstrual sx (that ceased for 3 years prior). Random hot flashes, diaphoresis (1 episode night sweats), vaginal dryness over past year. Vaginal discomfort with intercourse, improved with lubrication. ONe week ago 2 days of stomach flu with nausea/vomiting, self-resolved in 2 days. PMH: HTN treated with CHTZ, no surgeries, 2 vaginal births, normal pap smears.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]regular menses for 5 days, regular menses with moderate flow, regular menses 3-4 pads a day, with intercourse, Vaginal discomfort improved with lubrication, irregular menses, Periods became unpredictible, ONe week ago flu, ONe week ago nausea/vomiting, premenstrual sx ceased, female, LMP 2 months ago, duration 2-6 days, ranging light to heavy, ranging 1-2 pads/day to 6 pads/day, frequency ranging 3 weeks to 3 months, over last 3 years, for 3 years, 44 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 yo F with a h/o HTN who complains of irregular menses. started 3 years ago, no pattern to when menses occurs, periods may range from light to heavy (6 pads/ day), lasting from 2-6 days. Has hot flashes and night sweats not accompanied with menses. Menses was previously regular. No h/o surgeries, denies h/o fibroids, thyroid abnormalities. Reports 1 episode of breast tenerness, cramping, and back pain. Denies painful menses, fever chills, nausea, vomitting, consitpation, diarrhea. 

FH: brother - HTN, mom - osteoarthritis, obesity
SH: lifetime nonsmoker, uses alcohol socially, denies IV drug use, denies any increased stress
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Menses was previously regular, irregular menses, F, hot flashes, no pattern to when menses occurs, range from light to heavy, lasting from 2-6 days, started 3 years ago, night sweats, 44 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms Montgomery is a 44yo female with chief complaint of irregular meses x 3 years. Her periods last from 2-6 days and alternate between light spotting and heavy bleeding requiring 5-6 pads per day. LMP was 2 months ago. Prior to 3y ago she had regular 28 days cycles. She is a G2P2 with normal vaginal deliveries 10y ago and 14y ago. She is utd on her pap smears, last was 1 year ago, nl. UTD on mammograms, last 1y ago nl. 
ROS: denies heat/cold intolerance, denies hirsutism, denies voice changes. No changes in bladder or bowel habits. 
PMH HTN, treated with HCTZ
denies allergies
No family history of irregular menses
lives with husband and children, everyone feels safe
No smoking or illicit drugs, drinks socially.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]had regular 28 days cycles, pap smears, last was 1 year, irregular meses, female, LMP was 2 months ago, alternate between light spotting and heavy bleeding, last from 2-6 days, x 3 years, 44yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 yo female c/o irregular periods
- started 3 years ago, is getting worse, has never had this before
- irregular periods that las for 2-6 days and may have a light or a heavy flow, LMP was 2 months ago
- has hot flashes
- denies dysmenorrhea, weight changes, stool changes, fatigue, urine changes, vaginal discharge,  hair changes, visual changes, skin changes, fever or mood changes.
- PMH: HTN treated with HCTZ,  had 2 vaginal deliveries (the last was 10 years ago); Allergies: none, PSH: none, FH: mother has osteoarthritis and brother has HTN
- SH: no smoking, is a office manager, has a diet with low salt and fat, no drugs, drinks etoh on rare ocasions (1 glass of wine), exercises 3x a week, feels safe at home, is sexually active with husband only.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]sexually active, irregular periods, irregular periods, female, LMP was 2 months ago, hot flashes, las for 2-6 days, may have a light or a heavy flow, started 3 years ago, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs Montgomery 44 year old F Presented wth Irregular Mesntruation. For Past 3 years has noted abnormal/irregular mestrual cycle length -time between cycles varying between 3 weeks and 4 months -  and volume of menstrual blleding - sometimes very heavy cycles, sometimes very light. Periods last between 2 and 6 days. No spotting or abnormal vaginal discharge or itch. Has noted vaginal dryness and occasional hot flashes. 1x episode of night sweats last week. No weight change, fatigue, skin or hair changes or abdominal pain. Bowel and bladder habit normalObs/Gyn Hx: Previously periods were every 28-29 days and lasted 5 days with 2/3 pads or tampons used per day. 2 uncomplicated pregnancies with vaginal deliveries. No miscarriages or abortions. PMH: Htn PSH: Nil Meds HCTZ NKDA Family Hx: Mother osteoarthritis and htn Social: Office Manager, Alcohol on special occaions only. non smler, no illicit drug use, sexually active with husband only.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Previously periods were every 28-29 days, Previously periods lasted 5 days, Previously periods with 2/3 pads or tampons used per day, sexually active, vaginal dryness, Irregular Mesntruation, abnormal mestrual cycle, irregular mestrual cycle, F, Mrs, hot flashes, time between cycles varying between 3 weeks and 4 months, sometimes heavy sometimes light, last between 2 and 6 days, For Past 3 years, For 3 years, night sweats, 44 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Montgomery is 44year old female with cheif coplaint of irregular periods. For the past three years she has had unpredictable periods both in time and heaviness. Prior to this periods were every 28-29 days with moderate flow and some pms.  last period was 2 months ago and moderate flow. SHe endores one episode of drenching sweats last weak and occaisonal hot flashes. Also complains of stomach flu last week with n/v. She endorses vaginal dryness but no pruritis or discharge. 
OB/GYN history: 2 children via uncomplicated vaginal birth. Used IUD for contraception x20yrs, most recently changed 4 yrs ago. 
ROS: Denies HA, dizziness, weakness, tremors, CP, SOB, constipation, diarrhea, weight change
PMH: HTN
PSH: none
meds: HCTZ
allergies: NKDA
Family: mother has OA, brother has HTN
Social: works as office manager, lives with husband and 2 children. Safe in marriage, sex only with husband, uses lubricant. Rare EtOH, no tobacco.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Prior to this periods were every 28-29 days, IUD, sex only with husband, vaginal dryness, irregular periods, complains of stomach flu last week with n/v, female, last period was 2 months ago, hot flashes, unpredictable heaviness, unpredictable in time, For the past three years, drenching sweats, 44year</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Montgomery is a 44yoF who presents with 3 years of irregular periods. These periods can last for 2-6d with variable amounts of flow and are not associated with pain, crmaps, breast tenderness, or back pain which are her usual PMS symptoms. Her last period was 2 months ago which she did have pain but says it was a normal period for her.  She had recent history of flu-like gastric distress last week.  She denies any bleeding anywhere else but does admit to night sweats recently without fever. She has 2 children who were born vaginally with uncomplicated pregancies. She uses IUD for contraception which was placed 4 years ago. Pt had PAP last year and has no history of abnormal paps.  She has HTN for which she takes HCTZ and NKDA.  Mother has obesity and osteoarthritis, brother has HTN. She does not smoke, has EtOH rarely, no drugs, is married for 20years, and works as an office manager..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]had PAP last year, IUD, irregular periods, recent history of flu -like gastric distress, flu-like distress last week, not associated with PMS symptoms, not associated with crmaps, breast tenderness, or back pain, Ms, F, last period was 2 months ago, can last for 2-6d, with variable amounts of flow, with 3 years of, night sweats, 44yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 y F c/o irregular periods. Menarche was 14 yrs. Cycles were 28-29 days. 3/4 pads a day. No spotting or bleeding in between cycles. Vagina is dry, uses lubricant. Having hot flashes and woke up one day with sweat. No STDS/hiv test. Has vomited couple of days ago, no blood. No abortions/miscarriages. No numbness or tingling. Denies vision changes, chest pain, SOB. Appetite is good. Excerises 3-4 a week. Works as an office manager. 

ROS-negative
PMH- high BP
A-none
medications-HCTZ
Sh-none
Sexual- with husband, IUD, no std in past, no hiv test
Social- drinks on rare occasions, does not smoke/use illicit drugs
Fh-Brother high BP, mother- osteoarthritits
Diet- low fat/salt.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Cycles were 28-29 days, IUD, Sexual- with husband, Vagina is dry, irregular periods, vomited couple of days ago, F, hot flashes, woke up one day with sweat, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: Irregular peroids

HPI: 44 year olf F c/o irregular peroids for the last 3 years. Patient says she sometimes goes months without a menstrual period. Patient endorses night sweats with subjective fevers for the last year. Denies vaginal puritus, pain-ful sexual intercourese, discharge and intermenstrual bleeding. 

ROS: Per hpi
OB/GYN: G2P0: both vaginal. LMP; 2 months ago. Peroid frequncy ranges from weeks to months and last 2-6 days. Last pap smear was 1 year ago; it was normal. No history of abnormal pap smears. No history of STDs.
 
PMH: Hypertension
PSH: None
Meds: Hydrochlorothiazide 
Allergies: None
SH: Works in office management. Lives with husband and two kids. Sexually monogamous with husband. Denies tobacco and recreational drug use. Occasional alcohol; a few drinks a month.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Last pap smear was 1 year ago, Sexually monogamous, Irregular peroids, irregular peroids, F, LMP; 2 months ago, for the last 3 years, night sweats, 44 year olf</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44yo woman c/o 3yrs of ""unpredictable"" periods last 2-6d, with flow light to heavy, q3wks to 4mo. No spotting between periods. Endorses hot flashes and sweating and vaginal dryness- lubricant with husband during intercourse. Some abdominal pain with last  menses but not usually. Last week, one episode of drenching night sweats with nausea and flu-like sx's, went away. Before, pt had regular periods ~q28d, lasting 4days with moderate flow and PMS symptoms- breast tenderness, back pain, cramps. Today, denies wt changes, voice changes, nipple d/c, vision changes, cold/heat intolerance, facial hair. Pt has 2kids, born vaginally, pregnancies uncomplicated- last born 10yrs ago. Has copper IUD- 4yrs old
ROS: neg cough, cold-like sx's, chest palpitations/pain, SOB, vomiting, changes in bowel habits, dysuria, blood in stool/urine.
PMH: HTN
Meds: HCTZ
Aller: none
FH: noncontributory
SH: manager, rare Etoh, no tobacco/drugs.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Before had regular periods, Before periods ~q28d, Before periods lasting 4days, Before periods with moderate flow, IUD, during intercourse, vaginal dryness-, unpredictable"" periods, Last week, nausea, ""Last week flu-like sxs"", woman, hot flashes, last 2-6d, flow light to heavy, q3wks to 4mo, 3yrs of, sweating, night sweats, drenching sweats, 44yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 yo G2P2A0 female presents to the clinic with irregular menstrual period for three years. The patient states that her menstrual period is unpredictable. The interval ranges from 3 weeks to 4 months. The duration ranges from 2-6 days. The flow ranges from very light amount to 5-6pads when heavy. She denies any spotting between menstruation, or cramps. The pateient denies vaginal discharge. Before that, patient had regular period of 28days and her menstruation lasted for 5 days with daily use of 2-3pads. She is sexually active with her husband and they use copper IUD for contraception. Patient noticed night sweat a week ago. Her last pap smear was normal a year ago. The patient denies headache, dizziness, skin change or change in hair. Patient denies intolerance to heat and cold.

ROS: negative except the above.
PMH: high blood pressure, MEDS: HCT
FH: noncontributory
SH: drinks alcohol 1-2glass/ month, tobacco(-), illicit drug (-).
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Before had regular period, Before had period of 28days and her menstruation lasted for 5 days with daily use of 2-3pads, pap smear a year ago, IUD, sexually active, irregular menstrual period, period is unpredictable, female, interval ranges from 3 weeks to 4 months, duration ranges from 2-6 days, flow ranges from light to 5-6pads, flow ranges from light to heavy, for three years, night sweat, 44 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 44 year old female presenting with irregular periods. Periods have been ""unpredictable"" for the last three years, occurring every 3-6 months w/ bleeding lasting 2-6 days and varying in amount from heavy to light flow. She also complains of vaginal dryness for the last year alleviated by lubrication. She woke up from sleep last week ""drenched in sweat"". She describes having ""hot flashes"" for the last two years lasting approx 1-2 minutes. Denies change in weight, change in bowel habits, fatigue, hirsutism, hair loss and mood change. LMP 2 months ago, had two negative home pregnancy tests last week.
ROS: per HPI
Allergies: NKDA
Meds: HCTZ, IUD (x4yrs)
PMH: Hypertension
FHx: No thyroid disease or premature ovarian failure
Obstetric: G2P2, uncomplicated pregnancies (children 10 and 14yrs)
Social: No cigarette or illicit drug use. <1 drink EtOH/month. Sexually active w/ husband, uses protection. No Hx of STD.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Sexually active, vaginal dryness, irregular periods, Periods have been ""unpredictable, female, LMP 2 months ago, hot flashes, occurring every 3-6 months, lasting 2-6 days, from heavy to light flow, for the last three years, drenched in sweat, woke up, 44 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 yo african american lady with irregular periods of 3 years, lasting each between 2 to 6 days with light to heavy flow as described, with no pelvic main or nausea or weight loss. she has intermittent hot flashes, sweating and vaginal dryness but no dyspareunia or vaginal infections , no dysuria or urinary frequency, no constipation, no bleeding disorder, no fatigue.  menarche at 14 years.married with 2 kids, sexually active with her husband, has an IUD placed 4 years ago, no past surgeries. she has HTN on hctz.no allergies. nonsmoker nonalcoholic, walks daily, well balanced diet, no eleict drug use, 1 ocffee cup daily, happy with her husband, works as an office manager with no increasing stress levels. LMP was 2 months ago.last pap smear and mammography were normal last year.fam hx: mom has osteoarthritis and obese, brother has htn, no cancers in family.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]IUD, sexually active, vaginal dryness, irregular periods, lady, LMP was 2 months, hot flashes, lasting each between 2 to 6 days, with light to heavy flow, of 3 years, sweating, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 44 yo F G2P2 with 3 year history of irregular periods
- regular periods before (5 days of periods with 20-29 days in between); used about 3-4 pads
- now ""unpredictable"": 1 or more elements (bleeding, duration) change with each period, light to heavy bleeding, 2-6 days of period)
- biggest concern: nocturnal heavy sweating 
- endorses: daytime hot flashes and sweating, nausea & vomitting x 2 days
- denies: mood changes, weight changes, diet changes, new excercize regimen, no family history of early menopause
Ob/Gyn: G2P2002, no gynecological issues, most recent pap smear 1 yr ago was normal, pregnancies and deliveries normal
PMH: HTN
PSHx: none
Med/Allergies: HCTZ, no allergies
FHx: no gynecological issues
Soc: lives with hsuband and two sons, uses copper IUD; no past or present tobacco or recreational drug use; ""rare"" use of alcohol (champagne, weine)
ROS: none except as stated above.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]regular periods before, most recent pap smear 1 yr ago, IUD, irregular periods, now ""unpredictable"", F, hot flashes, 1 or more elements (bleeding, duration) change with each period, 2-6 days of period, light to heavy bleeding, 3 year history of, sweating, sweating, 44</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: Stomach pain 

HPI: Patient is a 35 year old male presenting with stomach pain that is getting worse. States that his pain is located in the epigastric region and it comes and goes. Describes it as a burning/gnawing pain and rates it as a 5/10. States that he has been feeling nauseous but denies vomiting. States that Tums helped at first with the pain but has not been helping recently. States that nothing makes the pain worse and there is no association between the pain and meals. States that his stools have appeared darker occasionally. States that he has been stressed out after splitting with his wife one year ago. Admits to feeling tired the past few weeks. Denies headache, chest pain, diarrhea/constipation. 
ROS: Negative unless stated above 
Meds: Motrin once/week
Allergies: Denies
PMH: Denies
Surgical: Denies 
FH: Uncle with bleeding ulcer 
SH: Smoked 1/2 pack per day since 15. Occasional alcohol use..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Uncle with bleeding ulcer, pain is located in the epigastric region, stools have appeared darker, Motrin, burning/gnawing, getting worse, Occasional alcohol use, male, comes and goes, Tums has not been helping, nauseous, 35 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Chad Hamilton is a 35yo male with no significant PMH who is here for evaluation of stomach pain. For the last two months he has been experiencing 1 to 2 hr episodes of epigastric stomach pain twice a day. He experiences nausea along with the pain. There is no associations with mealtime or with type of food eaten. The pain is burning/gnawing in nature and is a severity of 5/10. It sometimes wakes him up at night. He is also experiencing bloating with meals and has noted darker than normal stool. He has tried taking Tums but not found it to be very helpful.
Denies travel or sick contacts. He reports considerable stress as he is undergoing a divorce.

Review of systems: Negative except as in HPI
Allergies: NKDA
Meds: Motrin 400mg once a week
PMH: None
PSH: None
Family History: Uncle with ""Bleeding ulcer""
SH: Smokes cigarettes 1 ppd for 20 years
  ETOH: 1-2 beers a week. Quit recently.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Uncle with ""Bleeding ulcer, epigastric stomach pain, darker than normal stool, Motrin, burning/gnawing, bloating with meals, twice a day, 1-2 beers a week, male, last two months, wakes him up at night, tried taking Tums but not found it to be very helpful, nausea, 35yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 35 year old M who presents c/o episodes of 5/10 gnawing epigastric pain since 2 months ago. Patient states he also feels nauseous when the pain occurs but has no vomited. Patient states he initially had 1 episode of this pain per week, but now it occurs twice per day. He states tums helped the pain but it no longer helps. The pain is unrelated to food intake. He also sometimes wakes up with this pain during the night. The pain comes on gradually, lasts for 1-2 hours. Patient notes his stools have been darker lately. He also has less appetite. Develops gastric bloating with food. 

ROS: negative except as above
allergies: NKDA
Medications: motrin (400 mg as needed for ""aches"") and tums as needed
PMH: ""Aches and pains"" from construction work
PSH: None
SH: Patient drank 1-2 beers/week up until 2 weeks ago. He does not smoke cigarettes or use illicit drugs. He has not had sex for 1 year.
FH: bleeding ulcer in uncle.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]bleeding ulcer in uncle, epigastric pain, stools have been darker, motrin, gnawing, bloating with food, initially had 1 episode of this pain per week, but now it occurs twice per day, 1-2 beers/week, M, since 2 months ago, wakes up with this pain during the night, tums helped the pain but it no longer helps, nauseous, 35 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo M with CC of ""my stomach is bothering me"".
- Stomach pain that started 2 months ago 1X per week is not occuring multiple times a day and at night
- Pain lasts 1-2 hours and is described as burning and knawing, rated 5/10
- Pain is above his umbilicus and does not radiate
- Two weeks of intermittent black stools
- No aversion to food
- Tums no longer alleviate pain and he takes ibuprofen for back pain and spasms
ROS has nausea but no vomitting, fever, chills, night sweats, wt loss, no aversion to food, he does complain of back spasms
PMH None
PSH None
Alleriges NKDA
Family history fathers brother had a stomach ulcer
SH construction worker for 10 years and has 1/2-1 pack of cigarettes a day for 20 years, few beers a week but stopped since stomach pain, no illiciut drug use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]fathers brother had a stomach ulcer, Pain is above his umbilicus, black stools, takes ibuprofen, burning and knawing, few beers a week, M, started 2 months ago, Tums no longer alleviate pain, nausea, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 35 yo M c/o epigastric pain for 2 months burning, has become constant and rates it 5/10. Tums helped earlier but no relief now, Food has no relationship to pain.He has nausea, dark colored stools, stress of getting a divorce, belching and feeling of bloating. Denies chest pain, vomiting, headache , dizziness, LOC, SOB+.
ROS: none except above
PMH: has had back ache for some time
PSH: none
FH: Father has  a bleeding ulcer
SH: construction worker, not sexually active,smokes 1/2 to 1 ppd since the age of 15 yrs, stopped taking alcohol, no illicit drugs
NKDA
Medicines: tums, Motrin
Diet: junk food low fiber diet.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Father has  a bleeding ulcer, epigastric pain, dark colored stools, Motrin, burning, feeling of bloating, has become constant, M, for 2 month, for 2 months, Tums helped earlier but no relief now, nausea, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: - 35 yo M with worsening mid epigastric pain for the past 2 months
- Never had this before
- Describes as a gnawing, burning sensation
- Had it once a week, but not 2-3 times a week, with episodes lasting 1-2 hours
- Associated with bloating
- Partially relieved by Tums before
PMH: Back paind and spasms
PSH: None
Meds: Motrin once a week
Allergies: none
FH: Uncle has a bleeding PUD
SH:  Filed for divorce in the last year. Works in contstruction. 1/2-1 PPD for 20 year smoker. Drinks beer occasionally but stopped more recently.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Uncle has a bleeding PUD, epigastric pain, Motrin, gnawing, burning, bloating, worsening, Had it once a week, but not 2-3 times a week, Drinks beer occasionally, M, past 2 months, Partially relieved by Tums before, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr Hamilton a 35 yo male, presenting with burning non radiating midepigastric pain three days ago of 5/10 intensity .He tried some antacids which used to help but no longer efective.His pain was associated with hiccup for last months together with nausea bloating ,and  his stool getting darker .No vomitting , diarrhea, chest pain , SOB , cough, fever or other constitutional symptoms.
ROS: normal except for above
PMH: low back pains treated with motrins for a year.
PSH : none
SH:construction worker, smoker since was 15 , 0.5-1 , Etoh: quitted recently beacuase of bloating , not sexually active ,no hx of STDs
FH: Uncle with bleeding stomach ulcer..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Uncle with bleeding stomach ulcer, midepigastric pain, stool getting darker, motrins, burning, bloating, bloating, Etoh: quitted recently, Mr, male, antacids no longer efective, nausea, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35M w/ no PMHx/PSHx now p/w 2 months of episodic epigastric pain associated with nausea
- Denies vomiting
- Episodes increasing in frequency lately and epigastric pain now 5/10
- Episodes wake patient up at night and last 1-2 hours
- Previously sx improved with food and TUMS, but not recently
- Episodes are sporadic with no obvious triggers or palliating factors
- Noticed stools are darker in past 2 weeks
ROS: Denies vision changes, numbness/tinginling, chest pain, SOB, urinary or bowel changes, denies recent travel or sick contacts. Negative except as per HPI
FHx: Uncle with bleeding ulcer
Occupation: Construction worker for high-rise buildings
Current smoker since age 15, 0.5-1 pk/day. Denies rec drug use. Not sexually active.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Uncle with bleeding ulcer, epigastric pain, epigastric pain, stools are darker, increasing in frequency, M, w 2 months, Episodes wake patient up at night, episodic, last 1-2 hours, sporadic, Previously sx improved with TUMS, nausea, 35</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Hamilton is a 35 yo male who presents with 2 months of upper abd pain that has been worsening. The pain is burning and nawing, does not radiate , and is a 5/10 severity. The pain comes and goes with no specific associations. Initially tums made the pain a little better but doesn't work any more, nothing makes the pain worse. He also complains of bloating, nausea, no vomiting, and darkening of his stools without diarrhea. No urinary symptoms, no fever/chills.
ROS negative except as above
PMHx backaches
Medications motrin 400mg per week.
FHx: paternal uncle with ""bleeding ulcer""
NKDA
patient usually has a few alcoholic beverages a week but has recently stopped due to the abd pain and bloating
smokes 1 PPD for past 20 years
no other drug use
not sexually active.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle with ""bleeding ulcer"", upper abd pain, darkening of his stools, motrin, burning and nawing, bloating, bloating, worsening, few alcoholic beverages a week, Mr., male, with 2 months, comes and goes, ""tums doesnt work any more"", nausea, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI 35 YO M IN OFFICE C/O  BURNING EPIGASTRIC PAIN  IN THE MIDDEL OF HIS CHEST THAT STARTED 2 MONTHS AGO. THE PAIN WAS ONCE A WEEK IN THE BEGINNING BUT NOW IT IS TWICE A DAY. IT IS 5/10 IN SEVERITY.NOTHING AGRRAV/ALLEV THE PAIN. HE NOTICED HIS STOOL IS DARKER THAN USUALL RECENTLY . NO BLOOD IN IT.  HE HAS NAUSEA WHEN HE FEELS THE PAIN BUT NO VOMITING.AT FIRST TUMS HELPED HIM  BUT NO IT ISN'T. THERE IS NO RELATION  OF PAIN TO  FOOD.  DENIES ANY CHANGE IN URINARY OR BOWEL HABIT, NO FEVER , NO COUGH.
ROS NONE EXCEPT AS ABOVE
PMH BACK PAIN MANAGED CONSERVATIVLY, MEDS MORTIN AND TUMS. 
PSH/HOSP/TRAUMA NONE
FH UNCLE HAD BLEDDING PUD 
SH CONSTRUCTORE WORKER, DRINKS OCC, SMOKES 0.5-1 PPD FOR SEVEERAL YEARS.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]UNCLE HAD BLEDDING PUD, EPIGASTRIC PAIN, STOOL IS DARKER, MORTIN, BURNING, NOW IT IS TWICE A DAY, DRINKS OCC, M, STARTED 2 MONTHS AGO, NO BLOOD IN IT, ""AT FIRST TUMS HELPED HIM  BUT NO IT ISNT"", NAUSEA, 35 YO</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo M c/o 2 month history of epigastric pain with a background history of smoking. Pain is burning, does not radiate, nausea, intermittent, severity of 5/10, but no vomiting or diarrhea. Toms helped relieve pain at beginning, but no longer helps. Pain occasionally wakes patient up from sleep. Pain onset unrelated to food consumption.No change to bowel movements or urination, except stool is darker than usual with no blood. Bloating present, but no appetite changes or weight loss. Pain no exacerbated by postural changes.
ROS: negative except as above.
PMH/PSH: back pain (construction worker)
Medications: Toms, Motrin.
Allergies: NKDA.
FH: paternal uncle had bleeding ulcer.
SH: smokes 1/2-1 PPD for 20 years. No illicit drugs. Drinks few beers a week, but not for past couple of weeks. Lives alone, not sexually active. Works as construction worker. Eats fast food or food from food truck. Regular exercise except past couple of weeks..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]paternal uncle had bleeding ulcer, epigastric pain, stool is darker, Motrin, burning, Bloating, few beers a week, M, 2 month history, wakes patient up from sleep, intermittent, Toms helped relieve pain at beginning, but no longer helps, nausea, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo M c/o pain in the middle of the stomach for a few months. It comes and goes, lasts for 1-2 hours, burning pain, no radiation PS 5/10, alleviated with Tums at first, but nor anymore, no aggravating factors, not related to meals. He sometimes feel nauseated, but not vomitted. No fever, no nightsweats, no change in his bowel movement, appetite, weight, urination. However, he reports black stool without blood sometimes. He also feels fatigue and tired. 
ROS: normal except above
PMH: back pain with muscle aches
Allergies: NKDA
Meds: Motrin for back pain once a week
FH: Uncle has bleeding ulcer
SH: smoking for 20 years 1/2-1 PPD, no EtOH, illicit drug use. He is not sexually active.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Uncle has bleeding ulcer, pain in the middle of the stomach, black stool, Motrin, burning, M, for a few months, stool without blood, comes and goes, lasts for 1-2 hours, alleviated with Tums at first, but nor anymore, nauseated, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr Hailton, a 35 year old male comes for evaluatiuon of an epigastric tenderness. Patientr had had this pain for 2 months now, its intermittent, ocuring 2 times daily and last about 2 hours when it happens. Pain resolves spontaneously. Pain is rated 5/ 10 in severity, non-radiating  and progressively getting worse. Patient has had darlk stools recently. patient uses motrin very often for body pains.
ROS: no fever, chills, vomiting, urinary symptoms, no receent travels
Pmhx: None
Allergies: NKA
Meds:, Motrin PRN for pain, TUMS
FHX: Pternal uncle with Bleeding gastric ulcer
Social HX: lIVES ALONE, CONSTRUCTION WORKER, drinks ocasionally, smokes 1/2 to 1 PPD. No illicit drug use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle with Bleeding gastric ulcer, epigastric tenderness, darlk stools, uses motrin, Motrin, ocuring 2 times daily, progressively getting worse, drinks ocasionally, Mr, male, for 2 months, intermittent, 35 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 M who presents with 2 months of progressive epigastric abdominal pain. Pain initially occurred a few times per week but has progressed to occurring 2x/day. Pain is not associated with eating or hunger. Initally better with Tums but now nothing makes the pain better. No aggrevating factors. Burning and gnawing in quality. 5/10 in severity. No radiation. Has associated nausea and bloating after meals. For the past week, patient has noticed stool is darker in color. No recent illness

ROS: + nausea; denies: difficulty swallowing, heartburn, sour taste, vomiting, diarrhea, constipation, weightloss, fevers, chills, rashes
PMH: none
PSH: none
FH: uncle with bleeding ulcer
Med: motrin 400mg 1x/wk, Tums
All: none
Social: EtOH 1-2 beer/wk - stopped 3 wks ago due to lack of appetite, Tob: 1/2-1ppd x 20 yrs, not ready to quit, Drugs: none, Work: construction, not sexually active.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle with bleeding ulcer, epigastric abdominal pain, stool is darker, motrin, Burning and gnawing, bloating after meals, progressive, progressed to occurring 2x/day, 1-2 beer/wk, M, with 2 months, Initally better with Tums but now nothing makes the pain better, nausea, nausea, 35</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Hamilton is a 35yo M who presents to the clinic complaining of stomach problems. He states that he has had a burning pain in his upper mid epigastric area that transiently began 2 months ago but is now recurring daily. He initially was using TUMS for relief but now states that it is no longer effective. The pain does not radiate and has occasionally awoken him from sleep. He endorses nausea and some darkening of his stools. 
ROS: negative for vomitting, diarrhea, constipation, cough, or SOB
Meds: TUMS and motrin
FH: uncle diagnosed w/ bleeding ulcer
Social hx: eats mostly from food trucks (e.g. burritos), smokes 1/2-1 ppd of cigarettes since age 15 no interest in quitting today, used to drink a few beers/wk. but that made his pain worse, works in construction
no prior surgeries or hospitalizations.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle diagnosed w/ bleeding ulcer, pain in his upper mid epigastric area, darkening of his stools, motrin, burning, now recurring daily, few beers/wk, Mr., M, began 2 months ago, pain has occasionally awoken him from sleep, TUMS is no longer effective, nausea, 35yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: A 35 yo M presented with abdominal pain for 2 months
- began 2 months, getting worse, intermittent (2-3/day), sometimes at night, no previous episode
- burning pain, no radiation, 5/10, no trauma
- alleviated by tums; no aggravative factor
- has nausea, dark brown stool (no blood/melena)
- no fever, vomiting
ROS negative except above
MEds Motrin, Tums; Allergies NKDA
PMH/PSH none
SH smoking 20 py, EtOH occasionally, no illicit drugs; work as high elevator constructor; no sexually active
FH Ulcer had bleeding peptic ulcer.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Ulcer had bleeding peptic ulcer, dark brown stool, Motrin, burning, getting worse, 2-3/day, EtOH occasionally, M, for 2 months, began 2 months, sometimes at night, no blood/melena, intermittent, nausea, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Chad Hamilton is a 25 yo gentleman presenting with two months of epigastric pain.  Pain is intermittent, rated at 5/10 occurring 2 times daily and lasting 1-2 hours.  Patient reports that originally it was occurring once a week and relieved with Tums, he reports that antacids are no longer helping.  Patient reports nothing that alleviates or worsens his pain.  There is no radiation of the pain, although he generally has some back pain, he treats with motrin. Nausea, no vomiting, no fevers or chills. He has had decreased appetite.  He has had some darker brown stools, no gross blood, no change in consistency. No change in urination. No CP and no SOB.
ROS: otherwise -, PMH/ PSH: back pain  Meds: Motrin and Tums PRN, NKDA
SH: Works in construction,not sexually active,15py smoking pre-contemplation stage of change,was drinking a couple beers weekly,none for 2 weeks, no drugs.
FH: Uncle bleeding pep ulcer..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Uncle bleeding pep ulcer, epigastric pain, darker brown stools, motrin, Motrin, 2 times daily, couple beers weekly, Mr., gentleman, with two months, no gross blood, intermittent, antacids are no longer helping, originally relieved with Tums, Nausea</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: A 35 YO M C/O EPIGASRIC PAIN X 1 MO , GRADUAL , GETTING WORSE , OCCUR 2 TIMES /DAY AND WAKES HIM UP FROM SLEEP 3 TIMES / WK , AFFECTING HIS DAILY ACTIVITIES. GNOWING IN NATURE , LOCALIZED , 5/10 IN SEVERITY , NOT RELATED TO FOOD ,, AND TUMS ARE NOT WORKING FOR IT ANYMORE. HE FEELS NAUSEATED BUT NEVER VOMIT , HE HAS BLOATING AND AVOIDS FOOD BECAUE OF THAT BLOATING BUT DENIES WEIGHT CHANGES . HE ALSO DENIES CHANGES IN HIS BOWL HABITS .HE HAS NO FEVER  OR JANDICE . HE IS RECENTLY STRESSED BECAUSE HE RECENTLY DIVORCED WITH HIS WIFE.HE DENIES DYSPHAGEA, ODYNOPHAGEA OR BAD TASTE IN HIS MOUTH 
ROS:NO DIZZINESS, NO PALPITATIONS 
PMH : BACK ACHES AS HE'S A CONSTRUCTIOM WORKER 
PSH : NONE    ALLERGIES : NONE
MEDS : MOTLIN ONCE / WK , TUMS ( STOPPED WORKING)
FH : UNCLE HAS BLEEDING PEPTIC ULCER 
SH : SMOKER 1/2- 1 PPD/ 20 YRS , QUIT DRINKING (USED TO DRINK 3 BEERS/WK ) , NO ILLICIT DRUGS , NO SPECIAL DIET , NOT SEXUALLY ACTIVE AS HE'S DIVORC.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]UNCLE HAS BLEEDING PEPTIC ULCER, EPIGASRIC PAIN, MOTLIN, GNOWING, BLOATING, BLOATING, GETTING WORSE, 2 TIMES /DAY, 3 BEERS/WK, M, WAKES HIM UP FROM SLEEP, TUMS ARE NOT WORKING, TUMS ( STOPPED WORKING, NAUSEATED, 35 YO</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo M c/o stomach pain for 2 months.
HPI: The pain gradually started 2 months ago and it is getting worse. It is located in the epigastric area and does not radiate to anywhere. It is a dull and intermittent pain. It last 1-2 hours every time and Tums relieved the pain before. However, Tums did not improve his symptom right now. Nothing makes the pain worse. The severity is 5/10. He also noticed intermittent dark stools in last few weeks and he denies any change in the shape of the stool. He feels tired but denies any change in body weight and appetite. He denies nausea, vomiting or diarreha. 
ROS: negative except as above
PMH: has back and musle pain which was treated wiht OTC NSAIDs
Medications: Tums and NSAIDs, and NKDA
FH: father and uncle had history of bleeding ulcer
SH: construction worker, 0.5 PPD tobacco since 15 years old, EtOH occasionally, no sexually active, eats fast food usually.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]father and uncle had history of bleeding ulcer, pain in the epigastric area, dark stools, NSAIDs, NSAIDs, getting worse, EtOH occasionally, M, for 2 months, started 2 months ago, intermittent, Tums did not improve his symptom, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 35 YO M CO EPIGASTRIC ABD PAIN, STARTED 2 MO AGO, INTERMITTENT, INCREASED  IN FREQUENCY RECENTLY, 5/10 INTENSITY, USED TUMS TO HELP IT BUT STOPPED AS IT DOES NO LONGER HELP, PAIN IS ASSOCIATED WITH NAUSEA BUT NO VOMITING, ALSO ASSOCIATED WITH BLOATING.  NO RELATION TO FOOD, NO ABNORMAL TASTE IN THE MOUTH, NO COUGH AT NIGHT, NO CHANGE IN BOWEL HABITS, BUT HE NOTICED THAT THE STOOL IS DRAKER THAN USUAL STARTED 3 WKS AGO, ON AND OFF. NO CHESTPAIN, FEVER, WEIGHT CHANGES, BUT HE EATS LESS THAN USUAL BECAUSE OF THE PAIN. HE ALSO DESCRIBES BACK PAIN AND RELATES THE PAIN TO HIS WORK IN CONSTRUCTIONS. 
ROS: - EXCEPT AS ABOVE.
MEDS: USED TO USE TUMS BUT HE DOES NO LONGER USE IT. NKDA.
PMH: BACK PAIN.
PSH: NONE.
FH: UNCLE HAD BLEEDING PEPTIC ULCER.
SH: SMOKES 1/2 TO 1 PPD SINCE AGE 15. DRINKS ETOH BUT CUT DOWN HIS BEERS LATELY. NO ILLICIT DRUGS..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]UNCLE HAD BLEEDING PEPTIC ULCER, EPIGASTRIC ABD PAIN, STOOL IS DRAKER, BLOATING, INCREASED  IN FREQUENCY, M, STARTED 2 MO AGO, INTERMITTENT, USED TUMS TO HELP IT BUT STOPPED AS IT DOES NO LONGER HELP, USED TO USE TUMS BUT HE DOES NO LONGER USE IT, NAUSEA, 35 YO</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Chad hailton is a 35M with 2 months of epigastric pain. Pain is burning, non-radiating intermittent lasting for 1-2 hour, rated 5/10 severity. Accompanied by nausea, no vomitting. He has noted bloating sensation after every meal and now eatss maller portions. Has noted darker stool. No hematochezia, vomiting, diarrhea, or change in appetite. Feel tired as pain is waking him up in night No fver, chest pain, or palpitatons. mhx: chronic low back pain. surgeries: none. Med: motrin 2 200 tables once/week. Allergies none; family hx: n/a shx: work as construction worker, No recent travel, 20 pack-year smoking history, 2 alcoholic beverage/week (but stopped drinking 2 weeks ago), not sexually active, no hx of sexually transmitted infection. Diet: eats from food trucks.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]epigastric pain, darker stool, motrin, burning, bloating sensation after every meal, 2 alcoholic beverage/week, M, with 2 months, pain is waking him up in night, No hematochezia, intermittent, nausea, 35</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35-year-old male presents with 2 months of epigastric pain which has worsened. Pain is 5/10 in severity, dull knawing pain which strarted gradually. He reports increased frequency of the pain; 2 times per day and each episode lasts about 1 hour. Admits to nausea, no vomiting. Patient reports food avoidance because it makes the pain worse though appetite is otherwise normal. Denies constipation or diarhea or pain any where else in the abdomen. He reports having dark stools for 2 weeks. and admits to feeling fatigued. 
ROS - denied chest pain, SOB, headache, feverm, chills or weight loss. 
PMH: aches and pains
PSH: none
Meds: motrin and tums 
FH: bleedign ulcer in uncle
Social history: 0.5 to 1 ppd for 20 years, few beers per week (now none because makes pain worse), high elevation contruction worker, going through divorce which makes his stressed. Provided counselling on smoking cessation , NKDA, no illicit drug use,.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]bleedign ulcer in uncle, epigastric pain, dark stools, motrin, knawing pain, has worsened, increased frequency, 2 times per day, few beers per week, male, with 2 months, nausea, 35-year-old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35-year-old male, has come to the physician's office today because of abdominal pain
- occurred 2 mo ago, intermittnetly, twice a day, in upper middle ABD, intensity 5/10, burning and iching
- feel bloated after eating, neaseated, stool is darker, reduced appetite
- deny vomiting, heart burn, urine changes, fever, constation and diarrhea, weight changes, sleep and mood changes, fresh blood in stool
ROS: neg except as above
PMH/PSH: none
All: NKDA
Med: Methotrix
FH: NONE
SH: 1/2-1ppd for 20 yr, ETOH 1-2 beers a day, reduced recently, no recreatinal drugs, regular GYM exercise, not active sexually.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]in upper middle ABD, stool is darker, burning, bloated after eating, twice a day, 1-2 beers a day, male, occurred 2 mo ago, deny fresh blood in stool, intermittnetly, neaseated, 35-year-old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: patient is a 35yo male with intermittant buring stomach pains for the last 2 months assicted with nausa but no vomtting. pain is non radating in the epigartric region. not made worse by food inatke or positon change or time of day. has noticed some darknmesing of stool but do change to bowel habits
med: tums/ motrin chronic
allergies: none
pmh: back pain
fmh: unlce bleeding ulcer
smh: smokes 1/2ppd, occaional etoh, -drugs
ros: no dizzyness, palpitation, sob, chest pain, brusing, hetaturia, hemochezia.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]unlce bleeding ulcer, pain in the epigartric region, darknmesing of stool, motrin, buring, occaional etoh, male, the last 2 months, no hemochezia, intermittant, nausa, 35yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: Mr. Hamilton is a 35 year old male who presents with ""stomach problems"". This has now been going on approximatley 2 months. The pain is described as gnawing/burning, and comes and goes. The pain does not radiate. He has experienced nausea, but no vomiting or diarrhea. He has noticed dark stools. He has never had this pain before. He has not noticed an association with foods. Tums helped at first, but now don't help. He denies headache, vision changes, cough, shortness of breath, or chest pain.
PMH: back pain/spasms
PSH: none
Rx: Motrin
FH: Uncle with ""bleeding ulcer""
SH: smoked 0.5-1 ppd for 20 years, occasional EtOH until 3 weeks ago, no other drug use, not sexually active, works constuction.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Uncle with ""bleeding ulcer"", dark stools, Motrin, gnawing/burning, occasional EtOH, Mr., male, approximatley 2 months, comes and goes, Tums helped at first, ""Tums now dont help"", nausea, 35 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 y.o M with 2 month history of abdominal pain in epigastric area. Burning knawing pain that comes and goes. Pain the same over last 2 months. Can occur at any time of day. Used to be relieved by tums but no longer effective. Associated with nausea but no vomiting. Nothing makes it better or worse. Eating makes him feel more bloated. 
PMH: back pain attributed to heavy lifting
FH: uncle has bleeding ulcer
SH: construction worker, divorced, tobacco for last 15 years 1/2-1 ppd, occasional alcohol, no recreational drugs
Meds: motrin 1/wk for back pain
ROS: nausea, darker stools.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle has bleeding ulcer, pain in epigastric area, darker stools, motrin, Burning knawing, Eating makes him feel more bloated, occasional alcohol, M, 2 month history, last 2 months, comes and goes, tums no longer effective, nausea, nausea, 35 y.o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 35 yo M who presents with c/o stomach problems. Patient reports onset 2 months ago that have been worsening. Patient reports non-radiating epigastric pain that occurs 2x a day, 3x per week that last 1-2 hours and has burning and gnawing qualities. Patient reports previous relief with tums, but is no longer working. Patient denies association with food. Patient rates pain 5/10. Patient reports associated bloating and early satiety for 2 months, nausea, and melena. Denies vomiting, hematoschezia, heartburn, cough. Patient PMH notable for lower back pain related to construction work. denies PSHx. Medications include motron (2 tablets of 200mg 1x/week) and tums. NKDA. Patient FH notable for uncle with PUD. Works in construction. Drinks 2-3 drinks/week, reports absinence for 2 weeks due to abd sxs. Smoking 0.5-1PPD since 15. Not interesting in quitting. Denies drug use. Not currently sexually active..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle with PUD, epigastric pain, melena, motron, burning and gnawing, bloating, worsening, occurs 2x a day, 2-3 drinks/week, M, onset 2 months ago, Denies hematoschezia, tums no longer working, nausea, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo M presents with epigastric pain accompanied by nausea for 2 months. Has progressed and occurs twice a day and 3 nights a week. Pain is waking him up from sleep. Intermittent, burning pain with 5/10 in intensity. No relationship of food to pain. Noticed darker stool the past 2 weeks, on and off. Feeling bloated after eating which is making him eat less. Has a good apetite, no changes in weight. Significant stress, divorce and work related. Pain was alleviated with tums previously not anymore. Denies diarrhea or constipation, fresh blood. No fever or chills. 
ROS:negative except as above
Allergies: nkda
Medications: tums, motrin
PMH: back ache, spasms
SH: construction worker, lives alone, One sexual partner and regular use of condoms. EtOH use of a few beers a week since age 21, cut down since symptoms of bloating. Tobacco use of 1/2-1PPD since age 15. No use of illicit drugs
FH: uncle with a bleeding ulcer..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle with a bleeding ulcer, epigastric pain, darker stool, motrin, burning, bloated after eating, bloating, Has progressed, occurs twice a day, few beers a week, M, for 2 months, Pain is waking him up from sleep, Denies fresh blood, Intermittent, Pain was alleviated with tums previously not anymore, nausea, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 35 year old male complains of intermittent, non-radiating, gnawing, burning epigastric pain rated 5/10 for the past 2 months. Associated with nausea, bloating, and a change in stool color from lighter to darker (possible melena). Alleviated by Tums, no aggravating factors.
PMH: back pain, muscle spasms from construction work
Allergies: denies
Medications: Motrin
Hospitalizations/Infections/Trauma/Surgeries: denies
ROS: denies fever, diarrhea, constipation, urinary changes.
Family history: Uncle: bleeding ulcer
Social: Occupation: construction worker; Tobacco: 1 PPD for 20 years, occasional EtOH, denies illicit drug use; no pets, travel, or sick contacts
Sexual: not active, no history of STI.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Uncle: bleeding ulcer, epigastric pain, stool color from lighter to darker, Motrin, gnawing, burning, bloating, occasional EtOH, male, past 2 months, intermittent, nausea, 35 year old, 5 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 35M w/ no PMH p/w epigastric pain of 2 months duration. Pain lasts 1-2 hours and is a burning, dull pain. No radiation to the back. Tums used to alleviate the pain, but not anymore. 5/10 pain with episodes, 0/10 currently in office. Also endorses nausea with pain and dark bowel movements of 2 months duration. Denies any chest pain, SOB, changes in bladder function. Pain is not related to food intake. 
PMH: none       PSH: none 
Meds: 2 200 mg Motrin tabs for pain weekly. 
Allergies: NKDA
FH: Uncle complains of bleeding ulcer occasionally 
SH: 0.5-1 ppd tobacco since age 15. Cut out alcohol recently since had no desire for it. No illicit drugs. Lives alone. Works in construction..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Uncle complains of bleeding ulcer, epigastric pain, dark bowel movements, Motrin, burning, M, 2 months duration, Tums used to alleviate the pain, but not anymore, nausea, 35</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35yoM with 2 month hx of worsening stomach pain
-initally few times a week to 2x/day of gnawing/burning pain in mid-epigastric area
-denies cough, vomiting however endorses darker brown stools as of 2 weeks, never any bright red blood per rectum
-initially alleviated with tums, now less effective; nothing made worse 
-takes ibuprofen 400mg one a week for back pain for 10 years straight 
-denies any unintentional weight loss/gain
pmh: chronic back pain (never diagnoses) 
famhx: uncle with peptic ulcer disease
meds: ibuprofen once a week for 10 year
allergies: nkda
surg/hosp: none
social: works in contruction, takes pain meds for back pain/muscle aches, 20 pack year smoking hx - conteplative quitting stage, no etoh, no illicits/ivdu, lives alone.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle with peptic ulcer disease, pain in mid-epigastric area, darker brown stool, takes ibuprofen, ibuprofen, gnawing/burning, worsening, initally few times a week to 2x/day, M, with 2 month hx, never any bright red blood per rectum, tums, now less effective, 35yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35yo male presents due to mid epigastric pain x2mo. The pain comes and goes, but is getting worse. Never had it before, non-radiating, used to be relieved w/ Tums, now it does not, does not get worse w/ anything. Comes randomly, no associated w/ food, has nausea but no vomiting. Gnawing pain that wakes him at night, 5/10 in severity. He has extra bletching, has noticed dark stools of normal caliber, and bloating after food intake. Denies appetite changes, changes in weight, recent travel, HAs, fatigue, sweats/chills, recent infections, changes/problems w/ urinary habits. 
ROS: negative except as above.
PMH: Back pain due to construction work 
PSH: none FH: uncle has peptic ulcer disease
SH: smoking since he was 15yo, 1/2-1 ppd. Used to drink alcohol until this pain stated. No drug use. Construction worker, going through a divorce w/ extra stress, eats fast food or whats near, used to exercise before pain.
Meds: Motrin, 7-8 coffee.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle has peptic ulcer disease, epigastric pain, dark stools, Motrin, bloating after food intake, getting worse, Used to drink alcohol, male, x2mo, wakes him at night, comes and goes, used to be relieved w/ Tums, now it does not, nausea, 35yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: A 35 Y M CONSTRUCTION WORKER C/O EPIGASTRIC PAIN X 2M, STRTED GRADULLY,GETTING WORSE,5/10 INTENSITY,BURNING TYPE,ON &OFF,OCCURS EVERYDAY ,LASTS FOR 1 HR,INITIALLY RELIVED WITH TUMS,BUT NOW NOT RELIVING
H/O MALENA X 2 WEEKS,NO BLOOD IN IT
H/O BLOATING AFTER EATING,NAUSEA,NO VOMTINGS,APPETITE IS DECRESED
H/O BACK PAIN X 10 Y,USING MOTRIN FOR PAIN
NO H/O CHEST PAIN,SOB,WATER BARSH,CHANGE IN TASTE OF MOUTH,FEVER,WT CHANGES,
NO H/O RELATIONSHIP BETWEEN FOOD INTAKE AND PAIN,ASSO WITH SPICY FOOD
ROS:AS PER HPI,PMH:AS ABOVE,PSH:NONE,ALLERGIES:NKDA,MEDS:TUMS AND MOTRIN
FH:UNCLE HAS PUD
SH:SMOKES 1PPD X 15 Y,ETOH OCCATIONALLY,NO ILLICIT DRUGS


.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]UNCLE HAS PUD, EPIGASTRIC PAIN, MALENA, USING MOTRIN, MOTRIN, BURNING, BLOATING AFTER EATING, GETTING WORSE, OCCURS EVERYDAY, ETOH OCCATIONALLY, M, X 2M, NO BLOOD IN IT, ON &OFF, LASTS FOR 1 HR, INITIALLY RELIVED WITH TUMS, NAUSEA, 35 Y</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Hamilton is a 35 y.o. male with 2 month history of epigastric pain, 6/10, described as burning, gnawing. Pain is not worse at night or atrributable to a specific food. Pain comes and goes and patient does not know what makes it better or worse. Tums helps previously but no longer help. Pt also reports dark stools but no blood in stools. Under a lot of stress with work and splitting up with wife. 
ROS: denies dyspepsia constipation, diarrhea, chest pain, shortness of breath, hematuria

PMH: back pain and muscle spasm
PSM: none
Meds: motrin, 2 pills once a week
Allergies: NKDA
Fam Hx: noncontributory
Soc Hx: smokes 1/2 pack to one pack per day for 20 years, high stress life with work and currently splitting up with wife, no drug use, alcohol during week but not every day.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]epigastric pain, dark stools, motrin, burning, gnawing, alcohol during week but not every day, Mr., male, with 2 month history, no blood in stools, comes and goes, Tums helps previously but no longer help, 35 y.o.</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Chad Hamilton, a 35-year-old male, has come to the physician's office today because of stomach problems. The patient has experienced middle sense of burning and gnawing pain that is localized to the epigastric region for 2 months.  He has not experienced any radiation of pain and desribes the severity as 5 out of 10. The pain is on and off and for a few weeks taking tums made the pain better.  At this point he has not noticed any exacerbating factors .  He has noticed no change in bowel habits, but has been nauseous and eats less because of the pain, the pain also wakes him up at night occasionally.  He denies fever/chills, weight loss or any othe constitutional symptoms.  
ROS: see HPI 
Past medical history  back pain, muscle aches 
Meds:  motrin 
fam hx: uncle with ulcer 
allergies: none 
Social hx:  1/2-1 pack for 20 years.  not interested in quitting.  Works in construction.  No alcohol use or sexually active. eats fast food..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle with ulcer, pain that is localized to the epigastric region, motrin, burning and gnawing, male, for 2 months, wakes him up at night, on and off, nauseous, 35-year-old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Chad Hamtilton is a 35 y/o M presenting with abdominal pain. Reports that he started experiencing epigastric pain 2 months ago. Occured 1x/week but now occurs 2-3x/day and alsts 1-2 hrs. The pain is 5/10 and localized to the mid-epigastric region. During these episodes he also has nausea and feels bloated. No emesis, no radiation. Has had darker stools during this time but no frank blood in stool or diarhea. His only other complaint is back pain he has from work that he takes Motrin for. Otherwise in his normal state of health.

ROS: As stated in HPI
PMH: Back pain with spasms
Meds: Motrin 1x/week PRN back pain
Allergies: none
Surg hx: none
Fam hx: Ulcer had a bleeding ulcer
Sox hx: Works in construction. EtOH use on average 1-2x/week but less recently, smokes 1/2-1 pack per day tobacco (not interested in stopping at this time). No drug use. No sexually active but uses condoms regularely when he is..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Ulcer had a bleeding ulcer, epigastric pain, pain mid-epigastric, darker stools, takes Motrin, Motrin, feels bloated, now occurs 2-3x/day, EtOH 1-2x/week, Mr., M, 2 months ago, no frank blood in stool, nausea, 35 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 35 y/o M with no PMH presents with epigastric pain for 2 months. The pain is described as burning pain, no radiation, 5/10, partially relieved with Toms but not helping recently, associated with nausea, bloasting and stomach fullness. Denies food regurgitation, vomiting, diarrhea, constipation, weakness , numbness, fever, headache, chest pain, SOB. Pt has been using Motrin excessicvely for back aches and muscle pain. He works in construction. He also takes 5-6 cups of coffee every day.
ROS: -ve except HPI
Allergy : NONE
Meds: Motrin, toms
PMH: NONE
PSH: None
FH: uncle had PUD
SH: Drinks alcohol, few beers a week but has decreased intake, Smoking 1/2-1 packs per day since age 15, no illicit drug use, exercises regularly.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle had PUD, epigastric pain, using Motrin, Motrin, burning, bloasting, stomach fullness, few beers a week, M, for 2 months, relieved with Toms but not helping recently, nausea, 35 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 Yo M c/o epigastric  pain since 2 months ago, scale 5/10, progressive, intemittent pain, use to occure every week for 1-2 hours but now it occurs 2-3 times per day. it is a burning pain, does not radiates anywhere, TUMs used to make it slightly better but not anymore and nothing aggravates the pain, he has cut down on his eating due to bloating after eating. his diet is mostly Fast food. he lifts heavy stuff at work and because of muscle aches he has been  taking  Motrin once a week for 9 years. he recently has night time awakening due to the pian, positve for nausea but no vomiting. he feels tired. no diaphoresis, no weight loss. no Hx of similar episode in the past .  pain is not related to any specific food. 
ROS: negative excpet as above 
allergies: nkda
 medication: motrin , TUMS
PMH/SH ; none
smoking 05-1 PPD since he was 15, oocasional ETOH, no illcit drugs 
not sexually active 
FH: probable PUD in uncle.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]PUD in uncle, epigastric  pain, taking  Motrin, motrin, burning, bloating after eating, progressive, occurs 2-3 times per day, oocasional ETOH, M, since 2 months ago, night time awakening, intemittent, TUMs used to make it slightly better but not anymore, nausea, 35 Yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Hamilton is a 35 yo male with no PMH who reports 2 months of intermittent, worsening epigastric ""burning"" and ""gnawing"" pain. Pt also endorses ""darkened stool"" for the last 2 weeks as well. The epigastric pain has increased in frequency over last few weeks, not associated with food or activity, and was originally partially relieved by tums and motrin, but these no longer help. Pain does not radiate and pt rates it as a 5/10. Pt also endorses nasua and bloating. Pt denies weight loss, fevers, night sweats, sick contacts, or recent travel. The darkened stools began 2 weeks ago. No changes in stool consistency or frequency. Denies hematochezia
ROS - wnl except as above
PMH - none
PFHx - uncle with peptic ulcer
PHosp - none
Social - 1/2-1 ppd for 20 years, drank 1-3 12 oz beers weekly prior to symptoms, currently does not drink, no illicit drugs, construction worker, no stress at home or work
allergies - none
meds - tums, motrin.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle with peptic ulce, epigastric pain, epigastric pain, darkened stool, darkened stools, motrin, burning"" and ""gnawing, worsening, increased in frequency, drank 1-3 12 oz beers weekly, Mr., male, reports 2 months, Denies hematochezia, intermittent, originally partially relieved by tums, tums no longer help, nasua, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr Hamilton is a 35M w/ PMHx of bain pain and muscle spasms who presents w/ 2 month epigastric pain
- described as burning sensation lasting 1-2 hrs, accompanied by nausea and wakes him from sleep at night
- no vomiting, no related to foods, no recent weight loss, pain does not radiate, no cough or chest pain
- eats mostly fast food, drinks coffee and water
- tried tums for relief, but no longer effective
- also reports occassional dark stools, but no blood per rectum, no diarrhea
ROS: negative except as above
PMHx: back pain, muscle spasms; PSHx: none
Meds: motrin 2 pills/wk for body aches; All: NKDA
FHx: uncle w/ bleeding ulcer
SocHx: currently divorcing wife, works in high-elevation construction, smoked 1/2pack -1pack/d since age 15, not interested in quitting, no recr drug use, no history of STIs, normally drinks beer occassionally, but stopped since onset of symptoms
PsychHx: never seen psychiatrist.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle w/ bleeding ulcer, epigastric pain, dark stools, motrin, burning, drinks beer occassionally, Mr, M, w/ 2 month, wakes him from sleep at night, no blood per rectum, tums no longer effective, nausea, 35</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo M presents wtih stomach problems. Pt states a burning gnawing epigastric pain comes and goes and lasts for about 1-2 hours in duration. He states the pain does not radiate anywhere but he noticed an increased in frequency over 2 months now feeling symptoms 2 times a day instead of every week initially. Pt states tumes initally helped alleviate the pain but now nothing helps and nothing makes it worse. Pt states the pain is 5/10 in severity and noticed feeling nausea, burping more, pain that wakes him up at night, dark stools for 2 weeks and decreased appetitie with abdominal bloating and increased saitey with small portions of food. 
ROS: negative for fever,night sweats, chest pain, sob, hematura diarrhea,constipation
allergies: none 
pmh: none
psh: none
Meds: motrin PRN
FH: uncle bleeding ulcer
SH: construction, stress with recent divorce, 20 smoking pack year hx, stopped EtOH 3 weeks ago (prior 2 beers/wk) deneis drug use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle bleeding ulcer, epigastric pain, dark stools, motrin, burning gnawing, abdominal bloating, increased in frequency, symptoms 2 times a day, 2 beers/wk, M, over 2 months, pain that wakes him up at night, comes and goes, tumes initally helped alleviate the pain but now nothing helps, nausea, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yr old male , previously healthy , coming with history of Burning central abdominal pain for 2 months . Non radiating and associated with decreased intake , but didn't affect the appetitie or wt . There's ALSO BLOATING SENSATION AND increased burping . There's hsitory of caffiene intake 
No fever , nausea or vomiting , diarrhea
ROS body aches and back aches related to his work  
PMH and PSH : unremarkable 
Family Hx : Both parents are healthy . 
Social Hx : construction worker . Going through a divorce with good social support .
Diet is Unhealthy , mainly junk foods  
Drinking only on weekends , but cut down on drinking since his current problem 
Smokes since he was 15 yr old , half to 1 pack per day.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Burning, BLOATING, Drinking only on weekends, male, for 2 months, 35 yr old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Chad Hamilton, a 35-year-old male, has come to the physician's office today because of stomach problems for 2 months. Patient states that he had the pain before, but the pain was more frequent than before. it occurred twice a day/ 
the pain is 5/10. getting with TUM but it didn't improve the problem recently. 
the pain is not associate with food or meal. He felt nauseated but didn't vomit. His stool was dark brown w/o blood. He denies diarrhea.
He had chronic back pain from his job as a construction worker, and he took mortrin 2*200 mg. He sometimes took it w/o food.
Hospitalization Hx: NONE
FMHx: bleeding ulcer from parental uncle
Social history: Patient is under the process of divorce with his wife and he felt stressed. Not sexually active now.
                     smoking 1/2 pack per day for 20 year, alcohol : 2-3 beers CAGE neg. no drug use
Allergy NDKA.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]bleeding ulcer from parental uncle, stool was dark brown, mortrin, more frequent, occurred twice a day, 2-3 beers, male, for 2 months, stool w/o blood, ""TUM didnt improve the problem"", nauseated, 35-year-old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr hamiton is a 35 year old male presenting with abdominal pain that has been occuring for the past 2 months. He states that the pain is waxing and waining and is unrelated to food intake. He describes the pain as a 7/10 and states that it has been increasing in severity over the past 2 months. Pain does not radiate  anywhere and is localized to the middle of the abdomen. He states that tums used to make it better but it has no longer been affective. patient is burping throught interview. Patient eats hoggies and burritos on a regular basis. He relates mild nausea and no vomiting. Bowel movements have been regular. 
ROS: no weight loss, patient also reports lower back pain

Allergies: none
medications: tums
PMH: none
PSH: none
SH: constrution worker, smoker half/pack a  day for 20 years. stopped drinking. poor diet of hoggies and burritos 
FH: uncle with Peptic ulcer disease.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle with Peptic ulcer disease, Pain localized to the middle of the abdomen, increasing in severity, Mr, male, past 2 months, past 2 months, tums used to make it better but it has no longer been affective, nausea, 35 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo Chad presents with stomach problems. Started two months ago. Nawing/epigastric pain. Experiencing nause without emesis. It was worsened due to increased frequency. Tums initially helped. Denies diarrhea or constipation. Stools appear darker. Feels tired and pain wakes him up at night. Denies fevers, night sweats or chills. Takes motrin for back pain.
PMHx: back pain- takes motrin
No other medication
No surgeries
Family history: uncle with bleeding ulcer
Single, works in constuction. 1/2-1 pack smoking history (20 years). Denies being stressed. No new changes in his life. Occassional drinks 2-3 beers a week. no other drug use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle with bleeding ulcer, epigastric pain, Stools appear darker, Takes motrin, takes motrin, Nawing, increased frequency, worsened, 2-3 beers a week, Started two months ago, Tums initially helped, nause, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo M complains of epigastric abdominal pain that started 2 months ago. Pain in nonradiating, intermittent, ""gnawing and burning"" in nature, with an intensity of 5/10. Initially, pain was relieved by Tums, but does not seem to relieve it now. Sometimes the patient is awaken in the middle of the night with the pain which last 1-2 hours.  Pain does not worsen with food intake.  Episodes occur 2-3x/day. Denies chest pain, dyspnea, vomitting. 
ROS: Negative except as above. 
PMH: None.
PSH: None.
Allergies; NKDA. 
FH: Paternal uncle with bleeding ulcer.
SH: Contruction worker; smokes half to 1 ppd/day, 2-3 beers/ week. Not sexually active..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle with bleeding ulcer, epigastric abdominal pain, gnawing and burning, occur 2-3x/day, 2-3 beers/ week, M, started 2 months ago, awaken in the middle of the night with the pain, intermittent, Tums does not seem to relieve it now, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 35 yo M c/o stomach pain
-started 2 months ago, epigastric region, nauseated. pain is 5/10, nagging, burning, it comes and go. No assoaciatio with intake of food. 
_ no fever, headache, travel, SOB. 
H/O bodyache x 20 years and takes Motrin for it. associated with back pain and muscle cramps.
Assoaisted with dark colour stool, decrased appettie, disturbed sleep, and stooped excercise. 
ROS: no chnge in urinary habits. Meds: Motrin x 20 years, No Rx All: NKDAPMH: None, PSH; none
FH: non contributory Occupation: heacy elevation lifting worker SH: Alcohol occasionally, Tobacco x 1 PPD x 10 years. No active sexually due to break up..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]pain epigastric, dark colour stool, Motrin, Motrin, nagging, burning, Alcohol occasionally, M, started 2 months ago, comes and go, nauseated, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo M presents w/ c/o epigastric pain, nonradiationg, burning, intermittent, worseing, at least 2x/day, not associated with food. assoicated with bloating with each meal and nausea with pain, and darker stools.  uses nsaids 1x/wk 200 mgx2 pills for aches and pains r/t job. expresses high stress and going through a divorce. denies fatigue, vomiting, recent sickness, fever, hx GERD, bleeding disorders, diarrhea, constipation, or joint pains.ros: denies headaches, changes in vision, chest pain, sob, weakness, nubness or tingling. pmh: back pain fh: uncle bleeding ulcer sh: used to drink a few beers/wk but stopped a few weeks ago, smokes 0.5-1 ppd since age 15, no rec drugs, not sexually active.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle bleeding ulcer, epigastric pain, darker stools, uses nsaids, burning, bloating with each meal, worseing, at least 2x/day, few beers/wk, M, intermittent, nausea, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo M presents c/o abd pain
-began 2 months ago, gradual onset, has gotten progressively worse, no previous episodes
-occurs 2x/day, lasts 1-2 hrs, epigastric, no radiation, 5/10 in severity, also occurs at night
-alleviated by Tums (no longer helping), no aggravating factors
-has nausea, no vomiting, darker stools (no noticeable blood), bloating with meals, increased stress (d/t divorce, work)
PMH/PSH: occasional back aches and spasms / none
Meds/Allergies: Motrin, Tums / none
SH: smokes 0.5-1 ppd since age 15, drinks couple beers per week, no illicit drug use
FH: uncle with bleeding ulcer

.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle with bleeding ulcer, abd pain epigastric, darker stools, Motrin, bloating with meals, progressively worse, occurs 2x/day, drinks couple beers per week, M, began 2 months ago, also occurs at night, stools (no noticeable blood, lasts 1-2 hrs, alleviated by Tums (no longer helping), nausea, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 35 year old male presenting with a 2 month hx of epigastric pain
pain is sharp and stabbing in nature and occurs 2-3x a day 
described as 5/10 in severity, no radiation
tums originally made the pain better but no longer help
pain not related to eating, sometimes occurs at night
endorses some dark stools, no constipation, diarrhea, no vomiting
endorses occasional nausea
PMH: back pain and spasms, no surgeries
Meds: motrin 2 pills/week for pain
FH: uncle with ulcer
SH: works as construction worker, not sexually active, smokes 0.5-1 pack pr day
no allergies.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle with ulcer, epigastric pain, dark stools, motrin, occurs 2-3x a day, male, 2 month hx, tums no longer help, nausea, 35 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Chad Hamilton, a 35-year-old male, has come to the physician's office today because of stomach problems.
HPI: 35 y.o. M stomach discomfort and pain, worse 5/10, located in epigastric area, non-radiating, 2 months duration seems to be progressing, described as burning. No precipitating events noted, tums helped at first now nothing seems to relieve it. Assoicated with nausea and feels like he has to vomit but no emesis, and notes stools are darker. Denies fevers, chills, weight loss or gain, travel, changes in diet. He is getting a divorce and stressed with that but feels supported by family.
PMH: Back pain longstanding, no illnesses, hosp/surgeries
Meds: motrin, no rx, no otc
NKDA
SH: used to drink 1-2 etoh per night now stopped due to stomach pain. no tobacco or other drug use. 
FH: peptic ulcer disease father side.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]peptic ulcer disease father side, pain in epigastric area, stools are darker, motrin, burning, progressing, male, M, 2 months duration, tums helped at first now nothing seems to relieve it, nausea, 35-year-old, 35 y.o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: 35 yo m c/o stomach problems
HPI: burning epigastric pain, x 2 months, progresion: worse, 5/10 in intensity, No radiation. Allev by: thums at the begining, now by nothing. Aggrav by nothing. No precipitating events.
He refers dark brown stools since 2 weeks and nausea. No red blood in his stools.
Denies fever, weight change, no diarrhea or constipation. No fatigue. The pain is not related with food. No dysphagia. No vomiting. No cough, no change in his skin, no pale. 
PMH: no prior hx of CC. No illnesses
NKDA
Meds: Ibuprofen 1 time/week x 10 years. No Rx
FH: uncle h/o bleeding gastric ulcer
SHx: smoking 0.5-1 pack/day/20 years. No drug use. ETOH: social
No sexual active.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle h/o bleeding gastric ulcer, epigastric pain, dark brown stools, Ibuprofen, burning, progresion: worse, ETOH: social, m, x 2 months, No red blood in his stools, Allev by: thums at the begining, nausea, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 y/o M complains of worsening epigastric pain that started 2 months ago. Pain is intermitent, burnig, 5/10 in severity , and last 1-2hrs. Associated with nausea. Patient also reports passing dark brown stool..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]epigastric pain, dark brown stool, burnig, worsening, M, started 2 months ago, intermitent, last 1-2hrs, nausea, 35 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Hamilton is a 35 y/o male with PMHx significant for back pain/muscle spasms who presents with 2 months of epidural abdominal pain which he describes as a gnawing burning sensation in his epidrual region with no radiation. Pt is currently not experiencing the pain, but when he does he reports a pain level of 5/10. Pain was originally 1 x week but currently getting worse as patient is experiencing the pain 2-3 times per week. Patient attempted the use of tums to alleviate pain, but reports not working. Furthermore, pt reports a darkening of stool (melena) more so than usual. Denies any bright red blood per rectum, changes in stool, diarhea, nausea, vomiting, chest pain, SOB. Denies nocturnal asthma. Denies recent travel, pets at home, denies sick contacts. Medications: motrin 1 x week Allergies: None; Social: smokes 1/2 a pack to 1 pack per day since he was 15 (20 year pack year history), drinks socially..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]pain epidrual region, darkening of stool, motrin, gnawing burning, getting worse, drinks socially, Mr, male, with 2 months, Denies any bright red blood per rectum, tums not working, 35 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: stomach hurts"". HPI: Mr. Hamilton is a 35 y/o Male complaining of epigastric pain for the past 2 months that has progressively become worse. Pain comes and goes, feels like ""burning, knawing"" and is 5/10 on the pain scale. Tums helped at first but patient stopped taking them now as they no longer provide relief. Nothing makes the pain worse. Patient confirms nausea and 2 week history of dark stools. Pain occurs at random, day or night and has woken him from sleep. ROS: Denies vomiting, blood in stools, stool caliber change, cough, SOB, CP, palpitations, fevers, weight loss. PMHx: back aches, muscle spasms from construction work. PSHx: None. Allergies: None. Meds: Tums as need (now stopped) and Motrin 200 mg once a week for back pain. FHx: Uncle had bleeding ulcer. SHx: Smokes 1-2 PPD x 20 yrs. Used to drink a few beers a week but has stopped drinking. Denies drug use. Works as construction worker, lives alone, not sexually active..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Uncle had bleeding ulcer, epigastric pain, dark stools, Motrin, burning, knawing, progressively become worse, few beers a week, Mr., Male, past 2 months, Pain has woken him from sleep, Denies blood in stools, comes and goes, Tums helped at first, Tums no longer provide relief, nausea, 35 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 year old malepresents with complaint of epigastric pain associated with nausea that has been affecting him about 2-3 times per day. Patient describes pain as Burning pain that is 5/10 severity that is non radiating. Initially the pain was relieved by Tums, but that is no longer the case. The patient also states that he feels bloated after eating, but that eating does not affect the pain or nausea. Pt has also nnoticed increased fatigue and darkening of his stools recently.  Patient denies headache, dizzyness, chest pain, fever, chills.

ROS: none other than above
PMH: none
PSH: none
Meds: Motrin.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]epigastric pain, darkening of his stools, Motrin, Burning, bloated after eating, 2-3 times per day, male, pain was relieved by Tums, but that is no longer, nausea, nausea, 35 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35yo M presents with c/o stomach pain
-Begin 2 months ago, buring, gnawing, intermittent pain
-5/10 pain, initial relieved by Tums but not now
-Has black/tarry stools
+Nausea, -vomiting, +burping
-Not associated with food intake
-Slightly relived after stopping alchohol intake
-Denies fever, infection, changes in weight
-Uses Motrin for back pain
PmHx: Denies
Allegies: None
Medications: Motrin
SHx: None
S: last sexually active w/ wife 6 mo. ago. Pending divorce. No children.
-has worked in construction for 10 years.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]black/tarry stools, Uses Motrin, Motrin, buring, gnawing, M, Begin 2 months ago, intermittent, initial relieved by Tums but not now, Nausea, 35yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35M with CC of epigastric pain. The pain is burning in sensation with no radiation, has occurred for the past 2 months and is getting worse. Tums initially helped but is no longer helping. Every time he eats he feels bloated but food is not associated with the pain. He states that his stools have also been darker than usual. He also endorses nausea but no vomiting. No fevers, chills, no increased urinary frequency, no pain with urination. No chest pain or other abd pain. No yellowing of skin. He has never had anything like this before.

PMHx
Takes motrin, but only once a week for aches and pains from his work as a construction worker.
Healthy, no hospitlizations or surgeries. NKDA.

FHx
Uncle with gastric ulcers. Mother, father, alive and healthy. 

Shx
Works as construction worker. Smoked 0.5-1ppd since his teenage years. Had about 2-3 drinks per week but has stopped since the pain started. No other drug use..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Uncle with gastric ulcers, epigastric pain, stools have also been darker, Takes motrin, burning, Every time he eats he feels bloated, getting worse, 2-3 drinks per week, M, past 2 months, Tums initially helped but is no longer helping, nausea, 35</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35yo M Chad Hamilton intermittent epigastric gnawing burning pain. Onset 2 months ago. Pain worsening. Last 2 weeks pain now wakes him at night. Feeling fatigued. TUMS was working but now does not. Nothing makes it worse. 5/10 pain. Stools dark. No blood in stool. Feels bloated when eating. Mood is good. Nauseous.
ROS: No coughing. No SOB. No vomiting. No headache. No fever. No change in diet. No night sweats.
PMH: none
PSH: none
Meds: TUMS, motrin for pain relief
FH: negative for IBS/IBD. Uncle positive for peptic ulcer disease.
SH: smokes 1PPD since 15yo. Quit beers couple weeks ago. Construction worker that lives alone..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Uncle positive for peptic ulcer disease, epigastric pain, Stools dark, motrin, gnawing burning, Feels bloated when eating, Pain worsening, M, Onset 2 months ago, pain now wakes him at night, No blood in stool, intermittent, TUMS was working but now does not, Nauseous, 35yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI- 35 yo m c/o abd pain x 2months.
- epigastric, burninng and worsening, intermittent intially 1xs/week but now 2xs/week. tums relieved it but nothing makes it worse.non radiating
-assoc bloating, anorexia, poor sleep due to pain waking him up, nausea but no vomiting,belching and anorexia.
-denies fever, trauma, heartburn, sob, sweating, cough, chest pain, wt loss or urinary symptoms.
ROS- neg except as above.
PMH- back ache and spasm treated with motrin. MED_ tums, motrin. ALLERGIES- NKA.
FH- uncle had a bleeding ulcer.
SH- construction worker, 1ppd  since 15yrs, quit beer 2 weeks ago due to pain. exercises and sexually active, no sti.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle had a bleeding ulcer, pain epigastric, motrin, motrin, burninng, bloating, worsening, intially 1xs/week but now 2xs/week, quit beer 2 weeks ago, m, x 2months, poor sleep due to pain waking him up, intermittent, nausea, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 year old male with no significant past medical history presenting with epigastric pain and nausea. The pain is a burning quality and is rated at a 5/10 on the pain scale. the pain has become more frequent and occurs twice daily. the pain lasts 1 to 2hrs and is associated with nausea. Eating food does not make it better or worse. tums used to help with the pain but has now stopped working. denies trauma to the area. reduced apeptite due to nausea but denies weight loss. no vomiting or diarrhea.
ROS: muscle aches and spasms in lower back
PMH: none
Medications: Motrin for back pain
SHx: none
FH: uncle with bleeding ucler
SH: works as a high elevation construction worker, 1-2 beers/week no longer drinks due to nausea, smoked 1/2pack to 1 pack per day for 15 years, no illicit drug use, not sexually active.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle with bleeding ucler, epigastric pain, Motrin, burning, has become more frequent, occurs twice daily, 1-2 beers/week, male, tums stopped working, nausea, nausea, nausea, nausea, 35 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: 35 yo male c/o stomach pain
HPI: pt c/o epigastric pain 5/10 for the past 3 months, pt awakens at night laying down with pain, the pain doesnt radiate, pain has been getting progressively worse, never happened before, comes and goes 3x per, tums used to alleivate the pain, no longer does, food does not make it worse. Pt reports darkened stools (melena) for the past 2 weeks, caliber is unchanged, endorses nausea and bloating following meals, pt denies fever, chills, myaglias, unintentional weightloss, joint pain, steatorrhea, fatigue, hematemesis
ROS: negative excpet as per HPI
Alleriges: none
PMHX: no hospitalizations, surgeries, trauma, or medical illnesses
RX: motrin 1x /week 
Social: high altitude concentration worker, smokes 15 years 1PPD, used to drink a couple of beers a week, recently stop ETOH, no recreationla drug use, diet is balanced
FHX: uncle had bleeding peptic ulcer
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle had bleeding peptic ulcer, epigastric pain, darkened stools, melena, motrin, bloating following meals, getting progressively worse, couple of beers a week, male, past 3 months, awakens at night, comes and goes, tums used to alleivate the pain, no longer does, nausea, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35-year-old previously healthy man here with 2 months of burning, gnawing epigastric pain and nausea. Pain used to occur once per week now 2-3 times per day. Tried taking TUMs which seemed to help for awhile but now no longer offer relief. Nothing in particular seems to make pain worse. Does not associate pain with eating, though does describe a sense of bloating and fullness after eating. No difficulty swallowing. No fever, emesis, diarrhea, constipation, rashes. Says occasionally stool is dark in color but denies seeing frank blood or black color. 
PMHx: back pain, muscle spasms. 
Meds: motrin 1x/week. 
Allergies: none
Surgery: none
Family hx: uncle with h/o bleeding ulcer
Social history: works high elevation construction. Lives alone. Endorses recent increase in stress level as is separating from wife. Smokes 1/2 - 1 pack per day. Previously drank 3-4 beers per week, no alcohol in past 2 weeks. No other drug use..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle with h/o bleeding ulcer, epigastric pain, stool is dark in color, motrin, burning, gnawing, bloating and fullness after eating, used to occur once per week now 2-3 times per day, 3-4 beers per week, man, with 2 months, denies seeing frank blood or black color, Tried taking TUMs which seemed to help for awhile but now no longer offer relief, nausea, 35-year-old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo M with h/o chronic NSAID use presents for 2 months of worsening epigastric pain
- Epigastric pain started two months ago, associated with nausea. Describes pain as a ""gnawing"" and rates it as a 5/10 at its worst
- says episodes of pain occur intermittently and last for an hour; previous once per week but have increased in frequency to once/day
- Has attempted tums with minimal relief; denies aggravating factors including meals or fatty foods 
- denies pmh but reports h/o NSAID use (1 motrin per week) for chronic pack pain; otherwise denies pmh, surgical history, medications, allergies
- Paternal uncle with ""bleeding ulcer""; other denies FH. 
- Drinks 1-2 alcoholic beverages per week but has stopped drinking since onset of pain, smokes 1/2 pack of cigarettes per day for last 15 years, no rec drug use. not sexually active. works as constructino worker. li.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Paternal uncle with ""bleeding ulcer, epigastric pain, Epigastric pain, NSAID use, NSAID use, motrin, gnawing, worsening, increased in frequency to once/day, 1-2 alcoholic beverages per week, M, for 2 months, started two months ago, occur intermittently, tums with minimal relief, nausea, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Hamilton is a 35 yo male who presented with stomach pain. Pain started about 2 months ago. The pain is described to be sharp and in the epigastric region. Patient states that he does not notice anything that makes it worse. Seems to be ""random"" in timing. Does not notice any food that makes it worse or better. Has tried tums which helps relieve the pain, but recently it has not worked as well as it used to. Pain is 5/10. Has felt naussous but has not vomited. Has noticed darker stool recently, but no blood or diarrhea. Denies any fever, chills or cough.
ROS: all other negative
PMH: Back pain for which he takes Motrin
Meds: Motrin
Surg Hx: none
FH: parents both alive and healthy. Has uncle with stomach ulcer.
SH: smokes 1ppd x 20 years. Used to drink 1 to 2 beers per week but has now stopped due to stomach problem. No drugs. Not currently sexually active..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle with stomach ulcer, epigastric region, darker stool, Motrin, Motrin, 1 to 2 beers per week, Mr, male, started about 2 months ago, no blood, tried tums which helps relieve the pain, but recently it has not worked, naussous, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 YO M COMES WITH C/O STOMACH PROBLEMS X 2 MONTHS. IT IS GRADUAL, PROGRESSIVE,GRADUAL, PROGRESSIVE, LOCATED IN EIGASTRIUM, 5/10, BURNING, NON-RADIATING, BURNING, NON-RADIATING, NO AGGRAVATING FACTORS AND RELIEVING FACTORS. PT WAS TAKING TUMS NOW NOT USING. PT IS CONSTRUCTION WORKER TAKING MOERTIN FOR BACK PAIN, STOOLS ARE DARK IN COLOR. PT HAS BELCHING AND BURPING, NAUSEA X 2 MONTHS, ABDOMEN IS BLOATED AFTER EATING.
DENIES FEVER, VOMITING, JAUNDICE, CHANGE IN TASTE OF MOUTH, SLEEP/BLADDER CHANGES.
ROS: -VE EXCEPT AS ABOVE
PMH: BACK PAIN X 10 YRS
MEDS: TUMS AND MORTIN
FH: H/O SIMILAR PROBLEMS 
SSH: SMOKING SINCE AGE OF 15 YRS, CUT DOWM BEERS FROM MANY TO FEW, NO DRUD USE, SEXUALLY INACTIVE
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]LOCATED IN EIGASTRIUM, STOOLS ARE DARK IN COLOR, TAKING MOERTIN, MORTIN, BURNING, BURNING, BLOATED AFTER EATING, PROGRESSIVE, PROGRESSIVE, M, X 2 MONTHS, NAUSEA, 35 YO</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 y/o M presenting with 2 mo history of abdominal pain. has been getting progressively worse, previously relieved by TUMS, but no longer effective. Pain comes and goes, maximum 5/10. No precipitating factors, nothing improves or worsens pain, and no association with meals. Pt also notes some increased bloating with food, so has been eating some smaller meals. Does not note any weight loss. Also denies lightheadness or dizziness. Has some nausea but no vomiting. Has also noted some darkening of his stool over the past few weeks, but no frank blood.
ROS: As per above. - headaches, myalgia/arthralgia, no change in urinary function or stool caliber.
PMH: none
PSH: none
FH: paternal uncle- bleeding ulcer
SH: 1/2 to 1 ppd smoker since age 15y. Previously drank a couple beers a week, quit drinking several months ago. No drug use. Works in construction, has some associated muscle aches and pains due to phyiscal labor.
MEds: Motrin 400mg.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle- bleeding ulcer, darkening of his stool, Motrin, increased bloating with food, getting progressively worse, couple beers a week, M, 2 mo history, of his stool no frank blood, Pain comes and goes, TUMS, but no longer effective, nausea, 35 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI 35 yo M complains of epigastric pain for 2 mo. pain is burning sensation, no radiarion, episodic, 2/daily and each episode last for 1-2h, 5/10 on severity scale. doesnt relate to food, denies hurtburn or vomiting but he has nausea. wake up at night cause of pain. TAMS helped but not anymore. darker stool and feels more tired. denies fever or weight loss, diahrrea or constipation. 
ROS negative except as above. 
PMH backaches. 
PSH none
MEDS NSAID
ALLERGIES none
SH smoke 0.5-1PPD*20y, stopped drinking previous couple beers/wkdenies illicit drugs. not sexually active. exercise. regular diet. divorce process. 
FH unkle ulcer 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]unkle ulcer, epigastric pain, darker stool, NSAID, burning, 2/daily, couple beers/wk, M, for 2 mo., wake up at night cause of pain, episodic, TAMS helped but not anymore, nausea, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Chad Hamilton is a 35 yo male who came in with complaint of stomach pain. Patient localized pain to epigastric area. Pain started 2 months ago and has been getting progressively worse. Described pain as burning and gnawing and 5/10 in severity. Sometimes the pain would wake him up at night. Pain has been intermittent, seeming to come randomly with no associating to eating. Patient stated Tums used to make it better, but no longer works. Patient states nausea, but denies vomiting, dirrhea, constipation, night sweats, weight loss, and fever. 
PMHx: back pain that spasms due to construction
Surgical Hx: none
Allergies: none
Meds: Motrin 400 mgs 1x week
FHx: parents are healthy
SHx: Works in construction. Has a 20 year smoking history, drinks 1-2 beers a week, doesn't do drugs..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]localized pain to epigastric area, Motrin, burning and gnawing, getting progressively worse, 1-2 beers a week, male, started 2 months ago, pain would wake him up at night, intermittent, Tums used to make it better, but no longer works, nausea, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 35 YO w CC of stomach prob
Pts has epigastrium pain, burning, nagging, 5/18 pain for last 2 months associated w/ bloating, Nausea and darkened stool. He denies any urinary or bowel changes. He denies any greasy stool or diarrhea and urinary symptoms and fever or chills. He tried tums which used to help but not anymore.  Eat fast food mostly. He feels worried about it  affecting his job. his uncle has PUD. He is a current smoker 25 Pack year and drinks alcohol 2-3 night. He is not sexually active..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle has PUD, epigastrium pain, darkened stool, burning, nagging, bloating, alcohol 2-3 night, last 2 months, tums used to help, Nausea, 35 YO</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Chad Hamilton is a 35 y.o. male who has been having burning eipgastric pain 2x per day for the past 2 months. Pain lasts 1 hour and is 5/10 and occasionally wakes him from sleeping. Not related to eating. Tums initially made pain better but is no longer helping. He has also been feeling stomach bloating during this period. Endorses fatigue and darker stools. Takes motrin occasionally for back pain and muscle spasms. Has not noticed any weight loss or bright red blood in stool. No chest pain, shortness of breath, or other abdominal pain. no cough
ROS: negative except as above
Medications: motrin occasionally for back pain. TUms
allergies: None
PMHx: none
PSHx: none
Social. 1/2 to 1 ppd since age 15. Few drinks per week until recent pain started. No drug use.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]eipgastric pain, darker stools, motrin, motrin, burning, stomach bloating, 2x per day, Few drinks per week, male, past 2 months, wakes him from sleeping, not noticed bright red blood in stool, Tums no longer helping, 35 y.o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Chad Hamilton is a 35 M presenting with midline epigastric pain with onset 2 months ago. He reports no inciting event or illness. Pain does not radaite to chest or back. It is not effected by eating. He has experienced no chnage in his appetite but reports eating less as he has had feeling of early satiety and bloating. Has noticed darkened stools in last 2 weeks but no frank blood. No cosntipation or diarrhea. Intermittent nasea but no vomiting. Reports taking Motrin weekly for back pain and myalgias secondary to job in construction. Moderate EtOH use without bingeing but has abstained for last 2-3 weeks due to EtOH exacerbating feeling of bloatedness. No weight loss or fatigue.

PMH: none
Meds: only Motrin
SocHx: 15 PY smoking hx, counsled about quitting, EtOH as above, no drug use
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]epigastric pain, darkened stools, taking Motrin, Motrin, bloating, Moderate EtOH use, M, onset 2 months ago, no frank blood, nasea, 35</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Chad Hamilton, a 35-year-old male, has come to the physician's office today because of stomach problems. 
began 2 months ago, midepigastric, no radiation, burnning , 5/10
intermittent, 2 time per day, last 1 hour
has nausea, melena x 2 week, use NSAID, 
denies, chest p;ain, urinary and cough, sob, palpitation, regurgitatoin , not related to meal and food, 
aggravated by nothing, relieved by Rx for heart burn
all; none   pmh; none
psh; none med; NSAID, Thymm for GERD
fh; non rele\vant
sh; 1/2 pppd x 15, no drug,etooh, live aloen   , constructon worker, 
feel tired for \pain, 

.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]problems midepigastric, melena, use NSAID, NSAID, burnning, 2 time per day, male, began 2 months ago, intermittent, nausea, 35-year-old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 35 yo male who presents with epigastric pain. Pain started about 2 months ago. He describes burning, nawing pain. 5/10 in severity. Pain has be geting progressively worse. He uses tums for relief, but now they dont help much. He also endoses bloating, feeling full, nausa, dark stools. He denies fevers, chills, chest pain, vomiting, diarrhea. He also uses mortrin.
PHMX= Back pain from work
NKDA
- No recent hospitalizations
FH- Uncle - bleeding ulcer
No surguries, no travel.
Social- Lives in phily, works construction. smokes 1/3-1pack for 15 years. Drinks couple of beers a week, CAGE 0/4
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Uncle - bleeding ulcer, epigastric pain, dark stools, mortrin, burning, nawing, bloating, geting progressively worse, couple of beers a week, male, started about 2 months ago, tums for relief, but now they dont help much, nausa, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: ""pain in mid epigastric area""
35 yo M c/o 2 mo of constant, intermittent epigastric abdominal pain. Pain is 5/10 and is present at least 2X daily and wakes him up 3X each night.  There are no precipitating or exacerbating factors. Pain was alleviated by tums in past but no longer helps. patient has no past medical history but reports that an uncle had h/o peptic ulcer disease. Patient reports darker stools for 2 months, + nausea but denies vomitting. There has been no changes in frequency or texture of stools. He feels bloated after food. 
PMH: backache and spasms PSH: none SH: recently divorced and is stressed about that. Recently stopped alcohol but has smoked 1/2 pk for 15 yrs. no illicuit drugs use. 
FH: Uncle - bleeding ulcers. Health maintenance: Last visit to physician was long time ago. 
ROS: negative except as in HPI.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle had h/o peptic ulcer disease, Uncle - bleeding ulcers, epigastric area, epigastric abdominal pain, darker stools, bloated after food, 2X daily, Recently stopped alcohol, M, wakes him up 3X each night, intermittent, alleviated by tums in past but no longer helps, nausea, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo male presents with stomach pain. Progressive in nature, 5/10, episodes were few/wk now 2x/day lasting 1-2 hr, no radiation, pain wakes him up at night, + nausea, - vomiting, +darkstools. No diarreha, constipation, weight change, fever, NS, rashes, chills, ligh headedness, chest pain, palpitations, dypsnea.
PMH: chronic back pain - motrin 1x week 
FH: uncle w bleeding ulcer
SH: 15y .5-1ppd smoking hx, not ready to quit. occasioanl etoh use. no illicit drug use. use to execercise before the pain. Nml diet. Not sexually active. Going through dovrce..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle w bleeding ulcer, +darkstools, motrin, Progressive, episodes now 2x/day, occasioanl etoh use, male, wakes him up at night, + nausea, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 35 yo M complains of 2 months of stomach distress. Indicates the pain in the epigastric region, epsidic, and intensity of 5/10. Reveals that he is going trhourh a divorce and stress caouses intensify pain. Indicates nausea, bloated, and darkening of stool. Denies urinary symptoms, no flushing, no fever,  no palpiations, and no visual distrubances. Indicates myalgias since early 20s. Pain is mininally alleviated with motrin.
ROS: negative except for above
Allergies none
Meds: motrin
PMH: myalgias since 20s; low back pain
PSH: none
SH: 1 ppd for 20years; occasional alcohol consumtiop; no drugs; not sexuyaly actice; works as construction worker
FH: uncle had a bleeding ulcer.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle had a bleeding ulcer, pain in the epigastric region, darkening of stool, motrin, motrin, bloated, occasional alcohol, M, of 2 months, epsidic, nausea, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Hamilton is a 35 year old man presenting with ""stomach problems""
-Reports experieincing burning sensation in epigastric (""mid-chest"") area
-Started 2 months ago with episodes occuring on weekly basis
-Over past week, pain is worsening and becoming more frequent (daily) and is waking up patient from sleep
-Burning sensation episodes lasts 1-2 hours
-Denies associated with food intake
-Took TUMS, which initially helped with symptoms but over the past week, not as useful
ROS: Endorses darker stools than usual over the past 2 weeks. Denies bright red blood in stools. Denies cough. Denies lower abdominal pain. Denies hematuria or urinary changes.
PMHx: None
PSHx: None
Medications: TUMS, motrin
Family history: Uncle had bleeding ulcer
Social Hx: Construction worker. Reports life is very stressful with work and recent divorce). Smoking 1/2 to 1 pack per day currently for past 10 years. Denies EtOH/drug usage. No recent sex. 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Uncle had bleeding ulcer, sensation in epigastric (""mid-chest"") area, darker stools, motrin, burning, Burning, is worsening, more frequent, Mr., man, Started 2 months ago, waking up patient from sleep, Denies bright red blood in stools, episodes lasts 1-2 hours, TUMS, which initially helped, TUMS not as useful, 35 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 Y M presents with stomach problems. Patient has had intermittent stomach pain for the past two months. Located above stomach, described as gnawing, 5/10, non-radiating, slightly better with tums, no better or worse with eating, associated with nausea when painful. Patient also noted darkening of stool for the past two weeks. No vomiting, sour taste in mouth, diarrhea. Patient takes Motrin 2x200mg approximately 1x/wk for back pain.

ROS: No fevers, chills, chest pain, shortness of breath, diarrhea, constipation.
PMH: Denies.
PSH: Denies.
FH: Bleeding gastric ulcer in uncle.
SH: Lives alone, construction worker, not sexually active. Previously drinking 3 beers/wk stopped 3 weeks ago, 20 Y h/o smoking 1/2-1 pack per day, denies recreational drug use.

Medications: Motrin as needed.
Allergies: Denies..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Bleeding gastric ulcer in uncle, darkening of stool, takes Motrin, Motrin, gnawing, 3 beers/wk, M, past two months, intermittent, slightly better with tums, nausea, 35 Y</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: - 35 yo male with stomach pain
- Pain started 2 months ago, no trigger or trauma to the area. It has been increasing since that time
- Pain is located in epigastric region, no radiation
- Tums used to help the pain but that has not helped recently. Nothing makes the pain worse. No association with food
- Dull pain. Always 5/10
- Nausea, no vomiting, dark colored stools. No changes in bowel habits. No vomiting. No dysuria or polyuria. 
- Pain comes and goes
- No headache, fever, chest pain, no reflux, no diarrhea/constipation
PMH: none, no hospitalizations
Surgical hx: none
Medications: Motrin 400 mg PO as needed (around 1/week)
Allergies: NKDA
Family Hx: uncle with ""bleeding ulcer"" 
Social hx: lives alone. Works as a construction worker. 20 pack-year smoking history. Used to drink a couple beers on the weekend; has cut down now. No illicit drug use
Diet: fast food; has not exercised recently due to pain.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle with ""bleeding ulcer"", Pain is located in epigastric region, dark colored stools, Motrin, increasing, couple beers on the weekend, male, started 2 months ago, comes and goes, Tums used to help the pain but that has not helped recently, Nausea, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Chad Hamilton is a 35 y/o male who comes into clinic with ""stomach problems"". The burning/gnawing pain is located at the mid-epigastrium and has been a 5/10 pain. It started 2 months ago, happening 1 time per week. The past two weeks it has been happening multiple times per day. It lasts an hour and is random in onset. he endorses belching, nausea, bloating after eating, and the pain wakes him up at night some times. He states his stools have been darker.
ROS: negative 
Mast medical Hx: back related injury
Past surgical hx: none
Medications: tums and motrin
FHx: paternal uncle had ulcer
Social: 2-3 beers per week, .5 ppd since 15 y/o.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]paternal uncle had ulcer, pain is located at the mid-epigastrium, stools have been darker, motrin, burning/gnawing, bloating after eating, happening multiple times per day, 2-3 beers per week, male, started 2 months ago, pain wakes him up at night, nausea, 35 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35yo m c/o of epigastic discomfort for the past  2 months. pain has gotten worse and frequent. pain is 5/10, burning in nature, no precipitating factors, feels bloated with meals but not necessarily painful. non radiating, takes pain medication that has not helped he is fatigued. he has associated nausea , dark stools which he noticed  2 weeks ago,. denies palpitaion, he takes motrin occasionaly for aches. no change in bowel habits,no change in urine habits, eats a lot of take outs
fever , vomiting, 
pmh/psh: none
ros negative except above
fh non contributory
nkda
shx smoke 1/2 - 1 ppd since age 15yrs, he has not decided to quit yet..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]epigastic discomfort, dark stools, motrin, burning, feels bloated with meals, gotten worse and frequent, m, past  2 months, nausea, 35yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo M complaining of pain in upper abdomen since 2 months which gotten worse since last 2 weeks, burning sensation in upper abdomen, started suddenly, progressive, continuous, initially reliefed by tums but not anymore, nothing makes it worse. patient also complains of dark brown stools, nausea, bloating, decreased appetite due to pain, several night time awakenings due to pain. Patient is construction worker and have back pain for which he is taking moltrin.
ROS- negative except as above
PSH- none
PMH- none
SH- smoke x 20 years x half to 1 ppd, drink beers but recently decreased due to belly pain, no illicit drug use, sexually active and monogamous
Allergy- none
Meds- TUMS, Moltrin.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]pain in upper abdomen, dark brown stools, Moltrin, taking moltrin, burning, bloating, gotten worse, progressive, M, since 2 months, several night time awakenings, initially reliefed by tums but not anymore, nausea, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr Hamilton is a 35 year old caucasian male who presents to clinic today due to 2 months of mid abdminal pain. Pain is a gnawing 5/10, constant discomfort. He has recently had stress in his life drom pending divorce and increased work realted stress. He has been feeling naucious  - he has not thrown up as of yet. Increased belching and bloating after meals . 

ROS was negative for CP, SOA, diarrhea, constipation, emesis, changes to ears and eyes. No urinary changes. 

PMH back pain from physical labor with 10 year history of ibuprofen use 1 time per week
No PSH
FH - uncle with bleeding gastric ulcer
Social - smoked 20 pack years. used to drink socially but stopped since last 2 months. no illicit drug use
Meds: tums and motrin 1 tablet qWeekly
NKDA.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle with bleeding gastric ulcer, mid abdminal pain, ibuprofen use, motrin, gnawing, bloating after meals, used to drink socially, Mr, male, 2 months of, naucious, 35 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: PT 35 YO M TAKING PAIN MEDS X 10 YRS WITH FH OF PUD, C/O EPIGASTRIC PAIN X 2 MONTHS, INTERMITTENT, STARTED GRADUALLY, GETTTING WORSE, 3 TIMES/NIGHT, USUAL IN NIGHT TIME, SHARP PAIN,  TUMS DOES NOT HELP , NO ALLEVIATING/AGGRAVATING FACTORS. PT HAS BACK PAIN TAKING  PAIN MEDS X 10 YRS.  PT REPORTS ABD DISTENSTION AFTER MEALS AND NOTICED DARK STOOL. PT DENIES ANY FEVER,  VOMITING, CHEST PAIN, SOB, REGURGITATIONS, METALIC TEST IN MOUTH, SKING CHANGES AND PALPITATIONS.
ROS: NO CHANGE IN WEIGHT BUT DECREASED APPETITE. NO CHANGE IN URINARY HABITS. 
PMH: NONE. 
PSH: NONE.  ALLEG: NKA. 
MEDS: TUMS AND MOTTRIN. X 10 YRS 
FH: UNCLE DIED OF PUD. 
SH: SEXUALLY NOT ACTIVE. SMOKING 1/2 PPD X 15 YRS. STOPPED DRINKING ETOH, NO ILLICIT DRUGS. 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]FH OF PUD, UNCLE DIED OF PUD, EPIGASTRIC PAIN, DARK STOOL, MOTTRIN, ABD DISTENSTION AFTER MEALS, GETTTING WORSE, M, X 2 MONTHS, 3 TIMES/NIGHT, INTERMITTENT, TUMS DOES NOT HELP, 35 YO</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 35 yo M c/o worsening epigastric pain x 2 months.
- 5/10. burning. duration 1-2hr. freq. 2times/day. intermittent pain. better with TUMs in the past - worse with nothing. not related to eating. 
- poor appetite due to bloating sensation. -BM 2 times/day. dark brown colored stool. no particular odor. 
ROS: No prev. similar symptom. No change in wt. no vomiting, diarrhea, constipation. no fever
Allergies: none
Meds: motrin
PMH: none. no hospital. no trauma.
PSH: none
FH; uncle ulcer disease. 
SH: no EtOH. smoking 1/2-1pack a day since age 15. no illicit drugs. not sexually active. works for construction site..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle ulcer disease, epigastric pain, dark brown colored stool, motrin, burning, bloating, worsening, 2times/day, M, x 2 months, intermittent, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 YO M comes to the clinic c/o stomach problems since 2 mo ago. Epigastric pain , getting progressively worse, and intermittent.  Happening 2 times at day and lastinf 1-2hrs. 5/10 in intensity,  gnawing and deep like.  Used to get better w antacid but now nothing makes it better. Nothing makes it worse. It is affeting the pt life.  Denies fever, chills, N/V, HA, relation  w food. No burning sensation on throat or  dysphagia. No changes in appetite or weight. No changes in urinary/bowel habits.
ROS neg except as above 
PMH  hx LBP taking ibuprofem 2 times at week. NKDA 
PSH none 
FH uncle has PUD 
SH 1 PPD x 15 yrs , 1-2 beer/ wks 
sx.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle has PUD, Epigastric pain, taking ibuprofem, gnawing, progressively worse, Happening 2 times at day, 1-2 beer/ wks, M, since 2 mo ago, intermittent, Used to get better w antacid, 35 YO</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35-year-old male h/o stomach problems; epigastric pain (burning/nawing like pain) for 2 months; causing him nausea but not vomiting. Feels the pain twice a day; no certain time. After eating he feels bloated; was taking tums but no longer working. Patient has not been able to exercise due to pain. ROS: Bowel movements wnl- dark brown stool; no melena; no pain when defecating. Pt denies appetite change/ weight change/ no headache/ chest pain/ SOB.
Pt is a construtction working; stressed going through a divorce and living alone; no sexual activity.
PH: back pain and muscle pain from work
Surgeries: none
Allergies: NKDA Medication: 2 motrin of 200mg 1 time a week
FH: paternal uncle bleeding ulcer
Hx of tobacco use 15 years of half/1 pack per day. quit  recently; gave information on tobacco counseling; ETOH couuple times a week no recreational drug use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]paternal uncle bleeding ulcer, epigastric pain, dark brown stool, motrin, burning/nawing, After eating he feels bloated, twice a day, ETOH couuple times a week, male, for 2 months, no melena, was taking tums but no longer working, nausea, 35-year-old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: STOMACH PROBLEMS
HPI: 35 YO M C/O EPIGASTRIC PAIN STARTED GRADUALLY 2 MONTHS AGO. THE PAIN IS DULL, REACHING 5/10 INTENSITY, INTEMITTENT 2-3 TIMES/DAY, NONRADIATING. NO PRECIPITATING FACTORS, NO RELATION WITH FOOD. IT WAS PARTIALLY ALLEV BY ANTACIDS, NOT ANYLONGER. HE ALSO HAS NAUSEA W/O VOMITING, AND NOTICED BLACK STOOL FEW TIMES, NO BLOOD. 
ROS: NO WEIGTH CHANGES, NO URINARY CHANGES, NO FEVER, NO CHEST PAIN
PMH: OCC BACK PAIN D/U HEAVY WORK. NO PSH
FH: UNCLE WITH PUD
SH: 1/2-1 PPD/ 20 YRS, OCC ETOH/NO RECR DRUGS.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]UNCLE WITH PUD, EPIGASTRIC PAIN, BLACK STOOL, 2-3 TIMES/DAY, OCC ETOH, M, STARTED GRADUALLY 2 MONTHS AGO, STOOL NO BLOOD, INTEMITTENT, PARTIALLY ALLEV BY ANTACIDS, NOT ANYLONGER, NAUSEA, 35 YO</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: Stomach problems
35yo M who presents with epigastric pain. Pain present over last 2 months and has been worsening in last few weeks. The pain is a gnawing/burning 5/10 pain with no radiation. It is unrelated to food or time of day, but has woken him up from sleep. The frequency has increased from 1/week to 3x/day. Patient reports increased belching, nausea, bloating and fullness after meals for 2 months, and darker stools over the last 2 weeks. The pain had been relieved by Tums but is no longer. Patient reports 1 year of increased stress due to work and divorce. He denies vomiting, reflux, weight loss. He takes 2 motrin a week on average.
ROS: Negative
PMHx: back aches/muscle spasms; Meds: motrin and tums PRN; NKDA; FHx: uncle with bleeding ulcer; Lives alone, high elevation construction worker; drank a few beers a week, but has now stopped. current smoker w/ 15 pack year smoking history. Diet: frequent eating out high fat foods.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle with bleeding ulcer, epigastric pain, darker stools, takes motrin, motrin, gnawing/burning, bloating, fullness after meals, worsening, frequency has increased from 1/week to 3x/day, few beers a week, M, last 2 months, woken him up from sleep, had been relieved by Tums but is no longer, nausea, 35yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo m, c/o stomach pain since 2 months. Pain is located in the epigastric region, 5/10 intensity, burning in nature, non-radiating. Pain is intermittent and has been getting worse. Would occur once a week earlier, but now occurs 2-3 times a day. Also gives h/o dark stools since 2 weeks. Intermittent back pain. Denies palpitations, chest pain, sweating, changes in urinary / bowel movements. H/o eating junk food. Reduced apetite. No aggravating or relieving factors. 
ROS - negative except as above
Allergies - NKA 
Meds - Tums once a week. 
PMH - noncontributory. No hospitalisation, injuries, trauma, surgeries. 
FH - Uncle who had a bleeding ulcer 
SH - smokes half to one ppd for 20 years. Occasionally drinks beer. Denies illicit drugs. Not sexually active. Construction worker..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Uncle who had a bleeding ulcer, Pain is located in the epigastric region, dark stools, burning, getting worse, now occurs 2-3 times a day, Occasionally drinks beer, m, since 2 months, intermittent, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: This is a 35 yo previously healthy male presents with a 2 months h/o progressive worsening pain in epigastric area with bloating and possible melana. The pain is described as burning, pt has belching. pain worse with eating, rated 3/10. pain is intermittent, no vomiting, no hematemesis, but does have some nausea. Has noticed dark brown stool since the onset of the stomach pain, no bright red blood. 20 pack-year smoking hx. Has a uncle with possible PUD. 

ROS: negative except for listed in HPI
PMH: none 
PSH: none 
Med listed in 
FH: uncle with possible PUD
SH: 20 pack-year smoking, 2-3 beer/week, no STD, no recreational drug
allergy: none.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle with possible PUD, uncle with possible PUD, pain in epigastric area, melana, dark brown stool, burning, bloating, progressive worsening, 2-3 beer/week, male, 2 months h/o, no bright red blood, intermittent, nausea, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Chad Hamilton is a 35yo M presnting with abdominal discomfort. Describes a burniung nawing midepigastric pain that does not radiate. Occurs 2-3x per day for the last two months. No association with meals. Tums used to make it better but stopped working. Just started happening at night, same pain. Does experience bloating and fullness with meals. Voluntary anorexia to avoid the feelings of fullness. Moderate back pain and muscle pain. Bowel movements have been darker in color just in the last couple of weeks. Denies any episodes of tremulousness, lightheadedness, palpitations.

ROS- negative except for above, no chest pain, palpitations, squeezing or exertional chest pain, no pain in other parts of abdomen.
PMH- negative
Meds- motrin once a week
Allergies- NKDA
Fam Hx- uncle with a bleeding ulcer
Social- Diet- whatevere is available, greasy foods. Exercise has decereased, Tobacco 20 pack year hx, Not sexually active.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle with a bleeding ulcer, midepigastric pain, Bowel movements have been darker, motrin, burniung nawing, fullness with meals, bloating with meals, Occurs 2-3x per day, M, happening at night, Tums used to make it better but stopped working, 35yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Chad Hamilton, a 35-year-old male, has come to the physician's office today because of stomach problems. 
Has had pain and discomfort which started 2 months ago. No previous similar complaints, getting worse, located mid epigastrium, does not radiate, pain occurs twice daily and 3 nights a week which causes sleep distrurbance and tiredness as a result. Has nausea everytime pain is there without vomitting, also has noticed dark stools. He feels bloated after meals. Denies sour taste in mouth, sob, fever, chills, night sweats. 
ROS: negative except as above
PMH: back spasms after work
Meds: Motrin
Allergy: none
Family: uncle wit peptic ulcer disease
PSH: none
Social: smoke 1/2-1 pack daily for 20 years, cut down drinking 1 beer before symptoms daily, no drugs
Sexual: not active
Diet: eats fast food, unbalance, excercise decreased due to decreased sleep, no weight or appetite changes
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle wit peptic ulcer disease, discomfort located mid epigastrium, dark stools, Motrin, bloated after meals, occurs twice daily, getting worse, male, started 2 months ago, 3 nights a week which causes sleep distrurbance, nausea, 35-year-old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 35 yo M who presents for epigastric pain for 2 months
- 5/10, burning, gnawing pain in upper part of stomach that is not getting worse but is happening more frequently associated with nausea
-happens randomly, not associated with food intake
- has taken tums which helped initially but has now stopped
-noticed dark stools 2 weeks ago. well formed stools. no constipation or diarrhea
-no aggravating sx
-no changes in diet
ROS- no weight loss, dysphagia, myalgias, headaches, fatigue, vomiting, issues with urination, palpitations
meds- motrin 400 mg 1/week for back pain from from work. NKDA
medHX- none
surg hx - none
famHX- uncles had bleeding ulcer
SH- 0.5-1 PPD smoker for 20 years. 1-2 beers/week but has since quit. no drug use. works in construction. does not exercise. Poor diet with no fruits or veggies
surg hx - none
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncles had bleeding ulcer, epigastric pain, pain in upper part of stomach, dark stools, motrin, burning, gnawing, happening more frequently, 1-2 beers/week, M, for 2 months, tums which helped initially but has now stopped, nausea, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35yo man presenting with epigastrium pain. First noticed pain 2 months ago, burning ngawing pain, intermittent but episodes have been increasing in frequency. Associated with nausea. Endorses melena. Has taken Tums which helped a month ago but not recently. No diarrhea, no BRBPR, no constipation. Also burping a lot recently. No cough. No pain in other parts of the abdomen. No dizziness or syncope. Takes ibuprofen regularly 2x200mg 1x/week for back pain and muscle spasms from construction work. Has cut down alcohol use recently because of pain.
PMHx: None.
PSHx: None
Meds: Moltrin PRN for back pain
NKDA
FHx: Uncle with bleeding ulcer. Otherwise no pertinent.
SHx: Works in construction. Alcohol use 1-2 beers per week. Current smoker, 20-pack year history. No illicit drugs. Not sexually active currently, last activity over a year ago..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Uncle with bleeding ulcer, epigastrium pain, melena, Takes ibuprofen, Moltrin, burning ngawing, episodes have been increasing in frequency, 1-2 beers per week, man, 2 months ago, no BRBPR, intermittent, taken Tums which helped a month ago but not recently, nausea, 35yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: patient is a 35 y.o. male who presents with stomach pain. He reports that over the past 2 months he has felt a 5/10 gnawing pain in his epigastric region. the pain occurs about 2 times per day and lasts for 1 to 2 hours. it does not radiate anywhere. he has tried tums which initially helped but no longer provide relief. in addition he reports nausea with these episodes but no vomiting. he reports darkening of his stool over the past two weeks. He also reports that he has a sensation of bloating with meals, so he has been eating smaller meals. The pain has been waking him from his sleep roughly 2 times per week. He feels that he is under stress becuase of a recent divorce.
ROS: negative except for above
PMH: denies
Meds: motrin, and tums
Med All: denies
Hospitalizations: Denies
PSH: Denies
Fhx: uncle  bleeding ulcer
SHx: works as construction worker; lives west philly; 2 drinks per week; 15 pack years; no recreational drugs.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle  bleeding ulcer, pain in his epigastric region, darkening of his stool, motrin, gnawing, bloating with meals, 2 times per day, 2 drinks per week, male, past 2 months, waking him from his sleep, tried tums which initially helped but no longer provide relief, nausea, 35 y.o.</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: patient is a 35-year-old male, has come to the physician's office today because of stomach problems. He says the problem started 2 months ago and is associated with a burning/knawing type pain in the epigastric region. he says he has bloating and fullness every time he eats. he also noticed he stool has been darker recently. Patient says TUMS help for a little while, but has stopped. The pain has progressively gotten worse from onset and is intermittent about 2x a day. Patient says the pain has also been waking him up in the middle of the night. Patients diet consists of food trucks and eating out Denies exacerbating factors such as food, denies recent travel or ill contacts. pt. says he also feels nausea
ROS- - except stated above
pmhx: chronic back pain
medications- TUMS, motrin 200mg
fhx: uncle with cleeding ulder
social- 1 ppd since 15 y/o, few beers a week; has stopped since pain, denies drug use
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]uncle with cleeding ulder, pain in the epigastric region, stool has been darker, motrin, burning/knawing, bloating, fullness every time he eats, progressively gotten worse, 2x a day, few beers a week, male, started 2 months ago, waking him up in the middle of the night, intermittent, TUMS help for a little while, but has stopped, nausea, 35-year-old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Hamilton is a 35 yo M who presents today due stomach pain. He states that the pain has been occuring for the past 2 months and comes and goes randomly. Endorses nausea, rates the pain at a 5/10, it is nonradiating. Endorses feeling bloated after meals, diet consists of mostly fast food. Previously noted pain was worse with food. Recent Bowel Movements have been darker than usual. Previously had relief with TUMS, now pain does not go away. Patient takes motrin PRN for aches/pains he experiences while working construction. 
Allergies: NKDA
Meds: Motrin PRN. 
PMH: None
PSH: None 
Fam: Paternal uncle had bleeding ulcer 
Social: drinks few beers per week, smoked since age of 15, 0.5 to 1 PPD, not interested in quitting. No Drug use, not sexually active, no history of STIs..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Paternal uncle had bleeding ulcer, Bowel Movements have been darker, motrin, Motrin, bloated after meals, few beers per week, Mr, M, past 2 months, comes and goes, Previously had relief with TUMS, now pain does not go away, nausea, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: 35 y/o male patient that comes to clinic due to stomach pain.
HPI: Patient mentions pain began 2 months ago. The pain was described as a 5/10 gnawing, and burning in the epigastric area. It does not radiate or move anywhere else. Mentions having nausea , pain waking him from sleep, bloating, and dark stools since 2 weeks ago. Denies fever , vomiting, diarrhea or weight loss. Not alleviated by antacids anymore.
PMH: Recurrent back aches due to construction work. Takes Motrin
Allergies: None
PSH: Non contributory
FH: Fathers side of family has alcohol problem and bleeding ulcer in stomach.
SH: Patient works in construction. Lives alone. Mentions smoking cigarettes 1 PKD for 15 years. Mentions consuming 2-3 beers a week but having to cut down recently due to bloating..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Fathers side bleeding ulcer in stomach, pain in the epigastric area, dark stools, Takes Motrin, gnawing, and burning, bloating, bloating, 2-3 beers a week, male, began 2 months ago, pain waking him from sleep, Not alleviated by antacids anymore, nausea, 35 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Moore is a 45 year old female presenting with ""nervousness"". She reports the nervousness started a few weeks ago and has become constant. She's stressed at work as a English Professor and endorses the nervousness had happened while she is lecturing. She denies a history of panic attacks, anxiety or any alleviating factors. She also reports having trouble going to sleep but getting enough sleep. She complaints of a headache that resolves with tylenol use. She denies any depression, palpitations, sweatness, panic attacks, weight loss or tremors.
PMH: none
PSH: none
Meds: tylenol for headache
NKDA
SH: english professor, 1-2 wine or beer per month, denies smoking or IVDU, monogamous with husband who had vasectomy
FM: father died of MI

.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies palpitations, denies tremors, denies sweatness, nervousness, nervousness, nervousness, denies any depression, denies weight loss, trouble going to sleep, female, 45 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Karin Moore is a 45 year old F who presents with nervousness. It has occured every day over the last few weeks. It is constant, but is worst on Sundays and Mondays before lecturing on Mondays. She also reports decreased appetite and difficulty falling asleep. She reports no early morning awakenings and sleep is restful. She identifies many triggers in her life. She recently resumed lecturing (she is an English Professor), and is currently taking care of her elderly mother and in-laws. She denies palpitations, diaphoresis, weight loss, weight gain, heat and cold intolerance, palpitations, chest pain, shortness of breath, and diarrhea/constipation.

ROS: Per HPI, otherwise negative.
PMHx: None
PSHx: None
Meds: tylenol
FHx: Father died from MI, mother elderly but healthy. 1 child, healthy.
Allergies: NKDA
Social: english professor. Occasionally drinks alcohol at social occasions, denies tobacco, MJ, illicit drug use..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies palpitations, denies diaphoresis, denies heat and cold intolerance, denies palpitations, denies diarrhea/constipation, nervousness, taking care of her elderly mother and in-laws, denies weight loss, denies weight gain, difficulty falling asleep, F, decreased appetite, 45 year</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Karin Moore, a 45-year-old female, has come to the outpatient clinic with episodes of nervousness. 
- PATIENT REPORTS A FEW WEEKS OF FEELING ANXIOUS. IT WAS PRECIPITATED BY CHANGES IN THER FUNCTION AT WORK.  SHE ALSO TAKES CARE OF SICK MOTHER AND OF HER CHILDREN
- IT'S GETTING WORSE AND IT'S CONSTANT. IT'S ASSOCIATED WITH DIFFICULTY TO SLEEP, NO APPETITE
ROS: NO PALPITATION, CHEST PAIN, CHANGES IN HAIR OR SKIN, SOB, DIZZINESS, LOSS OF INTEREST, CHANGES IN CONCENTRATION
PMH/PSH: NO
ALLERIGIES: NO
MEDICATION: TYLENOL
FH: FATHER - MI
SH: NO SMOKING, ILLICIT DRUGS. DRINKS ALCOHOL OCCASIONALLY. EATS A HEALTHY DIET.
SEXUAL: SEXUALLY ACTIVE WITH HER HUSBAND, LOSS OF DESIRE.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]NO PALPITATION, NO CHANGES IN HAIR OR SKIN, nervousness, ANXIOUS, TAKES CARE OF SICK MOTHER, NO LOSS OF INTEREST, NO CHANGES IN CONCENTRATION, DIFFICULTY TO SLEEP, female, NO APPETITE, 45-year</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC/HPI: 45yo F c/o nervousness starting few weeks back. she recently had change in work nature from researcher to lecturer. anxiety is most pronounced sunday nights/ monday mornings, when she has to give the lectures. she also reports difficulty falling asleep, esp sunday night. no difficulty staying asleep. she has decreased appetite but hasn't lost any weight recently. ROS normal otherwise.
PMH and PSH: none; allergies NKDA; meds: tylenol for occasional headaches from reading
FHx: father died from heart attack. mother alive and well
OBGYN: LMP 1wk ago, regular, no menorrhagia. 
Sexual Hx: monogomous with husband who got vasectomy; pt concerened about decreased sexual activity w/ husband since onset of nervousness. 
Social: lives at home with mom, husband; drinks alcohol on social occasions only, nonsmoker, exercises 3x/ week, eats balanced diet..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]nervousness, anxiety, nervousness, ""hasnt lost any weight"", difficulty falling asleep, F, decreased appetite, 45yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 yo f pt come to the outpatient clinic due to nervousness since few weeks ago. Two weeks ago patient switched role in her work as a teacher and has multiple tasks at home that includes nursing. She states that for the past two Sundays and Mondays she has been feeling like these, and reports lose of her appetite. Patient reports this nervousness as been constant and denies previous episodes. Patietn has been having trouble sleeping since she got to bed at 9:30 and does not get sleep after hours. Denies changes in weight, bowel movements, hot intolerance, diaphoresis, palpitations, dyspnea and urinary changes.
ROS: neg except as above
All: NKDA
Meds: Tylenol
PMH: healthy
PShx: none  Trauma: none
Hospitalization: when her children born
Social history: Balanced diet and exercise. Denies toxic habits, except for caffeine use 5-6 times a day. Sexually active with husband. No STD..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Denies bowel movements, Denies hot intolerance, Denies diaphoresis, Denies palpitations, nervousness, nervousness, caffeine use 5-6 times a day, Denies changes in weight, trouble sleeping, f, lose of her appetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 yr old f came to clinic with c/o nervousenss for few weeks. She is nervous all the time, getting worse, nothing helps with the nervousness. The pt is in teaching profession and just switched jobs few weeks ago in her teaching profession. On sunday evening and on monday she is more worried. She had decreased sleep from before. On sundays she had decreased appetite. Pt drinks 5-6 cups of caffeine every day. No h/o sadness, loss of interest, memory changes, or loss of concentration, heart racing. ROS as above; ALLERGIES NKA NKDA; MEDS none; PMH none; PSH none; FH father died of stroke, Mother is doing well; SH monogamous with husband, 2 kids, drinks wine ocassionally on the weekend..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]No heart racing, nervousenss, nervous, nervousness, 5-6 cups of caffeine, No h/o sadness, No loss of interest, No loss of concentration, decreased sleep, f, decreased appetite, 45 yr</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Karin Moor is a 45 yo F with no significant PMH now presenting with 2-3 weeks of constantly feeling anxious, associated with decreased appetite, and difficulty falling asleep. During the last three weeks she has been switched from research to the lecture circut for her work as a professor.  Other life stressors include taking care of her elderly mother and in-laws, having a 17 yo son at home, and having a busy self-employed husband.  She denies palpitations, SOB, nighttime awakenings, chest pain, weakness, abd pain
PMH: none
FH: denies family history of thyroid disease, denies family hx of heart disease, HTN, DM
Medications: occasional Ibuprophen
Allergies: NKA
Social: as stated above
Surgical: none.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies palpitations, anxious, stressors include taking care of her elderly mother and in-laws, difficulty falling asleep, F, decreased appetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Moore is a 45yoF with 2-3 week history of ""nervousness"". She works as a college professor and has recently begun giving lectures; preparing for these lectures increases her anxiety. She also cares for her elderly mother and teenage son who live at home, as well as her elderly in-laws who live nearby. She says she does not get much help from her husband taking care of her mother.

CC: ""unbearable, constant nervousness all of the time""
ROS: Some trouble falling asleep, gets around 7 hours of sleep per night. Occasional loss of appetite while nervous. Rarely has headaches which improve with tylenol use. Denies fever, weight loss, palpitations, pain.
Medications: Tylenol as needed for headache.
SocHx: lives with husband, mother, and teenage son.
Smoking history: None
Alcohol: rarely/socially
Drugs: none
FamHx: father died of MI at age 65.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Denies palpitations, nervousness, nervousness, nervous, cares for her elderly mother, cares for her elderly in-laws, Denies weight loss, trouble falling asleep, F, loss of appetite, 45yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: mrs Moore 45 yo f present c\o nervousness and anxiety started couple weeks after she started a new job, that where sudden , constant, same severity since started, no allev, aggrev sunday evning and monday morning, no previous episodes. she also reported diffuclty falling asleep, go to bed at 10pm , sleeps 11pm , and decrease appetite. she exersize regularly 3 times \wk , during the day 
she denies depression, suicidal ideation, wt changes, loss of interest, palpitation, heat intolerance, headache, SOB, fever, dizziness, weakness
ROS neg excpet as above 
PMH\meds none.  NKDA
PSH\hosp\trauma\travel none
SH english professor, live with family, sexually active w husband, dont smoke or take illicit drugs, drink ETOH occ.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies palpitation, denies heat intolerance, nervousness, anxiety, denies depression, denies suicidal ideation, denies loss of interest, denies wt changes, diffuclty falling asleep, f, decrease appetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 45 yo anxious f comes in clinic with c/o nervousness x few weeks (3) that is constant, progressive and aggravates before delievering a lecture and has no alleviating factor. 
Pt states that she feels nervous especially a night before she has to give a lecture and have problems sociallizing.
PT is also stressed out because she has to take care of her children and ill in laws and has been having difficulty sleeping because of it.
Pt also changed her role in her job from researcher to lecturer recently.
Pt denies any SOB, chest pain, numbness, inc fear of having these attacks in future, hand tremors, sweating, change in bowel/urinary habits, travel/trauma recently.
ROS: neg except above
PM/MED HX: neg    ALL: nka   FHX: father died of IHD    OB?GYNAE: no active compalints.
SHX: no smoking.et.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies hand tremors, denies sweating, denies change in bowel habits, anxious, nervousness, nervous, stressed has to take care ill in laws, has been having difficulty sleeping, f, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 yo F. CC: nervousness x 3 weeks. Increased stress at work. Change in role from researcher to lecturer. Also many responsibilities at home, caring for elderly mother and in-laws, and 17 and 19 yo sons. Noticed decreased appetite, but forces herself to eat 3 meals a day. Associated with difficulty falling asleep (duration 30 to 60 min), but attaining full 7 hours with no interruptions, no early morning awakenings. Also decreased libido for 2 weeks. Nervousness worsened on Sunday and Monday when preparing for lectures for the week. 
ROS: no recent illness, no headache, dizziness, palpitations, tremors, chest pain, SOB, n/v/d/c, pain
PMH: none, no pasMeds: none, Past hosp/surgeries: 2 vaginal births no complications, FHx: no pysch hx, father passed from acute MI at age 65 yo, no thyroid disease
LMP: 1 week ago 
SHx: English literature professor, no smoking, occasional EtOH, no ilicit drug use, sexually active..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]no palpitations, no tremors, no d, no c, nervousness, Nervousness, responsibilities at home, caring for elderly mother, responsibilities at home, caring for in-laws, difficulty falling asleep, F, decreased appetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 yo female presents with complaints of anxiousness for 2-3 weeks. Reports that she is overwhelmed and ""has a lot on her plate"" with work, taking care of mother, and other responsibilities. Reports decrease in appeitite and difficulty falling asleep. Denies anhedonia, fatigue, decrease in concentration, psychomotor retardation or suicidal ideation. No past suicide attempts. Denies weight gain, cold intolerance, constipation, brittle nails, or hair loss. 
OB/GYN: G2P2, no miscarriages. LMP 1 week ago. regular every 4 weeks. No dysmenorrhea. Sexually active with husband only, husband had vasectomy 18 years ago. 
ROS: negative except for above 
PMH: none 
PSH: none 
Meds: tylenol 
allergiesL none 
FH: dad passed at 65 yo due to MI 
SH: lives with husband, mother, and youngest son. Works as english professor. Occasional EtOH, never smoker or drug use..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Denies cold intolerance, Denies constipation, Denies hair loss, Denies brittle nails, anxiousness, overwhelmed taking care of mother, Denies anhedonia, Denies decrease in concentration, Denies suicidal ideation, Denies weight gain, ifficulty falling asleep, female, decrease in appeitite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 45 yo F presents with a few weeks of increased nervousness. She has a constant feeling of nervousness in the setting of a new job change and home stresses. She recently swited from a research focused to teaching focused job at the university. She has decreased appetite on Sun evening and Mon morning. She also has had difficultly falling asleep. She feel ""overwhelmed"". Denies SI or HI. Still enjoys reading at home. Denies SOB, CP, palpitations, diaphoresis, lightheadedness, numbness, tingling, fever, chills, or abdominal comlaints. No change in attention or energy.
PMH: none. Takes occaisional tylenol
FMH: Father had an MI
SH: works as an English teacher. She recently started teaching more instead of research which is stressfull. She aslo takes care of numerous people at home including cousins which is added stress in her life. She feels safe at home and with her husband. Infrequent EtOH use. No tabacco or drugs.
ROS: as per HPI.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Denies palpitations, nervousness, nervousness, people at home added stress takes care of, Denies SI, No change in attention, No change in energy, difficultly falling asleep, F, decreased appetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 y/o F with complaints of nervousness since the last few weeks. She has been feeling this way since she changed jobs from a researcher to a professor in school. She says she feels overwhelmed, especially on sundays and mondays. She also has a lot of work load at home as a caregiver to her in-laws, mother, and youngest child. The nervousness is constant but there are no palpitations or feeling of chest tightness. She has not increased her caffeine intake and says she has lost her apetite but still manages to eat healthy. She exercises 3 times a week and has not had any weight loss. Her husband is supportive and helps with taking care of his parents. She has been having difficulty falling asleep. Her work environment is friendly.
ROS: Negative except as above
Allergies: none
Medications: Tylenol occasionally
PSH and PMH: Nothing
SH: Teacher, non smoker, occasional alcohol use
FH: Father died of heart attach, mother alive healthy.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]no palpitations, no feeling of chest tightness, nervousness, nervousness, a lot of work load caregiver to her in-laws, mother, difficulty falling asleep, F, lost her apetite, 45 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Karin Moore, a 45-year-old female, has come to the outpatient clinic with episodes of nervousness. 
- the symptoms started 2 months ago, suddenlly, it is getting worse, constant no  alleviated or aggavated factors.
- she also c/o increase of symptoms in the Sunday evening when she has a apresentation in he school, she has loss of energy, difficulty to started sleep, occasional headache. 
- she denies, SOB, diarrhea, cold intolencace, constipation, tremors, chest pain, no suicidal toughts.
ROS: none except as above
PNH: none
All: none, Meds: OTC tylenol
Fhx: fther died at age 65 of MI.
Obgyn: LMP 1 week ago, regular periods.
Social: no tobacco use,  occasional alcohol use, no illicit drugs. she works a Englisgh Profession, with stressful at job.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies diarrhea, denies cold intolencace, denies constipation, denies tremors, nervousness, no suicidal toughts, difficulty to started sleep, female, 45-year-old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Karin Moore, a 45-year-old female, is here becuasue of nervousnous for a few weeks. She feels nervous and ""overwehlmed"" by her life, especially when thinking about her english lectures. Nothing seems to make it better She does not report any hisrtory of anxiety. Denies feeling of being on edge, muscle tension, anhedonia, suicidal thougths. Does endorse loss of apetite, but no weight lost. denies fevers and night sweats, athritis. Does report trouble sleeping (takes 30 to 1 hr to fall asleep). Does not report illicit drug use or smoking.  No significant PMH or PSH or SH..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]nervousnous, feels nervous, Denies suicidal thougths, Denies anhedonia, no weight lost, trouble sleeping, female, loss of apetite, 45-year-old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 45 year old female presenting with few weeks of neurvousness at all times especially on sunday nights and monday mornings. SHe describes unbearable anxiety that started when she was transitioned at work to more of a lecturing role after 15 years doing research, She has never had this before and nothing makes it better. She has has decreased appetite, but no weight changes, no fatigue, no headaces, no issues with her mood, concentration or energy level. She has severeal stressors including moter living with her, inlaws with health issues and her son living at home. She denies changes in skin or hair, cold/heat intolerance.
ROS: negative except as above
PMH, surgeries, meds: none
Social: no smoking, social drinker, caffiene 5-6 cups/days, no illicit drug use, sexually active with husband, healthy diet, walks 3x/week for exercise
Fam Hx: MI.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]no fatigue, denies changes in skin or hair, denies cold/heat intolerance, neurvousness, anxiety, stressors moter living with her, stressors inlaws with health issues, caffiene 5-6 cups/days, no issues with mood, no issues with concentration, no issues with energy level, no weight changes, female, decreased appetite, 45 year</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 yo f c/o nervousness for 1 month. c/o difficulty fallling asleep. takes 1hours to fall asleep. no trouble maintaining sleep or early awakenings. stressors at home and at work. taking care of sick mom and children. works as a english liturature professor. just started to give lectures. drinks 5-6 coffee during the day. no SOB, chest pain, recent headache, fever, chills, changes of hair and skin, hand shaking, heat intolerance, changes to bowel movements. loss of interests, suicidal thoughts. do not feel sad. feel safe at home.
PMH: none. nkda, no rx drug. used tylenol for occational headache. 2 vaginal deliveries.
SH: lmp last week. no smoking. drinks occasionally. no rec drugs. walks 3 times a day..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]no changes of hair, no changes skin, no hand shaking, no heat intolerance, no changes to bowel movements, nervousness, stressors at home taking care of sick mom, drinks 5-6 coffee, no loss of interests, no suicidal thoughts, do not feel sad, difficulty fallling asleep, f, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 y/o F who presents with a several week hx of episodes of nervousness
other symptoms include headaches
occur predictably with regard to work, family, and daily tasks
has affected every aspect of her life
Describes life as very stressful working, taking care of 2 kids, mother and in-laws
Describes husband as supportive, but very busy
Worse Sunday nights and Monday mornings preparing for class
Not alleviated by anything
All: NKDA
Mdx: Tylenol 
PMH: headaches
FHx: Heart attack at 65 (paternal)
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]nervousness, stressful taking care of mother and in-laws, F, 45 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 yo F presents c/o nervousness
- few weeks duration, constantly ""feeling nervous"", progressively worsening over time
- significant social stressors of being carer for elderly mother who lives with her; also has recently started new job as lecturer
- nervous feeling is worst on Sunday nights / Monday morning prior to work
- no panic attacks, no mood changes, just ""feels overwhelmed""
- los of appetite, nausea with no loss of weight
- loss of libido related to nervousness
- no palpitations, no hair / skin changes, no neck lumps, no heat / cold intolerance
ROS: unremarkable
PMH / PSH: nil
DH: tylenol occasionally for headache, nil allergies
FH: father had heart attack, elderly mother is well
SH: non smoker, drinks alcohol occasionally, nil illicit drug use, excessive caffine intake 5 - 6 cups per day, works as lecturer, lives with elderly mother, husband, and teenage son, good social supports, sexually active with husband only.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]no palpitations, no hair / skin changes, no heat / cold intolerance, feeling nervous, nervous, nervousness, nervousness, stressors carer for elderly mother, lives with elderly mother, excessive caffine intake 5 - 6 cups, no mood changes, no loss of weight, F, los of appetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 Y/O F CAME TO THE CLINIC C/O NERVOUSNESS. SHE HAS THIS SYMPTOM FOR A FEW WEEKS. SHE IS A ENGLISH PROFESSOR. AFTER SHE GAVE LECTURES THE SYMPTOMS STARTED. IT IS WORSE SUNDAY NIGHTS, MONDAY MORNING. SHE HAS NO PREV EPISODES. SHE IS HAVING DIFFICULTY FALLING ASLEEP, SLEEPS 7 H A DAY, WAKES UP REFRESHED. SHE FEELS OVERWHELMED. HER ENERGY LEVEL IS GOOD. HER APPETITE IS NOT LIKE BEFORE, THERE IS SOME DECREASING.
DENIES FEELING SAD, LOSS OF INTEREST, FEELING GUILTY, DIFFICULTY CONCENTRATING., WEIGHT CHANGES, SKIN CHANGES, HAIR CHANGES, TREMOR.
ROS NEG EXCEPT AS ABOVE.
PMH NONE. MEDS TYLENOL OCCASIONALLY. NKDA.
PSH NONE. HOSP TWICE WHEN SHE GAVE BIRTH. TRAVEL/ TRAUMA NONE.
FH FATHER DIED W MI.
SH SEX ACTIVE W HUSBAND, DECREASED SEXUAL DESIRE. NO STDS. SMOKE/ DRUG NONE. ETOH OCCASIONALLY.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]DENIES SKIN CHANGES, DENIES TREMOR, DENIES HAIR CHANGES, NERVOUSNESS, ENERGY LEVEL IS GOOD, DENIES FEELING SAD, DENIES LOSS OF INTEREST, DENIES DIFFICULTY CONCENTRATING, DENIES FEELING GUILTY, DENIES WEIGHT CHANGES, DIFFICULTY FALLING ASLEEP, F, APPETITE IS NOT LIKE BEFORE DECREASING, 45 Y/O</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: a 45-year-old female, has come to the outpatient clinic with episodes of nervousness. these episodes started a few weeks ago and they are getting worse. they are more on sunday and monday. she also has decreased appetite. she also has difficulty with starting sleep. she do not has diarrhea, no skin changes or hair changes, no chest pain or shortness of breath, no change in her menstrual periods and they are regular. she is just worried because she is taking care of 2 children and everyone at home, she also has some new stress in her job
ROS: nothing except the above
PMH: none.    PSH : none.
Meds: tylenol .
ALLERGIES: NKA
FH: father died of hear attack at age of 65
SH: nonsmoker, no illicit drug use, socoial drinker . works a ss english professor.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]do not has diarrhea, no skin changes, no hair changes, nervousness, worried she is taking care everyone at home, difficulty with starting sleep, female, decreased appetite, 45-year-old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 y/o female evaluated at clinec found hemodinamically stable and in NAD, a couple of weeks ago pte starte d with nervousness tht is contant got worst when job required public speaking, no alliviating factor, no associated symtoms, denies, fever, chil, sob, changes in GI. pte refer less apetite but force herself to eat regularly denies wight changes, diet. walks 3 times a week and have trouble getting to sleep but sleeps 7 hours. no headaches, numbness, weakness, fatigue or diziness. 
ROS: NEG EXCEPT AS ABOVE
PMHX NONE
ALL: NONE  MEDS NONE
OBGYN;vaginal delivery, regular period started at age 12, mamograhy and pap done in the last year, 5 days period 5 pads first day then 2-3.  no std. denies smoking or drugs, etoh socialy
PSHX; NONE
FMHX: MOM NONE DAD DIED OF MI, 
SOCIAL: WORKS, MARRIED 2 CHILDREN 17,19 ODER IN COLLEGE  , ETOH SOCIALLY ,DENIES SMOKING OR DRUGS, SEXUALLY ACTIVE WITH HUSBAND NO STD.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies changes in GI, nervousness, denies wight changes, trouble getting to sleep, female, less apetite, 45 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 yo female complaining of nervousness for the past few weeks. Attributes this to having so much on her plate because of changes at work and household changes. Its worse on Sunday nights and Monday mornings. Patient has also been having problems falling asleep. Patients mood is good, with no loss of interest. Patient has never used drugs before. No cold or heat intolerance.Patient has less of an appetite but no changes in weight. 

ROS: None
Obys/Gyne: LMP was a week ago, Menarche at the age of 13, regular every 30 days for 4 days. Last pap smear was 9 months ago and was normal.
PMH: None
Allergies: None
Medication: Tylenol
FH: Father died of a heart attack 10 years back
Social: Nonsmoker, social EtOH, sexually active with husband, English proffesor.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]No cold or heat intolerance, nervousness, mood is good, no loss of interest, no changes in weight, problems falling asleep, female, less of an appetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms Moore is a 45 year old female with no PMH who presents for feelings of nervousness for the past few weeks. She says it's all the time but is worse on Sundays thinking about work for the week.  Nothing makes it better.  She says it takes her longer to fall asleep, is less interested in sex, and she doesn't have an appetite.  She also reports stress at home as she is caretaker to her mother who lives with her.  She denies headaches, fevers, night sweats, weight loss, SOB, palpitations, racing heart, nausea, diarrhea, constipation, rashes, feeling dizzy or faint. She denies depressed mood or suicidal/homicidal ideations.  FMH for father dying of MI at 65 years old..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies night sweats, denies palpitations, denies racing heart, denies diarrhea, denies constipation, nervousness, stress at home caretaker to her mother, denies depressed mood, denies suicidal ideations, denies weight loss, takes longer to fall asleep, female, ""doesnt have an appetite"", 45 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 yo F presents with persistent nervousness which began a few weeks ago and is getting worse. She feels nervous about everything in every situation. Especially exacerbated when preparing for lectures. No alleviating factors. Reports drinking 5-6 drinks of coffee/day. Reports difficulty falling asleep; it takes 30-60 min to fall asleep but no awakenings. 7 hrs of sound sleep per night. Denies depressed mood, loss of interest, inability to concentrate. Denies increase in self-confidence and flight of ideas. Denies chest pain, palpitation, headache, change in weight, SOB. Occasional loss of appetite. Rarely has headache, relieved by Tylenol. 
PMHx: none. NKA. PSHx: none. Meds: Tylenol, rarely for headache. OBGYN: G2P2. LMP 1 wk ago, regular periods, normal flow, no pain during periods. SHx: no smoking, EtOH occasionally, 1-2/mo. no illicit drug use. sexually active with husband but decreased sexual desire due to anxiety. Professor..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Denies palpitation, nervousness, nervous, 5-6 drinks of coffee/day, Denies depressed mood, Denies loss of interest, Denies inability to concentrate, Denies change in weight, difficulty falling asleep, takes 30-60 min to fall asleep, F, loss of appetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: nervousness
HPI: Ms. Moore is a 45 yo woman previously healthy who presents with a 2 week history of increased nervousness. Symptoms began a few weeks ago when she began giving lectures at work to large groups of students. The anxiety is constant, but worsens in the days leading up to lectures. Appetite is decreased, but improves following the end of the week of lectures. Patient also endorses difficulty falling asleep, denies nighttime awakenings. Endorses decreased sex drive during this time. Denies anhedonia, guilt, energy decrease, concentration change, psychomotor slowing, and suicidal ideation. 
ROS: No headaches, no weight changes, no panic attacks, no heat intolerance, no heart palpitations, no chest pain, no diarrhea/constipation.
PMH/PSH: none
MED: tylenol prn for headache
ALL: none
FH: dad died at 65 from heart attack, mom healthy.
SH: English professor. Never smoked or used drugs. Alcohol 1-2x per month socially..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]no heat intolerance, no heart palpitations, no diarrhea, no constipation, nervousness, anxiety, nervousness, Denies anhedonia, Denies concentration change, Denies suicidal ideation, no weight changes, difficulty falling asleep, woman, Appetite is decreased, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 45 yo F c/o nervousness lately
- she is under stress especially for increased workload in the last few weeks
- decreased appetite and difficullty falling asleep: however, she sleeps at least 7 hours per night and has no nighttime awakenings
- denies chest pain, palpitations, SOB, skin changes, bowel changes
- no weight changes, fevers or night sweats. No fatigue
ROS: neagtivee xcept as above
PMH: none. PSH: none. allergy: NKDA. Meds: tylenol. FH: father died of AMI at age 65, mother is healthy. SH: no smoke or illicit drugs, occasional alcohol. She is a teacher, lives with her husband, mom and youngest son. Sexually active with husband only. Regularly exercise and follows a healthy diet.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies palpitations, denies skin changes, denies bowel changes, nervousness, no weight changes, difficullty falling asleep, F, decreased appetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. moore is a 45yo female who is here due to nervousness.
-endorses anxiety all the time for the last few weeks
-right before this, she switched to teaching students from a research job
-anxiety worst on sunday/monday
-associated with loss of appetite and insomnia
-no panic attacks, chest pain, shortness of breath or palpitations

ROS: -weight loss, fatigue, headache, skin/hair changes, chills, fever, nausea, vomiting, diarrhea, constipation, change in urinary/bowel habits, abdominal pain

PMH and PSH: none. Meds: tylenol. Allergies: none. FH: father MI at 65, mother is healthy. Social: english professor, 2 kiids, married, sexually active with no condom use with husband, no std history. no smoking or illicit drugs. socially drinks about 1-2 glass of wine a month.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]- skin changes, - hair changes, - diarrhea, - constipation, - bowel habits, no palpitations, nervousness, anxiety, anxiety, -weight loss, insomnia, female, loss of appetite, 45yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45yo F presents to clinic with a few weeks of nervousness and anxiety. She recently began lecturing more for her job, which is a change from her previous position as a researcher. In addition, she helps to take care of her two sons and aging mother and in-laws at home. Along with her nervousness and anxiety, she occasionally has a loss of appetite. In addition, she has difficulty falling asleep, stating she will lay awake for an hour before being able to sleep. Her bedtime routine involves getting things ready for the boys for the next day and reading on the couch. She denies diaphoresis, palpitations, chest pain or tightness. No headaches, vision changes. No abdominal pain or bowel or bladder changes. No skin rashes or hair loss. 
PMH: none
Meds: Tylenol for occasional headaches
Allergies: none
SHx: none
Family Hx: father - MI age 65
Social Hx: EtOH - 1 beer socially, tobacco - none, illicit drugs - none, sexual - w/ husband.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies diaphoresis, denies palpitations, No bowel changes, nervousness, anxiety, nervousness, anxiety, elps to take care of aging mother and in-laws, difficulty falling asleep, F, loss of appetite, 45yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Moore is a 45 yo woman who presents with 3-4 weeks of nervousness ""alltheh  time'. Nothing makes it better. She has trouble getting to sleep, but sleeps well once she falls asleep. She has taken no medications to treat it. The nervousness is worse when she gives lectures to her students, a practice which just started a couple weeks ago and which she only recently found out she would have to do. 

She has no other medical problems and has had no surgeries. She takes acetominophen only for occasscional headaches. Otherwise, she takes not meds. She has no allergies. Her family history is signficant for MI in her father at 65. She consumes 1-2 alcoholic beverages per week. She does not use tobacco or other drugs. She works as an English professor. She is married (20years) and is monogamous..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]nervousness, nervousness, trouble getting to sleep, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI:A 45 YO\F COMPLAINS OF NERVOUSNESS FOR FEW WEEKS ,SHE STATES THAT SHE HAS ALOT OF STRESS IN WORK AS SHE SHIFTED FROM THE DEPARTMENT OF RESEARCH TO THE LECTURING PEOPLE. SHE WORK AS TEACHER AND WORRIED ABOUT EVERYBODY IN HER HOME , SHE ALSO REPORTS DRINKING ALOT OF COFFIE 5-6 CUPS A DAY ,SHE DONT FEEL SAD BUT SHE'S OVERWELMED , SHE HAS DIFFICULTY SLEEPING BUT SHE HAS NO LOSS OF CONCENTRATION , INTEREST OR SUICIDAL THOUGHTS, SHE WALK A MILE FOR 3 - 4 TIMES A WEEK.
PMH\PSH; NONE
MEDICATION; TYLENOL
ALLERGIES: NKDA
SH: NO SMOKING, OCCASIONAL ETOH, ENGLISH PROFFESSOR,MARRIED AND LIVES WITH HUSBAND WHO HAD VASICTOMY.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]NERVOUSNESS, DRINKING ALOT OF COFFIE, COFFIE 5-6 CUPS A DAY, DONT FEEL SAD, NO LOSS OF CONCENTRATION, NO LOSS OF INTEREST, NO SUICIDAL THOUGHTS, DIFFICULTY SLEEPING, F, 45 YO</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 45 year old female presenting for ""nervous episodes"" for the past few weeks. She denies any associated trigger. She reports it to be constant and worse in the evenings the night before her lectures. She works as a teacher and has recently been assigned to lecturing 2 weeks ago, her normal assignments are related to research. She notes for the past 2 weeks she has not been as hungry and has had insomnia. She consumes 5-6 cups of coffee for a ""long time"". Her periods have been regular.
PMH: Denies
PSH: Denies
Allergies: NKDA
Meds: Tylenol PRN
FH: Father passed away 65 yo from MI; Mother is healthy
SH: Alcohol 1-2 drinks on special occasions; Denies smoking, drugs; Sexually active with her husband but not as much since the episodes of nervousness; English professor
ROS: Negative headache, chest pain, palpitations, SOB, Abdominal pain, changes in urination, constipation, diarrhea, weight change, social anxiety, mood chan.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Negative palpitations, Negative constipation, Negative diarrhea, nervous, nervousness, 5-6 cups of coffee, Negative mood chan, Negative weight change, insomnia, female, has not been as hungry, 45 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 yo, F, c/o of feeling nervousness it started few weeks ago, no preceding events noted, gradually deveopled, always feels nervousness all the time,  she has a lot of stress due to work changes, son in last yr of college, and mother need care for her health, also some family in law issues, it gets worse on sunday nights and monday morning, no relieving factors noted, she has no fever, fatigue, she feels her appetite is sometimes decreased although no changes seen in her weight, no changes in bowel and urinary habits, no cold intolerance or hot flashes, no hairloss or headcahes, no palpitaions or tremor
PMH: @ NVD, PSH;none, FH: father died og MI at 64yrs, mother healthy, MED tylenol for occasionla headaches, all;NKDA
SH: english professor, sexually active with husband only, husband has vasectomy after 2nd son, no STD, occasional use of ETOH on weekends, CAGE0/4, no smoking ot other illicit drug use, 1 miles walking 3 times a week,
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]no changes in bowel habits, no cold intolerance, no hairloss, no palpitaions, no tremor, nervousness, nervousness, stress due to mother need care for her health, stress due to in law issues, no changes seen in her weight, F, appetite is sometimes decreased, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: Mrs. Moore is a 45yo F who complains of nervousness that started a few weeks ago and has been getting worse. It is constant to where she has decreased appetite and difficulty falling asleep. Nothing has made it better or worse. She denies hx of cardiac or thyroid issues. She does have many changes in home life ie. changing jobs, taking care of in laws with health problems next door with little support. She also has decreased appetite. 
ROS: Negative except stated in HPI
PMH, PSH, ALL: None
Meds: Tylenol 
FH: Father died of MI
SH: No tobacco or drug use. Ocasional EOTH use, walks a mild 3x/week. Sexually active with husband. Feels safe at home. Works as English Lit teacher..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies thyroid issues, nervousness, taking care of in laws, difficulty falling asleep, F, decreased appetite, decreased appetite, 45yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Moore, is a 45 yo female who presents with nervousness.
-Started 3-4 weeks ago.  Is constant and has not progressed.
-Related to the stress in her life, ie caring for mother children job
-aggravated by public speaking
-associated decreased sleep

ROS: no skin changes, no palpitations, no diaphoresis

PMH: none
Allergies: nka
Medications: PRN tylenol (rare)
FH: father passed at 65 MI, mother healthy
Social: english professor, EtOH 2-3 per month, no tobacco, no recreational drugs, walks 3x/wk
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]no skin changes, no palpitations, no diaphoresis, nervousness, stress in her life, ie caring for mother, decreased sleep, female, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: A 45 y o f C/O NERVOUSENSS FROM PAST 2-3 WEEKS THAT IS CONSTANT, PROGRESSIVE AND WORSENING AND IS ESPECIALLY PRESENT ON SUNDAY NIGHTS AND MONDAY MORNINGS AND IS RELATED TO THE RECENT INCREASE BURDEN OF WORK AT HOME AND AT THE JOB. (TAKING CARE OF DISABLE MOTHER AND INC WORKLOAD.)
ALONG WITH THAT SHE HAS DEC APPETITE AND DIFFICULTY FALLING SLEEP (NORMAL LATENCY AND DURATION) AND IS ANXIOUS AND OVER WHELMED ALL THE TIME.
SHE DENIES FEVER, RACING OF HEART, CHEST PAIN, TREMORS, HEAT INTOLERANCE, SKIN, BOWEL/WEIGHT CHANGES, LOW MOOD.
ROS: NEG EXCEPT ABOVE
PMH/MEDS: N/C    PSH/HOSP: N/C   ALLERGIES: NKA
FH: + FOR MI IN FAMILY    
OBGY: LMP 1 WEEK BACK, MENARCHE AT 13, CYCLE 4/30 R.
SEXUAL: MONOGAMOUS WITH HUSBAND X 2 yrs
SH: DENIES SMOKING/ILLICIT DRUGS, ETOH OCCASIONALLY.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]DENIES RACING OF HEART, DENIES TREMORS, DENIES HEAT INTOLERANCE, DENIES SKIN CHANGES, DENIES BOWEL CHANGES, NERVOUSENSS, ANXIOUS, INCREASE BURDEN TAKING CARE OF DISABLE MOTHER, DENIES LOW MOOD, DIFFICULTY FALLING SLEEP, f, DEC APPETITE, 45 y o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Moore is a 45yo Female with a 2-3wk history of progressively increasing nervousness 
- Increased stressors over few weeks: taking care of her inlaws, taking care of her children (age 17 and 19) and working as a full time english literature professor 
- Feels nervous 24/7, has difficulty falling asleep, sleeps 7hrs/night 
- Decreased appetite, but forces herself to eat so has not lost weight 
- Worse on Sunday night/Mon morning when she has upcoming lessons for her job 
- Support from husband but he is busy with work
- Denies palpitations, chest heaviness, dyspnea; denies changes in hair or skin, joint pain 
- Has not tried anything to cope with stress (yoga, meditation
PMH: none ; meds: occasional tylenol for headaches (very rare) 
Fhx: no relevant fhx; father died of MI 
Social hx: working as english lit professor; 2 kids age 17 & 19;  Lives w/ husband and 17yo; denies tobacco, drug use; ETOH 1x/month; walks 2-3x/week.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Denies palpitations, denies changes in hair or skin, nervousness, nervous, stressors taking care of her inlaws, not lost weight, difficulty falling asleep, Female, Decreased appetite, 45yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: cc: 45 year old female c/o nervousness for the past 3-4 weeks.
hpi: 45 year old female c/o nervousness for the past 3-4 weeks. There is no perticular precipitating factor. It is consant, nothing makes it better, stress and giving lectures makes it worse. She has palpitation, poor sleep, but denies any sweating, visual problem, depressed mood, skin change, heat intolerance, weight or appetite change. She reports she is experiencing stress at work lately. SHe is taking are of her mom for the past 2 years and feeling stressed out with it. 
ros; negative
pmh: none
med: tylenol
allergy: none
sh: no smoking , occasional alcohol use, no illicit drug
fh: father died of heart attack at age 65 . mother is healthy.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies any sweating, denies skin change, denies heat intolerance, nervousness, nervousness, taking are of her mom for the past 2 years and feeling stressed, denies depressed mood, denies weight change, poor sleep, female, female, 45 year, 45 year</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 yo F comes to the clinic complaining of nervousness. started few weeks back, feels nervous and overwhelmed all the time, recent job change few weeks back; had more research initially now more teaching. nervousness is more esp on sunday evenings and monday morning as she is worried about her lectures on monday. has stress regarding her mom and her sons and in laws. no alleviating factors or diurnal variation, constant. a/w difficulty falling asleep. drinks 5-6 cups of coffee throughout the day, decreased appetite
denies any night time awakenings, nightmares, depressed mood, loss of interest, guilt, suicidality, menopausal symptoms, heat intolerance, changes in bowel bladder habits, fever, chest pain, n/v, palpitations, weight changes
ROS neg except as above
PMH none, no meds, NKDA
PsH none, no travel/ trauma
FH father died of MI 10 yrs ago
SH teacher, lives with husband, sons and mom, occassional EtOH, no smoking/ drugs,.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies heat intolerance, denies changes in bowel habits, denies palpitations, nervousness, nervous, nervousness, stress regarding her mom, stress regarding in laws, 5-6 cups of coffee throughout the day, denies depressed mood, denies loss of interest, denies guilt, denies suicidality, denies weight changes, difficulty falling asleep, F, decreased appetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 46 yo F with no PMH who comes in today with nervousness.
- Lot on her plate - taking care of elderly mom, two teenagers, her work
- Feels nervous about everything in the past few weeks; in business and personal life
- Difficulty sleeping and decreased appetite, still pushing herself to eat
- nothing seems to improve her situation. can't place her finger on what may have caused increased nervousness as of lately
- never had this in the past
- No heart palpitations, sweating, shortness of breath, nausea. 
PMH: N/A
PSH: N/A
Meds: Tylenol - occasional Headache
ROS: pertinent listed above.  
Obstetrical: 2 children, 17, 19. LMP was last week. Regular periods with moderate flow. 
Social: English lit. professor. Lives with mother, husband, younger son. Sexually active with husband. Husband had a vasectomy. Walks 3x a week, eats a balanced diet. 
No smoking, drug use. Couple drinks a month.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]No heart palpitations, No sweating, No nausea, nervousness, nervous, nervousness, taking care of elderly mom, Difficulty sleeping, F, decreased appetite, 46 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: nervousness
HPI: Ms. Moore is a 45 year old woman who presents to clinic today with nervousness for the last couple of weeks. She notices that her symptoms are worse Sunday evening, before her Monday lecture. She recently changed her job from research work to more lecture based. She also states some life stressors at home which include taking care of her mother and two kids. She states that her sleep is affected, taking over an hour to fall asleep. She denies changes in interest, energy levels, and concentration. She has had a decrease in appetite for the last two weeks, but has not had any weight loss. 
ROS: negative for palpitations, heat intolerance, sweating, changes in urinary habits, changes in eating habits
PMH: hostpitaliztions following the births of her two children, tylenol PRN for occasional headaches
Social: denies tobacco or recreational drug use; states she drinks socially occasionally
family: father MI age 65
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]negative for palpitations, negative for heat intolerance, negative for sweating, nervousness, nervousness, stressors taking care of her mother, denies changes in interest, denies energy levels, denies concentration, has not had any weight loss, sleep is affected, taking over an hour to fall asleep, woman, decrease in appetite, 45 year</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 45 yo F with a CC of two weeks of ""nervousness"" 
-pt reports that symptoms began after recent change in job description. used to do research now giving lectures every monday. considers this stressor. also reports that pt's mother is living with her and that this is very stressful for her. 
-one week history of decreased appetite. 
-pt reports that she has had difficulty falling asleep at night
-pt 3/8 SIGECAPS difficults sleeping decreased appetite and psychomotor agitation- denies others
ROS no jiterness, palpatations, LOC, light headedness, dyspnea, SOB, weight loss or gain,, sweating, heat or cold intolerance, changes in hair skin or nails, rashes or recent cough rhiorhea fever.
Med tylenol for occasional HA
allergies denies
PMH/SH denies 
FH drinks ETOH only socially 1-2 drinks
denies cigarettes and drugs use
english professor doing research recently lectures, grandma living with her is stressful..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies palpatations, denies sweating, denies cold intolerance, denies heat intolerance, denies changes in hair, denies changes in skin, denies changes in nails, nervousness, mother is living with her very stressful, grandma living with her is stressful, denies weight loss, denies weight gain, difficulty falling asleep, difficults sleeping, F, decreased appetite, decreased appetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs Moore is a 45 year old female presenting with feelings of nervousness. 
-started a few weeks ago
-feels nervous all the time, nothing improves this feeling but it is noticably worse on sunday evenings and monday mornings.
-changed job responsibilites about 1 month ago to include more lecturing and less research. 
-additional symptoms include decreased appetite and difficulty falling asleep at night. Denies lying in bed worrying about things.
-denies chest pain, palipations, nausea, vomiting, abdominal pain, diarrhea, tremors, unintentional weight loss.

PMHs: insignificant
Meds: occasioanl tylenol
Past surgical history: none
FHx: father died of MI
SHx: non-smoker, occasional EtOH, no drugs. drinks 5-6 cups of coffee per day as late as 5pm. lives at home with husband, 2 children, and her mother who is h. works as a professor, recently changed jobs from research to more lecturing. sexually active with husband only.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies palipations, denies tremors, denies nausea, vomiting, denies diarrhea, nervousness, nervous, 5-6 cups of coffee per day, denies weight loss, difficulty falling asleep, female, decreased appetite, 45 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 45 yo female who presents with episodes or nerviousness. Onset has been few weeks ago and she feels as though she is ""losing her mind"". She says that it was worse on Sunday night and monday morning. However, she states that the nervousness is constant. There is no particular onset to when she feels nervous.  She used to be a researcher but recently has been teachiing in a classroom. She states that she has had difficulty falling asleep. She lives with husband, sons and mom and says that she feels safe and has a good relationship with the,. She denies loss of interest, decreased energy, suididial ideation,  or harming of others. Additionally, she denies headache, tremor, palpitations and GI symptoms 
PMH: none
FH: father had HA
SH: no smoking , drugs or alcohol. sexually active with husband. 
Meds: none
Allergies: one.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies tremor, denies palpitations, denies GI symptoms, nerviousness, losing her mind, nervousness, nervous, denies loss of interest, denies decreased energy, denies suididial ideation, difficulty falling asleep, female, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: This patient is a 45 yo female who presents to the clinic due to a new onset of nervousness. She says that it started a few weeks ago and has been constant ever since it started. She states that nothing really helps her symptoms during this time. She has recently changed her position at her job from being a researcher to be a lecturer and feels as though it may be related to her change in jobs. Sunday and Monday appear to be the worse days for her as she tends to spend the days thinking about teaching. She also has had a decrease in appetite and difficulty sleeping during this time. She denies excessive sweating or tremors.

ROS: Negative except as mentioned above
Allergies: NKDA
Medication: None
PMH: None
PSH: None
Family history: Father died of heart attack
Social: Denies tobacco use, social drinker. No illicit drug usage. Only sexually active with husband..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies excessive sweating, denies tremors, nervousness, difficulty sleeping, female, decrease in appetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 45 y/o f c/o worsening nervousness for 3-4 wks. The symptom is intermittent.
A/w giving lectures, decrease appetite for 1 wks, increasing work load and caffeine intake ( coffee 4-5 cups/d * 12 y).
No hot intolerance, palpitations, diarrhea, hot flashes or wt loss.
She sleeps 7 h/d, no daytime sleepiness.
ROS: As per HPI
PMH/PSH/All: None
Med: OCC Tylenol
FH: Father c heart attack
SH: English professor, no smoking/drugs, OCC alc 1-2 wine, SI c husband
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]No hot intolerance, No palpitations, No diarrhea, No hot flashes, nervousness, increasing caffeine intake, coffee 4-5 cups/d, No wt loss, f, decrease appetite, 45 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI; 45 yo F with nervousness for  a couple of weeks
-It is constant, worsens with thinking about her work.
-Stressful for her job, an English professor 
-Difficulyt Sleeping; difficulty of satying asleep
-Appetite loss and coffeine taking 
-Denies fever, weight loss, any chagnes in urinary or bowel habits
OB/GYN; G2P2, LMP 1 week ago, q28-30 days, lasting 5 days. Menarche at age 12. Last pap smear was 10 months ago, normal.
ROS; Negative except as above.
PMH/PSH; None. Alleregies; NKDA. Medications; Tylenol, FH; Fahter died of MI.
SH; No smoking, 1-2 beers a week, Sexually active with husband only no illicit drug.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Denies chagnes in bowel habits, nervousness, coffeine taking, Denies weight loss, Difficulyt Sleeping, F, Appetite loss, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 year old female with persistent feeling of ""nervousness"" for past 3-4 weeks. Cannot identify any certain event associated with onset. Anxiety is constant but worsens in association with new lecture duties for work. No prior history of anxiety. No major life changes aside from new lecture duties. Describes feeling overwhelmed due to caring for aging mother and work responsibilities. Also endorses difficulty falling asleep. Endorses decreased appetite over the past 2 weeks. No weight changes, skin or hair changes, GI changes, palpitations,, neck masses, or excessive sweating. No mental health history. Denies any other mood changes.  No medicaiton or supplement use. No family history of thyroid disease..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]No hair changes, No skin hanges, No GI changes, No palpitations, No excessive sweating, nervousness, Anxiety, overwhelmed due to caring for aging mother, Denies mood changes, No weight changes, difficulty falling asleep, female, decreased appetite, 45 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 45 y/o f c/o nervousness for 2 weeks. she notes that it's present all the time and is worse during Sundays and Mondays (when she usually prepares lectures). nothing relieves the nervousness. she also noticed difficulty sleeping and decreased appetite. denies any tremors, hair loss, heat intolerance, palpitations, shortness of breat, tingling sensations, wt loss and changes in bowel habits. of note, she drinks 5-6 cups of coffee a day. she also denies any stresses in her life, but is worried that the nervousness is somehow affecting her dynamics with her husband.
ROS: negative except above
PMH: none
PSH: none
medications: tylenol occasionally for headaches
FH: noncontributory, no hx of anxiety disorders
SH: LMP 1 wk ago, regular periods; monogamous with husband, works as a professor, nonsmoker, no ETOH use, drinks 5-6 cups of coffee per day.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies any tremors, denies hair loss, denies heat intolerance, denies palpitations, denies changes in bowel habits, nervousness, nervousness, nervousness, 5-6 cups of coffee, 5-6 cups of coffee, denies wt loss, difficulty sleeping, f, decreased appetite, 45 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Moore is a 45 y.o female with no significant past medical history who presents with a 3-4 week history of increased anxiety and feeling nervous all the time. She reports feeling anxious and overwhelmed throughout the day regardless of what is going on during her day. She denies feeling down or depressed but this anxiety is ""overwhelming."" In addition, she has had difficulty falling asleep and has noticed decreased appetite for the past 1-2 weeks. She denies palpitations, change in bowel habits, skin rashes, fevers or chills, or dyspnea. She recently had to start giving lectures at work. She also experiences stress from caring for her mother at home but has no other identifiable changes in her stress levels.
PMH: None
PSH: None
Fam Hx: Father died of MI at 65 yo
Social: Social alcohol use 1-2/month, never smoker, no drugs. Lives with husband, son away at college.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies palpitations, denies change in bowel habits, anxiety, nervous, anxious, anxiety, stress from caring for her mother, denies feeling down, denies feeling depressed, difficulty falling asleep, female, decreased appetite, 45 y.o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Karin Moore is a 45 year olf F presenting with episodes of nervousness for about 2-3 weeks. Not present immediately prior and she has never had this problem before. This started when she began giving lectures not research. No headache, palpitations, N/V, jitteryness, or sweatiness. She has felt like not eating, although forces herself to have adequate nutrition. She has a normal energy level, and gets 7 hours of sleep per night, although has difficulty falling asleep. Nothing makes her anxiety better, and it is worse on Sunday evenings and Monday mornings before lectures. She is also anxious about things in her daily life (shopping, transportation) unrelated to work duties. She has no significant PMH and no past SHx. She occasionally takes Tylenol for headaches but can't recall her last dose. She drinks 2 times per month, does not used tobacco or illicit drugs. She is sexually active with husband, although less often due to anxiety..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]No palpitations, No jitteryness, No sweatiness, nervousness, normal energy level, difficulty falling asleep, F, felt like not eating, 45 year</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Karin is a 45 yo woman with no PMH who presents with 2-3 weeks of feeling ""nervous all the time"" at work, at home, and other situations. She states this all happened around the time she began a new job task of giving lectures at work. She works full time as well as providing support for her aging mother and in-laws. She does find some relief when going for walks 3 times per week. She states that she gets so nervous the night before giving her lectures that she loses her appetite. This has had negative impacts on her libido and intimate relationships with her husband, who remains supportive. She denies any sweating, SOB, chest pain, syncope, or NV associated with these episodes..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies any sweating, denies NV, nervous, nervous, providing support for her aging mother and in-laws, woman, loses her appetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Moore is a 45 y/o female presnting with anxiety. Pt states that over the last 3 weeks she has been having contant feelings of anxiety through out the day. She does not have particular triggers. Pt also c/o decreased appetite  and insomnia for 3 weeks. Having difficulty falling asleep, lays in bed for 30 minutes. No fever, chills, N/V, palpitations, changes in weight, changes in bowel or bladder function. Pt notes that she has stressors in her life that include taking care of her elderly mother, her 2 kids aged 17 and 19, and she works full time as an English professor. 2 weeks ago she started giving lectures at her job but states she has done this in the past with no anxiety. 
PMH: None. PSurgical hx: None. Meds: OTC tylenol. Family Hx: Dad dies of MI at 65. 
OB/GYN history: G2P2. LMP: 1 week ago. 
Risk: Denies tabcoo and drug use. 1-2 drinks a month. 
Drinks 5-6 coffee cups
Is sexually active with husband who had vasectomy..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]No palpitations, No changes in bowel function, anxiety, anxiety, stressors taking care of her elderly mother, Drinks 5-6 coffee cups, No changes in weight, insomnia, difficulty falling asleep, female, decreased appetite, 45 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Karin Moore is a 45yo female who present with feelings of nervousness. The patient reports feeling nervous over the past few weeks. It is a constant nervousness that gets worse before she gives a lecture and gets somewhat better after but never remits. She has noted a decrease in appetite and trouble falling asleep during this period. She also reports decreased sex drive but no problems engaging in sex. She has been under increased stress at work as she started lecturing at the time this nervousness began and her elderly mother has also been requiring more help. Denies fever, chills, nasuea, vomiting, diarrhea, constipation, feelings of depression and anhedonia.
ROS: Negative except above
PMH: Denies
PSH: Denies
SH: Never smoker, social drinker. English professor and likes her job.
FH: Denies history of thyroid or adrenal gland disorders. Deneis history of depression and bipolar.
Medications: None
Allergies: None.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Denies diarrhea, Denies constipation, nervousness, nervous, nervousness, nervousness, elderly mother has also been requiring more help, Denies feelings of depression, Denies anhedonia, Deneis history of depression, trouble falling asleep, female, decrease in appetite, 45yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: nervousness
HPI: Pt is a 45 y/o WF who presents with nervousness. Pt reports that she has been feeling nervous for a few weeks. States she has decreased appetite and difficulty sleeping. Pt reports she has had increased stressors in her life involving taking care of her mom and children at home as well as her inlaws with their health issues. Pt has also switched job roles from research to teaching recently and been feeling overwhelmed since. Pt denies any thoughts of wanting to harm herself or others. Denies CP, palpitations, SOB, n/v, constipation and dizziness.
ROS: negative except as above
PMH: none
Meds: none
Allergies: NKA
FH: father deceased from MI
SH: denies smoking, occasional alcohol use, denies drug use, currently working as an English professor.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Denies palpitations, Denies constipation, nervousness, nervous, feeling overwhelmed, stressors taking care of her mom, denies wanting to harm herself, difficulty sleeping, F, decreased appetite, 45 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: Nervousness
HPI: Ms. Moore is a 45 yo f who who is nervous for the past few wks. A few wks ago, she started giving lectures instead of doing research at her work as a literature professor which brought on anxiety. She thinks about her lectures and then worries about other parts of her life outside of work. Denies any alleviating factors. Aggravating factors include thinking about lectures on Sunday and Monday. Associated symptoms are decreased appetite and difficulty falling asleep. She feels overwhelmed. Denies SI, HI, AVH.
PMH: Denies
PSH: Denies
Allergies: NKDA
Meds: Tylenol for migraines
ROS: decreased appetite, insomnia
FH: father - MI at 65
SH: Literature professor. Occasional EtOH use. Denies drug, tobacco use. Drinks caffeine 5-6 times/day. Exercises 3 times/wk. Healthy diet. No recent travel or pets. Married 25 yrs. Sexually active with husband but reports decreased activity recently. No hx of STDs. Has two sons..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Nervousness, nervous, anxiety, feels overwhelmed, Drinks caffeine 5-6 times/day, Denies SI, difficulty falling asleep, insomnia, f, decreased appetite, decreased appetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: Nervousness
HPI: 45/F complains of nervousness which started 2 weeks ago. Patient has more  added workload which started two weeks ago. Her nervousness starts Sunday night during preparation of lectures and happens throughout the week. Nothing makes it better. It affects her business and personal life, she had difficulty falling asleep, she also lost appetite. Enjoys work. No weight loss, no suicidal ideation. Consumes 5-6 cups of coffee per day. No cold sweats, palpitations, no chest pain and no light headedness. No abdominal pain, no changes in bowel, no urinary changes. 
ROS: none
Allergies: None
Medications: Tylenol
PMH: None
PSH: None
SH: Professor, non smoker, consumes 1-2 glasses of wine per week, no illicit drug use, sexually active with husband but sexual desire decreased due to nervousness
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]No cold sweats, No palpitations, no changes in bowel changes, Nervousness, nervousness, nervousness, nervousness, 5-6 cups of coffee per day, no suicidal ideation, No weight loss, difficulty falling asleep, F, lost appetite, 45</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 y/o F visits clinic due to constant nervousness that started a few weeks ago. Patient states these episodes have gotten worse since her job changed from research to give lectures in English literature and has increased responsibilities, as well as has to take care of her mom and her husband's parents. Patient refers anxious, stressed, overwhelmed due to these changes, sleep changes such as taking more time to fall asleep & decreased appetite. Denies fever, chills, nausea, vomiting, skin changes, hair changes, cold/heat sensitivity, numbness, night sweats, tingling, dizziness, changes in bowel or urinary habits, SOB, cough, weight changes, chest pain, abdominal pain or joint pain.
ROS: Negative except as above
PMH/PSH: None  ALL: NKDA  Med: Tylenol
FH: Father had a hear attack
SH: Patient is an English professor. Denies tobacco, alcohol or recreational drug use. Sexually active with husband, who had a vasectomy. G2P2 SVD no compli.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Denies skin changes, Denies hair changes, Denies cold/heat sensitivity, Denies changes in bowel habits, nervousness, anxious, has to take care of her mom, Denies weight changes, taking more time to fall asleep, F, decreased appetite, 45 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 year old female presents for nervousness over ""a few weeks."" Symptoms impact ""everything"" in patient's life. Anxiety is constant, no alleviating factors, no exacerbating factors. Patient had change of responsibilities at work, but no particularly stressful in nature; no other major life events preceding onset. Patient has associated decreased appetite, difficulty with sleep onset.
ROS: Occasional headaches, but not since onset of symptoms.
Allergies: NKDA
Meds: Tylenol for headaches
Medical History: Occasional headaches associated with reading. No surgeries. Hospitalizations x 2 for child birth. otherwise, unremarkable. Last pap smear and Mammogram were 10 months ago, normal results.
Family: Father died of MI at age 66, mother is living and well.
Social: Lives with husband, mother, and two children (no recent move-ins or move-outs). Social alcohol, no tobacco or drug use. Patient drinks 5-6 cups of coffee daily..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]nervousness, Anxiety, 5-6 cups of coffee, difficulty with sleep, female, decreased appetite, 45 year</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs Moore, 45 yo f, no significant PMH, presents with nervousness, lack of appetite, difficulyt falling asleep. ""I feel nervous all the time"" She is the caretaker of her older mother and has in home nursing for her in-laws. Works has been more stressful since she is now lecturing (she is a professor)  no psychiatric hx, Family hx is signficant for father who died of heart attack at 65. 

She denies depression, difficulty concentrating, wt loss, changes in her BM,no chest pain, no SOB, no edema, 
Anxiety - denies recurring thoughts, no nighmares 
Exercises regularly. 
Takes Tylenol, 
healthy relationship with husband
NKDA
dneis arthrl.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies changes in her BM, nervousness, nervous, Anxiety, caretaker of her older mother, caretaker of her in-laws, denies depression, denies difficulty concentrating, denies wt loss, difficulyt falling asleep, f, lack of appetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: 45 yo F with nervousness
HPI: Patient comes in for 2-3 weeks of nervousness. Symptoms have been constant and associated with diminished appetite and difficulty falling asleep. They intensify on Sunday nights and Monday before she gives lectures. Patient is a college English literature professor. Of note, patient mentions many stressors and responsiblities and feels as if she is ""overwhelmed"" and ""losing her mind"" at times.
ROS: - weight loss, palpitations, diaphoresis, headache, heat intolerance, suicidal ideation
PMH: none, only hospitalized twice for the birth of her two kids
NKDA
meds: tylenol as needed for headaches
FH: father had MI at 65
SH: drinks socially, no smoking or drug use, college English literature teacher, 2 kids

.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]- palpitations, - diaphoresis, - heat intolerance, nervousness, nervousness, feels as if she is ""overwhelmed"", feels as if ""losing her mind"", - suicidal ideation, - weight loss, difficulty falling asleep, F, diminished appetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: A 45 y/o F came to the clinic c/o nervousness. Started gradually for the first time 3-4 weeks ago and since it started it is getting progressively worse. Describes it as anxiety over work achievements, constant throughout the day, relate to change in her work from research to lectures, worsen before the lectures and no improvements factors. Associated w/ decreased apetite, headache and difficulty falling asleep. Denies fever, chills, nausea, vomit, changes in weight, weakness, numbness, dizziness, palpitations, sweating or tremors. 

ROS: negative, except as above; PmHx: none; PSH: none; ALL: NKDA; MEDS: tylenol for headaches; FH: non relevant; SH: Married. Sexually active w/ husband. Works as a english professor. No h/o smoking or illicit drug use. EtOH: occ.; Caffeine: 5-6 cupps/day..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Denies palpitations, Denies sweating, Denies tremors, nervousness, Caffeine: 5-6 cupps/day, Denies changes in weight, difficulty falling asleep, F, decreased apetite, 45 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 y/o f with a h/o nervousness since few weeks. Patient has recently changed her job from research to lecturing her audience. The nervousness starts suddenly and is more on mondays and sundays. She thinks frequently about her work and performance on mondays. It is however also present throughout the week. It has never happened before. She has no h/o tremors, palpitations, SOB, headaches, sensation of doom, heat intolerance or weight loss. Patient has been eating less due to anxiety. She consumes 5-6 cups of caffeine everyday. She takes tylenol and was hospitalized for delivery. NKDA, she has reached menopause. Patient has no h/o smoking, alcohol consumption 1 drink socially. Husband has had a vasectomy. She is sexually active. 
ROS- occasional headaches+, No h/o Abdominal pain, nausea, vomiting, bowel or bladder changes, facial pain, sleep changes.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]no h/o tremors, no palpitations, no heat intolerance, bowel changes No, nervousness, nervousness, anxiety, 5-6 cups of caffeine, no sensation of doom, no weight loss, f, eating less, 45 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 yo F p/w 6-wk hx of ""nervousness"". She reports feeling a lot anxiety, moreso than usual, with her responsibilities in taking care of her mother and other family. She also has had to give presentations at work which exacerbate her nervousness leading up to it. She denies any palpitations, tremors, CP, or SOB when she is nervous. Her nervousness is constantly high and she has not been able to talk to anyone about it or tried ways to relieve it. She also reports a lack of appetite but is making herself eat so she has not been losing weight. Also has been having trouble falling asleep. Drinks 5-6 cups of coffee a day. Denies depressive thoughts or sadness.
ROS: negative except for above
Meds: none
Allergies: none
PMH: none
PSH: none
FH: non-contributory
SH: English professor. Lives at home with mother, husband and two daughters. Feels safe at home. Occasional ETOH use, denies tobacco, illicit drugs..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies palpitations, denies tremors, nervousness, anxiety, nervousness, nervous, nervousness, responsibilities taking care of her mother, 5-6 cups of coffee a day, Denies depressive thoughts, Denies sadness, has not been losing weight, trouble falling asleep, F, lack of appetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Karen Moore is a 45 yo G2P2 f presents with feelings of nervousness/ feeling overwhelmed for the last few weeks. Reports a constant feeling, associated with increased stressors at work. Reports that her work requirements to present new lectures have made her feel increasingly overwhelmed. 
ROS: Significant for Decreased appetite, difficulty falling asleep. No vision changes, numbness, tingling, nausea, vomiting, diarrhea, constipation, headaches. 
NKA/NKDA
M: Tylenol PRN for headaches
FMH: MI (dad) 
OB/S/Sx: 2 vaginal deliveries, 17 and 19 year old sons. LMP 1 week ago, reports normal periods .Sexually active with husband, safe at home. Decreased frequency of intercourse associated with nervousness in last 2 weeks. Denies smoking, illicit drug use. 1-2 drinks socially on rare occassions. Works as English professor x15 years. 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]No diarrhea, No constipation, nervousness, nervousness, difficulty falling asleep, f, Decreased appetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 YO F -CC - Nervousness x few wks. All started after she changed her roles at work from Research to teaching as an english professor. Since then every Sun/Mon she's been having episodes of feeling overwhelmed especially since she has presentations to give on Mondays. She is also feeling stressed due to taking care of kids, her mother and husbands parents who live next door. She has some difficulty falling asleep but no change in mood or loss of intrest or concentration. No hx of Palpitations, sweating, numbess, tingling or color changes in fingers
ROS - No Headache, dizziness, Chest pain, SOB, N/V, Hair changes, or skin changes
PMH - No hx of hypothyroid or psychiatric disorders
Meds - Tyelenol coz of headaches when she reads.     PSH - None
FH - No hx of hypothyoid or psychiatric disorders.
Ob/Gyn - LMP 2 weeks back, Periods regular
SG - Married x 25 ys, 2 kids youngest 18. Nonsmoker, drinker or drug user. No travel or trauma.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]No hx of Palpitations, No sweating, No Hair changes, No skin changes, Nervousness, feeling overwhelmed, stressed due to taking care of her mother, tressed due to taking care of husbands parents, no change in mood, no loss of intrest, no change in concentration, difficulty falling asleep, F, 45 YO</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 45 year old female with no significant PMH presenting with constant nervousness for 3 weeks associated with a decrease in appetite and a decrease in her sex drive.  She endorses that she has been much more stressed over the past three weeks between her job as a professor, her role in taking care of her mother, her role in being the wife of her husband, and her role as being the parent of her children.  She has had difficulty falling asleep due to the nervousness, but has no problems staying asleep and averages 7 hours of sleep per night.  She has never felt that she didn't need to sleep at any point in her life.  Her only loss of interest in normal activities has been her desire for sex.  No history of physical or sexual trauma/abuse.  She has normal energy levels.  Denies homicidal and suicidal ideations.  Feels safe at home living with husband, mother, and children.  Denies audio/visual hallucinations..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]nervousness, nervousness, stressed taking care of her mother, Denies suicidal ideations, difficulty falling asleep, female, decrease in appetite, 45 year</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 45 year old female with complaint of nervousness. It is persistent with little relief. She has been experiencing symptoms for a few weeks. She is having difficulty falling alseep, but sleeps through the night when she does fall asleep. She doens't feel tired throughout the day. She endorses loss of appetite. She has had increased stress after starting teaching and she is the primary care taker of her sick mother, her in-laws, and her son. She does feel supported and helped by her husband. Denies racing heart, changes in bowel movements, shortness of breath, feelings of being hot or cold, or changes in weight.

medical history- none
surgeries-none
hospitalizations- twice afet giving birth to two children
family- father had a heart attack
menstration- regular, husband only sexual partner, visectomy as birth control
No tobacco or drug use, drinks wine if out to dinner a few times a month.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Denies racing heart, Denies changes in bowel movements, Denies feelings of being hot or cold, nervousness, primary care taker of her sick mother, primary care taker of her in-laws, Denies changes in weight, difficulty falling alseep, female, loss of appetite, 45 year</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 45 yo female experiencing episodes of nervousness and anxiety for the past 3 weeks. She has had changes in her job in which she now has to give lectures, the anxiety is worse on Sunday and monday prior to the work week. Feels very overhwlemed by her duties at home as well, she takes care of her mother with mobility issues. Drinks 5 cups of coffee per day.She has had a decrease in appetite and some trouble falling asleep. 
ROS: denies depressed/sad feeling, denies suicidality, homicidality, decreased energy, guilt, denies palpitations, edema, diarrhea constipation, changes in hair
PMH: none, Medications: Tylenol PRN, Family Hx: father died of MI at age 64
Social: her mother lives at home, she is a care giver for her mother, Denies drug use, denies tobacco use, social alcohol use, has one son, English Professor.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies palpitations, denies diarrhea, denies constipation, denies changes in hair, nervousness, anxiety, anxiety, Feels very overhwlemed takes care of her mother, care giver for her mother, Drinks 5 cups of coffee, denies depressed/sad feeling, denies decreased energy, denies suicidality, denies guilt, trouble falling asleep, female, decrease in appetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Karin Moore is a 45 year old woman, previously healthy, who presents with several weeks of ""internal nervousness"" since her job as an English professor required her to start giving lectures in front of students. Nervousness is present constantly for past few weeks. Nothing makes better, nothing makes worse. Never experienced before. Has not increased alcohol intake in this time. She also notices decreased hunger and difficulty sleeping. Other life pressures include living with elderly mother who is slowing down, checking on in-laws, caring for 2 teenage sons. 
ROS: Denies fever, racing heart, dyspnea, high energy, weight change, low mood, panic attacks. 
PMH: neg; PSH: neg; Meds: occasional tylenol for headache, not recently; no med allx.
Fam Hx: no anxiety/depression
Soc Hx: lives with husband, elderly mother. 1-2 drinks social occasions, no tobacco, no illicit drugs, sexually active, balanced diet, walks 3x/wk for exercise.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Denies racing heart, Denies high energy, nervousness, Nervousness, life pressures include elderly mother, life pressures include checking on in-laws, Denies low mood, Denies weight change, difficulty sleeping, woman, decreased hunger, 45 year</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: hpi : 45 yo f c/o nervousness , few weeks ago , getting worse , constant , throuh the day , reports sleeping difficulty , denies any , hot flashes , weight changes , no tremor , no hot intolerence, drink 6 cup of coffee daily , 
ros : nl except above 
pmh : none
allergy : nkda
meds : tylenol 
psh : none
obs / gyn : lmp 1 w ago , no irregularities , pregnancy twice , 2 children 
sh : sexually active w/ husband , vasectomy , no smoking , drink alchol socially , no recreational drug use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]no tremor, nervousness, drink 6 cup of coffee daily, denies weight changes, sleeping difficulty, f, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 45 year old female with no relevant PMHx who presents with nervousness and anxiety. She states her anxiety started 3-4 weeks ago, and began after she changed positions from a english literature researcher to a professor. She has anxiety about taking care of her kids, her career, and taking care of her mother. Her anxiety is worst on weekends when she knows she has to give lecture. Nothing seems to exacerbate her anxiety. She feels as if she is ""losing her mind"". She also reports eating less and having difficulty falling asleep. She denies any heat/cold intolerance, chest pain, palpitations, SOB, abdominal pain, diarrhea, or constipation. 

PMHx- none
Psurghx- none
PFMHx - father died of HA
medications - tylenol for occasional HA
Social hx: lives at home with kids and husband. no tobacco or illicit drug use. socially drinks alcohol.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies cold intolerance, denies heat intolerance, denies palpitations, denies diarrhea, denies constipation, nervousness, anxiety, anxiety, anxiety, anxiety, anxiety about taking care of of her mother, difficulty falling asleep, female, eating less, 45 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 YOF who presents with nervousness.  Started a few weeks ago, along with a decrease in appetite and difficulty falling asleep, denies racing thoughts.  Once she falls asleep is able to stay asleep, sleeps 7 hours on a bad night and 8 hours on a good night.  States that feels overwhelmed, has had to take care of her parents, her in-laws, and her children.  She is an english literature professor and has been lecturing more, she denies this has caused much stress.  Denies any changes in energy, weight, hair, or changes in skin.  Denies any episodes of SOB or chest pain. Denies a change in energy. Her LMP was 1 week ago. She has a menstrual period every 28 days, they last 4 days, denies any recent changes in menstural periods.
ROS: denies changes in bowel movements, fevers, vomiting, or abdominal pain. PMH: none. Medications: rare Tylenol use. Allergies: none. PSHx: none. FH: father with MI. SH: social drinker, no EtOH or drug use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]changes in skin Denies, denies changes in bowel movements, Denies any changes in hair, nervousness, had to take care of her parents, had to take care of her parents in-laws, Denies changes in energy, Denies a change in energy, Denies changes weight, difficulty falling asleep, F, decrease in appetite, 45 YO</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45yo complains of increased nervousness during the past few weeks, mostly on Sundays related to Monday teaching activities (she is a professor), she is also concerned about her in-laws since she must now take care of them at home during her free time. She has decreased appetite. She denies any N/V, increased bowel movement, weight loss, eye problems, increased sweating, abdominal pain, headaches, or increased temperature.
PMH:She has no history of prior illness, surgery, trauma and was only hospitalized when her two kids were born.
She does not take any drugs or have any allergies.
FH: Her father dies of MI aged 65, she is an only child.
Sx: Sexually active with husband, only sexual partner. No STD history.
OBG: G2P2
SH: Professor, drinks socially does not smoke or do drugs. Two kids, aged 21 and 18, dont present a worry to her..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies increased bowel movement, denies increased sweating, nervousness, concerned about her in-laws since she must now take care of them, denies weight loss, decreased appetite, 45yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45YO female c/o nervousness for the past few weeks....feels as if she is ""loosing my mind"". Seems to notice these feelings mostly on Sunday evenings as she prepares for work on Monday morning. Has had difficulty falling asleep and a decreased appetite as well. Has never had similar symptoms. Denies feeling as if she is an anxious person at baseline. No previous psych hx or care. Has been under a lot of stress lately since changing positions in her job and with demands at home. Denies recent illness, fevers, chills, CP, palpitations, SOB, Abd pain, N/V/D/C, bowel or bladder changes, rashes, or swelling. 
ROS: Neg except as mentioned above. 
PMH: neg
PSH: neg
Meds: Tylenol
Allergies: NKDA
Social: Denies tobacco or illicit drug use; Occasional/social alcohol use; Drinks 5-6cups of coffee per day, no recent increase in amount. Is married. English professor. Cares for mother and child at home. Assist w/ care of inlaws. 
Fly hx: neg.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Denies palpitations, Denies bowel changes, nervousness, Cares for mother Assist w/ care of inlaws, 5-6cups of coffee, difficulty falling asleep, female, decreased appetite, 45YO</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Moore is a 45 year old female who presents to clinic complaining of increased nervousness. She states that she has been more nervous at her baseline for the past two weeks, but is then even more nervous Sunday night and Monday morning as the work week approaches. She reports that the things she feels nervous about include her care of her children, care of her inlaws, and care of her elderly mother, along with lectures she has to prepare for her job as a literature professor. She denies any change in support in the past two weeks, denies loss of interest in activities, denies loss of energy, denies feelings of hopelessness or slowed movement. She admits to trouble falling asleep- it now takes her 30 minutes when previously it took her just a few. She denies change in cafffiene intake. PMH: non contributory. Denies surg. No allergies. Social: 2-3 glasses of wine/month, no tobacco use, or ilicit drugs. Family hx: dad died of MI at 65..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]nervousness, nervous, nervous, nervous, care of her inlaws, care of her elderly mother, denies loss of interest, denies loss of energy, denies feelings of hopelessness, trouble falling asleep, female, 45 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 Y/O F C/O NERVIOUSNESS SINCE FEW WEEKS, IT IS CONSTANT, AND PROGRESSIVE, AND IS PRESENT AT MULIPLE SETTING. SHE REPORTED THAT SHE IS ANXIOUS ABOUT HER PARENT, FAMILY, IN LAWS, AND EVERYONE, SHE ALSO REPORTED THAT SHE HAS CHANGE HER WORK ENVIROMENT FROM RESEARCH TO TEACHING RECENTLY. SHE ALSO REPORTED THAT SHE FINDS DIFFICULTY IN FALLING ASLEEP.
PT DENIES RACING OF HEART, GUILT, DECREASE IN ENERGY, LOSS OF INTEREST, CHANGE IN HER MOOD/BOWEL/BLADDER/DIET/WEIGHT RECENTLY.
ROS: -VE EXCEPT ABOVE.
PMH/PSH: NONE.
OBGYN: LMP 2 WEEKS BACK, CYCLES ARE REGULAR.
SH: SEXUALLY ACTIVE WITH HUSBAND ONLY, DENIES, SMOKING/ILLICIT DRUGS USE. 1-2 GLASS OF WINE OCCASSIONALY.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]DENIES RACING OF HEART, DENIES CHANGE IN BOWEL, NERVIOUSNESS, ANXIOUS, ANXIOUS ABOUT IN LAWS, DENIES GUILT, DENIES LOSS OF INTEREST, DENIES CHANGE IN HER MOOD, DENIES DECREASE IN ENERGY, DENIES CHANGE IN WEIGHT, DIFFICULTY IN FALLING ASLEEP, F, 45 Y/O</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 45 yo F comes to office due to episodes of nervousness. Patient relates constant state of nervousness, high level of stress due to work, family, children. Indicates the episodes are getting worse. Indicates a loss of appetite, but forces herself to eat. Indicates severe insomnia, as she has a hard time falling asleep. Denies trauma, violence, panic attacks, and SOB. Indicates decreased sexual activity since the nervousness started.  Indicates nervousness increase before going to present lectures at school. Nothing decrease level of nervousness. 
OB/GYN: G2T2 vaginal deliveryx2, uncomplicated; LMP 1 wk ago, menache at 13 yo, periods usually last 5 days, regular, moderate flow. Pap smear was 10 months ago, no abonormalites. 
ROS: negative except for above
Allergies: none
PMH: none
PSH: none
SH: English proffesor; occasional drink alcohol in social events
FH:  Father died MI at 65.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]nervousness, nervousness, nervousness, nervousness, nervousness, stress family, insomnia, hard time falling asleep, F, loss of appetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Karin Moore is a 45F who presents to the clinic for episodes of nervouseness. It started few weeks ago. She takes care of her mom who lives with her, works as an english professor with new added responsibilities, takes care of kids and inlaws. She has decreased appetite and insomnia. Trouble falling asleep.
Denies palpitations, weight changes, dysphagia, pain, headache, depressive mood, decreased interest, agitation, suicidal or homicidal ideation, visual or audio hallucinations.

PMH and PSH: none
FH: dad passed at age 65 of sudden MI
Meds: tylenol for occasional headaches
Denies drug use and smoking. drinks 1-2 drinks socially. Has a support system of her husband. Lives with husband, son, and mother. Works as an english professor..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Denies palpitations, nervouseness, takes care of her mom, takes care of inlaws, Denies depressive mood, Denies decreased interest, Denies suicidal ideation, Denies weight changes, decreased insomnia, Trouble falling asleep, F, decreased appetite, 45</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 yo F c/o nervousness for a few weeks
-feels nervous on sundays and mondays thinking about oncoming week,no exacerbating or relieving factors,constantly present,progressively wrosening,associated feeling of losing her mind and worrying about all her responsibilities at home and work
-assocaited decrease in apetite and inability to fall asleep for a few weeks
-increased intake of caffeine throughout the day
-feels overwhelmed by responsibilities,headache sometimes with reading
-no palpitations,weight changes,urine problems,mood changes
ROS:as above
PMH:Admitted for 2 normal deliveries Takes tylenol for headache
FH:Father died of MI.
SSH:Teacher,recently changed job decscription,no etoh,smoking,drugs..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]no palpitations, nervousness, nervous, feeling of losing her mind, feels overwhelmed, worrying about all her responsibilities at home, increased intake of caffeine, no mood changes, no weight changes, inability to fall asleep, F, decrease in apetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms Moore is a 45 year old woman who has been experiencing feelings of nervousness the past two weeks.  She describes it as constant and unbearable. She feels overwhelmed taking care of her son, her mother who lives at home with her, and her two in-law parents. She drives and does activities of daily for all three of her elderly parents in addition to teaching english literature. She recently began having to perform lectures and teach students in the last two weeks, whereas she was primarily doing independent research beforehand. HAs had decreased appetite. Denies weight loss, shortness of breath, diarrhea, chest pain, or palpitations.
No past medical history
Taking tylenol for occasional headache
No surgeries
FH - father died of MI at 65
No smoking, drugs. 2 ETOH/month.
Recent decrease in libido (2 weeks). Husband has vasectomy. LMP 1 week ago.
G2P2, both uncomplicated vaginal deliveries..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Denies palpitations, Denies diarrhea, nervousness, overwhelmed, overwhelmed taking care mother who lives at home with her, and her two in-law parents, does activities of daily for all three of her elderly parents, feels overwhelmed taking care of her mother two in-law parents, Denies weight loss, woman, had decreased appetite, decreased appetite, 45 year, 45 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Karin Moore is a 45yoF with no PMHx presenting with c/o nervousness. The patients states that for the last couple of weeks she has felt a sense of nervousness that has been constant. She recalls no inciting factor. She states that she has to cope with the stresses of working as an English professor and taking care of her mother at home. She states that she is able to get by each day, but the feeling of nervousness is bothersome. Endorses decreased appetite, but denies any loss of interest, endorses good energy, and good sleep w/o nightmares. Denies tremors, headaches, weight gain/loss, dry skin/hair, diarrhea, constipation, sweatin. Endorses feeling supportive.
PMHx: none. Tylenol for occasional headaches, no allergies, NSVD x 2 in hospital, no surgeries, immunizations UTD.
Family hx: Dad had MI at 65 
Social: negative for tobacco or drugs. 1-2 drinks on occasion. Works as english professor. Lives with husband, two kids, and mother..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Denies tremors, Denies dry skin, Denies dry hair, Denies diarrhea, Denies constipation, Denies sweatin, nervousness, nervousness, nervousness, stresses of taking care of her mother, denies any loss of interest, Denies weight gain, Denies weight loss, F, decreased appetite, 45yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 yo otherwise healthy female w/ several weeks of ""nervousness"" that she feels ""all the time"". She feels ""overwhelmed"" by her responsibilities which include taking care of her mother who lives w/ her family, keeping up with the responsibilities of her family, checking in on her in-laws who live nearby, and working full time as an english professor. She has recently been given increased responsibilities at work and is lecturing in front of a class. Although she finds this stressful, her anxiousness is not limited to public speaking. She has a visiting RN 2x/wk to help w/ her mom. She walks 3x/wk for her health. She has regular menstral cycles and has no concerns or changes in her periods. She has also noticed difficulty falling asleep and decreased appetite. She denies chest pain, dyspnea, dizziness, feelings of sadness, ETOH/drug use, weight loss.

PMH: none
Rx: none
Allergies: none
SH: Never smoker, rare ETOH, no drugs
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]nervousness, feels ""overwhelmed"", anxiousness, overwhelmed taking care of her mother, overwhelmed checking in on her in-laws, denies feelings of sadness, denies weight loss, difficulty falling asleep, decreased appetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: nervousness
HPI: ms moore is a 45 yo f who complains of 3 weeks of anxiety. She has had constant anxiety that is worsened sunday and mondays prior to her classes teaching. She recenltly changed roles at her job which now requires public speaking. She has had difficulty sleeping during this same time as well as loss of appetite. She has never had any episodes like this prior to 3 weeks ago. she has not taken any medication for any of her current problems. No factors relieve the anxiety. 
ROS: negative, denies palpitations or chest pain
PMH: none
PSH: none
MEDS: occasional tylenol
Allergies: none
FH: Father died of MI at 65
SH: English professor recently switched from research to teaching. Denies tobacco and drugs. Social drinker. Sexually active with husband. Has 2 children..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies palpitations, anxiety, anxiety, anxiety, nervousness, difficulty sleeping, f, loss of appetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 yo F w/ anxiety for the past 2 weeks. Pt describes nervousness as constant but especially increased on weekends just prior to giving college lectures as an English Lit professor that she has not had to do for a while now. Nothing helps the anxiety. Pt also has many responsibilities at home. Pt also endorses decreased appetite especially on weekends but pt makes sure she eats and has not had weight change. Pt denies heat intolerance, palpitations. Has difficulty falling asleep. Pt denies recent fevers, chills, vision changes, headaches, chest pain, SOB, abdominal pain.
ROS: negative except as above Allergy: none Meds: rarely tylenol PMH: none PH: hospialized for birth of 2 children FamHx: father died of MI (10 yrs ago) Menstrual: last menstrual period last week, regular, no changes. SH: no EtOH, smoking, decreased sexual activity with husband d/t to decreased desire.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies heat intolerance, denies palpitations, anxiety, nervousness, has not had weight change, difficulty falling asleep, F, decreased appetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Moore 45 y/o F c/o nervousness. This symptoms started cople weeks ago. This symptos are constanst and are affecting her daily activities. Nothing makes this symptoms better or worst. Patient refers truble falling asleep also cince couple weeks ago. 
ROS: patient denies palpitation, SOB, fever, Abdominal pai, changes in bowel movements. Recently change to another job, under a lot of stress. 
llergies: NKDA
Medictaion: Tylenol occasionally for headaches.
FH: father had a heart attack.
Social H: EtOC occasionally. Patient is a english profesor . Exercises 3 times per week. Caffeine ingestion throughout the day..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies palpitation, denies changes in bowel movements, nervousness, Caffeine ingestion throughout the day, truble falling asleep, F, 45 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 yo F presents with nervousness for the past few weeks. Constantly feels this way. SHe is an english professor and it started after changing positions in work from doing resarch to teaching in a classroom. She feels it the most on Sunday nights and monday mornings when preparingfor work. It is affecting her personal and her work life. Feels overwhelmed with the change and has a decreased appetite. Difficulty falling asleep, it takes her an hour to fall asleep when it used to be 10 minutes. Denies sweating, palpitations, or chest pain 
PMH: none  Meds: tylenol   Allergies: NKDA
FH: father died of heart attack at 65
SH: Denies smoking, drinking, alcohol; walks 1 mile 3x per week. Healthy and balanced diet.
Sexual: active with husband 
OBGYN: LMP 1 wk ago, regular, lasting 4 days. PAP smear every year, no abnormal; G2P2.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Denies sweating, Denies palpitations, nervousness, Feels overwhelmed, Difficulty falling asleep, takes her an hour to fall asleep, F, decreased appetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 f c/o nervous from 4 months ago started gradually she swithced her job on that time  and problem w/ falling asleep, noo fever nausea heaart racing, has lot s problem in home has to manage, drink 6 cup of caffe each day, enjoy from life, has hobby for her slef, decrease appetitte, no hot falshes, or vaginal dry ness
FH: father died MI,
SH: proffesor , no cig/ etoh occasional? no rec drug, lives w/ family
OB&GY: LMP 1 WK AGO  the same as past no spotting, pap smear normal,.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]no heaart racing, no hot falshes, nervous, drink 6 cup of caffe, problem w/ falling asleep, f, decrease appetitte, 45</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Moore is a 45 y/o WF who presents w/ nervousness. This started out of the blue 2 weeks ago with no inciting event. She just noticed a general sense of constant nervousness that is showing no signs of abatement. This has never happened to her in the past. Stated that ""I feel like I'm losing my mind a bit."" Endorses no recent traumatic events of any regard.

ROS: endorses occasional HAs, denies dizziness, denies anxiety, denies depression, denies chest pain, denies SOB
PMH: none
PSH: none
Social Hx: never used tobacco, has 1-2 drinks once a month, no illicit drug usage, good diet, exercises regularly; is an english professor and endorses being quite overwhelmed
PSexualHx: monogomous w/ husband, but this current constant nervousness is negatively affecting their sex life - husband is understanding
Meds: Tylenol on occasion
Allergies: none.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]nervousness, nervousness, ""I feel like Im losing my mind a bit"", nervousness, denies depression, F, 45 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: Nervous all the time
HPI: Mrs. Moore is a 45 year old WF that comes to clinic with constant nervousness about her personal and work life. She has recently sqwitched jobs and is lecturing infront of students on Mondays. She gets most nervous on sunday evenings and monday mornings but the nervousnes continues throughout the week. She also gets headaches when she gets stressed and takes a tylenol which resolves the issues. She also has a decrease in appetite during Sunday/Monday. c/o insomnia. She denies racing thoughs, CP, palpitations, nail changes, hair changes, abdominal pain, and quivering voice during presentations.
ROS: See HPI
PMHx: Hospitalized for the birth of her 2 kids. Takes tylenol. Denies surgeries, allergies,traveling, and sick contacts. Up to date on vaccinations
FHx: Father heart attack at 65
Shx: Denies tobacco, drug use. Drinks socially 1-2 wine glasses. Monogamous with husband, no condoms. English professor.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies palpitations, denies nail changes, denies hair changes, Nervous, nervousness, nervous, nervousnes, insomnia, F, decrease in appetite, 45 year</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Moore si a 45 yo woman with chief complaint of nervousness over the las 3-4 weeks. States that she is less hungry, but denies CP,SOB,palpitations,nausea,vomiting,diarrhea,abdominal pain/sweating/hot or cold intolerance/HA/hair loss. States that she has had difficulty falling asleep but that once she gets to sleep she has no issue with staying asleep. She has no daytime naps and works as an English professor with new lectures that began 2 weeks ago. She states that the nervousness is about anything and everything, and that she thinks about her kids, and her work and taking care of her mother. she states that it starts in the morning and is constant. She has no past medical/sugical history. 2 hospitalizations for the birth of her two children. Father had sudden MI at 65 and she takes tylenol occasionally for headaches. NKDA. drinks socially 1-2 drinks, no tobacco or drug use. Denies psychiatric history, depression or anxiety..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies hair loss, denies hot or cold intolerance, denies sweating, denies palpitations, denies diarrhea, denies nausea,vomiting, nervousness, nervousness, thinks about taking care of her mother, Denies depression, Denies psychiatric history, difficulty falling asleep, woman, she is less hungry, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 yo female presents with several week history of increased anxiety about multiple issues including family and work. it has effected her work as an english professor. She notes an associated difficulty with falling asleep at night and denies any associated decreased mood, anahdonia, Suicidal ideation, homicidal ideation, Audiohallucinations, visial hallucinations or delusions. She notes increased life stressors with caring for her family and in laws. She denies any alleviating factors for her anxiety and any assocaited sweating or plapations. 
PMH: none, Surgires: none, Allergies: NKA, Meds: occasional tylenol for frontal headache, last headach a while ago. ROS - for skin changes, sweating , wieght changes. fx: father  MI, sexually active 1 partner i past year. no condums no STI hx. Social: occasional etoh use (a few time/ month) no tabacco or ilecit drug use feels safe at home.
Obstertic: G2P2002, last menses last week, last pap Nl..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies sweating, denies plapations, - for skin changes, - sweating, increased anxiety, increased life stressors with caring for her in laws, denies any associated decreased mood, denies anahdonia, denies Suicidal ideation, - wieght changes, difficulty with falling asleep, female, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Moore is a 45 year old female who presents complaining of nervousness that has been occurring for a few weeks since her job changed from primarily research to now lecturing at univerisy. She finds that her nervousness is worst on Sunday and Monday leading up to her Monday lecture. However, the nervousness is constant. She also has had reduced appetite and trouble falling asleep. This has never happened before. She notes other stressors including her elderly mother lives with her and the majority of the burden of care falls to the patient. She feels that she is becoming overwhelmed with responsibility. ROS negative except as noted above.
PMH: None, no surgeries FH: Father had MI, Mom healthy SH: No tobacco, occasional alcohol use, no drug use, is a professor, current stressors include job change and being a caretaker. MEDications: Tylenol for headaches. Allergies: NKDA, NKA.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]nervousness, nervousness, nervousness, stressors including her elderly mother lives with her, trouble falling asleep, female, reduced appetite, 45 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Karin Moore is a 45 year old female with an episode of nervousness. It has been for hte past few weeks. Nothing has made it better, and it is worse on sunday mornings and mondays before lectures. The lecturres have made her nervous and stressful, she changed her job about a month and a half ago. She also states a loss of appietite,difficulty falling asleep. She says that she is happy and enjoys her hobbies and has no thoughts of harming herself.

ROS: Denies sweating, consptiation, diarrhea, N/V, no weight changes, no axiety, no thoughts of harming herself. 

PMH: None
PSH: None
Meds: Tylenol occasionally
Allergies: NKDA
SH: No smoking, occasional social alcohol, no illecit drugs
Occupation: English Professor
Travel: No Receny
Exercises: Walks
Sexual: Sex with husband.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Denies sweating, Denies consptiation, diarrhea, Denies N/V, Denies diarrhea, no weight changes, Denies consptiation, nervousness, nervous, no thoughts of harming herself, she is happy and enjoys her hobbies, she is happy, enjoys hobbies, no thoughts of harming herself, no weight changes, difficulty falling asleep, female, loss of appietite, 45 year, 45 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 y/o female who reports to the office experiencing a few week of increased nervousness. The patient reports that she experiences consistent nervousness but it increases on Sunday evening and monday morning. The patient reports experiencing increased nervousness but with no identifying relieving factors. She has not tried any treatments for the symptoms. She has never experienced these symptoms before. The patient has recently switched jobs from being a researcher to an English professor a few weeks ago. 
Endorses: trouble falling asleep, and decreased appetitie, drinking coffee
Denies: Blurry vision, dizziness, Dry mouth, SOB, Cough, fever, chills, palpitations, chest pain, abdominal pain, change in urinary or bowel habits, swelling of the legs and the inability to concentrate.
PMH: none
Medications: Tyenolol PRN
PSH: none
Family history: father passed from heart attack at 65
Alcohol denies, tabacco denies, illicit denies.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Denies palpitations, Denies change in bowel habits, nervousness, nervousness, nervousness, drinking coffee, Denies inability to concentrate, trouble falling asleep, female, decreased appetitie, 45 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 45 yo f  g2p2 c/o nervousness since a few weeks ago. It is present constantly every day but worsens every sundays and mondays. she worked at reasearch and recently started teaching class on mondays, she feels very anxious at the moment, and nothing makes it better. she denied any recent stressor other than her new job and taking care of many sick family members. she expresses having difficulty falling asleep but once she falls asleep she feels refreshed next morning and wakes up with alarmshe also experiences headache while reading which is relieved by tylenol. she denied any recent trauma, fever, chills or nightsweats. no recent change in weight or appetite, urinary or bowel habits. 
ros: -
all: nka
meds: tylenol prn headache
pmh/pshx: none
fh: father died at 65 of mi
sh: english profesor, drinks 5-6 cups of caffeine daily, no illicit drugs, drinks socially, no smoking, exercises 3miles per week, monogamous with husband.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]no recent change in bowel habits, nervousness, anxious, stressor aking care of many sick family members, drinks 5-6 cups of caffeine daily, no recent change in weight, difficulty falling asleep, f, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Moore is a 45 yo female with 1 month history of nervousness. Patient reports that one month ago, she changed from doing research to giving lectures in front of many people. Patient reports that her nervousness is worst on Sunday nights and Monday mornings, when thinking about these lectures. Patient reports that this nervousness is non-stop. She reports that this nervousness has caused difficulty with sleeping and affects every aspect of her life. She says that nothing helps relieve the nervousness. No similar previous episodes.
ROS: Slight decrease in appetite, but no weight loss. No hot/cold intolerance, N/V, headaches, palpitations
VS: HR 96, BP 130/85; otherwise WNL
PMHx: none
SH: lives with supportive husband and youngest son; social alcohol, no tobacco, no illicit drugs
Meds: None - at times tylenol for infrequent headaches
FH: Father passed from heart attack at 65, mom healthy.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]No hot/cold intolerance, No palpitations, nervousness, nervousness, nervousness, nervousness, nervousness, no weight loss, difficulty with sleeping, female, decrease in appetite, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Karin Moore, 45 yo f comes in complaining of nervousness throughout the day but especially on sundays and mondays when she has to give a presentation for her english lit classes. She has difficulty falling asleep and stressed from her responsibilities of work and taking care of her family. She consumes caffeinge throughout the day but denies mood changes, depression, tremors, palpitations or sweating.
ROS: WNL
PMH: none 
Allergies: NKDA
Medications: none
FH: father died of heart attack
SH: decreased sexual activity, no cigarettes or alcohol, good relationships at home.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies tremors, denies palpitations, denies sweating, nervousness, stressed from taking care of her family, caffeinge throughout the day, denies mood changes, denies depression, difficulty falling asleep, f, 45 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Moore is a 45 year old, previously healthy woman, who presents with 2-3 weeks of worsing nervousness. During this time, she reports constant, increasing nervousness, restless sleep, loss of appetite and feeling overwhelmed. She denies any episodes of panic attacks. She is a professor and has been conducting research for the last few years; she returned to lecturing students 3 weeks ago. This has reportedly been the only recent change in her life. She denies any history of anxiety. She denies headaches, changes in gastrointestinal patterns, weight loss, palpitations, or recent illnesses. She reports that her anxiety has significantly impacted her personal and professional life. 

Denies any significant past medical history. 
Denies any allergies.
Denies prior surgeries. 
Family history: Father died of heart attack, mother alive and healthy 
Denies any smoking or drug use.
Endorses occasional alcohol use..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]denies palpitations, denies changes in gastrointestinal patterns, nervousness, her anxiety, nervousness, feeling overwhelmed, anxiety, denies weight loss, restless sleep, woman, loss of appetite, 45 year, 45 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Whelan is a 26 yo F with a 6 mo hx of heart palpitations that have been increasing in freq in the past 2 weeks. She was seen 2 weeks ago for similar symptoms with a w/u WNL. 
-The events last 12-30 min, are not assoc with anything particular, no alleviating or aggrevating factors. 
-She has assoc SOB, hot and then cold and clamy skin
-Recently had numbness of fingertips on both hands during palpitation event 
ROS: No dyspne, CP, skin, hair or wt changes. 
PMH: none
PSH: None 
Meds: none 
Allergies: NKD
FH: non contributory 
SH: 2 months unemployed, recently purchased a condo but is optomistic about her financial and occupational situation. Lives alone, sexual active with one partner, uses condoms. No alcohol, tobacco or drug use..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, assoc SOB, palpitations, palpitation event, was seen 2 weeks ago for similar symptoms with a w/u WNL, No CP, No drug use, increasing in freq in the past 2 weeks, last 12-30 min, clamy, numbness of fingertips, numbness of hands, 2 months unemployed, recently purchased a condo, 26 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Whelan is a 26y/o F presenting to f/u from the ED with heart palpitations.  She staes she has felt her heart ""pounding"" and ""racing"", she feels a sense of doom, ""like somehting bad is going to happen"" and also gets hot, then very cold and clammy.  She also becomes nauseous and can become very fatigued afterwards. Her fingers also went numb with the attack 2 weeks ago.  Pt does state she's under a lot of stress, as she recently bought a condo and just lost her job 2 mos. ago.  She has been noticing these attacks for about 5 years.
ROS + for SOB, chest tightness, sense of doom, stress, anxiety, nausea, flushing, poor concentration
denies sweating, diarrhea, vomiting, dizziness, headache, or weight loss or gain, or brittle skin/hair
No allergies, meds, PMHx, SHx, FMHx, or OB Hx.
Lives alone in a condo, is a non-smoker, non-drinker, and no illicit drug use..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]noticing these attacks for about 5 years, F, palpitations, heart racing, no illicit drug use, felt her heart ""pounding"" and ""racing"", she feels a sense of doom, gets hot, clammy, fingers also went numb, fatigued, poor concentration, recently bought a condo, lost her job 2 mos. ago, under a lot of stress, 26y</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Edie Whelan is a 26 year old female who presents as follow up from the ED for palpitations. She has been having episodes where she will notice her heart pounding and feel hot/cold and have clammy hands. She was seen in the ED 2 weeks ago with normal CBC, metabolic panel, troponins, and ECG. This happened 5 years ago and stopped and recently started again 3 weeks ago. She has been under a lot of stress as she just bought a condo and lost her job 2 months ago. This last episode she did notice tingling in her fingers. This will come on sporatically. She will also get nauseous during the episodes. 
ROS: negative execpt for above
PMH/ past surgeries: none
Medications: none
Allergies: none
Family history: non contributory.
Social history: lives alone in a condo. Denies alcohol, tobacco, durg use and travel. Is sexually active with boyfriend and they use condoms. She walks a couple times a week for exercise and does not drink coffee..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]happened 5 years ago, female, does not drink coffee, palpitations, in the ED 2 weeks ago with normal CBC, metabolic panel, troponins, and ECG, Denies durg use, nauseous during episodes, feel hot, clammy, tingling in her fingers, under stress, bought a condo and lost her job 2 months ago, 26 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI:  26 YO F C/O EPISODES OF PALPITATIONS THAT STARTED 5 Y AGO BUT HAS BEEN MORE FREQUENT OVER THE LAST 2 WEEKS. THE EPISODES LAST FOR 15-30 MINUTES EACH AND RESOLVE SPONTANEOUSLY. NO SPECIFIC TRIGGERS OR ALLEVIATING FACTORS. SHE REPORTED SOB, NAUSEA AND CHEST TIGHTNESS AND NUMBNESS OF HER FINGERS DURING THESE EPISODES. SHE DENIED SLEEP DISTURBANCES, VOMITING, WEIGHT LOSS, DIARRHEA, ABDOMINAL PAIN, DIZZINESS, LOC OR OTHER NEUROLOGICAL SYMPTOMS.
SHE REPORTED RECENT LOSS OF HER JOB 3 MONTHS AGO WHICH IS A STRESSFUL EXPERIENCE FOR HER. SHE DENIED BEING AFRAID OR SAD. ROS IS OTHERWISE NEG
PMH, PSH: NEG, NKA
FH: NON CONTRIBUTABLE
SOCIAL: NON SMOKER, NO ALCOHOLS, SEXUALLY ACTIVE WITH BOY FRIEND, CONSISTENT USE OF CONDOMS
MENSTRUAL: LMP 2 WEEKS AGO, REGULAR, NO MENORRHAGIA
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]STARTED 5 Y AGO, F, SOB DURING THESE EPISODES, PALPITATIONS, NAUSEA DURING THESE EPISODES, MORE FREQUENT OVER THE LAST 2 WEEKS, EPISODES LAST FOR 15-30 MINUTES, NUMBNESS OF HER FINGERS, LOSS OF HER JOB 3 MONTHS AGO WHICH IS A STRESSFUL, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is 26 yo F presenting w/ c/o palpitations and racing heart. Symptoms have been present since 5 years ago, but have been fairly absent until 3 weeks ago. Patient describes feeling like heart is racing, about to jump out of chest, with assoc. chest tightness, dyspnea and nausea. Patient was seen in ED 2 weeks ago for same complaint and bloodwork (CBC, CMP, cardiac enzymes, and ECG) were all unremarkable. Patient is having some acute life stressors with recent loss of job and moving to new condo. Denies any caffeine use or illicit drugs. No hx of panic attacks or COPD. Endorses numbness/tingling in fingers, remits. Denies perioral tingling or spasms. Denies Headache, changes in vision, chest pain retrosternally with pressure, wheezing, abd. pain., dysuria, or muscle weakness.
PMH, Meds, Allergies all absent. Psurg.Hx, and Smoking, ETOH use and Illicit drugs all unremarkable.
ROS: negative except as above.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]since 5 years ago, F, Denies caffeine use, assoc dyspnea, palpitations, racing heart, heart is racing, heart is about to jump out of chest, in ED 2 weeks ago bloodwork and ECG) were all unremarkable, in ED 2 weeks ago CBC, CMP, cardiac enzymes and ECG) were all unremarkable, Denies chest pain, Denies illicit drugs, Hx, Illicit drugs unremarkable, assoc nausea, numbness in fingers, tingling in fingers, stressors, loss of job and moving to new condo, 26 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 y/o female w/o pertinent PMH who presents to clinic following presentation to emergency room with palpitations and bilateral numbness in the fingers. She reports that palpations have been occuring for the past 5 years inconsitently but began again 3 weeks ago. The poudning is a racing he her chest that is now occuring 1 to 2 times a day, during these episodes she is afraid that she is going to die. Not associated with LOC, dizziness, N/V, abdominal pain or visual changes. 2 weeks ago she presented to the ED due to new associated numbness in bilateral fingers. Evaluation in Emergency room was unrevelaing w/ CBC, metabolic panel, cardiac enzymes and EKG in normal limits. Patient reports no inciting factors. 

She has had increased life stressors recently with job loss, new condo and new prospect for a job on the horizon. 

ROS: dnegative except as above
PMH: None
PSH: none
meds: none
FH: not pertinent
SH: no drinking, smoking.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]for 5 years, female, palpitations, palpations, poudning is a racing, 2 weeks ago Evaluation in Emergency room was unrevelaing, 2 weeks ago in Emergency room CBC, metabolic panel, cardiac enzymes and EKG in normal limits, 2 weeks ago presented to the ED Evaluation was unrevelaing, occuring 5 years inconsitently 3 weeks ago occuring 1 to 2 times a day, during these episodes she is afraid that she is going to die, numbness in the fingers, numbness in fingers, stressors, job loss, new condo, 26 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 YO F COMING FOR A FOLLOW UP due to cardiac palpitations. the patient went to the ED 2 weeks ago when her heart started racing and felt numbness for the 1st time in her finger tips. The patient has been having these palpitations for 5 years that comes and goes, last 15-30 mins. patient denies sweating, loss of consciousness, weakness .however only numbness on finger tips. Patient denies recent fall, any cold sensation. pt denies cough, fever, vomiting however feels nauseated before the symptoms.

ros: negative except as HPI
PMH: NONE
PSH: NONE
FH: BOTH parents healthy
allergies: none
SH: no smoking, no alcohol, no drugs, no coffee or energy drinks
Sexually active.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]for 5 years, F, no coffee, palpitations, no drugs, eart started racing and felt numbness for the 1st time in her finger tips, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Whelan is a 26 yo F who presents with a history of palpitations. The palpitations started 5 years ago but worsened in the past 3 weeks. 2 weeks ago she visited the ER where her labs were normal. The episodes consist of shortness of breath, tight throat, nausea, feeling hot, palpitations, and they come out of no where. Also has numbness of her fingers. No alleviating or aggravating factors. Episodes go away on their own in 15-30 minutes. Does not consume caffeine. Has experienced lots of stress recently with losing her job and buying a condo.
PMHx: None
PSHx: None
NKDA
Meds: None
ROS: negative except as above.
FH: None
OB hx: G0P0. LMP 1 week ago. 1 male sexual partner. No hx of STDs. Condom use.
Social hx: Nonsmoker, no EtOH use. Denies illicit drug use. Feels safe at home. Support system includes her boyfriend..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]started 5 years ago, Ms, F, Does not consume caffeine, episodes consist of shortness of breath, palpitations, palpitations, palpitations, 2 weeks ago she visited the ER where her labs were normal, Denies illicit drug use, episodes consist of nausea, worsened in the past 3 weeks, go away in 15-30 minutes, episodes consist of tight throat, feeling hot, numbness of her fingers, experienced lots of stress, losing her job and buying a condo, 26 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Whelan is a 26F who presents with palpitations. Started 5 years ago during a stressful period in college, occured twice in 1 month. Afterwards occured 1 a year until 3 weeks ago when they reoccurred twice in one day. Then 2 weeks ago they occured with numbness in her hands, she went to ED with normal workup. She is now here for follow-up on this. She denies any history of cardiac or neurologica abnormalities
MedHx: none
SurgHx: none
Medications: none
Family History: none
Social: lives alone, no smoking, drinking, or drugs.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Started 5 years ago, F, palpitations, 2 weeks ago she went to ED with normal workup, no drugs, occured 1 a year until 3 weeks ago when they reoccurred twice in one day, occured with numbness in her hands, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Edie Whelan is a 26 year old AAF who presents to the clinic today for CC ""I'm having heart pounding"". She states that she was previously seen in the emergency room 2 weeks ago for heart palpitations and a sensation that she ""was going to die"". She was told to follow up in the clinic today. She states that for the past 5 years she has been dealing with heart palpitations which she describes as a feeling that ""my heart is going to beat out of my chest"". These occurences have become more frequent over the past 3 weeks. During the episodes she states she has nausea, SOB, throat tightness, hot flashes and clammy hands. She denies vomiting, weight loss, syncope, change in appetite or bowel habits. She states that these episodes occur randomly and occur once every 2-3 days. She has many life stressors at this time. 
PMH: none
FMH: none
SHx: denies tobacco, alcohol and illicit drug use.
Meds: none
Allergies: none
Surgeries: none 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]for the past 5 years, F, has SOB, feeling that ""my heart is going to beat out of my chest, palpitations, palpitations, denies illicit drug use, has nausea, more frequent over the past 3 weeks, sensation that she ""was going to die, has throat tightness, hot flashes, clammy hands, stressors, 26 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 26yo F who presents for foloow-up of palpitations.  Was seen in the ED 2 weeks ago for increasing occurance of palpitations; with heart racing, SOB, throat tightening, nausea, finger numbness, and diaphoresis.  Patient states she has felt like this for the past 5 years, with episodes occuring 1-2x/month, but that it has acutely gotten worse, with episodes occuring 1-2x/day in the past 3 weeks.  Patient denies any chest pain, exacerbating or relieing factors, wheezing, diarrhea, constipation, urinary symptoms, blurry vision, headache, or other systemic complaints. Is concerned by these episodes, stating she ""feels my heart is going to stop"", and is motivated to get to the bottom of them. 
ROS: negative unless stated above
PMH: none
Medications: none
Allergies: nkda
FHx: none
Social history: denies alcohol, tobacco, drug use. Unemployed. Eats balanced diet, no change in appetite. Sleeping well..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]felt like this for the past 5 years, F, with SOB, palpitations, palpitations, heart racing, denies chest pain, denies drug use, with nausea, for the past 5 years, episodes occuring 1-2x/month episodes occuring 1-2x/day in the past 3 weeks, feels my heart is going to stop, with throat tightening, finger numbness, Unemployed, 26yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Edie Whelan is a 26 year old female with no PMHx presenting today with a three week history of heart palpitations.  She reported to the emergency department two weeks ago with similar symptoms.  At that time, she had a normal EKG, CBC, CMP and cardiac enzymes.  Since then, she has been experiencing these palpitations multiple times throughout the day.  These palpitations are associated with feelings of 'clamminess', throat tightness, shortness of breath and nausea.  Patient recently lost her job, 1 month after closing for a condominium here in Atlanta.  She reports increased stress during the past few weeks.

Patient denies any chest pain, joint pain, fever or edema.  She reports similar palpitations 5 years ago, although she does not recall any triggers for these events.  Patient has no history of physical, emotional or sexual trauma.  Patient denies any anhedonia, feeligns of guilt, change in appetite or energy levels..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]palpitations 5 years ago, Ms, female, associated shortness of breath, palpitations, palpitations, palpitations, palpitations, emergency department two weeks ago had a normal EKG, CBC, CMP and cardiac enzymes, denies chest pain, associated nausea, associated throat tightness, clamminess, lost her job, after closing for a condominium, increased stress, 26 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Whalen is a 26 yo F without sig past medical history presenting for palpitations. She reports that she has experienced increased plapitations in the last 3 weeks. These episodes are described as ""heart pounding, feeling clammy"" which lasts for 15 minutes at a time. 2 weeks ago she presented to the ED because she also experienced ""fingers going numb"" that accompanies palpitations. ED work up included EKG, CBC, CMP were normal. Episodes goes away on its own. She has not tried anything for this. Last episode was yesterday. There were no reported changes in symptoms since being seen by the ED.  Denies chest pain. Endorses shortness of breath. Denies syncopal episodes. Endorses nausea, but no vomiting or abdominal pain. Denies caffeine intake. No hx of strokes or blood clots.  
ROS - neg. No meds, No PMHX or fam Hx
Social - denies smoking tobacco, alcohol use or drug use. Recent job loss and apartment. Reports good support. 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, Denies caffeine, Endorses shortness of breath, palpitations, plapitations, 2 weeks ago ED work up included EKG, CBC, CMP were normal, Denies chest pain, denies drug use, Endorses nausea, increased in the last 3 weeks, lasts for 15 minutes, feeling clammy, fingers going numb, Recent job loss and apartment, 26 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms Whelan is a 26 year old female who came in for a follow up visit from the Emergency room for palpitations. The patient started to notice ""heart pounding"" about 5 years ago, but the palpitations became more frequent about 3 weeks ago. Around that time, the patient lost her job and just bought a  new condo. 1 week ago, the patient stated that her fingers went numb and she went to the ED. At the ED, her CBC, BPM, EKG came back normal. She states that when she has these episodes she feels SOB, feels that her throat is closing in on her, and goes from hot to cold and clammy. The only things that make it better are rest and waiting for it to pass. She also states that she becomes fatigued after the episodes. 
ROS: denies HA, visual changes, constipation, diarrhea, hair falling out or becoming brittle, urinary changes, mood changes
PMHx: none
Meds: None, Surgeries: none, NKDA
Fam Hx: None
Socal: Denies smoking, alcohol, and drugs.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]started to notice 5 years ago, Ms, female, when she has these episodes she feels SOB, palpitations, palpitations, 1 week ago went to the ED CBC, BPM, EKG came back normal, 1 week ago At the ED CBC, BPM, EKG came back normal, Denies drugs, more frequent 3 weeks ago, when she has these episodes she feels that her throat is closing, feels hot, clammy, fingers went numb, fatigued, lost her job and just bought a  new condo, 26 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Edie Whelan, a 26-year-old female, has come to the outpatient clinic for a follow-up visit for palpitations.  Report from visit to the emergency department 2 weeks ago: Complete blood count - within normal limits; Metabolic panel - within normal limits; Cardiac enzymes - within normal limits; ECG - within normal limits.
She has had palpitations for 5 years.  2 weeks ago they were also associated w/ finger numbness, since resolved.  She admits to SOB, N, throat tightness, and going from ""hot to cold and clammy"" during the episodes.  She denies CP, V, bowel changes, urinary symptoms, HA.  She denies triggers and alleviating factors.
ROS: as above
PMHx: neg
PSHx: neg
Meds: none
FMHx: neg
NKDA
SH: denies toxic habits X3, sexually active w/ male partner, uses condoms
LMP 2 weeks ago, G0P0.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]for 5 years, female, SOB during the episodes, palpitations, palpitations, visit to the emergency department 2 weeks ago: Complete blood count - within normal limits; Metabolic panel - within normal limits; Cardiac enzymes - within normal limits; ECG - within normal limits, denies CP, denies toxic habits, N during the episodes, throat tightness during the episodes, clammy, going from ""hot, finger numbness, 26-year-old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26Y/O F C/O POUNDING OF THE HEART FOR 2 WEEKS 3 TIMES . LAST TIME SHE VISITED ER . SHE HAS THIS PALPITATION FOR 5 YR 3 ATTACKS IN 5 YR . LAST FOR 20 MINS  EVERY TIME. ASSOCAITED WITH NAUSEA, SOB, AND SWEATY AND COLD SKIN. SHE HAS LAID OFF FROM JOB FEW M AGO AND STRESSED OUT ABOUT IT. NOTHING MAKES IT BETTER OR WORSE . DENIES ANY WT LOSS, FEVER , HEAT INTOLERANCE, CHANGE IN BOWEL HABIT . CAHANGES IN URINATION AND TREMOR , CHEST PAIN , WHEEZING. DENIES ANY CAFFEINE INTAKE
MENS HX:  MENARCHE 13Y/O, REGULAR PERIOD 4DAYS /28DAYS . WITH NORNAL FLOW
ROS: -VE EXCPT ABOVE
PMH; NONE
PSH:NONE
MEDS: NONE
ALLERGIES: NKDA
FH:NONE
SH:DENIES ANY ETOH , SMOKING TOBACCO AND CAFFEINE AND SEXUALLY ACTIVE WITH BF WITH CONDOMS. SALES WORKER.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]SHE HAS THIS FOR 5 YR, F, DENIES ANY CAFFEINE, SH:DENIES CAFFEINE, ASSOCAITED WITH SOB, PALPITATION, ASSOCAITED WITH NAUSEA, LAST FOR 20 MINS, LAID OFF FROM JOB FEW M AGO, STRESSED OUT, 26Y</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 29 yo F retail worker c/o episodes of paliptations x 2 wk, assoc w/ feeling of sense of doom, feeling of dying, numbness of the fingers, SOB, throat tightness, nausea, feeling of warmth during episodes and cold and clammy after. No triggering events, last 15-30min, one episode every few days
-previous similar episodes x 3wk, 1-2/d, episodes x 5y 2-3/month during college
-denies assoc w/stress, currently under increased stress
-no thoughts of anxiety/LOC, dizziness/bladder/bowel complaints/bodyaches/skin changes/difficulty adjusting to temperatures (except in episodes)
-no changes in diet/appetite/weight.balanced diet, eating and drinking well
ROS: as above
PMH: ER visit for similar complaints 2 wk ago
PSH: none
Allergies: NKA medications: None
SH: no smoke/alcohol/illicit drugs. sexually active with boyfriend, regularly uses condoms
OBGYN: LMP 1 wk ago, regular cycles, last PAP smear normal
FH: noncontributory
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]episodes x 5y, F, assoc w/ SOB, paliptations, illicit drugs no, assoc w/ nausea, assoc w/ feeling of sense of doom, assoc w/ feeling of dying, assoc w/ throat tightness, assoc w/ feeling of warmth, assoc w/ numbness of the fingers, currently under increased stress, 29</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 yo woman with a 3 week history of heart pounding most recent happened about 2 weeks ago and associated with nausea, coldness, clammyness and throat tightness. During the most recent episode her hands went numb. She said she wasn't doing anyhting specific at the times and that the episodes come and go at randome times. Not associated wiht activity. has had these attacks some for 5 years but only got worse 3 weeks ago. They last 15 to 30 min. No diareah, no weight changes or apetitie changes. No dizzyness with the episodes. No changes in hand color with numbness. No signs of depression. 
ROS: negative except as above
PMH-negative
PSH: none
Medications: none
Allergies: NKDA
FH: noncontributory 
SH: healthy diet no Etoh, no smoking illicit drugs, walks once a day.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]has had for 5 years, woman, no illicit drugs, associated nausea, got worse 3 weeks ago, last 15 to 30 min, associated throat tightness, clammyness, hands went numb, 26 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 yo female with 5 year history of palpitations that has gotten worse in past three weeks
HPC- 5 years ago they started, infrequently. 2 months ago she lost her job. 3 weeks ago panic attacks became more frequent, usually 1-2 times/day. Last 15-30 minutes. Happen at random times. Nothing to exacerbate or alleviate. Must wait out the episode, nothing she does makes it goes away.
Describes each episode as ""heart racing, throat tightens, shortness of breath, feeling very hot then very cold, and feeling nauseous. Feels like I'm going to die"" Feels very tired after and has difficulty concentrating. No chest pain.
Since visit to ER, episodes are once every few days.
Med HX- nil. Surg Hx- Nil. Medications- Nil. NKDA. Social: nil smoking, nil drinking, nil recreational drug use. Lives alone. Used to work as sales consultant, lost job 2 months ago. Has another interview soon which she is looking forward to.
ROS negative except as above..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]5 year history of, 5 years ago they started, female, episode shortness of breath, palpitations, heart racing, No chest pain, nil recreational drug use, feeling nauseous, worse in past three weeks, 3 weeks ago more frequent, ""Feels like Im going to die"", Last 15-30 minutes, episode throat tightens, feeling hot, tired, difficulty concentrating, lost her job, lost job, 26 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: A 26 y/o female patient comes to the clinic to follow up after an ER visit due to symptoms of palpitations. 5 years ago she began to experience as she describes a ""Heart Pounding"" sensation that would come and go. It has gotten worse in the past 3 weeks. This would be followed with symptoms of shortness of breath, nausea, numbness of the fingers, tighting of the thoat and feeling clamy. Nothing would alleviate the symptoms, patient states that by waiting it reassures her that the symptoms will subside. Denies Headache, Sweating, radiating of chest pain to the left arm, diarrhea and loss of weight.
PMHx: No medical condition, does not take any medication, denies allergies, last menstruation was 1 week ago, regular, no cramps, no pregnancy.
PSHx: Denies smoking, Is unemployed - looking for a job, prior was a sale associate, well-balnced diet, no illicit drugs, no alcohol, no travel, Sexually active with boyfriend, uses protection.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]5 years ago, 5 years ago she began to experience Heart Pounding, female, y/o female, with shortness of breath, would be followed with symptoms of shortness of breath, palpitations, comes to the clinic to follow up after an ER visit due to symptoms of palpitations, Denies chest pain, no illicit drugs, with nausea, gotten worse in the past 3 weeks, has gotten worse in the past 3 weeks, with tighting of the thoat, This would be followed with symptoms of feeling clamy, feeling clamy, numbness of the fingers, This would be followed with symptoms of numbness of the fingers, unemployed, 26 y/o, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Whelan is 26 y/o F with palpitations that started 5 years ago and worsening 3 weeks ago to 1-2 x day (before it was 2-3 episodes/month). last 15-30 min. went to ED 2 weeks ago due to palpitations with numbness in fingers. palpitations stop by themselves, no preciptiating events. Endorses feeling hot and then cold and clammy afterwards and shortness of breath. Denies fever, hives, rashes, tremors, weight changes, headache, loss of conciousness, jerking moements. 
PMH: none. PSH: none. FH: health, no cardiac history or thyroid history. OBGyn hx: sex with boyfriend, uses contraception. menarche at 12, regular periods, uses condoms. Recently lost job, anxious over this. No tobacco, etoh, or drug use. no meds, no allergies, no caffeiene use..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]started 5 years ago, Ms, F, no caffeiene use, palpitations, palpitations, palpitations, No drug use, worsening 3 weeks ago, 3 weeks ago to 1-2 x day (before it was 2-3 episodes/month, last 15-30 min., feeling hot, clammy, numbness in fingers, lost job, 26 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Edie Whelan, a 26-year-old female, has come to the outpatient clinic for a follow-up visit for palpitations. 
- began 5 years ago, got worse 3 weeks ago, happens1-2 times/day, lasts 15-30 mins; 
- has numbness in her fingers, sweats, SOB, nausea
- after the events she has difficulty concentrating and fells tired
- Denies vomits, fever, changes in mood, weight changes, dizzness, changes in vision or hearing, seizures, LOC
- nothing makes it better or worse
- impares daily lives activities

OB/GYN: LMP 9 days ago, periods are regular
PMH: none          PSH: none
FH: none
SH: no smoking, no EtOH, no illicit drug; sexually active with boyfriend, uses condoms, no previous STIs;  unemployed for 2 months.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]began 5 years ago, got worse 3 weeks ago, female, has SOB, palpitations happens1-2 times/day, no illicit drug, has nausea, lasts 15-30 mins, sweats, numbness in her fingers, difficulty concentrating, fells tired, unemployed, 26-year-old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Whelan is a 26F presenting with 3 weeks of intermittent episodes of heart pounding and SOB
- The palpitations first began 5 years ago, but increased in frequency in the past 3 weeks. They now happen every 2 days or so, and last 15-30 minutes.
- Feels pounding of heart in chest; associated with SOB, feelings of impending doom
- Nothing relieves the episodes, patient just sits and waits it out
- No identified triggers

ROS: Denies any chest pain, lightheadedness during episodes. Denies any symptoms in between episodes, including nausea, vomiting, diarrhea, constipation, headaches
PMHx/PSHx: None
Meds: None
Allergies: None
Fam hx: None
Social history: No alcohol, tobacco, substance use. Only sexualyl active with boyfriend. 4 months ago, bought a condo, and 3 months ago, lost her job. Has been a stressful period of her life..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]first began 5 years ago, Ms, F, associated SOB, palpitations, Denies chest pain, No substance use, increased in frequency in the past 3 weeks, feelings of impending doom, last 15-30 minutes, lost her job bought a condo, and, stressful period, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: A case of 26 year old female patient comes in due to palpitations. Started 2 weeks ago. It has been better and occuring less. Intermittent. Lasting for 15-30 minutes. Used to be 1-2 last 3 weeks but now it is once every other day. Associated with clammy fingers, throat tightening, SOB, and nausea. Negative history for fluttering of chest, dizziness, Loc, chest pain, weight change, appetite change, hot intolerance, diarrhea, sweaty palms, fever, chills, vomiting, visual changes, headaches, abdominal pain

ROS;  negative except as above OB/GYN; LMP 1 week ago, 5/30 days, uses tampons, menorchea at 12 years with no discharge, itchness, redness PMH; none  PSH; none  FH; none SH;  no smoking, no alcohol, no illicit drugs, sexually active but uses protection, no STDs  MEDS; none  ALL; nkda.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, Associated SOB, palpitations, Negative history for chest pain, no illicit drugs, Associated nausea, Lasting for 15-30 minutes, Associated throat tightening, clammy, 26 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 28-year old female presents for a follow-up after 3 week history of palpitations. She describes sudden episodes of heart pounding, shortness of breath, nausea and feeling hot and clammy.No clear trigger. The episodes started from nothing 3 weeks ago, the episodes occured daily back then, currently they occur every other day. She visited the ER, the ECG, heart enzymes, metabolic panel and CBC weree all normal back then.
ROS: weight constant, no fever, no night sweats, no headaches, no cold or heat intolerance, no episodes of sickness recently, no chest pain, no vomiting, constipation or diarrhea, no urinary symptoms
OBGYN: G0P0, constant menstruation of 30days with 4 day bleeding, no contraception, sexually active with boyfriend only
Med: none
Nox, Allergies: none
FH: none
SH: looking for work currently.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, episodes of heart pounding, shortness of breath, palpitations, 3 weeks ago visited the ER, the ECG, heart enzymes, metabolic panel and CBC weree all normal, no chest pain, episodes of heart pounding nausea, feeling hot, clammy</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 26 y/o female who presents with palpitations. Pt was recently seen in ED 2 weeks ago and was found to name normal CBC, chem panel, cardiac enzymes, and EKG. Pt states palpitations started 5 years ago and was infrequent. sypmtoms worsened 3 weeks ago and become more frequent. Pt c/o episodes of palpitations with SOB, nausea, sensation of throat closing, trouble concenrating and diaphoresis that are now occuring 1 or 2 times per day. Pt also had an episode where her fingers went numb. Episodes resolve on their own and pt denies any inciting events. Pt denies sypmtoms of depression but notes she recently bought a condo and lost her job and is dealing with the stress associated with that. Denies CP, diarrhea, vomiting, abd pain, weight or appetite changes. No alleivating or exacerbating factors to these episodes.
PMH: none
PSH: none
Meds: none
FH: non contributory
SH: denies smoking, drinking, and drugs
NKDA.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]started 5 years ago, female, episodes with SOB, palpitations, palpitations, palpitations, in ED 2 weeks ago normal CBC, chem panel, cardiac enzymes, and EKG, Denies CP, denies drugs, episodes with nausea, 5 years ago was infrequent 3 weeks ago become frequent, sypmtoms worsened 3 weeks ago, 3 weeks ago become more frequent, now occuring 1 or 2 times per day, episodes with sensation of throat closing, fingers went numb, trouble concenrating, recently bought a condo and lost her job, stress, 26 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 y f presented with palpitations since 3 weeks, associated with nausea, tingling sensation in upper limbs, nausea and cold extremities. frequency of these episodes are increased since then with 1-2 episodes per day at present. Had similar complaints 5 years back, was asypmtomatic after that. Has feeling of impending doom and fear of death during these episodes.
- no excess caffeine use / no reacreational drugs . no intolerance to heat or cold. No changes in the weigth/ appetite/ skin or hair changes.
-Lost a job 2 months ago and worried about it. No temporal relation with palpitations.
-No low mood/ decreased energy. no suicidal tendencies.
SH - Non smoker / non alcoholic.
FH- insignificant
PMH/PSH- insignificant
Had pap smear done - normal..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]similar complaints 5 years back, f, no excess caffeine, no caffeine use, palpitations, palpitations, no reacreational drugs, associated nausea, associated nausea, since 3 weeks frequency of these episodes are increased, feeling of impending doom, fear of death, tingling in upper limbs, Lost a job, 26 y</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 yo F in the clinic for follow up after episode of palpitation with impending doom x 3 weeks ago and numbness in fingers.  This complaint started 5 years; it comes/goes; starts out of nowhere; a/w fear of dying; throat toghtness; shortness of breath and cold and clummy fingers. Increases in frequency. 
Denies HA; vission and hearing changes; sore throat; DOE; cough; heartburn; abd pain; bowel and urinary changes; muscle weakness/tingling/numbness (exc as stated above); nausea; vomiting; fever; night sweats; appetite changes; sleep disturbances.
ROS neg exc as above
PMH none; Meds: none; All none
PSH none; travel/trauma none
SH: lives alone; lost job looking for new one; no toxic habits; sex active w/ boyfriend and uses condoms consistently; no STD hx; LMP 2 weeks ago; regular; menarche 13 years..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]started 5 years, F, a/w shortness of breath, episode of palpitation, no toxic habits, 3 weeks ago Increases in frequency, impending doom, a/w fear of dying, a/w throat toghtness, clummy fingers, numbness in fingers, lost job, 26 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Whelan is a 26 yo woman with history of palpitations. First noticed 5 years ago, when they occured 2-3x/month. 3 weeks ago they occured multiple times per day, 2 weeks ago went to the emergency department. At that time CBC, metabolic panel, cardiac enzymes and ECG were within normal limits. Now episodes occcuring every few days. Associated with shortness of breath, tightness in the throat, nausea, feeling heat/claminess. Episodes last 15-30 minutes and are followed by fatigue. endorses stress associated with recent job loss 2 months ago, and buying a condo 3 months ago. denies changes in skin, hair loss, changes in weight, difficulty sleeping, or depressed mood. No muscle tension. No fevers, chills, night sweats.

No allergies, medications, past medical history, surgical history or family history.
Social history: No cigarrete, alcohol or illicit substance use. Sexually active with boyfriend (regular condom use). Feels safe..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]noticed 5 years ago, woman, Associated with shortness of breath, palpitations, 2 weeks ago went to the emergency department. At that time CBC, metabolic panel, cardiac enzymes and ECG were within normal limits, No illicit substance use, Associated with nausea, last 15-30 minutes, Associated with tightness in the throat, claminess, feeling heat, fatigue, endorses stress, recent job loss, buying a condo 3 months ago, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 26 yo female who presents to clinic for palpitations.  Patient states heart palpitations first started 5 yrs ago but have become more frequent in the last 3 weeks.  2 weeks ago she went to the ER because she had numbness in her fingers with the palpitations. She gets episodes 1-2x/day but sometimes only few times/week. They come on randomly without trigger, she never thinks about them, but she feels like she will die when she gets them, heart races, feels hot, clammy, throat tighness, has shortness of breath, nausea, and they can happen anywhere. No weight loss, no fever, no headaches, no diarrhea/constipation, no confusion or loss of sensation/weakness, no lumps in throat, no cold/heat intolerance, no chest pain. They interfere with her life and cannot focus after attack. No PMH, PSH, meds, FH, or substance use. Currently employed has interview soon. Has boyfriend, sexually active, uses condom. LMP 3 days ago normal flow..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]first started 5 yrs, female, when she gets them has shortness of breath, palpitations, no chest pain, No substance use, when she gets them nausea, have become more frequent in the last 3 weeks, feels like she will die when she gets them, when she gets them throat tighness, when she gets them clammy, when she gets them feels hot, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: elie welan 26 year female having palpitaion for last 5 year but now for last 3 week increase heart PONDING OR PALPITATION .LAST VISIT FOR 2 WEEK BACK DID ALL BLOOD INVESTIGATION CBC ,METABOLIC, ECG WNL. NOW SHE WORRIED ABOUT TIRNESS FOR LAST 2 WEEK . SHE WANT TO CAUSE OF PALPITATION. SHE DENY WT LOSS,VOMITING ,ABDOMINAL PAIN, SWEATING FLASH. DURING PALPITAION SHE FEEL SHORTEN OF BREATH. NO ASSOCIATION OF INCREASE AND DECREASE PALPITAION, FOOD IS NOT ASSOICITE PROBLEM
NO ALLERGEY 
PAST MEDI NOTING SIGNIFICANT
PAST SURGICAL NOTING SIG
NO SMOKING
NO DRINKING
NO ILLUCIT MEDIC
SEX ACTIVE WITH BOY FERIEND WITH CONDOM
CURRENT MEDI NOTHING.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]for 5 year, female, DURING FEEL SHORTEN OF BREATH, palpitaion, PALPITATION, PALPITATION, PALPITAION, PALPITAION, NO ILLUCIT MEDIC, for last 3 week increase, 26 year</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: chest palpitations
HPI: 26 yo females presenting with episodic chest palpitations for the past 3 weeks. States that multiple times throughout the day, with no identifiable trigger, she will feel chest palpatations with associated SOB, nausea, throat swelling and feeling ""something bad is going to happen."" The episodes last 15-30min then she feels back normal again with no intervention. Episodes have been happening for 5 years but since 3 weeks ago got more frequent. She presented to the ED 2 weeks ago where they did an ECG, troponins, CBC and metabolic panel which were wnl. Denies weight loss, changes to skin or hair.
ROS: negative except as above, PMHx: healthy
Meds: none  Allegeries: NKDA
FHX noncontributory,  SurgHx: none
Social: no ETOH, no tobacco use, no illicit drug use, lives alone in an apartment in midtown, currently unemployed, sexually active with monogamus boyfriend with consistent condom use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]have been happening for 5 years, females, associated SOB, chest palpitations, palpitations, palpatations, presented to the ED 2 weeks ago where they did an ECG, troponins, CBC and metabolic panel which were wnl, no illicit drug use, associated nausea, 3 weeks ago got more frequent, associated feeling ""something bad is going to happen."", episodes last 15-30min, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Whelan is a 26 yo female who presents to clinic for follow-up from ED for palpitations.  Work-up (CBC, Metabolic panel, Cardiac enzymes, EKG all WNL) in ED all WNL.  First started experiencing palpitations 5 years ago at that time occurred 2-3x/month, increased in frequency 3 weeks ago -- began occuring 1-2x/day for first week, and every few days for the last 2 weeks. Describes the palpitations as ""heart pounding"" rather than fluttering. Denies exacerbating sx, episodes occur randomly.
ROS: + nausea, warm sesnations, + throat tightness, + SOB during palpitation episodes, + sense of impending doom; denies dizzines, loss of consciousness, incontience
PMH: none; PSH: none; FH: non-contributory; Social: currently unemployed, increased life stress in context of financial stressors (condo purchase) & recent unemployment; denies smoking, drug & EtOH use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]5 years ago, female, + SOB during palpitation episodes, palpitations, palpitations, Work-up (CBC, Metabolic panel, Cardiac enzymes, EKG all WNL) in ED all WNL, denies drug, + nausea during palpitation episodes, increased in frequency 3 weeks ago, during palpitation episodes + sense of impending doom, + throat tightness during palpitation episodes, warm sesnations, increased life stress, financial stressors, recent unemployment, condo purchase, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 yo female with 5-year history of palpitations presenting for f/u after an ED visit for palpitations. Last ED visit was two weeks ago for ""heart pounding,"" where CBC, CMP, cardiac enzymes, and EKG were all within normal limits. She states these episodes began five years ago occuring once every 2-3 months, but has now become worse in frequency occuring ""every few days for the last two weeks."" Episodes are described as ""racing heart, feeling as if [she] might die,"" and are associated with dyspnea as if ""[she] can't catch breath,"" ""throat tightness,"" nausea (no vomiting), and feeling ""hot, then cold."" No associated diaphoresis. No chest tightness, no abdominal pain, no dizziness, no LOC during these episodes. Describes significant life stressor recently - she bought a condo and then lost her job, but is able to sustain herself through her savings. Is able to sleep ok. 

Remainder of HPI is negative..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]5-year history of, began five years ago, female, associated with dyspnea, ""associated with she cant catch breath"", palpitations, palpitations, racing heart, ED visit two weeks ago CBC, CMP, cardiac enzymes, and EKG were normal, No chest tightness, associated with nausea, five years ago occuring once every 2-3 months occuring ""every few days for the last two weeks, worse in frequency for the last two weeks, feeling as if she might die, associated with throat tightness, feeling ""hot, stressor, bought a condo and then lost her job, 26 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 26 y/o female w/ no significant PMHx who presents for multiple occasions of heart palpitations. The patient reported that the first episode of her heart beating fastly/strongly occured five years ago and gradually has been increasing in frequency and number. Since about 3 weeks ago, she's noticed more and more episodes. 2 weeks ago, she was seen by the 
ED and they performed a complete cardiac work-up with CBC, Metabolic panel, ECG, and Cardiac enzymes, which were all normal. The patient reports that she also becomes nauseated and Short of Breath during these episodes. She reports that they occur spontaneously and resolve on their own. She denies recent fevers, chills, ns, vomiting, diarrhea, and any recent weight changes. She is fearful for another episode. She does not drink any caffeinated beverages, does not smoke, does not use recreational drugs, and is sexually active with her boyfriend. Recently laid off and stressed..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]first episode occured five years ago, female, does not drink caffeinated beverages, also becomes Short of Breath, Short of Breath during these episodes, palpitations, heart beating fastly, heart beating strongly, 2 weeks ago seen by the ED work-up normal, also becomes nauseated, nauseated during these episodes, increasing in frequency 3 weeks ago, 3 weeks ago noticed more episodes, does not use recreational drugs, Recently laid off, stressed, 26 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 26 yo F who presents with episodes of palpitations since 5 years ago. These have occurred rarely since onset, until 3 weeks ago when they occured 1-2X/day. For past two weeks have occured every couple of days. Accompanied by nausea but no vomiting, feeling hot and cold/clammy, sensation that she is going to die, and dyspnea. 2 weeks ago, had an episode with finger numbness as well, presented to ED and work-up including cardiac enzymes, ECG was normal. Nothing alleviates. Denies changes in sleep, appetite, urination/BM, dizziness, chest pain, fever, headache. Mood is good, no anxiety, no SI. Stressor is loss of job 2 months ago. No temperature intolerance, no skin/hair changes
ROS: neg except as per HPI
PMH: none
Allergies: NKDA
Meds: none
Fam hx: helathy
PSH: none
SocHx: no smoking/EtOH/drugs. Sexually active with boyfriend, uses condoms
Ob/gyn: LMP 2 weeks ago, normal Pap 6mo ago, periods regular, nulliparous.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]since 5 years ago, F, Accompanied by dyspnea, palpitations, 2 weeks ago presented to ED work-up was normal, 2 weeks ago presented to ED cardiac enzymes, ECG was normal, Denies chest pain, no drugs, Accompanied by nausea, occurred rarely since onset, until 3 weeks ago when they occured 1-2X/day, sensation that she is going to die, feeling hot, clammy, finger numbness, Stressor, loss of job 2 months ago, 26 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms whelan is a 26 yo femalwe that presets for a follow up for palpitations. 2 weeks ago she went to the emergency room during one of these episodes where she felt numbness in her hands. She has had these for the past 5 years and the frequency has increased in the past 3 weeks. During these episodes her heart races, but there is no chest pain. She aslo has shortness of breath , nauseu, tight throat, and feelings of hot and cold with these episdoes. She has a terrible feeling about these episodes adn worries about them. Nothing makes them better or worse. NO inciting events. She is under stress because she boiught a condo and then lost her job. Denies any fever or chills, weight or diet changes.

PMH: negative
SH: does not smoke, drink or use other drugs, Her menstraul history is regualr
FH: none.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]had these for the past 5 years, femalwe, shortness of breath with these episdoes, palpitations, no chest pain, does not use other drugs, nauseu with these episdoes, has increased in the past 3 weeks, tight throat with these episdoes, feelings of hot, felt numbness in her hands, under stress, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 yo female with 5 year history of heart palpitations that intensified 3 weeks ago and promted a visit to the ER 2 weeks ago. At that time the patient experienced numbness in her hands. CBC, Metabolic panel, ECG and cardiac enzymes wnl at that time. Palpitations occur at random time points. No precipitating event, no alleviating or aggravating factors known to the patient. ROS: after the palpitations the patient feels slightly fatigued and tired for the rest of the day, associated with shortness of breath, Nausea and vomiting. No agina, no heat intolerance, no changes in bowel movements. Currently the patient presents for followup to the clinic, no current symptoms. Numbness never occured again after the one incident.
PMH: noncontributory: no surgeries, no hospitalizations, Allerigies: NKDA; Meds: none; fhx: none; shx: patient unemployed recently lost her job screening for depression negative, no etoh,tabacco or drugs.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]5 year history of, female, associated shortness of breath, palpitations, Palpitations, palpitations, visit to the ER 2 weeks ago CBC, Metabolic panel, ECG and cardiac enzymes wnl, No agina, no drugs, associated Nausea, intensified 3 weeks ago, numbness in her hands, fatigued, feels tired, unemployed, lost her job, 26 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 YO F WITH PALPITATION ,  THER IS NOO THING THAT MADE THIS PALPITATION AND NO EXACERBATING OR ALLEVIATING FACTORS FOR PALPITATION,NO DIZZINESS , NO FAINT OR SYNCOPE, NO CHANG E OF LIFRE STYLE RECENTLY EXCEPT BOUGHT A CONDO AND NOW SHE LOST THE JOB FOR 2 MONTHS , SHE LIVES ALONE , NO KIDS , NO PREGNANCY BEFORE , SOCIALIZED WITH PEAPOLE NORMALY, NO HEAT OR COLD INTOLERANCE, SHE HAS NOT HX OF ANXIETY OR PSCHIATRY PROBLEMS, SHE HAS HOBIES WITH FAMILY AND FRENDS, NO HX OF SLEEP DISORDER OR HX OF UNHEDONIA OR DEPRESSION, JUST ONE STRESSOR AS MENTIONED ABOVE, NO HX OF GAIT DISTERBANCES

PMH  NEG
FH   NEG
SH   NO SMOKING , NO DRUG , NO ETOH
NO ALLERGY.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, PALPITATION, PALPITATION, PALPITATION, NO DRUG, BOUGHT A CONDO AND NOW SHE LOST THE JOB FOR 2 MONTHS, STRESSOR, 26 YO</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Edie Whelan is a 26yo F who presents with history of palpitations for the past 5 years. She reports they have gotten worse in the past 3 weeks. She reports the palpitations as a heart pounding associated with SOB, nausea, diaphoresis, and impending doom. She reports that they happen from 1-2x day to every few days. The episodes last for 15-30min. She reports they are not associated with caffeine intake or exercise. She reports she feels tired after the episodes and finds it difficult to concentrate. She was seen in the ED two weeks ago with these same symptoms and she reported her fingers were numb. Workup in ED was negative. LMP was a week ago. No history of heart murmur. 
ROS: negative for diarrhea, weight loss, anxiety, headaches, lightheadedness, chest pain
PMH: none
Meds: none
Allergies: none
PSxHx: none
FH: mom and dad healthy
SH: no ETOH, no smoking, no drug use, sexually active with condom use every time, no contraception.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]for the past 5 years, for 5 years, F, not associated with caffeine, associated SOB, palpitations, palpitations, in the ED two weeks ago Workup in ED was negative, negative for chest pain, no drug use, associated nausea, worse in the past 3 weeks, impending doom, episodes last for 15-30min, fingers were numb, feels tired, difficult to concentrate, 26yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 26 y/o F p/w cc of palpitations. Patient seen in ER 2 wks ago for same sx, VS, EKG, cardiac markers, CBC, BMP all WNL at ED 2 wks ago. Patient has had sx intermittently for 5 yrs, increase in frequency 3 weeks ago, most recent episode yesterday. Patient describes palpitations, numbness, fear of something bad happening, nausea, throat tightness, and coldness/hot flashes. Episodes last 15-30 minutes. Nothing aggravtes or relieves sxs. Sxs infrequently a/w exercise or strenuous activity. Patient denies headache, fever, changes in vision chest pain, abdominal pain, vomiting, changes in weight, and changes in appetite. 

ROS: Negative except as mentioned above
PMH: None
PSH/Hospitalizations: None
FHx: None
SHx: Bought condo 3 months ago, lost job 2 months ago, looking for work, currently stressed, no EtOH, tobacco, or illicit drug use, sexually active w/ boyfriend using condoms
Diet: Normal
Exercise: Walks few times/week.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]for 5 yrs, F, palpitations, palpitations, in ER 2 wks ago VS, EKG, cardiac markers, CBC, BMP all WNL, VS, EKG, cardiac markers, CBC, BMP all WNL at ED 2 wks ago, denies chest pain, no illicit drug use, describes nausea, increase in frequency 3 weeks ago, fear of something bad happening, Episodes last 15-30 minutes, describes throat tightness, describes coldness/hot, Bought condo 3 months ago, lost job 2 months ago, stressed, 26 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 26 YO F C/O SUDDEN ONSET OF POUNDING HEART WITH SHORTNESS OF BREATH AND THROAT TIGHTNESS AND TINGLING SENSATION OVER PALMS AND NAUSEOUS.SHE HAS BEEN EXPERIENCING THESE SYMPTOMS SINCE 5 YEARS WITH INCREASE IN SEVERITY SINCE PAST 3 WEEKS.AFTER THE EPISODE SHE IS FEELING COLD AND CLAMMY EXTREMETIES.NO ASSOSCIATED HEADACHES,VOMITING,LEG SWELLING.PATIENT IS FEELING INCRREASE IN STRESS SINCE PAST 3 WEEKS SINCE SHE LOOSE HER JOB.
OBG: MENSES REGULAR
PMH: NONE
PSH: NONE
ALLERGIES: NONE
MEDS: NONE
ROS: NEGATIVE EXCEPT AS ABOVE
SH: NON ALCOHOLIC AND NON SMOKER,NOT USING ANY ILICIT DRUGS,NONEMPLOYEED AT PRESENT.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]SHE HAS BEEN EXPERIENCING THESE SYMPTOMS SINCE 5 YEARS, YO F, C/O SUDDEN ONSET OF POUNDING HEART WITH SHORTNESS OF BREATH, C/O SUDDEN ONSET OF POUNDING HEART, NOT USING ANY ILICIT DRUGS, INCREASE IN SEVERITY SINCE PAST 3 WEEKS, SHE IS FEELING CLAMMY, WITH TINGLING SENSATION OVER PALMS, PATIENT IS FEELING INCRREASE IN STRESS, 26 YO</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 26 year old female c/o palpitations for 3 weeks. Started around 5 years ago but past 3 weeks have gotten progressively worse. Episodes are accompanied by dyspnea, throat tightening, hot/cold sensation last about 15- 30 minutes. Three weeks ago used to come on 1-2x day but now are more frequent.  2 weeks ago had an episdoe that resulted in hand numbnes bilaterally. After episodes occur also feels fatigue and confrused. Nothing makes them better or worse. 3 month ago had recent stressor of buying a new condo. Positive h/o palpitations, dyspnea, confusion, fatigue. Negative h/o vision changes, headaches, weight changes, diarrhea, heat intolerance, h/o heart problems, loss of consciousness, post ictal urination, tongue biting, excessive, bruising, heavy menses. ROS: Negative except as above. Ob/gyn: Uses 3-4 tampons/day. 
Allergies: NKDA. Medications: None. PMH: None. PSH: None. FH: Parents are both alive and healthy..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Started 5 years ago, female, accompanied by dyspnea, palpitations, palpitations, Three weeks ago more frequent, past 3 weeks have gotten worse, last 15- 30 minutes, accompanied by throat tightening, hot sensation, hand numbnes, feels fatigue, fatigue, stressor, 26 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms Whelan is a 26 year old previously healthy woman who presents with 3 weeks of intermittent episodes of ""chest pounding"". They happened multiple times daily 3 weeks ago for one week, then every other day the last two weeks. They last 15-30 minutes and get better when she sits down and calms herself. She feels clammy and her throat feels tight. There doesnt seem to be an obvious trigger. She was seen in the ER for these problems 2 weeks ago and had normal CBC, CMP, cardiac enzymes, and electrocardiogram findings, She recently bought a new condo, then lost her job 2 weeks ago. SIGECAPS screening mostly negative for depression. No thought of harming self or others.

Denies urinary problems, constipation, diarrhea, hair loss, weight change, problems with vision, problems with balance, sleep changes,

Medhx: benign
Famhx: benign
Surghx: none
Socialhx: no alcohol, cigarettes, illicit drug use. has a boyfriend
No medications.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Ms, woman, in the ER 2 weeks ago had normal CBC, CMP, cardiac enzymes, and electrocardiogram, no illicit drug use, happened multiple times daily 3 weeks ago, last 15-30 minutes, clammy, recently bought a new condo, then lost her job 2 weeks ago, 26 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Whelan is a 26 year old female with no past medical history who presents for a follow up visit of palpitations. These palpitations have been occurring intermittently for 5 years and worsened 3 weeks ago. Her most recent episode was associated with bilateral finger numbness. She notes that SOB, throat tightness, nausea, and hot/cold intolerance can be associated with each of these episodes. Each episode lasts 15-30 minutes and it feels like her heart is racing. Over the past 3 weeks this has been occuring at least once a day. She has had a negative cardiac workup 3 weeks ago. Patient denies caffeine use.
ROS: no chest pain, no weight change, no diarrhea/constipation.
No notable PMHx or PSHx.
No medications or allergies
Social History: Recently lost her job. No alcohol, tobacco or illicit drug use. Sexually active with boyfriend, uses condoms. No STI history..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]for 5 years, female, denies caffeine use, SOB associated, palpitations, palpitations, feels like her heart is racing, negative cardiac workup 3 weeks ago, no chest pain, No illicit drug use, nausea associated, worsened 3 weeks ago, Over the past 3 weeks occuring at least once a day, lasts 15-30 minutes, throat tightness associated, finger numbness, lost her job, 26 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26yo asian female here for palpitations. Has been having heart pounding sensation for 5 yrs. 3 wks ago became more frequent 1-2x/day but is now 1x/every few days. She went to the ED 2 wks ago when she had heart pounding and numbness in her fingers. She gets nausea, throat tightening, short of breath, hot, cold ,clammy, feels like she's going to die with the heart pounding episodes. She does not have any previous medical or surgical history, does not take medications, G0P0, Does not use ETOH/tobacco/recreational drugs. Sexually active with  boyfriend, feels safe in relationship, uses condoms. Lives alone. Just lost her job 2 mths ago and bought a new condo 3 mths ago. Will have a job interview in a few weeks. LMP was 1.5 wk ago, occurs monthly, lasts 5 days, moderate flow. No family hx. Diet is healthy, walks every day. Denies heat/cold intolerance, weight changes, appetite changes, hair chang.
ED visit shows CBC, BMP, tropinin, ecg wnl.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]for 5 yrs, female, gets short of breath, palpitations, CBC, BMP, tropinin, ecg wnl went to the ED 2 wks ago, ED visit shows CBC, BMP, tropinin, ecg wnl 2 wks ago, Does not use recreational drugs, gets nausea, 3 wks ago became more frequent, ""feels like shes going to die"", gets throat tightening, clammy, numbness in her fingers, lost her job 2 mths ago and bought a new condo 3 mths ago, 26yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: The patient is a 26 year old female presnting for follow-up from the ED for palpitations. ED workup of Complete blood count, Metabolic panel, Cardiac enzymes and ECG were within normal limits. She reports feeling ""like my heart is pounding out of my chest"" intermittently for the last 5 years with a significant worsening of her symptoms over the last 3 weeks. She was laid off of work 2 months ago and has been more stressed. She also reports associated nausea, throat tightness, hot flashes alternating with feeling cold and clammy as well as one episode of her fingertips tingling. She reports a sense of impending doom and all the prior symptoms occuring at the same time and resolving spontaneously. She denies chest pain but she has also been short of breath during these episodes. ROS otherwise negative. She has no past medical history, no allergies and takes no meds. No family history of illness. No drinking, smoking or illicit drugs. 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]for the last 5 years, for 5 years, female, also short of breath, palpitations, heart is pounding out of my chest, ED workup of Complete blood count, Metabolic panel, Cardiac enzymes and ECG were within normal limits, follow-up from the ED workup within normal limits, follow-up from the ED Complete blood count, Metabolic panel, Cardiac enzymes and ECG were within normal limits, denies chest pain, No illicit drugs, associated nausea, worsening over the last 3 weeks, sense of impending doom, associated throat tightness, feeling clammy, fingertips tingling, laid off of work, more stressed, 26 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26yo F with no significant PMH presents with 3 weeks of heart palpitations.  She states she first had them 5 years ago and from then to 3 weeks ago has had maybe 4 occurances.  
3 weeks ago started happening 1-2x a day.  Accompanied by nausea, SOB, throat tightness, cold/clamy skin, but denies dizziness or syncope
went to ED 2 weeks ago when she developed hand numbness in conjunction with one of these episodes: CBC,CMP, Cardiac enzymes and EKG were all WNL at this time
These episodes last 15-30minutes and resolve on their own.  She takes no medications and has  no known allergies
No consistent timing, do not happen at night
She bought a condo 3 months ago and lost her job 2 months ago.  She has an upcoming job interview in 2 weeks.
Denies TOB, EToH or recreational drug use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]first had 5 years ago, F, Accompanied by SOB, palpitations, went to ED 2 weeks ago CBC,CMP, Cardiac enzymes and EKG were all WNL, Denies recreational drug use, Accompanied by nausea, 5 years ago to 3 weeks ago had 4 occurances 3 weeks ago started happening 1-2x a day, last 15-30minutes, Accompanied by throat tightness, clamy skin, bought a condo and lost her job, 26yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 year old female with no significant medical history presents for multiple episodes of palpitations for three weeks. Episodes come on without provocation, described as heart racing, feeling like something bad might happen including death, shortness of breath, throat tightness, nausea, hot/clammy feeling. Episodes come and go at random, lasting 15-30 mintues at a time. 5 years ago she had 2-3 episodes in a month. 3 weeks ago she had an episode every day for a week. She went to the ED at which time CBC, BMP, EKG, cardiac enzymes were negative. She continues to have an episode every few days since discharge. No recent changes in weight, energy or bowel movements. Mood is okay. No symptoms of anxiety including excessive worrying, preoccupation. No surgical history. No tobacco or illicit drug use. No relevant family history. No psychiatric history. During one episode she noted her hands went numb; has since resolved..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]5 years ago, female, Episodes including shortness of breath, palpitations, heart racing, 3 weeks ago went to the ED at which time CBC, BMP, EKG, cardiac enzymes were negative, No illicit drug use, Episodes including nausea, 5 years ago she had 2-3 episodes in a month. 3 weeks ago she had an episode every day for a week, feeling like something bad might happen, lasting 15-30 mintues, Episodes including throat tightness, feeling hot, clammy, hands went numb, 26 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 26 year old female presenting in clinic today for evaluation of intermittent palpitations. Patient presented to the ED 2 weeks ago with same symptoms. Workup in ED with CBC, metabolic panel, troponins, ECG within normal limits. Patient has been experiencing these  palpitations for the last 5 years but they have worsened in the last 3 weeks. She describes them as a feeling of her heart ""pounding"" with associated nausea, shortness of breath, and subjective feelings of alternating hot and cold. She has also recently noticed the subjective feeling of hand numbeness, impending doom during these episodes. They occur every 2-3 days and last 15-20 minutes before resolving spontaneously. They happen at rest and with activity and do not occur in a specific setting. Patient does not drink or smoke, no other recreational drug use. No PMHx. She does note some increased social stressors with recent unemployment and financial burden..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]for 5 years, female, associated shortness of breath, palpitations, palpitations, presented to the ED 2 weeks ago Workup normal, presented to the ED 2 weeks ago CBC, metabolic panel, troponins, ECG normal, no recreational drug use, associated nausea, worsened in the last 3 weeks, impending doom, last 15-20 minutes, feelings hot, hand numbeness, stressors, recent unemployment, 26 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 yo female patinet presents to the office for evaluation of heart palpitation since 5 years ago. Palpitations have been occuring more recently. she refers an episode of hand numbness BL after the palpitation occured. She also refered feeling hot, cold and clammy in the extremity, SOB and nausea. Denies any chest pain during the eipisoed. She worries that somwthing terrible is about to happend. Lab work done last visit was - for any abnormalities. 
ROS: Denies headache, fever, chills, abdominal pain, chest pain, weakeness or loss of sensation in any part of her body with exception of her hands.
PMH: None
PSH: None
Social: Unemployed at the moment. Denies alcohol, smoking and drug use. She walks 3-4 times a week for 30-60 min. Denies any consumption of Cofee or energy drinks. She is in a lot of stress atthe moment, she bought a condo and lost her job. Sexually active with Boyfriend use condoms and - for STD.
FH: Unremarkable.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]since 5 years ago, female, Denies any consumption of Cofee or energy drinks, heart palpitation, Denies chest pain, Denies chest pain, Denies drug use, Palpitations have been occuring more recently, feeling hot, clammy, hand numbness after the palpitation occured, bought a condo and lost her job, a lot of stress, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 26 yo f who presents for f/u after being seen 2 weeks ago in ED for palpitations. Prior to ED visit, palpitation would occur at least once throughout the day, multiple days a week. Since being seen in the ED, she has had 1 episode, 3 days ago while watching TV. She describes the events as heart pounding with associated SOB, throat tightness, nausea and feeling hot then cold with clamminess. They last 15-30 min. Frequency has improved since ED but quality of event has remained the same. No FH with these symptoms. No alleviating or aggravating symptoms. No attempted treatment. Of note, Unemployed for past 2 mo., reports as stressful. All workup in ED was WNL. ROS negative for lightheadeness, dizziness, HA, chest pain, abdominal pain, recent illness and edema. No PMH, SH, Allergies, Meds, or FH. Sexually active with boyfriend. No tobacco, illicit drug or alcohol use. Balanced diet with regular exercise..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]f, associated SOB, palpitations, palpitation, seen 2 weeks ago in ED workup in ED was WNL, negative chest pain, No illicit drug use, associated nausea, last 15-30 min, associated throat tightness, feeling hot, feeling clamminess, Unemployed, stressful, 26 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: The Pt is a 26 Asian female presenting with frequent episodes of palpiations for 2 weeks. They are usually 15-30 minutes in time and is usually asosciated with SOB, tighting of throat, feelings of Hot and Cold, Clamy, nausea. She has had one episode of numbs fingers. About 3 weeks ago it go worse but has tappered down since her last ER visit. She lost her job 2 months ago and bought a condo 3 months ago. She currently denies any anxiety, fevers, chills, abdominal pain, joint pain.
PMH negative, denies lupus, HTN, Diabetes
PSH negative
FH Negative all healthy
Social. She is interview for jobs in a couple of weeks, No ETOH/Drugs/Smoking. Single, sexually active with boyfriend only uses condoms. Regular diet. Excerices a few times out of the week
Meds negative
All NKDA.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, asosciated with SOB, episodes of palpiations, No Drugs, asosciated nausea, 3 weeks ago it go worse, 15-30 minutes in time, asosciated tighting of throat, feelings of Hot and Cold, Clamy, episode of numbs fingers, lost her job and bought a condo, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Whelan is our 26 year old lady coming in due to palpitations.  She said these episodes have been going on for 5 years but have acutely worsened during the last 3 weeks.  She describes them as a pounding and racing sensation of her heart.  She also develops shortness of breath, nausea, a throat tightness and a cold clamminess when they happen, this last episode was also associated with numbness in her fingers. They last approximately 15-30 minutes per episode.  They are followed by a period of tiredness and difficulty concentrating. She has not lost consciousness.  She has had increased stress over the last 3 months buying a condo 3 months ago and losing her job as a sales consultant 2 months ago.  She has never felt overwhelmed
ROS otherwise negative
NO PMH 
No PSH
No FH
NKDA
Social - no Tobacco, alcohol or drug use, lives alone in a condo.  Close with boyfriend. Was a sales consultant, currently looking for work.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]going on for 5 years, Ms, lady, develops shortness of breath when they happen, palpitations, racing of her heart, no drug use, develops nausea when they happen, worsened during the last 3 weeks, last 15-30 minutes, develops throat tightness when they happen, clamminess, numbness in fingers, tiredness, difficulty concentrating, increased stress, buying a condo and losing her job, 26 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 yo female presents for palpitations. Palpitations started 5 years ago and worsened in past 3 weeks, now occuring every few days. 2 weeks ago she had episode with associated numbess in fingers. Episodes also include SOB, throat tightening, nausea, and feeling clammy. Also states that she has feelings of impending doom during episodes. Episodes start suddenly and can occur at any time of day with no aggrevating or alleviating factors or triggers. Went to ED 2 weeks ago with CBC, CMP, cardiac enzymes, and EKG normal. She did not experience an episode in ED. ROS otherwise negative. 
PMH- none
PSH - none
Meds- none
All - none
FH - none
SH - no tobacco, drug, or alcohol use. She lives alone. Recent life changes include buying a condo and losing job 3 months ago..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Palpitations started 5 years ago, female, Episodes also include SOB, palpitations, Went to ED 2 weeks ago with CBC, CMP, cardiac enzymes, and EKG normal, no drug, Episodes also include nausea, worsened in past 3 weeks, has feelings of impending doom during episodes, Episodes also include throat tightening, Episodes also include feeling clammy, associated numbess in fingers, losing job 3 months ago, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 yo female with palpitations 
-Patient's palpitations began 5 years ago, with recent worsening starting about 3 weeks ago 
-Recently these episodes have worsened and occur 1-2x per day, episodes last 15-30 minutes 
-Desribes epsiodes as pounding feeling in chest with increased heart rate and a ""feeling like I am about to die""
-Episodes are assoc with SOB, nausea, tightness in throat, hot, cold clamy feeling
-She fears have another episode
-Endorses have many stressors in her life currently 
-Denies cold or heat intolerance, change in bowel movements, change in sleep patterns, worrying about other aspects of life, weakness or nubmness currently, also denies being sad or depressed 
past medical history: none
all: none
meds: none
fam hx: none
occupation: retail and currently looking for a job, currently living alone, denies smoking, alcohol drugs 
surg hx: none obgyn hx: last pd 1 week ago, normal periods no pregnancy.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]began 5 years ago, female, assoc with SOB, epsiodes as pounding feeling in chest, palpitations, denies drugs, assoc nausea, worsening 3 weeks ago, recent worsening, Recently episodes have worsened, feeling like I am about to die, last 15-30 minutes, assoc tightness in throat, clamy feeling, hot feeling, stressors, 26 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms Edie Whelan is a 26 year old female who presented for a follow up appointment after going to the ED for heart palpitations.  She states that she has been experiencing palpitations for the past 5 years, but they have increased in frequency over the past 3 weeks.  She describes the episodes as her ""heart pounding and racing"" for 15-30 mins.  She states that she also feels shortness of breath, nausea, and hot during the episodes, and afterwards she feels cold and clammy.  The episodes are not related to any particular stressors or events, but she states that she has recently purchased a condo and lost her job, so she feels more stress than usual.  
PMH- unremarkable, no medications, NKDA, no surgeries
Social- denies smoking, alcohol use, or illicit drug use
ROS- denies headache, vomiting, diarrhea, muscle cramps.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]for the past 5 years, female, shortness of breath, during the episodes, palpitations, palpitations, denies illicit drug use, nausea during the episodes, increased in frequency over the past 3 weeks, episodes for 15-30 mins, feels hot, clammy, recently purchased a condo, recently lost her job, feels more stress, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26/f comes to the clinic with co racing of heart for the past 5 years,getting worse, initially 2-3 episodes/month , now 1-2 episodes/day over the past 3 weeks lasting for a minute  its associated with SOB, chest tightness,cold clamy ,feeling hot during the episode,and lack of concentration following,but denies any triggers and resolves on its own.Reports she is feeling stressed over losing her job and buying a new condo.Denies sleeping difficulties, sadness, guilt,worthlessness, suicidal thoughts, denies appetite,bowel,weight,urinary changes,cold/hot intolerance,loc,headache, dizziness
Ros negative as above
PMH none. meds none, nkda
psh none, hosp none, trauma none
fh not significant
OBgyn lmp 1 week ago, regular, not associated with cramps, pap 6months ago normal.
social lives alone, no alochol,no illlicit drug, no smoking use
sexually active with boyfriend, uses protection, no ho sti.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]for 5 years, f, associated SOB, racing of heart, no illlicit drug, worse over the past 3 weeks, initially 2-3 episodes/month , now 1-2 episodes/day over the past 3 weeks, clamy, feeling hot, lack of concentration following, stressed, losing her job and buying a new condo, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: f/u palpitations
Ms. Whelan is a 26yo AAF here for f/u of ED visit 2 wks ago for palpitations with numbness of fingers. Has 5yr hx of palpitation episodes lasting 15-30mins, 3 wks ago began happening more frequently once/2-3days. During episodes she has SOB, nausea, throat tightening, and gets hot. Afterwards she feels cold/clammy and has trouble concentrating. No LOC. Denies symps when not having palpitations. No prev seizures. Mood good, no anxiety. No recent travel or illness. 
ROS neg except as above
PMH: none
PSH: none
Fam HX: none
Meds: none
NKDA
Social Hx: no tobac/EtOH/drugs, lives alone, sexually active w/ boyfriend using condoms. Laid off 3 months ago has been stressful.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Has 5yr hx of palpitation, 26yo AAF, she has SOB, here for palpitations, ED visit 2 wks ago, no tobac/EtOH/drugs, 3 wks ago began happening more frequently, she has throat tightening, and gets hot, she feels cold/clammy, with numbness of fingers, has trouble concentrating, Laid off 3 months ago has been stressful, 26yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 26 year old female presented for a follow up of heart palpitations. 5 year history of palpitations, increased in the last 2 weeks, occuring almost every day. they are associated with finger numbing, nausea, shortness of breath, feeling cold and clammy, and a fear of impending doom. they are not triggered by anything specific. she denies chest pain, loss of conciousness, weight or appetite changes, skin and hair changes., change in bowel habit, abnormal mood or sleep changes. the patient reports increased stress after buying a condo and then losing her job.
ROS: nil except as above
PMH: nil
PSH: nil
meds: nil
allergies: NKDA
FH: non contributary
SH: currently unemplyed, lives alone, no alcohol, smoking or drugs use, walks 3-4 times per week, balanced diet, sexually active with BF, uses condoms.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]5 year history, female, associated with shortness of breath, palpitations, palpitations, denies chest pain, no drugs use, associated with nausea, increased in the last 2 weeks, associated with fear of impending doom, feeling clammy, finger numbing, increased stress, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Whelan is a 26 yeo female who presents for a followup for heart palpitations. She has been having intermittent ""heart pounding"" for the past 5 years 2-3 times/month but starting 3 weeks ago it occurs 1-2 times per day. 2 weeks ago, it decreased in frequency to 1 time every 2 days. 2 weeks ago, she went to ED for palpitations where all labs WNL. When these palpitations do occur, she feels like her throat feels tight, she has trouble catching her breath, and feels hot and nauseous. Afterwards she feels cold and clammy. She says these palpitations occur randomly and are not associated with exercise or caffeine intake. She does acknowledge that she's been stressed in the past 2 months after losing her job. 
ROS: No chest painheadache, dizziness, blurry vision, lightheadedness, cough, unsteadiness
PMH: none
PSH: none
LMP: last week, 4-5 days, 5 pads/day - normal for her
Meds: None
NKDA
FH: none
SH: no tobacco, EtOH, or drug use
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]for the past 5 years, Ms, female, not associated with caffeine intake, When palpitations occur she has trouble catching her breath, palpitations, palpitations, palpitations, 2 weeks ago went to ED all labs WNL, No chest pain, no drug use, When palpitations occur she feels nauseous, for the past 5 years 2-3 times/month starting 3 weeks ago it occurs 1-2 times per day, When palpitations occur throat feels tight, feels hot, clammy, stressed, losing her job, 26 yeo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 yo f presents w/ cc of palpitations that began 5 years ago but have worsened over the last three weeks. 2 weeks ago, she had an episode in which finger nymbess accompanied the palpitations. She went to the ED and CBC, ECG, Metabolic Panel were normal. She states that these episodes have gotten somewhat better since her ED visit. She States that the episodes occur 1-2 times/ day. they last 15-30 minutes and she feels hot, someimes cold, and clammy. and has associated dyspnea. She reports feelings that something bad may happen to her during one of these episodes, but has no overall impairment of function. She denies weight loss, fever, chills, heat or cold intolerance when she isn't having an episode and changes in bowel or bladder function. 
Meds: No medications
All: NKDA
PMHx: None. no surgeries.
FHx: None
SHx: Live in Atlanta. Worked as sales consultant but recently lost her job and can't pay for it. No tobacco, etoh, or drugs..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]began 5 years ago, f, associated dyspnea, palpitations, 2 weeks ago went to the ED and CBC, ECG, Metabolic Panel were normal, No drugs, worsened over the last three weeks, feelings that something bad may happen during one of these episodes, last 15-30 minutes, feels hot, clammy, finger nymbess, recently lost her job, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: 26 yo F with palpitations, comes for follow up
HPI: started 5 y ago, got worse 3 weeks ago with episodes every day and 2 weeks ago had an episode with numbness in fingers on both sides. Gets clammy, hot and cold, has a tight throat feeling and SOB during those episodes. Episodes last 15- 30 min, nothing makes them better or worse. Has not had this before. No chest pain, no other pains, no fever, chills, weight loss.
PMH: No hospitalisation, no trauma, no surgeries, no illnesses, no meds, NKDA
FH: noncontributory
SH: lost job and is still looking and stressed, lives alone, no drugs, alcohol or smoking
Sx/OB: LMP 2 weeks ago, regular, sexually active w boyfriend, uses condoms,.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]started 5 y ago, F, SOB during those episodes, palpitations, No chest pain, no drugs, got worse 3 weeks ago, last 15- 30 min, tight throat during those episodes, clammy, Gets hot, numbness in fingers, lost job, stressed, 26 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Edie Whelan is a 26 year odl female who presents to the clinic for follow up after being seeng at the ED for palpatations and finger numbness
- 5 year history of ""heart pounding"" that has recently increased in frequency over the past 3 weeks
- In past 3 weeks, occuring 1-2 times per day
- No other episodes of finger numbness
- Patient endorses shortness of breath, throat tightening, nausea, episodes of hot flushing followed by cold clammy feeling
- Patient denies menstrual changes, prior episodes of hypoglycemia
PMH - denies
PSH - denis
FH- denies
SH- recently unemployed 2 mo ago, purchased a condo and is stressed she cannot afford to keep it
Denies tobacco, alcohol, drugs. In a monogamous relationship with boyfriend, uses condoms.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]5 year history of, female, Denies drugs, recently increased in frequency over the past 3 weeks, hot flushing, clammy, finger numbness, finger numbness, recently unemployed 2 mo ago, 2 mo ago, purchased a condo, is stressed, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 26 yo F c/o palpitations X5 years, with increased  frequency recently. Last week she had 2 episodes aday. palpitation episodes are associated with SOB, numbness in the fingers, nausa and feeling hot. She reports having stress in life due to unemployment. patient denies weight , skin,hair or appetite changes. She also denies weakness and menstural abnormalities.
ROS: - except as above.
Meds: none.
All: NKDA.
PMH: - except for similar episodes in the past.
PSH: none.
SH: No tobacco, alcohol, illicit drugs or caffee. sexually active with boyfriend only and use condoms regularly. no hx of STIs, unemployed.
FH: noncontributory.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]X5 years, c/o palpitations X5 years, F, yo F, No caffee, associated with SOB, associated with SOB, palpitation episodes, c/o palpitations, palpitations 2 episodes aday, No illicit drugs, associated with nausa, increased  frequency recently, c/o palpitations with increased  frequency recently, feeling hot, palpitation episodes are associated with feeling hot, numbness in the fingers, palpitation episodes are associated with numbness in the fingers, having stress, unemployment, She reports having stress, 26 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 Year old highly functioning women presents with history of palpation two weeks. Happened before 5 years ago. No associated prodrome. Palpation lastrs for about 10-15 minutes and then abates. No alleviating factors other than just resting. Mighht be worse when she feel wrroied or stressed about something. 
No chest pain. Nausea assoiated. No vomiting. Does not exercise but has no problem climbing stairs. 
No loss of weight. no concentration problems. no constipation or diarrea. no heat intolerance. 
Surgical History: nil
Allergies Nil
Shx some financial concerns about house
No smoking or alcohol.
Illicit drugs none
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Happened before 5 years ago, women, palpation, No chest pain, Illicit drugs none, Nausea assoiated, lastrs for about 10-15 minutes, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: ""heart racing""
HPI: Ms. Whelan is a 26 y/o female with history of 5 years of intermittent episodes of ""heart racing"" which has been increasing in frequency over the last 3 weeks. Sheexperiences racing heart, SOB, Nausea, and feels cold and clammy, lasting for 15-30 minutes. This used to happen rarely but now every couple of days. She feels as though something very bad is happening when the events occur. She presented to the ED and had workup notable for normal CBC/metabolic panel and normal EKG and cardiac enzymes. She was not symptomatic when EKG was done.
ROS: +Nausea, +palpitations, + SOB, -Constipation/diarrhea, -weight change, -menstrual change
PMH: none
PSH: none
Meds: none
Allergies: none
FHx: family all are healthy
Social: just lost job, searching for a new one. lives alone. never smoker, no alcohol, no illicits.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]5 years of, Ms, female, experiences SOB, heart racing, heart racing, racing heart, palpitations, no illicits, experiences Nausea, increasing in frequency over the last 3 weeks, used to happen rarely but now every couple of days, feels as though something bad is happening, lasting for 15-30 minutes, clammy, just lost job, 26 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Edie Whelan, 26 y/o female, presents with palpations x5 years but more so in the past few months which nessecitates her ER visit 2-3 weeks ago. She experiences heart pounding; finger numbness; heart racing; breathing fast; tight throat; feel slightly clammy. Reports been laid off work past few months, but coping well, denies sleeping issues but palpatations affect concetration; good mood; appetite; no weight change. The episodes are unexpected. 
ROS: above; general (no fever/chill); neuro (no dizziness; headache); GI (no constipation; diarrhea); gyn (no change to period); endo (no shakiness; no hair/voice change); psy (not anxious) 
FHx - none; Surgery - none; Med - none; allergy - none; social - no drugs/smoking/drinking; Used to be a sale person..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]x5 years, female, experiences breathing fast, palpations, heart racing, palpatations, no drugs, experiences tight throat, feel clammy, finger numbness, affect concetration, laid off work, 26 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: cc: heart pounding. 
Pt is 26 yo f that presents with ""heart pounding"" that she says first occured five years ago and happened rarely but has recently increased in frequency within the past three weeks occuring about 1-2 times a week. She also gets numbness in her fingers bilaterally during with the most recent episode. She says the heart pounding occurs at any time of the day and not associated with a particular activity. She presented to the ED a week ago for the same symptoms and was sent home after. She denies any chest pain, dizziness, loss of conciousness and vomiting during episodes. She admits to SOB, nauseas, and clammy skin during episodes. She states that she recently bought a condo and lost her job 2 months ago.
ROS
All negative except mentioned above
PMH : none
Past Surgical Hx: none
Allergies: nkda
Meds: none
SH: no smoking, no EtOH, no illiciti drug use, sexually active with one boyfriend only use condoms cons

.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]first occured five years ago, f, SOB during episodes, recently bought a condo and lost her job 2 months ago, denies chest pain, no illiciti drug use, nauseas during episodes, increased in frequency the past three weeks, recently increased in frequency, within the past three weeks occuring about 1-2 times a week, clammy, numbness in her fingers, 26 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 yo F presenting to clinic for follow up of ED visit for palpitations
- first began 5 years ago but only once in a while then increased in frequency, duration and severity 3 weeks ago
- 3 weeks ago occured 1-2 times per day, last 2 weeks has decreased to once every few days lasting 15-30 minutes
- associated with SOB, throat tightening, sense of worry, hot/cold, and decreased ability to concentrate afterwards as well as fatigue afterwards
PMH: none
NKDA
Meds: none
Hospial/Surgeries: none
FH: all healthy
SH: no tobacco, EtOH, recreational drugs. Sexually active with boyfriend, uses condoms, no history of stds, LMP 1.5 weeks ago.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]began 5 years ago, F, associated with SOB, palpitations, no recreational drugs, increased in frequency 3 weeks ago, associated with sense of worry, lasting 15-30 minutes, associated with throat tightening, hot, decreased ability to concentrate, fatigue, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 26 yo F presenting with c/o heart pounding, numbness, claminess and coldness in both hands. Symptoms started approx 5 yeras ago but was more prominent about 3 weeks ago. It last about 15-30mins. No particular events assoc to it. Freq has reduced from 1-2x/day to 1x/2 days. Nothing makes it better or worse. Pt c/o SOB, throat tightness and nauseas. Denies heat intolerance, changes in skin or hair. No fever/chilss/vomiting/diarrhea/constipation. No weight loss. NO drugs or coffee intake. No dysuria. No LOC
ROS: neg except for above
all/meds: none
PMH/Hosp: none/2 weeks ago to ER for palpitations
PSH: none
SH: None
Exercises, Regular diet, unemployed
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]started approx 5 yeras ago, F, NO coffee intake, NO drugs, more prominent about 3 weeks ago, last about 15-30mins, claminess, numbness in both hands, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 26 y/o female presenting with palpitations. She reports feelings of impending doom during these episodes. She first had these symptoms 5 years ago when she was in college, but would come on infrequently. Three weeks ago, she was having them 1-2x/day, and 2 weeks ago was having them every 1-2 days. She states the palpitations are associated with SOB, nausea, and tingling/numbness 1x. She denies dizziness, diarrhea, flushing, or headache. Patient states she lost her job 2 months ago, and that is her only recent stressor.

PMH/PSH/Meds/All: denies
SHx: unemployed, was a sales consultant. Lives alone with cat. Denies alcohol, drugs, tobacco.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]first had 5 years ago, female, associated with SOB, palpitations, palpitations, Denies drugs, associated nausea, would come on infrequently 2 weeks ago was having them every 1-2 days, would come on infrequently Three weeks ago, she was having them 1-2x/day, feelings of impending doom, associated with numbness, lost her job, stressor, unemployed, 26 y/o</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: Patient is a 26F here for ED followup for palpitations. 5 years ago in college, no specific context, felt heart pounding, associated w/ anxiety, SOB, throat tightness, rapid breathing, cold and clammy skin, lasts for 15-30min, followed by fatigue and difficulty concentrating. Were sporadic until 3 weeks ago, started every day, 2 weeks ago had associated finger numbness went do ED, negative CBC, electrolytes, cardiac enzymes, EKG. Patient denies chest pain, abdominal pain, fever/sweats, dizziness, changes to vision, sleep disturbances. No changes in weight, no menstrual disturbances, denies syncope. Recent social stressors, 3 mo ago bought condo, 2 mo ago lost job, currently unemployed. 
ROS as above. PMH none, PSH none, Meds none, NKDA, FHx none.
SHx: lives alone, feels safe, was sales consultant currently unemployed. Denies ever using tobacco, no alcohol or drugs. Walks few times a week, LMP one month ago..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]5 years ago, F, associated SOB, associated rapid breathing, palpitations, 2 weeks ago went do ED, negative CBC, electrolytes, cardiac enzymes, EKG, denies chest pain, Denies drugs, 3 weeks ago, started every day, lasts for 15-30min, associated throat tightness, clammy skin, finger numbness, fatigue, difficulty concentrating, stressors, 3 mo ago bought condo, 2 mo ago lost job, unemployed, unemployed, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Edie Whelan is a 26 year old female here for follow up for palpitations. She was seen in the ER 2 weeks ago for episodes of palpitations that have been occuring for 5 years but started increasing in frequency 2 weeks ago up to 1-2x day. They are less frequent now wiht only 1x every few days. She describes these episodes as lasting a few mintues with palpitations, SOB, throat tightening and with nausea and feeling hot then clammy after it subsides. She recently bought a condo 3 months ago then lost her job 2 months ago due to downsizing which has been a source of stress. She denies any recent illnesses, consitpation, diarrhea, headaches or other symptoms besides these episodes.
PMH: no medical diagnoses
meds: none
Allergies: NKA
FMH: family is ""healthy""
SH: lives alone in condo, has boyfriend with whom she is sexually active using condoms, denies smoking, drugs, or alcohol..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]occuring for 5 years, female, with SOB, episodes of palpitations, was seen in the ER 2 weeks ago for episodes of palpitations, denies drugs, with nausea, increasing in frequency 2 weeks, with throat tightening, feeling hot, clammy, bought a condo then lost her job, source of stress, 26 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: This is a 26 year old female presenting with palpitations. The palpitations has started 5 years ago but has been worsening during the last three weeks (2-3 episodes per week). The palpitations is associated with tingling in the 10 fingers and she also has shortness of breath and rapid breathing. During these episode she feelslike her heart might stop and she might die. The is also throat tightening after which she feels hot and then clammy. The patient does not have any trmor weight or appetite changes and does not drink caffiene. She has nausea but has not vomited. She has no change in bowel or urinary habits. No avoidance or agrophobia
ROS: negative other than what stated above
Medication: none
Surgeries: none
PMH: none
FH: none
Social: non smoker and does not drink. Sexually active with her boyfriend.
Allergies: none.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]started 5 years ago, female, does not drink caffiene, associated with shortness of breath, associated rapid breathing, palpitations, palpitations, worsening during the last three weeks, feelslike her heart might stop, feelslike she might die, associated throat tightening, feels hot, clammy, tingling in the fingers, 26 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 F presents for follow up for episodes of palpatations, shortness of breath, feeling clammy, nauseated, and feeling hot and cold. The patient first experienced this 5 yrs ago in college but hass gotten worse in the last 3 wks. The last episode was a day ago. The patient states that the episodes come on without warning and she has not linked certain events that bring it on. The patient purchaesd a condo 3 months ago and lost her job 2 months ago. She states that she doesnt believe it is associated with stress. The patients labs and workup in the ER 2wks ago was all WNL. The patient denies feeling depressed. 

PMhx none
Social no alcohol or drugs worked as a sales consultant and is looking for work 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]first experienced 5 yrs ago, first experienced this 5 yrs ago, F, 26 F, shortness of breath, presents for shortness of breath, episodes of palpatations, presents for episodes of palpatations, workup in the ER 2wks ago was all WNL, The patients labs and workup in the ER 2wks ago was all WNL, no drugs, nauseated, worse in the last 3 wks, hass gotten worse in the last 3 wks, feeling clammy, feeling hot, presents for feeling clammy, presents for feeling hot, purchaesd a condo 3 months ago and lost her job 2 months ago, 26, 26 F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 y/o F presents for 5 year history of intermittent palpitations, SOB, diaphoresis, and throat tightness at rest.  She visited the ER most recently 2 weeks ago for symptoms and was worked up for cardiac chest pain with normal ECG, troponins, BMP, and CBC. As of three weeks ago she is experiencing symptoms randomly at rest about 1-2 times daily with symptoms lasting 15-30 minutes and self resolving. patient states she moved to new condo 3 months ago and has no other stressors. No use of caffeine or other stimulants. Patient is not able to identify any actions that make symptoms better or worse. Symptoms not worse with exertion. Denies anxiety

ROS: denies chest pain, nausea, vomiting, fatigue, heat/cold intolerance, increased metabolism, depression, fatigue, or mood changes. 

Medical  hx, Surgical hx, allergies, family hx: none
Social history: unemployed, getting job as sales consultant. Lifelong non-user of alcohol and tobacco..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]5 year history, F, No use of caffeine, palpitations SOB, palpitations, visited the ER most recently 2 weeks ago for symptoms and was worked up for cardiac chest pain with normal ECG, troponins, BMP, and CBC, denies chest pain, symptoms lasting 15-30 minutes, palpitations throat tightness, moved to new condo 3 months ago, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 yo f presents with palpitations. Reports palpitations started 5 years ago, occured 1-3/month and then rarely, until 3 weeks ago when they occured 1-2x/day. 2 wks ago went to ED due to palpitations and numbness in fingers, had nl ECG, CBC, metabolic panel and cardiac enzymes. Presents today for followup. Feels the past 2 weeks the episodes have become less frequent (once every few days). Episodes last 15-30 mins and sxs include palpitations, SOB, ""feels hot,"" cold and clammy hands, throat tightness, ""feels like something bad is gonna happen."" Denies dizziness, lightheadedness, confusion, headaches, vision changes, weight changes, chest pain. No inciting factors. Does not avoid situations due to episodes. PMHx/Sx: none. Meds: none. Allergies: NKDA. Gyn: LMP 1mo ago, regular periods, G0. SH: no tobacco, EtOH, rec drug use. Sexually active with boyfriend, always uses condoms. FMH: none..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]started 5 years ago, f, Episodes include SOB, palpitations, palpitations, 2 wks ago went to ED due to palpitations and numbness in fingers, had nl ECG, CBC, metabolic panel and cardiac enzymes, Denies chest pain, no drug use, occured 1-3/month and then rarely, until 3 weeks ago when they occured 1-2x/day, Episodes include feels like something bad is gonna happen, Episodes last 15-30 mins, Episodes include throat tightness, feels hot, clammy, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26-year-old female, has come to the outpatient clinic for a follow-up visit for palpitations. Intermittent palpitations for 5 years, worsened over last 3 weeks with 2 episodes/day. Pt feels like something terrible is happening, like she is going to die, throat gets tight, +nausea, feels cold/clammy, +SOB. They last 15-30 minutes with no aggravating/alleviating factors. She gets tired and difficulty concentrating after the episodes. There is associated numbness of fingers. 
ROS: No chest pain, syncope, vomiting, fever/chills, dizziness/lightheadedness, abd. pain, heat or cold intolerance, appetite changes, weight gain or weight loss
Sexual hx: sexually active with boyfriend, uses protecton, G0P0
PMhx: none
Medications: none
Allergies: none
Family hx: noncontributory
Social history: Lost job 2 months ago in sales and recently bought condo, which has been stressful. No alcohol, tobacco or drugs. Has good family support..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]palpitations for 5 years, female, palpitations, No chest pain, No drugs, worsened over last 3 weeks, associated numbness of fingers, gets tired after the episodes, difficulty concentrating after the episodes, Lost job 2 months ago, recently bought condo, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Edie Whelan, a 26-year-old female, has come to the outpatient clinic for a follow-up visit for palpitations. Patient reports that since she bought a home 3 months ago, then lost her job 2 months ago that she has been having episodes of heart pounding, SOB, throat tightness, feeling hot, nausea, and fingers going numb. She denies her fingers changing color, loss of concioussness. Not feeling depressed or lack of interest in things. She denies heat or cold intolerance, weight loss, and skin changes. She does not drink, smoke or use recreational drugs. Last menstrual period was last week. Sexually active with boyfriend and use condoms. No PMH or surgeries. No FH and no meds..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, episodes of SOB, palpitations, does not use recreational drugs, episodes of nausea, episodes of throat tightness, feeling hot, fingers going numb, bought a home 3 months ago, then lost her job 2 months ago, 26-year-old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 years old female comes for check of palpitations, she has had this for 5 years, and its getting worse in the past 3 wks, she has it 2-3 times a day each time lasts for 15-30 minuties accompanied with feeling of warmth, shortness of breath, sweating, and numbness, she does not reacall any triggiring events, no alleviating or aggravating factores, 
she states that she lost her job recently, in a lot of stress latley. 
medication: none
allergy NKDA 
g0p!: lmp 2 weeks ago, regular, no contraceptives, condoms use regulary
PMH: healthy
PSh: no surgeries
PF: none
SH: no alcohol no drinking, no recreatioanl drug use, sexually active with her boyfried for the pas t 1 year.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]for 5 years, getting worse in the past 3 wks, female, accompanied with shortness of breath, palpitations, no recreatioanl drug use, lasts for 15-30 minuties, feeling of warmth, lost her job recently, lot of stress, 26 years old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Whelan is a 26 year old female who presents to clinic complaining of heart palpitations. The y first started about 5 years ago but have gotten worse in the last 3 weeks. She went to the ER 2 weeks ago and is here as a follow up. At that time she also complained of a feeling of numbness in her fingers. She denies ever pasing out due to the palpitations. When the palpitations occur, she feels hot and clammy, and also experiences some shorntess of breath. She also feels nauseous. During these episodes she feels an impending sense of doom, and is worried that her heart might stop. She has not identified a trigger.
PMH: noncontributory; no surgeries
Medications: none; Allergies: NKDA
FH: noncontributory. everyone is healthy.
SH: Denies EtOH use. Denies tobacco or recreational drug use. Sexually active oinly with boyfriend and uses condoms. She has currently been unemployed for 2 months.
ROS: Negative except as noted in HPI.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]started 5 years ago, Ms, female, experiences shorntess of breath, palpitations, palpitations, palpitations, recreational drug use Denies, feels nauseous, worse in the last 3 weeks, feels an impending sense of doom, worried her heart might stop, feels hot, feels clammy, numbness in her fingers, unemployed, 26 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Whelan is a 26 yo F complaining of palpitations. She reports episodes of palpitations for past five years, however, recently they have increased in frequency without clear trigger. During an episode she reports feeling shortness of breath, nausea, feeling overheated and then clammy and cold, and sometimes a sense that she might die. These episodes are unpleasant and have caused her quite a bit of distress. She visited ED two weeks ago for such an episode where she also experienced hand numbness. At that time cardiac enzymes, ECG, CBC and metabolic panel were normal, but Ms. Whalen reports she was no longer feeling her symptoms when they performed the ECG.
No pyschiatric or thyroid history. No chest pain. No headche, weakness, numbness, heat intolerance, skin/hair changes.
PMH/PSH: none
Meds: none
Allergies: NKDA
FMHx: no history of palpitations
Social: minimal alcohol usage, no smoking/drugs, under stress due to unemployment.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]for past five years, F, During an episode she reports feeling shortness of breath, palpitations, palpitations, visited ED two weeks ago for such an episode cardiac enzymes, ECG, CBC and metabolic panel were normal, No chest pain, no drugs, During an episode she reports feeling nausea, recently they have increased in frequency, During an episode she reports feeling a sense that she might die, feeling overheated, feeling clammy, hand numbness, under stress, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 yo F, f/u after ED visit for heart pounding
- over past 5 years, has had intermittment epidoes where she ""feels like something bad is going to happen""; during these epidoes, she feels like her heart is pounding out of her chest; she halso has associated shortness of breath, nausea, and feeling like her throat is tightening
- over the last 3 weeks, epidoes are more freuqent, ocurring once or twice/day
-2 weeks ago, an episode was associated w/ numbness in her fingers; she went to the ED after this episode, where she was found to have a normal CBC, CMP, cardiac enzymes, & EKG
- worried about something being wrong; no triggers, not associated with time of day, epidoes occur ""out of the blue""
- more stressed than usual lately; bought a condo, but then lost her job; has support system and coping with reading/relaxing
ROS: no fevers, chest pain, vomiting, heat intolerance, weight loss
PMH/PSH/FH: none, SH: no alcohol/drugs; No meds.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]over past 5 years, F, associated shortness of breath, heart is pounding out of her chest, 2 weeks ago went to the ED found to have a normal CBC, CMP, cardiac enzymes, & EKG, no chest pain, no drugs, associated nausea, over the last 3 weeks, epidoes are more freuqent, feels like something bad is going to happen, worried about something being wrong, associated feeling like her throat is tightening, numbness in her fingers, stressed, bought a condo, but then lost her job, 26 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 26yo f presenting for 2 week follow up following ER visit for palpitations. Labs drawn at ER visit were shown to be within normal limits. Her first occurrence of palpitations was 3 weeks ago and seemed to come on suddenly with no known trigger. Palpitations were first occurring once every few days but now occur more often. Palpitations last for about 15-30 minutes and resolve on their own. She has been under stress due to losing her job but is not overly anxious or worried. During episodes, she feels short of breath, nauseous, and skin feels clammy. She denies any excessive diaphoresis, weight loss, constipation, diarrhea, or chest pain. She has had no recent sickness or sick contacts. 

PMH - none
PSH - none
MEds - none
NKDA
FH - none
SH - no tobacco, illicit drug use, EtOH; well-balanced diet and exercises regularly; sexually active and uses condoms; does not drink caffeine.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]f, does not drink caffeine, feels short of breath, occurrence of palpitations, 2 week follow up ER visit Labs were within normal limits, denies chest pain, no illicit drug use, feels nauseous, first occurring once every few days but now occur more often, last 15-30 minutes, feels clammy, under stress, losing her job, 26yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Whelan is a 26 y/o F who presents for a follow up visit after going to the Emergency department with severe palpitations. She reports that she feels her heart is racing and her fingers go numb. These episodes have occured for several years but have become worse within the past few weeks. She has a feeling of doom. She has SOB and a feeling of a ""lump in her throat"", and she feels clammy and has nausea when the episodes happen. No pain. Not sure what brings these episodes on. So has no recent illness, fever, no weight loss, no changes to appetite, no travel, no genitourinary problems. Her cardiac tests and electrolytes came back normal from her visit at the emergency department.

Med Hx: none
surg hx: None
Medications: none
NKDA
Family Hx: None
Social: never drank, smoked, or did illicit drugs. She is sexually active with her boyfriend. 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Ms, 26 y/o, F, SOB when the episodes happen, palpitations, heart is racing, follow up visit to the Emergency department cardiac tests and electrolytes came back normal, never did illicit drugs, nausea when the episodes happen, worse within the past few weeks, feeling of doom, lump in throat when the episodes happen, clammy, fingers go numb</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 yo F at clinic for followup visit for palpitaion since her last visit to the ED 2 weeks ago. She had palpitaion or pounding and finger numbness 3 weeks ago and came to ED 2 weeks ago. A/w cold and clamy fingers, SOB, feels like throat closing up and feels like she is dying . All of this came suddenly. she is under a lot of stress as she bought a condo and then  lost her job 2  months ago. Hx similar episode 5 years ago. she says she is feeling more tired and has  decreased concentration as well. denies dizziness, Cp, HA, caffine intake, bowel or bladder changes, menstrural changes 
ROS neg except as above 
PMH none meds none 
PSH none hosp none 
FH NC
SH was a sales consultant, lives alone, denies toxic habits, sexually active with BF and uses protection and no stds, LMP was 1.5 weeks ago and it regular and 4-5 day flow..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]similar episode 5 years ago, F, denies caffine intake, A/w SOB, palpitaion, palpitaion, denies Cp, A/w feels like she is dying, A/w feels like throat closing up, A/w clamy fingers, finger numbness, decreased concentration, feeling more tired, under a lot of stress, bought a condo and then  lost her job 2  months ago, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 yo female w/ unremarkable PMHx c/o heart palpitations over the last 3 weeks associated with SOB, throat tightness, tingling in hands and fingers. Symptoms occur at rest and with activity. Denies inciting or alleviating factor. Seen in ED 2 weeks ago. Work up including EKG negative. denies changes to hairs, eyes, skin or shins. Had prior episode 5 years ago. + life stress, lost job several months after buying condo. Takes no medications. Denies si/hi, reports good support network of friends and family.  Denies EtOH, Caffiene, recreational drugs or smoking..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]prior episode 5 years ago, female, Denies Caffiene, associated with SOB, palpitations, Seen in ED 2 weeks ago. Work up including EKG negative, Denies recreational drugs, associated with throat tightness, associated with tingling in hands and fingers, + life stress, lost job several months after buying condo, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 26 year old female with no significant past medical history who presents today for follow up after visiting the emergency department 2 weeks ago for palpitations. She states that she has experienced unpredictable episodes of palpitations associated with clammy skin, nausea, dyspnea, and a sense of impending doom over the past 5 years. However, the attacks have become more frequent and concerning in the last 3 weeks. The episodes last for 15-30 minutes. She notes nothing that consistently brings the episodes on or relieves them. She states that she is asymptomatic outside of episodes. She denies drug use, smoking, and alcohol consumption..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]over the past 5 years, female, associated dyspnea, palpitations, palpitations, denies drug use, associated nausea, more frequent in the last 3 weeks, sense of impending doom, last for 15-30 minutes, clammy, 26 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: pt is a 26 yo f with no significant pmh that present with 3 week heart palpitation. 2 week ago she went to the ER and they recommended she come see doctor. nothing make better, nothing make  worst. tried nothing for it. no specific situation induce the heart palpitation. sh experience somethign similar 5y ago when in college. recently bought condo and lost job.
positive symptom: shortness of breath, cold, clamy, nausea, heart race and she feel like she going to die, also report havign tingling in fingers
negative symptom: no weight loss, no history of depression or anxiety, no chest pain, no fever, no agoraphobia, no sleep change, 
ROS: as per above 
A: none 
PMH: none 
PSH: none 
FH: non contributory 
SH: unemployed (sale consultant in past), no smoking, no drinking, no illegeal drug. no cahnge in diet 
menstrual:30d, 4-5d , normal flow, 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]somethign similar 5y ago, f, positive symptom: shortness of breath, palpitation, palpitation, heart race, no chest pain, no illegeal drug, positive symptom: nausea, feel like she going to die, positive symptom: clamy, tingling in fingers, unemployed, recently bought condo and lost job, 26 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26F with no PMH presents for follow-up of palpitations. Since 5 yrs ago, pt has had episodes of palpitations, SOB, throat tightness, nausea, and feeling hot then cold+clammy, which have increased in frequency recently to 1-2x per day. 2 weeks ago, in addition she experienced numbness of her fingers but denies any color changes at the time; she was seen in the ED and found to have normal CBC, BMP, cardiac enzymes, and ECG at the time. Episodes typically last 15-30mins. No alleviating or exacerbating factors. Reports that she bought a condo 3 months ago but lost her job 2 months ago. Reports good support system with friends and family. Denies weight loss, fever, changes in bowel movements.
ROS: negative other than HPI
PMH/PSH: none
Meds and allergies: none
FH: healthy
SH: worked as sales consultant but currently unemployed, no smoking/alcohol/drugs, healthy diet and exercise, lives alone
Sexually active with boyfriend, - STD and HIV.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Since 5 yrs ago, F, episodes of SOB, palpitations, 2 weeks ago seen in the ED and found to have normal CBC, BMP, cardiac enzymes, and ECG, no drugs, episodes of nausea, increased in frequency recently, increased in frequency 2 weeks ago, last 15-30mins, episodes of throat tightness, feeling hot, feeling clammy, numbness of her fingers, bought a condo but lost her job, unemployed, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Whealon is a 26yo F with no PMH who presents today with complaints of intermittent palpitations for last 5 weeks, worse over the last 3 weeks. Reports increase in frequency of palpitations to the point that her fingers went numb 2 weeks ago. Episodes last 15-30 minutes and are associated with SOB, throat swelling, and nausea. Also reports feeling cold and clammy during episodes. She denies recent illness, fevers/chills, or vomitting/diarrhea. No hair loss, weight loss, or appetite changes. She reports recently losing her job after a recent housing purchase that has led to increased stress and anxiety.
Of note, ED workup from 2 weeks ago revealed a normal CBC, metabolic panel, cardiac enzyme level, and ECG.

ROS negative otherwise.
PMH: None
PSH: None
Allergie: None
Medications: None
FH: None
SH: Denies smoking, etoh use, drug use. Sexually active with boyfriend, uses condoms.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Ms, F, associated with SOB, palpitations, palpitations, ED workup from 2 weeks ago revealed a normal CBC, metabolic panel, cardiac enzyme level, and ECG, Denies drug use, associated with nausea, worse over the last 3 weeks, over the last 3 weeks increase in frequency, last 15-30 minutes, associated with throat swelling, clammy, fingers went numb, recently losing her job after a recent housing purchase, increased stress, increased anxiety, 26yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 yo f with presents with palpitations that started 5 years ago. they used to occur rarely but now occur 1-2 times per day. Associated with feeling clammy, hot throat tightening, SOB and nausea. No LOC. She ""feels like something bad is going to happen."" She has not noticed a pattern or any precipitating events. No weight loss, diarrhea, or flushing. used to work as a sales consultant but lost her job shortly after buying a condo. She is under significant stress. ECG at Ed was normal, but she is not sure if this was done when she was having an episdode of palpitations.
PMH none, Meds - none. allergies - none. FH - none.
SH - no smoking, alochol, drugs. Sexually active with her boyfriend, uses condom regularly. feels safe with him. LMP 1 week ago..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]started 5 years ago, f, Associated with SOB, palpitations, palpitations, no drugs, Associated with nausea, Associated with feels like something bad is going to happen, Associated with throat tightening, clammy, feeling hot, under significant stress, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is Edie whelan a 26 year old female with no significant PMH presenting for a follow up from an ER visit 2 weeks ago from ""heart racing"". She describes the pain as being like a pounding feeling in which she hasnt really felt it in the past. She gets it every few days since 2 weeks ago and comes and goes and each episode last about 15-30minutes. She also states she feels nauseas, SOB cold and calmy with this episodes. She hasnt noticed if anything worsens it but usually tries to make it go away by sitting but there is no specific factor bringing it on. She has no pain and no pain anywhere else. 
ROS-negative except above 
PMH - no current med condition
PSH-no surgies
Meds-none
immunizations-UTD
Fx-mom(54) and healthy
dad(53) and healthy
Sx - works as a sales consultant in retail. she lives alone. she recently bought a condo 3 months ago but lost her job which has been very stressful on her life and is worried..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, she feels SOB, presenting for a follow up from an ER visit 2 weeks ago from ""heart racing"", no pain anywhere else, she feels nauseas, last about 15-30minutes, she feels cold and calmy, she recently bought a condo 3 months ago but lost her job which has been very stressful, 26 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 26 yo female who presents to clinic for follow up of heart palpitations. These occur as episodes and are not constant and the symptoms first started 5 years ago but in the last three weeks have increased in severity. She now also gets short of breath, nauseous, feels like her throat is tightening, feels cold and clammy during these episodes. She is not able to attribute this to any triggers, no aggravating nor relieving factors. She was recently seen in the ED 2 weeks ago for the same symptoms and her work up of CBC, metabolic panel, EKG, and cardiac enzymes was all within normal limits. Continues to have symptoms

ROS: Denies headache, chest pain, dizziness, problems with sleep, no feelings of sadness or anxiety.
PMHx: none
Medications: none
Allergies: none
PSH: none
FM: healthy parents, no siblings
SH: Lives with self, no pets. No smoking, no illicit drug use, sexually active with boyfriend and uses condoms every time.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]started 5 years ago, female, also gets short of breath, palpitations, recently in the ED work up was normal, in the ED 2 weeks ago work up was normal, recently in the ED CBC, metabolic panel, EKG, and cardiac enzymes normal, in the ED 2 weeks ago CBC, metabolic panel, EKG, and cardiac enzymes normal, Denies chest pain, no illicit drug use, also gets nauseous, last three weeks have increased, also feels throat is tightening, feels clammy, 26 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: A 26 Y./O F COME TO THE CLINIC C/O OF PALPITATIONS. FIRST TIME WAS 5 YEARS AGO, BUT SINCE 3 WEEKS AGO  STARTED AGAIN PALPITATIONS EOPISODES LIKE TWICE PER DAY, LASTING 15 TO 30 MIN ASSOCIATES WITH NUMBNESS OF FINGERS, NAUSEA, NARROWING OF THE  THROAT, FATIGUE AND LAST OF CONCENTRATION. 
ROS NEG EXCEPT AS ABOVE
PMH NONE
PSH NONE
ALL NKDA
MEDS NONE
FH NONE
SH ETOH OCASIONALLY, NO SMOKING, NO ILLICIT DRUGS, SEXUALLY ACTIVE W BOYFRIEND, CONDOM USE, NO HX OF STD'S, LMP 1 WEEK AGO, LAST PAP SEMAR 6 MONTH AGO, NORMAL.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]FIRST TIME WAS 5 YEARS AGO, F, PALPITATIONS, PALPITATIONS, NO ILLICIT DRUGS, ASSOCIATES WITH NAUSEA, LASTING 15 TO 30 MIN, ASSOCIATES WITH NARROWING OF THE  THROAT, ASSOCIATES WITH NUMBNESS OF FINGERS, FATIGUE, LAST OF CONCENTRATION, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Whelan is a 26yo female coming for follow-up regarding episodes of heart palpitations. She has had episodes for 5 years, but they have recently become more frequent the past 3 weeks. These episodes are brief and associated symptoms include feeling of doom, heart racing and pounding, SOB, throat tightness, nausea. She recently visited the ER two weeks ago for these symptoms in addition to numbness of her finger in both hands, but workup at that time including CBC, metabolic panel, cardiac enzymes, and ECG were unremarkable. 
ROS: She denies depressive symptoms, feeling anxious, excessive worrying, history of trauma, nightmares, hallucination, delusions. No syncope is mentioned.

PMH: unremarkable; Meds: none; Allergies: none
FH: unremarkable
SH: unemployed for 2 mo previously in retail, no alcohol, nonsmoker, no ilicit drugs
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]has had for 5 years, Ms, female, associated SOB, palpitations, heart racing, visited the ER two weeks ago workup were unremarkable, recently visited the ER workup were unremarkable, visited the ER two weeks ago CBC, metabolic panel, cardiac enzymes, and ECG were unremarkable, recently visited the ER CBC, metabolic panel, cardiac enzymes, and ECG were unremarkable, no ilicit drugs, associated nausea, more frequent the past 3 weeks, feeling of doom, associated throat tightness, numbness of finger, numbness of hands, unemployed, 26yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 year old woman with 3 week hx of racing heart. It has happened infreqwuently over 5 year and worseing over the last 3 weeks. She also has SoB with the racing heart as well as nausea and one episode of numbness in her hands. She went to the ER 2 weeks ago due to the numbness with regular ECG, CBC, metabolic panel. She has felt clammy recnetly. Episodes occur 1-2 times daily over the last 3 weeks, nothing makes them better or worse.
ROS: No recent illness, no Chest pain, no change in bowel movements, no weakness or tingling
PMH: none
No allergy
no meds
SH: lives alone, looking for work and feeling very stress, no smoke or drugs or etoh.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]over 5 year, woman, SoB with the racing heart, racing heart, no Chest pain, no drugs, with the racing heart nausea, worseing over the last 3 weeks, clammy, numbness in her hands, feeling very stress, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 26yo F with 5 years of episodic palpitations increasing in frequency over the last 3 weeks. Episodes last 15-30 minutes, no alleviating or aggravating factors, characterized by SOB, nausea, sensation of cold/clamminess, throat tightening. Sense of tiredness with difficulty concentrating after. Over the last 3 weeks have occurred 1-2  times/day. Went to ED during episode with finger numbness two weeks ago. Denies loss of consciousness, headaches, blurry vision, chest pain, extremity pain, changes in bowel or bladder function, intolerance to temperatures, weight changes, tremor. Reports some recent stress losing job, describes mood as good, no problems with sleep. Denies history of trauma/abuse.
PMH: none. LMP 2 weeks ago, regular cycle. No meds, no allergies. FH: none. SH: unemployed, lives alone, good support. Denies alcohol, tobacco, other recreational drugs..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]5 years of, F, characterized by SOB, palpitations, Denies chest pain, characterized by nausea, increasing in frequency over the last 3 weeks, last 15-30 minutes, characterized by throat tightening, sensation of clamminess, finger numbness, tiredness, difficulty concentrating, recent stress, losing job, unemployed, 26yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 26 year oild female with no PMH who presents with a 5 year history of episodes of palpitations which have recently occurred more frequently in the past 3 weeks. FOr the past thre weeks she has had palpitations which occur every couple of days to 2x a day. Patient says that the episode lasts about 15 to 30 minutes, and is associated with feeling hot then cold and clammy. SHe also feels nauseous, SOB, and feels like her throat his tightenig up. During these episodes she has fear taht something bad is going to happen. Patient has no psychiatric history and denies social anxiety and fear of being in crowded or big spaces. 

PMH: none 
Surgical history: none 
Allergies: none 
Sexual history: sexually activy with boyfriend and uses protection 
Social: denies alcohol, drug, or tabacco use; currently unemployed, looking for work, lives in condo in the city 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]with a 5 year history, female, associated with SOB, palpitations, palpitations, drug denies, associated with nauseous, recently occurred more frequently in the past 3 weeks, During these episodes she has fear taht something bad is going to happen, lasts about 15 to 30 minutes, associated with feels like her throat his tightenig up, feeling hot, clammy, 26</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 y/o male with ches pain. Pt woke up yesterday morning with pain in right upper chest, described as sharp, stabbing, constant. Pain is 5/10 but can be 8/10 with deep inspiration or with movement. Pt tried tylenol (4x yesterday) and albuterol but no relief Pt also recently had running nose, feeling febrile, and diffuse muscle pain prior to symptom onset that is resolving. Pt denies headaches, swelling in neck, SOB, abd pain, nausea vominting. 
ROS: negative except as above
PMH: asthma
Meds: albutero, tylenol
Surg: none
Fam: father asthma, HTN
Soc: works as carpenters assistant (denies dust exposure), no smoing, occasional marjuana (last use over week before symptoms), occasional EtOh 1-2 beers 1-2x monthy, sexually active with girlfriend and consistent condom use
All: NKDA.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]feeling febrile, male, 17 y/o, recently had running nose, 8/10 with deep inspiration, asthma, ches pain, woke up yesterday morning with pain, denies SOB, albuterol no relief, sharp, stabbing, 8/10</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 y/o M comes to the clinic for chest pain that is sudden in onset and present on the left side since yesterday morning. It is sharp pain that is 4/10 on rest and increases to 7-8/10 on deep breathing and movement. It is localized to the upper left chest. Tylenol and albuterol inhaler do not help. No relieving factors. There is no precipitating factor or trauma. He has felt warm and had nasal congestion since 3-4 days. He denies sore throat or cough/palpitation.
ROS-negative except above
PMH- excercise induced asthma
PSH/allergy-none
Med- tylenol and albuterol inhaler. last used inhaler 6 mo ago.
FH- father has HLD and asthma. 
SH-occasional drinker. no smoking tobacco. smokes weed occasionally. Student. sexually active with GF and uses condoms regularly. monogamous..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]felt warm, M, 17 y/o, nasal congestion since 3-4 days, increases to 7-8/10 on deep breathing, excercise induced asthma, chest pain, since yesterday, albuterol inhaler do not help, sharp, 7-8/10</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: chest pain
HPI: 17 yo male with history of exercise-induced asthma treated with albuterol here today with 1 day history of sharp chest pain. Never had this pain before. Pain worse with inspiration. Has taken Tylenol and used inhaler without alleviation. Had 5 days of nasal congestion, subjective fever, and muscle aches prior to chest pain. No cough or headache, no eye or ear drainage, no loss of appetite. 
ROS: Negative except as above
PMH: exercised induced asthma
PSH:none
Meds: albuterol inhaler, tylenol Q4H PRN
Allergies: none
FH: father with asthma and hypercholesterolemia, mother A&W, grandfather with MI 2 years ago
SH: drinks beer at parties, CAGE 0/4, no tobacco, no drugs, sexually active with girlfriend and uses condoms, avid rock climber.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]subjective fever, male, 17 yo, nasal congestion, worse with inspiration, exercise-induced asthma, exercised induced asthma, chest pain, 1 day history, rock climber, used inhaler without alleviation, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 17 yo male hx of exercise asthma on inhaler w 1 day history of ""chest pain."" He was in his usual state of health until yesterday morning when he noticed an abrupt presentation of chest pain on his left side. He said while it is present at rest, it worses with breathing and gets severe, but unable to rate it on a 1-10 scale. He says motion makes it worse. Does not radiate anywhere. He has tried Tylenol and his inhaler, but those have not helped him. He says he has never had something like this happen before. No falls/trauma, LOC 

Of note, he went rock climbing 3 days ago; also endorses stuffy nose, muscle aches, and ""warmth"" for the last 3 days. Denies headache cough, SOB, palpitations, reflux, abdominal pain, nausea, diaphoresis. PMH/PSH non contributory. FH + heart attack grandfather. No medications/allergies. 1 female sexual partner for the past year. Non smoker, social-drinker, no IVDU. Concerned about rock climbing..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]male, 17 yo, stuffy nose, worses with breathing, exercise asthma, chest pain, 1 day history, yesterday, Denies SOB, rock climbing 3 days ago, rock climbing, inhaler have not helped</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17M with a hx of exercise induced asthma who presents with chest pain. Patient is unaccompanied by mother.

- Chest pain is substernal, sharp without radiation. pain is worse with deep breaths. pain staryed yesterday morning and is constant and worsening. Tylenol and albuterol has not helped the pain. First time having this type of pain. Does not feel like asthma attack
- 3-4d ago, had fever (? Tm), runny nose, muscle aches. Sx have improved. No sick contacts. No cough. No sore throat. No nausea, vomiting, leg swelling, no SOB with exercion, no smoking at home, no feelins of anxiety. No ear tugging;  mood is ""good""
- Feel safe at home
- No surgery
- no tobacco; social drinker; social MJ user; 
- No sig fam hx
- Up 2 date on immunization
- No recent travel hx.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]fever, M, 17, 3-4d ago runny nose, pain is worse with deep breaths, exercise induced asthma, chest pain, Chest pain, staryed yesterday, no SOB, albuterol has not helped, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 YO M, WITH VERBAL CONSENT FROM MOTHER, C/O CHEST PAIN x 1 DAY. THE PAIN IS ON THE LEFT SIDE OF CHEST, WAS SUDDEN, CONTINOUS, 5/10 AT REST AND 8/10 INTENSITY WITH RESPIRATION, WORSENS WITH MOVEMENT. PT ALSO REPORTS LOCAL TENDERNESS ON LEFT SIDE OF CHEST THAT INCREASES ON PALPATION. PT DENIES SOB, SWEATING, ILL CONTACTS, PND, ORTHOPNEA, TRAVEL, TRAUMA AND RASH.
ROS -VE EXCEPT AS ABOVE.
PMH- EXERCISE INDUCED ASTHMA ON ALBUTEROL
ALLERGY- NKDA
FH-N/C
SSH- SEXUALLY ACTIVE WITH GIRL FRIEND x 6 MONTHS AND USES PROTECTION, ETOH-NO ALCOHOL USE, DRUGS-WEED x 1 WEEK AGO, OCCUPATION -STUDENT AND CARPENTER PRT TIME
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]M, 17 YO, 8/10 INTENSITY WITH RESPIRATION, EXERCISE INDUCED ASTHMA, CHEST PAIN, PAIN CHEST, x 1 DAY, DENIES SOB, 8/10</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Smith is a 17 year old male who presents to clinic with chest pain. Pain is in left upper chest, non-radiating, sharp, 5/10 at rest, 9/10 with deep breathing or movement. Started yesterday, is constant, no change, not relieved with Tylenol or Albuterol inhaler. Reports 3-4 days ago flu symtpoms of rhinorhea, muscle aches, fever. Denies nausea, vomiting, abdominal pain, constipation, diarrhea, headache, cough, swollen lymph nodes.
Medication: albuterol PRN for exercise induced Asthma, and tylenol; Allergies - no
PSH: no, Family history: Father asthma, high cholesterol, grandfather MI - alive
Social: Senior in high-school, lives with parents, things are ""okay"" at home. Sexually active with girlfriend, always use condoms. Denies tobacco and ilicit drugs, occasional beer.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]fever, male, 17 year old, 3-4 days ago rhinorhea, Pain 9/10 with deep breathing, exercise induced Asthma, chest pain, Started yesterday, not relieved with Albuterol inhaler, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo M comes to the clinic with mothers verbal consent for a history, physical examination, and treatment, c/o chest pain. Patient refers pain occurs everytime he takes a deep breath. This started yesterday morning, it has been constant, located in the upper Lt chest. He has used tylenol, and his albuterol inhaler with no significant relief. Deep breathing and movement make pain worse. Since started pain has been the same, he recalls no precipitating event, and this has never happened before. Patient adds feeling warm, muscle aches, and stuffy nose, for which he has been feeling better recently. Patient has an active excercise regimen where he goes rock climbing for 2-3 x a week.
ROS: neg exc as above
PMH: ASthma excercise induced
ALL: NKDA MEds: ALbuterol inhaler
Hosp/surg: no FH: Father with asthma
Social: student and carpenter/ no excess alcohol, smoke marijuana ocasionally.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]feeling warm, M, 17 yo, stuffy nose, Deep breathing make pain worse, ASthma excercise induced, chest pain, started yesterday, rock climbing, used albuterol inhaler with no significant relief</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Smith is a 17 y.o M who presents with sudden onset L-sided chest pain. Three days ago he had a stuffy nose, fever, and muscle aches. Yesterday he woke up with severe pain on inspiration. He describes it as a constant pain that worsens with inspiration and movement. He has been taking tylenol for the pain but it has not helped much. He denies abodminal pain, SOB, changes in bowel habits. He endorses muscle aches. 
PMH: exercise induced asthma
Meds: albuterol 1-2x/week
Surg: none
Allergies: NKDA
FHx: Dad with asthma and high cholesterol, grandfather with MI
SoHx: sexually active with girlfriend, uses condoms consistently, never smoker, occasional beer at parties, has tried weed a couple times, no other illicit drug use, works as a carpenter and uses protective gear.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]fever, M, 17 y.o, Three days ago stuffy nose, severe pain on inspiration, worsens with inspiration, exercise induced asthma, chest pain, Yesterday, denies SOB</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: KANE SMITH IS A 17 Y/O M WITH PMH OF EXERCISE-INDUCED ASTHMA WHO PRESENTS WITH 1 DAY OF CHEST PAIN TO HIS UPPER RIGHT CHEST. HE DESCRIBES THE PAIN AS SHARP AND STABBING. IT IS NONRADIATING AND WORSE WITH BREATHING AND MOVEMENT. HE TRIED TAKING TYLENOL AND ALBUTEROL INHALER BUT HIS PAIN PERSISTED. IT IS CONSTANT AND HE RATES IT AS 5/10 AT REST AND 8/10 WITH MOVEMENT OR COUGH. HE ALSO COMPLAINS OF NASAL CONGESTION AND MUSCLE ACHES THAT STARTED A FEW DAYS PRIOR AND HE FEELS WARM BUT DID NOT MEASURE A TEMPERATURE. HE DENIES CHILLS, NIGHT SWEATS, APPETITE CHANGE, WEIGHT CHANGE, PALPITATIONS, ORTHOPNEA, COUGH, SOB, WHEEZING, RASH, SKIN LESION. HE DENIES ANY RECENT TRAUMA OR INJURY TO THE CHEST.
ROS: PER HPI, ALL OTHERS NEGATIVE
PMH: EXERCISE-INDUCED ASTHMA, LAST EXPERIENCED SYMPTOMS 6 MONTHS AGO
MEDS: ALBUTEROL, TYLENOL
ALLERGIES: NONE
PSH: NONE
FH: MI IN GRANDFATHER, FATHER HAS ASTHMA AND HLD
SH: NONSMOKER, 1-2 DRINKS/MONTH. 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]FEELS WARM, M, 17 Y/O, NASAL CONGESTION, WORSE WITH BREATHING, EXERCISE-INDUCED ASTHMA, EXERCISE-INDUCED ASTHMA, CHEST PAIN, 1 DAY, DENIES SOB, TRIED ALBUTEROL BUT HIS PAIN PERSISTED, SHARP, STABBING, 8/10</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo m comes to the office complaining of sharp L constant chest pain that worsenes with deep breaths. Pt had a stuffy nose and muscle aches 3-4 days ago but feels better. Tylenol and albuterol have not relieved his symptoms. Pt denies previous chest pain an dill contacts. Denies cough, rash, changes in urine or bowel habits, nausea/vomit, fevers and weigth/appetite changes.
ROS: - except as above
PMHx: exercise induced asthma
Allergies: none
meds: tylenol and albuterol (does not need it as much anymore)
hospitalizations: none
vaccines: unsure
FH: father has asthma and high cholesterol; grandfather had an MI
SH: senior at high school, lives with mom and dad and get along well, gets good grades in school, does rock climbing (last time 3 days ago), occasionally drinks alcohol, has tried weed at parteis (last use: weekend), no smoking, sexually active with girlfrined and uses protection..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]m, 17 yo, stuffy nose, exercise induced asthma, chest pain, rock climbing, albuterol have not relieved his symptoms, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Kane Smith is a pleasant 17 yo M with PMHx exercise-induced asthma presenting with 1 day history of acute onset CP. Pt states yesterday in the morning he woke up with CP over his left pectoralis muscle. The pain is constant, stabbing in nature and not alleviated by tylenol or albuterol. Deep breathing, movement make this pain worse. Assocaited symptoms include stuffy nose and muscle aches diffusely. Of note, pt rock climbs and climbed 3 days ago.
PMHx: as above
PSHx: None
Rx: Albuterol prn, tylenol q4 hours PO prn for pain
Allergies: NKDA
FHx: Father: asthma HLD
Mother: healthy, brother, healthy
Social Hx: senior in high school, carpentry assistant for side work, denies Tobacco, endorses occasional drinking and marijuana use.
ROS: Endorses pleuritic CP, denies SOB, Nausea, vomiting, diarrhea, constipation, diaphoresis
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]M, 17 yo, Assocaited symptoms include stuffy nose, Deep breathing make this pain worse, pleuritic, exercise-induced asthma, CP, CP, CP, 1 day history, denies SOB, rock climbs and climbed 3 days ago, not alleviated by albuterol, stabbing</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17y/o male c/o chest pain
he woke up with the chest pain yesterday monining, it is a sharp pain that is every time when he brathes in. denies trauma. no radiation of pain. Took tylonol several times, helped a little. 
(-) sick contacts, cough. 
(+) muscle aches, 
NKDA. Exercise induced-asthma. Takes albuterol inhaler . 
Father: asthma, high cholesterol, Mother: no known diseases. 
Climber, lives with parents and sister and brother. 
(-) smoking. drinks beers on parties. 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]male, 17y/o, Exercise induced-asthma, chest pain, chest pain, yesterday, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Smith is a 17 yo M here with chest pain. He woke up yesterday with sharp chest pain localized over the L side of his chest. The pain is associated with breathing and does not radiate. He rates it as 5/10 with spikes to 8-9/10 when he takes a big breath or moves around. The pain is relatively constant. He tried tylenol and his albuterol inhaler but those did not help. He has also been experiencing ""stuffy nose"" and muscle aches and is feeling ""hot"". He is not sure if he had a flu shot this year. 
ROS: no headache, sore throat, palpitations, SOB, nausea/vomiting, diarrhea/constipation, no dysuria/increased frequency. no rashes.
MedHx: exercise induced asthma, on PRN albuterol (last inhaler use 6 mo ago)
rx: PRN albuturol, PRN tylenol
allergies: NKDA
surg: none
Fam: dad has asthma, mom healthy, grandfather had MI 
Soc: drinks beer 1/month, never tobacco, never drugs, sexually active with girlfriend (always uses condoms).
Extract phrases from this text which may help understand the patient's medical condition.[/INST]feeling ""hot, M, 17 yo, stuffy nose, exercise induced asthma, chest pain, chest pain, yesterday, no SOB, albuterol inhaler did not help, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Smith is a 17 year old African American male with a past medical history of exercise induced asthma who presents with one day of chest pain. He describes ""very sharp"" pain ""like a knife"" in the left side of his chest. It does not radiate or move. The pain is worse with deep breaths and with movement, and better when he rests. Tylenol and albuterol have not helped. He does report several days of stuffy nose and muscle aches. He reports some fever. He exercises often.
ROS: No nausea, vomiting, diarrhea, constipation, cough, shortness of breath, changes in urination, numbness, tingling
PMH: exercise induced asthma
PSH: none
Meds: albuterol inhaler as needed
NKDA
FH: Father with asthma and hypercholesterolemia, paternal grandfather with heart attack. Mother healthy
SH: Senior, planning on attending college. Works for a carpenter.  Reports one beer a month, no drug use, no tobacco use, sexually active with girlfiend, uses condoms.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]fever, male, 17 year old, days of stuffy nose, worse with deep breaths, exercise induced asthma, exercise induced asthma, chest pain, pain in chest, one day of, No shortness of breath,, albuterol have not helped, sharp, like a knife</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 17 yo m c/o left-sided chest pain. It suddenly started yesterday during walking. It is constant, non-progressive, sharp, non radiating, no alleviating factors amd aggravated by movement and deep breathing. He also has subjective fever for the past 2-3 d. He had runny nose and muscle aches 1 w ago.
RoS: he denies cough, SoB, weight loss, abdominal pain, sore throat, rash.
PMH/PSH: he has exercise-induced asthma, well controlled w/ albuterol. Allergies: NKDA, NKA. MEds: albuterol occasionally
FH: none
SexH: active w/ girlfriend only for the past y, use condoms consistently. No h/o STI
SH: no tobacco/EtoH socially/ marijuana 2 times..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]subjective fever, m, 17 yo, runny nose, aggravated by deep breathing, exercise-induced asthma, chest pain, started yesterday, denies SoB, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Kane Smith is a 17 yo man with history of exercise-induced asthma presenting with sharp pain on his left-mid upper chest since yesterday morning. Pain started when he woke up, noticed no preceding events. Sharp quality, severe pain when moving or taking a deep breath. Tylenol and albuterol have not helped. +stuffy nose, muscle aches, and fevers. Denies fatigue, sore throat, coach, chills, night sweats, headache, dizziness, urinary or bowel changes. PMH: asthma Meds: albuterol PRN (last use 6 mo ago), 2 tylenol pills q4h for this pain. FH: dad with asthma and high cholesterol, grandmother with heart attack. SH: no smoking or concerning drinking. no cocaine. Senior in high school, also works as carpenter assistant. Sexually active with his girlfriend and uses condoms..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]fevers, man, 17 yo, +stuffy nose, severe pain taking a deep breath, exercise-induced asthma, pain chest, since yesterday, albuterol not helped, sharp pain, Sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC - chest pain
HPI - 17 yo M complains of sharp consistent chest pain x 1 day. Woke up with chest pain yesterday. Worse with deep breath and movement. Tried ttylenol and albuterol without improvement of pain. Pain improves with leaning forward. Nasal congestion/rhinorrhea, body aches, subjective fever x 3 days. Denies cough, shortness of breath, breathing fast, N/V, diarrhea, constipation, headache, change vision, tingling arms/legs
PMH - asthma, well controlled
Meds- albuteral, tylenol q4h PRN
NKDA
Sh - alcohol use 2 beers/month, no tobacco or drug use. Lives with parents. Likes to rock climb.
FH - grandfather myocardial infarction age 70, still living
dad - asthma
otherwise healthy.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]subjective fever, M, 17 yo, Nasal congestion, rhinorrhea, chest pain, chest pain, x 1 day, yesterday, Denies shortness of breath, rock climb, Tried albuterol without improvement, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 year old male who comes in for chest pain. It started yesterday morning when he woke up, and is located at the chenter left chest above his sternum. Its a constant pain, sharp in nature, and worsens on deep breath. It does not radiate, and the severity ranges from 4/10-8/10. He tried tylenol but it provided no relief. He has had fever. He denies cough, sweating, chills, fatigue, palpitations, shortness of breath, weight change, appatite change, nausea, vomiting, or change in bowel habits.
ROS- As above
PMH- exercise induced asthma
PSH- none
Meds- albuterol
Allergies- none
FH- father has asthma and HLD, grandfather had MI
SH- is sexually active with girlfriend and uses protection. No hx of STIs. No smoking, drinks only at parties, and doesn't use drugs.
Has not recieved flu shot.
Exercises by rockclimbing.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]fever, male, 17 year old, worsens on deep breath, exercise induced asthma, chest pain, started yesterday, denies shortness of breath, rockclimbing, sharp, 8/10</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 17 yo M presenting with 1 day left sided nonradiating chest pain that is worsened with deep inspiration and movement. It is described as sharp and stabbing, is constant, and not relieved by tylenol or albuterol. Patient also reports stuffy nose, fever, and muscle aches for 3-4 days. He has not recieved a flu shot or had recent travel. He reports no recent sick contacts, heartburn, SOB, wheezing, chills, fatigue, abdominal pain, diarrhea, or cough. 
ROS: negative except above
PMH: Exercise induced asthma, car accident at young age 
PSH: None
Medications: albuteral inhaler PRN, tylenol PRN 
Allergies: none 
FH: Asthma and hyperlipidemia in father, MI in grandfather at age 70
SH: Patient is a Philadelphia school student. He reports no usage of tobacco. He has tried marijuana, most recently 1 week ago, and drinks 1-2 beers when he attends parties, less than once a month..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]fever, M, 17 yo, stuffy nose, worsened with deep inspiration, Exercise induced asthma, chest pain, 1 day, no SOB, not relieved by albuterol, sharp, stabbing</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 YO M came to Clinic with consent from parents, he has been having Chest pain from yesterday,its sharp stabbing pain,which started suddenly when he woke up,gradually worsening,aggrav by deep breath and allev by nothing, he also Reports FEVER from last 3-4 days he didnt checked,and he is having body aches, he feels fatigued.
Denies SOB,Vomittings,wheezing, headache,weakness in body parts,abd pain.
ROS neg except abv
PMH excercise induced asthma,
Meds Albuterol,advil,tylenol
PSH/HOSP none, NKDA
SH work as corporate,lives with parents and siblings,drinks 1-2beers/months,no smoking,Drugs weed occasionally,last weknd was last time he took. sexually active w girl frind,uses protection.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Reports FEVER, M, 17 YO, aggrav by deep breath, excercise induced asthma, Chest pain, Denies SOB, sharp, stabbing</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo male presents with sharp acute chest pain since yesterday
- pain strated since yesterday while patient wokeup
- pain is not radiating, while sitting 5/10 - when moving pain worsens to 9/10
- no SOB, headache, cough, palpitations

ROS: negative except as above
PMH: Asthma
PSH: none
Allergies: NKA
Medication: Albuterol
FH: father: Astham, grandfather: MI 
SH: denies smoking, occasional alcohol, tried weegd otherwise no drugs, sexual active with girlfrined using condoms.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]male, 17 yo, chest pain, since yesterday, since yesterday, no SOB, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo male Hx of Exercise Induced Asthma with c/o  L sided Chest pain
-started yesterday, sharp in quality, nonprogressive, constant, nonradiating, aggravated by deep breathing and movement, relieved by nothing, took tyelonol which did not help
-reports having fever, stuffy nose, muscle ache for the past 3-4 days, did not take anything for it
-denies racing of heart, sweating, recent trauma, appetite loss or weight loss, bowel or bladder movemnt changes
PMH-Exercise induced Asthma took albuterol inhaler 
MEDS-TYELONOL, 
FH- Father had Asthma and hypercholesterolemia, Grandfather had heart attack once
ALL/PSH-None
SSH-sexaully active with girlfriend for 1 yr, drinks etoh occ, denies smoking, smokes weed , last use last weekend.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]reports having fever, male, 17 yo, stuffy nose, aggravated by deep breathing, Exercise Induced Asthma, Exercise induced Asthma, Chest pain, started yesterday, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: - 17yr male with L sided sharp chest pain with deep breaths. Also endorses stuffy nose and myalgias. Pain does not radiate and is a 4/10 at rest and 7/10 with deep breaths
- Pt also has ""felt warm"" at home, but not measured temp. Sxs serious enough for him to call out from work as a carpentry assistant
- Tylenol does not help and albuterol inhaler has not helped sxs
- PMH: exercise-induced asthma, never hospitalized; No PSH
- Med: albuterol inhaler prn, tylenol for pain; NKDA
- FH: Dad with asthma and HLD, Grandfather with MI at age 81
- SH: Lives at home with parents, senior in high school, works as carpentry asst, rock climbs for hobby, never smoker, occasional social beer, has tried marijuana on some occasssions at parties, sexually active with girlfriend and uses condoms, denies depressive sxs
- ROS: neg except noted.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]felt warm, male, 17yr, endorses stuffy nose, chest pain with deep breaths, 7/10 with deep breaths, exercise-induced asthma, chest pain, rock climbs, albuterol inhaler has not helped, sharp, 7/10</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr Smith is a 17 y/o M who presents for chest pain. He reports the pain started yesterday morning without any precipitating factor. Since then the pain is sharp in nature, 5/10 at rest and 8/10 when worsened by deep breathing or movement. He reports little improvement with albuterol and tylenol. The pain does not radiate. He also reports a 3-4 day history of mild warmth, myalgia and stuffy nose. Denies any burning sensation in the epigastrum, shortness of breath, wheezing, palpitations or cough. Denies any recent sick contacts or travel.  

ROS negative except as above.
PMH excercise induced asthma
Medications albuterol rarely and 2 tylenols q4hr
PSH no surgeries
Social history - Is a senior at school and a carpenter. Drinks 1-2 beers at parties, denies tobacco use. Occasional marijuana use. Sexually active with 1 female partner in the past year and uses condoms. 
Family history - asthma in the father, grandfather had MI.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]warmth, M, 17 y/o, 3-4 day history of stuffy nose, worsened by deep breathing, excercise induced asthma, chest pain, started yesterday, Denies shortness of breath, little improvement with albuterol, sharp, 8/10</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: Pt. is a 17y/o male who is complaining of left sided chest pain for the last 1 day. The chest pain is unprovoked, and occured when he woke up. Described as sharp, 4/10 intesnsity, but 7/10 intensity when breathing in deep. Deep inspiration and movement worsen the pain. The pain is not worse when supine, or when leaning forward. Tylenol does not improve the pain. He has a subjective fever, and associated malaise and nasal congestion for the past 3 days. He is unsure of his vaccine status, and did not recieve an influenza vaccine this year. He denies palpitations, dyspnea, and trauma to his chest.
ROS: Negative.
Meds: Albuterol inhaler, Tylenol
Allergies: NKA
PMHx: Exercise induced asthma 4 years.
PSurg Hx: None.
Fam hx: Dad - asthma, hypercholesterolemia, Grandfather - MI
Social Hx: Never smoker, drinks occassional beer at parties, denies drug use. Sex with girlfirend only, uses condoms. Carpenters assistent. Rock climbs..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]subjective fever, male, 17y/o, nasal congestion for the past 3 days, 7/10 intensity when breathing in deep, Deep inspiration worsen the pain, Exercise induced asthma, chest pain, chest pain, for the last 1 day, Rock climbs, sharp, 7/10</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo male with CP that started yesterday morning and has worsened. Now 8 or 9/ 10 pain. Worse with inspiration and movement. Denies trauma, SOB, N/V. Tried albuterol inhaler and tylenol but did not relive pain. 3-4 days ago experienced nasal congestion and muscle aches. Those symptoms resolved. 

PMHx- exercise induced asthma (well controlled w/ inhaler)
Meds- albuterol inhaler and tylenol
PSHX- none
PFamHx- grandpa MI age 70yo
Soc HX- lives with parents and older brother, drinks 1-2 beers per month, used weed 3x in life, does not smoke or vape, senior in highschool, works as carpenter assistent
NKDA

.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]male, 17 yo, 3-4 days ago nasal congestion, Worse with inspiration, exercise induced asthma, CP, started yesterday, Denies SOB, albuterol inhaler did not relive pain, 8 or 9/ 10</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yr old male c/o sudden, sharp, pleuretic left chest pain that started yesterday, after a recent URI when he experienced nasal stuffines, rhinorrhea, for 3-4 days. Chest pain is aggrevated and triggered by sudden positional changes, and deep breaths and alleviated by shallow breathing. Tylenol and albuterol did not alleviate the pain. H/O subjective fever. The patient denies any previous similar episodes, palpatations, trauma, rash, weight or appetite changes, dyspnea, bowel or urinalry changes neck swellings or pain or abdominal discomfort.
PMHX: Exercise induced asthma, for 4 yrs stopped medications 
PSH: none. MEds: Tylenol and albuterol yesterday only
ALL: nka
FHX: NC
Social HX: Part time carpenter, College student, Non smoker, drinks occassionally at parties, and smokes marijiuana at social events/parties.
Exercises at the gym..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]subjective fever, male, 17 yr old, recent URI, nasal stuffines, rhinorrhea, for 3-4 day, pleuretic, aggrevated by deep breaths, Exercise induced asthma, chest pain, Chest pain, started yesterday, albuterol did not alleviate the pain, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: a 17-year-old male, has come to the outpatient clinic with chest pain
-began yesterday morning, suddenly, woke him up, constant, staying the same, no previous episodes
-left side, no radiation, 5/10 when sitting, 8/10 when taking deep breath, no trauma or injury, sharp pain
-has nasal congestion, muscle ache, and fever for 4 days
-denies dyspnea, nausea, vomiting, palpitation, dizziness, diaphoresis, cough, weight/appetite/sleeping changes, sick contact, night sweats
-alleviated by nothing, aggravated movement and deep breath
PMH: exercise induced asthma for 4 years PSH: none Meds: ibutoral inhaler, Tylenol All: NKDA FH: father has asthma and hypercholesteremia, grandfather has myocardial infarction
SH: denies smoking, uses weed, last use was last weekend, drink etOH once a while, monogamous with girlfriend, exercises regularly, twice/week, high school student.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]fever, male, 17-year-old, nasal congestion, 8/10 when taking deep breath, exercise induced asthma, chest pain, began yesterday, denies dyspnea, 8/10</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo M who complains of sharp, L sided pleuritic chest pain over the anterior chest since yesterday morning when he woke up. THe pain is worse with changes in position and walking and Tylenol q2-4 hrs and albuterol inhaler have not helped with the pain. He reports that the pain may be slightly improved with leaning forward. He reports 3-4 days of congestion, rhinorrhea, muscle aches and subjective fevers. He denies cough, congestion, abdominal pain, SOB, chest pain with exertion N/V/D. He denies sick contacts. He is most worried about being able to get back to rock climbing. 
PMHx: exercise-induced asthma, takes albuterol inhaler (last needed 6 months ago) 
no allergies, PSHx or other meds
FMHx: father has asthma and and HLD. grandfather survived MI few yrs ago 
Social: lives at home with mom and dad. senior in high school, likes to rock climb. Drinks 1-2 beers with friends once/month, denies tobacco, drugs.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]subjective fevers, M, 17 yo, congestion, rhinorrhea, pleuritic, exercise-induced asthma, chest pain, since yesterday, denies SOB, rock climbing, rock climb, albuterol inhaler have not helped, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Kane Smith is a 17 year old male who presents with chest pain that began yesterday morning when he woke up. Consent from mother. It is a left sided, sharp stabbing pain worse with deep inspiration and movement. Unrelieved with tylenol q 4 hours as per bottle. Reports subjective fever, congestion, myalgias. Denies history of trauma, SOB, angina, numbness, nausea, vomiting, diarrhea, dysuria, abd pain, chest pressure, sick contacts. Senior in high school. Works as carpenter's assistant. Enjoys rock climbing. Participated in both in the last 2-3 days, lots of heavy lifting. PMH of exercise induced asthma controlled with albuterol prn, last used 6 months ago. NKDA. No surgeries. Lives at home with parents. Reports occasional beer and marijuana at parties. No drug use otherwise. Concerned about missing school and what the pain could be. Permission to speak with mother..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]subjective fever, male, 17 year old, congestion, worse with deep inspiration, exercise induced asthma, chest pain, began yesterday, Denies SOB, last 2-3 days heavy lifting, sharp, stabbing</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Kane Smith is a 17-year-old male presenting with chest pain since yesterday. He does not recall any precipitating events, including trauma. The pain is primarily located on the left parasternal border and does not radiate anywhere. He describes the pain as sharp and stabby. It is worse when he takes a deep breath and when he moves around. Better with rest. He has tried tylenol and his albuterol inhaler with no relief. Of note, he states that he recently had a stuffy nose and some muscle aches, about 4 days ago. He has been feeling warm for the past several days.
ROS: Denies exertional dypnea, nausea/vomiting, and diaphoresis. Denies changes in bowel habits.
PMH:  Exercise induced asthma
Meds: Albuterol inhaler
NKDA
FH: HA in grandfather at age 70.
SH: Non-smoker. Drinks 1-2 beers occasionally at parties. Has tried marijuana, but no other illicits. SEnior in high school. Works in woodworking. Rock-climbs..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]feeling warm, male, 17-year-old, stuffy nose, worse when he takes a deep breath, Exercise induced asthma, chest pain, since yesterday, Denies exertional dypnea, Rock-climbs, albuterol inhaler with no relief, sharp, stabby</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo Male with sharp L sided chest pain for 1 day. worse with deep inspiration. Took tylenol and albuterol inhaler and did not help. Located broadly around the L chest area. 
PMH includes excersize induced asthma. medications are albuterol inhalor for asthma. no allergies, no hospitilizations, no GI symptoms, no Urinary symptoms, no surgeries. 
Endorses a stuffy nose and muscle aches 3-4 days ago. 
Denies tobacco use, some EtOH use socially, denies any drug use. Senior high school student also works as carpenter assistant, lives at home with parents. Will need doctors note for school today. Has been feeling warm/feverish, no weightloss or gain, no night sweats..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]feeling warm, feverish, Male, sharp, 17 yo, Endorses a stuffy nose 3-4 days ago, worse with deep inspiration, excersize induced asthma, chest pain, for 1 day, albuterol inhaler did not help</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 17-year-old man presenting with sharp chest pain that began yesterday morning. He describes the pain as sharp like a knife and occurs every time he takes a depp breath. The pain is located in his left anterior chest and does not radiate. He has tried Tylenol and using his albuterol inhaler without relief. The only aggravating factor is taking a deep breath - he denies the pain being worse or better when leaning foward. Notably, he has had 3-4 days of feeling warm, stuffy nose, and muscle aches. He denies any shortness of breath, racing heart, weight loss/gain, change in bowel movements or urinary frequency/urgency. 
Past medical history: exercise-induced asthma, uses inhaler every 6 months
Past surgical history: none
NKDA
Family history: dad - asthma, paternal grandfather - MI, mom - healthy, older brother - allergies
Social history: no tobacco use, alcohol 1x/month, no illicit drug use, lives with Mom and Dad.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]man, 17-year-old, 3-4 days stuffy nose, aggravating factor taking a deep breath, exercise-induced asthma, chest pain, pain chest, began yesterday, denies shortness of breath, albuterol inhaler without relief, sharp, sharp, like a knife</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Kane smith, 17 yo M presents with Left chest pain, sharp, 5/10 at rest, 9/10 during deep inspiration that started yesterday morning. Pain does not radiate. Deep breaths makes pain worse. Nothing makes it better. Rhinnorhea muscle aches and feeling warm for past 3-4 days with possible URI. Used tylenol and albuterol yesterday for pain but did not help; -cough; -headache; -sore throat; -racing heart
ROS: all other ros neg
allergies: nkda
PMH: exercise induced allergies
Meds: Albuterol prn; tylenol prn
PSH: None
SH: 1-2 etoh drinks per month; occasional weed use, used last week; no tobacco use; lives at home with mother, father and 21 yo brother; senior is high school; works part time at carpenter; sexually active with GF; 1 partner in past year; uses condoms; never screened for sti;
FH: Father - asthma and hypercholesterimia; Mother healthy; brother healthy
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]feeling warm, M, 17 yo, Rhinnorhea, URI, Deep breaths makes pain worse, chest pain, started yesterday, albuterol did not help, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Smith is a 17 yo male presentign with chest pain. Pain started acutely yesterday, described as sharp chest pain that worsens with breath and movement. No radiation. He has tried tylenol (2 pills every 4 hours) and albuterol inhaler with no relief. Does not know if pain improves with leaning forward. He has had muscle aches, stuffy nose and subjective fever for the past 3-4 days. Denies any N/V, palpitations, abdominal pain, wheezes, headaches. 
ROS negative except for above
PMH: exercise induced asthma, Allergies: NKDA, Medications: Albuterol inhaler, PSH: none
Fam Hx: dad has asthma, high cholesterol, mom is healthy, grandpa had heart attack 
Sexual Hx: Is sexually active with girlfriend, uses condoms, no hx of STIs
Social Hx: Does not smoke or use illicit drugs, drinks beer 1 a month at social occassions.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]subjective fever, male, 17 yo, stuffy nose, worsens with breath, exercise induced asthma, chest pain, yesterday, albuterol inhaler with no relief, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 y/o M with left sided chest pain
patient complaining of left sided chest pain that he woke up with yesterday morning. At rest it is 5/10 intensity, with movement or palpation 7/10. Tried tylenol, no relief. Deep breath causes intense pain too. No trauma to area, no travel, no sick contacts , no cough, no fever but patient feels warm, no nausea vomiting or diarrhea, no weight loss, no dizziness, no sore throat or oltagia. Pain stays localized in same spot. never happened. rock climber 4 days ago. 
PMHx: History of excercize induced asthma, but has not needed inhaler for 6 months. Uses albuterol PRN and tylenol OTC. No allergies. No surgeries. FHx of paternal asthma and HTN, and grandfather had MI at age 70. Does not smoke, occasional beer, uses marajuana (last one week ago). Denies cocaine use. Lives w/ parents and brother, works as carpenter assistent lifting heavy items. + sex, monogamous, w/ women, uses protection..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]feels warm, M, 17 y/o, Deep breath causes intense pain, excercize induced asthma, chest pain, chest pain, woke up with yesterday, rock climber 4 days ago, carpenter assistent lifting heavy items, 7/10</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI:  17 YO M C/O LT SIDE CHEST PAIN SINCE YESTERDAY.
- STARTED SUDDENLY, STAY THE SAME, SHARP, NOT RADIATING, INCRSEAE BY MOVEMENTS AND DEEP BRATHING, ALLEVIATED BY TYLENOL
- ASSOCIATED WITH FEVER 100 F, 
- HAS STUFFINESS OF NOSE AND MUSCLE ACHES 4 DAYS AGO
- DENIES COUGH, SOB, PALPITATIONS, DIZZINESS, URINE/WEIGHT/BOWEL HABITS CHANGES, SIMILAR PAIN BEFORE
-ROS: AS IN HPI
PMH: EXERCISE INDUCED ASTHMA X 4 Y
ALLERGY: NKDA
MEDS: INHALOR, TYLENOL
FH: FATHER ASTHMA AND HIGH CHLOESTEROL
SH: HIGH SCHOLL STUDENT, WORK AS CARPENTER ASSISTANT. DRINKS ONCE IN  AWHILE. MONOGAMUS ..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]ASSOCIATED WITH FEVER, M, 17 YO, STUFFINESS OF NOSE, INCRSEAE BY DEEP BRATHING, EXERCISE INDUCED ASTHMA, CHEST PAIN, SINCE YESTERDAY, DENIES SOB, SHARP</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo male seen with verbal parental consent. He states that he has been having chest pain with deep breathing for the past 2 days. Pain is accompanied by muscle aches, nasal congestions, and subjective fevers. Pain was not relieved by tylenol or albuterol inhaler. Denies cough, weight loss, chest pain, falls, recent trauma, or drug use (e.g. cocaine). Denies sick contacts or recent travel.  
PMH: Exerxcise induced asthma
Medications: albuterol PRN for asthma, last use 6 months ago.
NKDA
Family hx: father with asthma and hyperlipidemia, grandpa with MI at 70 yo, denies hx of sickle cell, marfans, or ehler danlos
Social hx: Senior in high school applying to college, works as carpenter assistant, rock climbs 2-3 times per week and stays active (denies falls), sexually active with one female partner uses condoms, drinks 1-2 beers & smoke 1-2 joints monthly at parties, denies tobacco or other drugs (e.g. cocaine, methamphetamine, MDMA).
Extract phrases from this text which may help understand the patient's medical condition.[/INST]subjective fevers, male, 17 yo, nasal congestions, pain with deep breathing, Exerxcise induced asthma, chest pain, rock climbs, not relieved by albuterol inhaler</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Kane Smith, a 17-year-old male, has come to the outpatient clinic with chest pain. Mr. Smith's mother has given verbal consent for a history, physical examination, and treatment.
New onset of sharp chest pain , first 5-6 /10 but now is getting worse 7-9/10 in severity 
He is a Carpenter assistant and lifting heavy materials
The pain is worse with movements and deep breathing 
No Nausea , Vomiting , SOB, Bowel or urinary troubles   
PMHx Exercise induce Asthma
Meeds Albuterol As needed 
Alergies none
Pshx : none 
Fhx DAd Asthma , mother healthy , grandfather MI 
Sexually active  use condoms always 
No Drugs , Alchol ocassional ,  tobacco.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]male, 17-year-old, worse with deep breathing, Exercise induce Asthma, chest pain, chest pain, No SOB, lifting heavy materials, sharp, 7-9/10</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr SMith is 17yo male who presents with 1 day of acute onset left-sided chest pain. Described as constant sharp stabbing pain that is worsened with deep breathing and movement. Not alleviated by tylenol or albuterol inhaler. He states that he woke up yesterday morning with this pain. At rest this pain is 5/10 but with breathing is 8-9/10 in severity. He also endorses recent fever, muscle aches, and stuffy nose 3-4 days ago. Denies dyspnea, heartburn, change in weight or appetite, cough.
ROS; negative except as above
PMH: exercise induced asthma diagnosed 4y ago
PSH: none
Meds: albuterol inhaler last needed 6mo ago
Allergies: NKDA
FH: Father has asthma and hyperlipidemia, grandfather had MI 2y ago
SH: Senior in high school, carpenter's apprentice. Denies smoking. Drinks beer once a month. Has tried marijuana, but denies other drugs. Sexually active with girlfriend, uses condoms. Active with good diet..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]fever, male, 17yo, stuffy nose 3-4 days ago, worsened with deep breathing, pain with breathing, exercise induced asthma, chest pain, 1 day of, woke up yesterday with this pain, Not alleviated by albuterol inhaler, sharp, stabbing, 8-9/10</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Case of 17 y/o M comes to the clinic because chest pain. Patient report he wake up this morning with pain in his Left chest pain. Pain is sharp, constant, worse with movements, improve if sit still, does not radiates. Patient also report fever, runny nose with with/yelllow mucous, no odor and some muscle pain since 2 days ago. Denies N/V, dizziness, cough, changhe in bowel movements, change in urinary habits, loss of weight, headache.
ROS: negative except as above
PMH: asthma. Meds: albuterol PRN, tylenol. NKDA
PSH/ hospitalization/surgeries: none
FMH: noncontributory
SH: senior student, work as a carpenter assistant and do rock climbings. EtOH social, Weed social last time last week, no smoke. Sexually active with girlfriend use condoms..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]fever, M, 17 y/o, runny nose since 2 days ago., asthma, chest pain, chest pain, report this morning with pain, rock climbings, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Kane Smith, a 17-year-old male, has come to the outpatient clinic with chest pain. Patient describes sharp CP, onset yesterday morning, that is worse with deep inspiration. Tyelonol has not helped the pain. Associated subjective warmth, no chills. Has never had pain like this before. Denies recent trauma, headaches, cough, SOB, sore throat, abdominal pain. Patient has had recent /associated ""stuffy nose""/congestion and muscle aches last 3-4 days. Denies sick contacts. 
ROS: per HPI
PMHx: Asthma (exercise-associated). No hospitalizations. Unsure immunizations hx. No trauma, surgeries. 
Allergies: NKDA
Meds: Albuterol prn. Tyelonol prn.
FHx: Father with asthma and HLD, mother healthy. Grandfather had MI, currently better. 
Social: nonsmokers, rare etoh use, does use marijuana occasionally. No IVDU. Sexually active with female partner, uses condoms. Enjoys rockclimbing..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]subjective warmth, male, 17-year-old, stuffy nose, congestion, worse with deep inspiration, Asthma exercise-associated, chest pain, Denies SOB, rockclimbing, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Smith is a 17 year old male here for a chief complaint of ""very sharp chest pain every time I breathe."" The pain is located in the upper left chest wall and does not radiate. The patient's pain began yesterday upon waking up, and was rated 5/10, but can become a 8-9/10 with breathing. The pain is constant, exacerbated by movement and deep breathing. The patient attempted to alleviate his pain with tylenol and albuterol however this did not alleviate his pain. The patient is a senior in high school, and is unsure of his vaccination history. 

ROS:The patient denies any fever, sob, cough, nausea or vomiting. 
Allergies: none
medications: albuterol PRN, tylenol 
past medical history: exercise induced asthma 
past surgical history: none 
Social history: denies tobacco or ilicit drug usage, drinks 1-2 beers per month, works as carpenter assistant 
Family history: Paternal (asthma, hyperlipidemia), grandfather (MI).
Extract phrases from this text which may help understand the patient's medical condition.[/INST]male, 17 year old, pain every time I breathe, exacerbated by deep breathing, exercise induced asthma, chest pain, yesterday, denies sob, albuterol did not alleviate his pain, sharp, 8-9/10 with breathing</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17yr m with mother's consent,  c/o sharp chest pain since yeterday. The pain started gradually, constant, non radiating, exacrebated with deep breaths, movement, walking, relieved with rest however he tries tylenol and albuterol but did not help. 
He also c/o fever, nasal stuffiness and malaise since 3days. 
He exercises regularly at an indoor rockclimbing arena, last time was 3 days ago.
He denies any cough, dyspnea, palpitaions, change in weight or appetie, change in urinary or bowel habits. 
ROS - neg except as above
PMH - Exercise induced asthma for 4yrs, takes Albuterol
PSH - none
Meds - as above
SSH - senior in school, works as carpenter assistant, Occasional EtOH , weed, no smoking. Sexually active with girl friend , uses condoms.

.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]c/o fever, m, 17yr, nasal stuffiness, exacrebated with deep breaths, Exercise induced asthma, chest pain, since yeterday, denies dyspnea, rockclimbing 3 days ago, albuterol did not help, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Smith is a 17 year male with a past medical history of exercise induceed asthma who presents today for evaluation of chest pain. He says that the pain began yesterday with a sharp stabbing pain that worsens with inspiration. He rates it aboust 5/6 at rest but can increase to a 7, 8, or 9 with deep inspriation. He tried some Tylenol 1-2 over 4 hours but it did not improve. He also used his inhaler without relief. He previously had runnose and muscle aches. He says he felt warm but denies fever, chills, nights sweates, SOB, or palpiations. 

ROS: Negative unless otherwise stated in HPI
PMH: exercised induced asthma
PSH: none
Meds: 1-2 tablets of tylenol but stopped, Albuterol inhaler stopped taking 6mo ago until now
Allergies: none
Socal Hx: senior in hight school, denies tobacco, drinks somes (CAGE:0/4), deneis illicits substnace use
Fam: Father alive asthma HLD, mom healthy, grandfather MI a few years ago.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]felt warm, male, 17 year, worsens with inspiration, exercise induceed asthma, exercised induced asthma, chest pain, yesterday, denies SOB, used his inhaler without relief, sharp, stabbing</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Kane is a 17 yo male here today complaining of chest pain that began yesterday morning. He reports the pain is sharp and isolated to the left side and does not radiate. No Trauma. Reports it is ok when he is sitting but worsens when takes a deep breath and with exercise. Endorses recent fever, stuffy nose, and muscle aches that began 3-4 days ago. Denies joint pain and cough. Reports the pain is constatnt and does not improve with tylenol or albuterol. Pt has a a history of exercise induced asthma and last used his inhaler 6 mos ago for this. His current medications are albuterol and motrin. Denies hospitalizations or surgeries in past, denies urinary frequency, urgency, burning, denies abdominal pain, changes in frequency/'color of bowel movements. Does enjoy rock climbing, lives at home with mom, is senior in High school. Does not use tobacco but does have beer 1x per month. Denies anxiety, useweed occasionally, sex with gf, condoms..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]fever, male, 17 yo, recent stuffy nose, worsens when takes a deep breath, exercise induced asthma, chest pain, began yesterday, rock climbing, does not improve with albuterol, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Smith is a 17 y/o male who presents with a 1 day history of chest pain. The pain began yesterday morning awakening the pt from sleep. Movement and breathing makes the pain worse, nothing makes it better though he tried tylenol and albuterol. Pain is 5/10-9/10 sharp constant pain with no radiation. Located on left sided chest. No previous episodes of chest pain. Pt reports fever but no night sweats or chills. stuffy nose and muscle aches since 3-4 days ago. No ill contacts. Denies headache and cough.
PMH: exercise-induced asthma
PSH: none
MEDS: tylenol 2x every 4 hours yesterday, albuterol as needed (last took yesterday morning)
ALL: NKDA
Social: social drinking, no tobacco, infrequent marijuana use (last took last weekend). Sexually active with girlfriend, consistent condom use. No prior STDs. Exercises by rock climbing , last exercised 3 days ago..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]fever, male, 17 y/o, stuffy nose 3-4 days ago, breathing makes the pain worse, exercise-induced asthma, chest pain., 1 day history, began yesterday, rock climbing 3 days ago, nothing makes it better tried albuterol, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 17 year old male with a PMHx of asthma complaining of chest pain onset yesterday morning. He describes the chest pain as sharp, non-radiating, and exacerbated by deep inspiration and movement. He notes that the pain has worsened since the onset. He denies SOB, palpitations, nausea and vomiting. Pt confirms a recent illness with myalgias and nasal congestion for three days.
ROS: negative except stated as above
PMHx: exercise-induced asthma
Medication: albuterol as needed
Allergies: none
PSHx: none
FHx: asthma (father), HLD (father), CAD (grandfather)
Social: non-smoker; occasional alcohol; no illicit drug use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]male, 17 year old, nasal congestion for three days., exacerbated by deep inspiration, asthma, exercise-induced asthma, chest pain, chest pain, onset yesterday, denies SOB, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Kane is 17yoM who presents with 1 day of chest pain assocaited with breething and reproducible on palpation. He says that he woke up yeswterday with pain in left center chest and has tried tylenol and his inhaler to no avail. The pain is 5/10 at rest but 9/10 with movement or deep inspiration. He denies a positional quality to the pain and it does not radiate. He denies SOIB, palpiations or worsening of pain with exertion. He mentioned that he has been having runny nose, muscle aches, fevers/chills/night sweats over the past few days.

PMH: exercis induced asthma
PSH: none
Meds: albuterol PRN
All: None
FamHx: HLD and asthma (dad), Mi (grandpa)
SHx: Senior in HS, carpenter assistant, No tobacco or drugs, occacsional alcohol, sexually active with GF with condoms

ROS: As per HPI, otherwise negative 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]M, 17yo, runny nose over the past few days, assocaited with breething, 9/10 with deep inspiration, exercis induced asthma, chest pain, pain chest, 1 day of, woke up yeswterday with pain, denies SOIB, inhaler to no avail</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Kane is a 17yo male with a history of exercise-induced asthma who presents with one day history of chest pain. He describes the pain as deep that is worse with deep breaths. He does not notice a difference in symptoms with change in position such as leaning forward. He also notes 3-4 days of stuffy, runny nose, muscle aches, and subjective fever. No recent travel history.
ROS: as per HPI; no wheeze, SOB, abdominal pain, heartburn, N/V, cough
PMH: exercise-induced asthma
Meds: Tylenol every 4 hours PRN for chest pain; albuterol
Allergies: none
Surgical history: none
SH: student; EtOH 1 beer 1 time per month; no smoking, no drug use; rock climbs
FH: HLD, asthma (dad); MI in 70s (grandfather).
Extract phrases from this text which may help understand the patient's medical condition.[/INST]subjective fever, male, 17yo, stuffy, runny nose, worse with deep breaths, exercise-induced asthma, exercise-induced asthma, chest pain, one day history, no SOB, rock climbs</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Smith is a 17yo male c/o of chest pain since yesterday. The pain began abruptly is a sharp pain 5/10 at rest but reaching 8-9/10 on inspiration. Movement also exacerbates the pain. Tylenol and Albuterol has not helped but staying still does. He has also noted stuffy nose and muscle aches for the 3-4 days and a subjective fevr though he has not taken his temperature.
ROS: Denies cough, SOB, night sweats, chills, nausea, vomting, diarrhea, weight loss, palpitations, prior cardiac issues, or sleep disturbance
PMH: Exercise induced Asthma
Medications; Albuterol; 2 tylenol q4h
PSH: None
NKDA
FHx: Granfather had MI, father has asthma and high cholesterol
SHx: Ptx denies tobacco abuse, drinks beer 1X a month, and smokes marijuana socially. He is monogamous with his girlfriend and uses protection regularly. Uncertain vaccination history, though recieved childhood vaccines
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]subjective fevr, male, 17yo, stuffy nose, pain 8-9/10 on inspiration, Exercise induced Asthma, chest pain, since yesterday, Denies SOB, Albuterol has not helped</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17  YO MALE C/O CHEST PAIN  SINCE YESTERDAY. PAIN IS IN LEFT SIDE, SHARP, SUDDEN ONSET, CONSTANT, 5/10 WHILE SITTING STILL, 8/10 WHILE DEEP BREATING AND MOVING, NON RADIATING, AGGRAVETED BY DEEP BREATH AND MOVEMENT, ALLEVIATED BY SITTING STILL. ASSICIATED WITH FEVER, RUNNY/STUFFY NOSE ANFD MUSCLE SORENESS.
HE HAS H/O FLU 3-4 DAYS BACK.
HE DENIES SOB, PALPITATION, RASH, TRAUMA, SICK CONTACT, RECANT TRAVEL, COUGH, NIGHT SWEAT.
NO APPETITE, WEIGHT, MMOD, SLEEP, BOWEL/ URINARY HABITS, MOOD CHANGES.
ROS: _VE EXCEPT AS ABOVE
PMH: EXCERSISE INDUCED ASTHMA, MEDS ALBUTEROL.NHDA
FH: ASTHMA
SH: NO SMOKE, ETOH. DRUG: WEED  LAST USE: LAST WEEKEND
SXH: MONOGAMOUS . CONDOM USE CONSISTANTLY
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]FEVER, MALE, 17  YO, RUNNY/STUFFY NOSE, AGGRAVETED BY DEEP BREATH, EXCERSISE INDUCED ASTHMA, CHEST PAIN, YESTERDAY, DENIES SOB, SHARP, 8/10</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo male with chief complaint of chest pain that began yesterday when he woke up. he states no other similar episodes. he took 2 tylenol yesterday and his albuterol inhaler for relief but it did not work. he state this pain is a sharp stabbing pain that occurs in his left chain that is worse with movement and deep breathing. better with rest.He states the pain is a 5/10 at rest and a 8/10 with movement. He states the pain does not radiate anywhere. He has been feeling ""hot"" for past 3,4 days
ROS negative unless stated above. denies any weight loss, nausea vomiting, 
Medications: albuterol, tylenol 
allergies: none
PMH exercise induced asthma 
PSH no surgeries 
Fhx dad asthma, high cholesterol. grandpa died of heart attack, mom healthy, older brother allergies 
Shx, senior in highschol works as a carpenter. tried marijuana. denies any tobacco products, sexually active uses condoms. is a rock climber.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]feeling ""hot"", male, 17 yo, worse with deep breathing, exercise induced asthma, chest pain, began yesterday, rock climber, albuterol inhaler for relief but it did not work, sharp, stabbing, 8/10</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo M with a hx of recent chest pain.  Began yesterday morning; has not changed in serverity since.  Pain is over the left upper chest for the 24 hrs. Described as constant, sharp, stabbing pain that is brough on by deep inhalation and movement.  Tried tylenol and albuterol, but didnt help.  At rest pain is 5/10, on movement or deep inhalation is a 8-9/10.  No relation to meals, no SOB, no tachycardia or palpitations, no sudden diaphoresis, no skin or hair changes, no rashes, no blood disorders, no cough, no nausea/vomiting.  Does endorse nasal congestion, muscle aches for last 3-4 days as well.  PMH significant for exercise induced asthma.  FamHx: dad - asthma and HLD, Grandpa- MI, now doing well. Current a senior in high school, also works as a carpenter assistant (wears mask at work), lives with parents, 1 beer/month, no tobacco, Marijuana a few times, Sexually active with GF, uses condoms consistently.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]M, 17 yo, congestion for last 3-4 days, brough on by deep inhalation, on deep inhalation is a 8-9/10., exercise induced asthma, chest pain, Pain chest, Began yesterday, no SOB, albuterol, but didnt help, sharp, stabbing</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Smith is a 17 yo M here today complaining of L sided deep chest pain that started yesterday morning. He does not recall an inciting event and denies any trauma to the area. He sys the pain is sharp and gets worse with deep breaths. He also admits to feeling warm recently but denies chills, night sweats, and cough. He says he has had a stuffy nose and muscle aches for the last 3-4 days. He says he has been taking tylenol every four hours for the pain and has tried his albuterol inhaler but neither have helped.
ROS: Negative except as above
PMH: Exercise induced asthma, has never been hospitalized for it and rarely uses his inhaler anymore
Surgeries: none
Hospitalizations: none
Meds: Tylenol q4hr for pain
FH: Father asthma, high cholesterol; Mother healthy, Bro allergies; Grandpa MI
SH: Alcohol once per month, no tobacco, uses marijuana occasionally, last time 4 days before the weekend. Works as carpenter. Likes rock climbing.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]feeling warm, M, 17 yo, stuffy nose, worse with deep breaths, Exercise induced asthma, chest pain, started yesterday, rock climbing, tried his albuterol inhaler but neither have helped, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 17yo M comes to the office complaining of left chest pain since yesterday. The pain is sharp, mild-intensity, constant, and without further progression. No radiation. It increases with movements and deep breaths. He had an episode of an upper tract respiratory infection 4 days ago, with nasal congestion. No recent chest trauma. He feels warm. He negates rapid palpitations, cough, SOB, fatigue, weight loss, decreased appetite, nausea, vomiting, constipation, diarrhea, and changes in urination. 
ROS: negative except for above.
PMH: asthma, well controlled. 
PSH: none. 
Allergies: NKA. 
Medications: tynelol and asthma inhaler.
SH: high school student. No tobacco. Drinks 1 beer per month. Patient have tried marijuana at parties, no other drugs..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]feels warm, M, 17yo, upper tract respiratory infection, increases with deep breaths, chest pain, since yesterday, He negates SOB, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Kane Smith, a 17-year-old male, presents with a 1-days hitory of chest pain that occurs with inspiration. Pain started yesterday morning and is left-sided, worsens with deep breaths. Pain is 5/10 at rest and 8-9/10 with isnpiration. Patient also endorses 3-day hx of stuffy nose, muscle aches, and subjective fever. Denies recent trauma. Tylenol and albuterol inhaler have not alleviated the pain. Pain is not associated with difficulty breathing, cough, weight loss, chills, shortness of breath. PMH - exercise induced asthma, last inhaler used 6 months ago. Surgical hx - none. Meds - albuterol inhaler, q4 hour tylenol yesterday. Allergies - none. Social - alcohol occasionally; expressed interest in future counseling. No drugs or tobacco. Family hx - dad has asthma, grandfather had cardiovascular event at age 70.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]subjective fever, male, 17-year-old, stuffy nose, worsens with deep breaths, exercise induced asthma, chest pain, 1-days hitory, started yesterday, not associated with shortness of breath, albuterol inhaler have not alleviated the pain</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo m c/o left sided chest pain  since yeterday morning x 2 days,  started suddenly, the pain is continuous, progressively worseing, 5/10 with rest and goes up to 8/10 with deep breathing and movement alleviated partially with tylenol , associated with low grade continuous fever without rigors/ chills, he has a flu like illness with nasal stuffiness and myalgia  3-4 days before which has resolved, he denies chest wall trauma, dyspnea, palpitations, heart burn and metallic taste, change in appetite, weight, energy level.
ROS: -ve except  as above
PMH,MEDS: ashtma treated with albuterol inhaler last use 6 months ago.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]fever, m, 17 yo, nasal stuffiness 3-4 days before, 8/10 with deep breathing, ashtma, chest pain, since yeterday, 8/10</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo m c/o L chest pain for 1d, 
+ sudden onset, constant, L middle chest pain, sharp, 5/10 when sitting still, 8/10 when move or taking deep breath,  aggrav by movement, deep breath
+ nasal congestion, muscle ache and fever for past 3-4 d,  
ros: no sore throat, dyspnea, palpitation, injury, cough,  leg swelling
pmh: exercise-induced asthma, well-controlled meds: albuterol when needed, tylenol no relieve. NKDA
FH: FATHER W/ ASTHMA, GRANDFATHER W/ HEART ATTACT
SH: STUDENT, wock as charpner , wear mask no smoking, beers occ, use majuana  occ. last use 1wk ago. 
sexually active w/ f, use condom.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]fever, m, 17 yo, nasal congestion for past 3-4 d, 8/10 when taking deep breath, aggrav by deep breath, chest pain, chest pain, for 1d, sharp, 8/10</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Kane Smith, a 17-year-old male, has come to the outpatient clinic with chest pain. 2-3 days ago the pt had stuffy nose and muscle ache. He has exercise-induced asthma, but the inhaler has not helped with the pain. Tylenol has not helped muxh either. The pain goes from 4/10 with resting to 7-8/10 with deep breathing. Pain has been constant, sharp, and has not improve;
PMHx: astham
Allergies none
all else none
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]male, 17-year-old, 2-3 days ago the pt had stuffy nose, 7-8/10 with deep breathing, exercise-induced asthma, astham, chest pain, inhaler has not helped, 7-8/10, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Smith is a 17 yo male presentign with a ""sharp chest pain."" The chest pain has been present since this morning, and is located in his upper left chest. The pain is constant and described as stabbing and it does not radiate. Taking a deep breath and any movement worsens the pain. The patient has tried tylenol and albuterol inhaler but it has not helped. The patient also reports rhinorrhea, and myalgia for the past 3 days. He has also ""felt warm"" today.

ROS: Negative for coughing, sputum production, headache, nausea/vomiting
PMH: exercised induced asthma
Surgical hx: none
Allergies: None
Medicine: albuterol inhaler PRN
FH: Father- asthma and hyperlipidemia; Grandfather: MI
SH: Senior in high school. Denies tobacco use. Patient has tried marijuana in the past. Reports only drink few beers at parties..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]felt warm, male, 17 yo, rhinorrhea, Taking a deep breath worsens the pain, exercised induced asthma, chest pain, albuterol inhaler has not helped, sharp, stabbing</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo m c/o left sided chest pain x 1 day. Pt reports to have sudden onset of left sided  sharp pain x yesterday, non progressive, non radiating, aggravated with deep inspiration and movement no alleviating factors. It is associated with nasal stuffiness x 3 days, low grade fever/ 100 f. Pt reporst to have muscle aches x 3 days. Pt reports to have SOB on exertion and relievd by rest.
Pt denies travel/trauma/sweating/pedal edema/urianry and bowel habit chnages/weight and appetite changes/nausea/vomitnig/sweating.
ROS:-ve xcept as above.
PMH:exercised induced asthma/using albuterol inhaler for it.
PSH/ALLERGIES:none.
FH:N/C.
SSH:no smoking/ocassional Etoh use/ocassional marjuana intake last intake was 1 week ago.
Sexually active with GF/using condoms..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]low grade fever, m, 17 yo, nasal stuffiness, aggravated with deep inspiration, exercised induced asthma, chest pain, x 1 day, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 YOM C/O CHEST PAIN X 1 DAY. IT WAS ACUTE IN ONSET, INTERMITTENT,AT THE LEFT CHEST, SHARP STABBING TYPE,NON RADIATING AGGRAVATED BY DEEP BREATHING AND CHEST MOVEMENTS;AND NOT RELIEVED BY TYLENOL AND ALBUTEROL.HE REPORTS FEVER, NOT DOCUMENTED, AND HX OF STUFFY NOSE, FLU LIKE SYMPTOMS 3-4 DAYS AGO. HE DENIES TRAUMA, COUGH, SOB,CHILLS , RIGORS, HEADACHE, FACE PAIN, PAIN IN THE BELLY, SLEEP/APPETITE IS NORMAL.NO WEIGHT CHANGES.
ROS:NEGATIVE EXCEPT AS ABOVE
PMH/PSH:EXCERISE INDUCED ASTHMA
MEDS:ALBUTEROL, TYLENOL
FH:GRANDFATHER DIED OF MI, FATHER HAVE DM, HIGH CHOLESTEROL
SH:MONOGAMOUS, NON SMOKER, NO ETOH USE, SMOKED WEED IN PARTY LAST WEEKENDS.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]REPORTS FEVER, M, 17 YO, HX OF STUFFY NOSE, AGGRAVATED BY DEEP BREATHING, EXCERISE INDUCED ASTHMA, CHEST PAIN, X 1 DAY, DENIES SOB, NOT RELIEVED BY ALBUTEROL, SHARP, STABBING</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Kane Smith is a 17 yo M who presents with acute onset of chest pain. Pain began yesreday morning after he woke up with no prior inciting event. He has sharp pain the left upper part of anterior chest that is 5/10 at rest and can increase to 7-8/10 sharp pain with inspiration, movement, and whenever something touches the area. He has tried his albuterol inhaler and tried tylenol 4 hours for the pain yesterday but this did not help. Of note, he does endorse 3-4 days of feeling warm (did not check temp), runny nose, muscle aches before onset of chest pain. He denies any sick contacts. He denies shortness of breath, N/V/C/D, lumps/bumps, abdominal pain

ROS - negative except as above
PMH - exercise induced asthma
Meds - albuterol prn, tylenol yesterday
Surg - none
Fam - dad has asthma and high cholersterol, PGF had an MI
Soc - senior in high school, non smoker, drinks 1-2 beers a month, is sexually active w 1 F partner uses condoms.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]feeling warm, M, 17 yo, 3-4 days of runny nose, pain with inspiration, exercise induced asthma, chest pain, pain chest, chest pain, began yesreday, denies shortness of breath, albuterol inhaler did not help, sharp, 7-8/10, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Smith is a 17 m with exercise-induced asthma with c/o one day of stabbing L chest pain. He describes it as sharp and constant, in the L thorax, without radiation, at a severity of 7/10. It is worse with inspiration and movement. Tylenol and his albuterol didn't help. He has also had nasal congestion and muscle aches, and feeling feverish. He is generally active and doesn't remember any trauma or overactivity. He has not had a cough, abdominal pain, change in sleep, weight, bowel, or bladder. 
ROS: negative except as above. 
Meds: albuterol inhaler when needed, tylenol for the chest pain. No allergies
Med Hx: exercise induced asthma
Surg Hx: none
Fam Hx: P grandpa had MI, dad with hyperlipidemia and asthma
Social Hx: high school senior, carpentry assistant, drinks 1-2 per month, no tobacco use, occasional marijuana. Sexually active with girlfriend, uses condoms..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]feeling feverish, m, 17, nasal congestion, exercise-induced asthma, exercise induced asthma, one day, ""albuterol didnt help"", stabbing, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17yo male presents with chest pain and minor fever. chest pain with deep btreath and movement - started yesterday morning - constant, left upper chest, no radiation, 5-6 without movement, 9/10 with it. Tried tylenol and albuterol without help. wopke up with chest pain. Non posititional. He endorses runny nose and fever. He denies left arm pain, sorethroat, abdominal pain, bowle and bladder habit chagnes, Nausea and vomiting, SOB, tingling in figners or toes, headache, cough, wheeze, or skin changes.  His PMH is significant for exercise induced asthma for which he takes albuterol but hsnt had to use in 6 months.  He deneis surgery, NKDA, no tobacco, 1-2 beers at parties, no recreational drugs, lives with parents and brother in ATL, is sexually active with girlfriend and uses condoms, likes to rock climb. Fh of dad with asthma and high cholesterol. MI in grandfather. Patient wants a note for his school.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]minor fever, fever, male, 17yo, runny nose, pain with deep btreath, exercise induced asthma, chest pain, chest pain, chest pain, started yesterday, denies SOB, rock climb, Tried albuterol without help</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo  c/o substernal constant chest pain  that started yesterday morninh, no progressive, no radiating , worsening with movement and deep breath, no alleviating factors, he takes tynolol and albuterol to help the pain goes away but no success , he also report muscle ache / stuffy nose and fever X 3 to 4 days ,he denies cough, phleghm, ill contact , no bowel movement change , no change in urinary habits, the patient feel scared , denies tremor, sweating, sleeping problem , weigh loss, changing in diet /appetite 

ros : -ve excpt as above 
pmh:  execise induced asthma
psh : none  
meds: albuterol, tynolol for the actual chest pain 
allergy: nkda 
fh : dad had asthma , grandfather had myiocardial infarction 
sh: no smoker, occational etoh on week ends, smokes matrijuana , sexually active with girl friend.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]fever, 17 yo, stuffy nose, worsening with deep breath, execise induced asthma, chest pain, started yesterday, takes albuterol to help the pain goes away but no success</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: chest pain
HPI: 17 yo m presents with one day history of sharp chest pain, worse with deep inspiration, Of note he has been experiencing muscle aches and stuffed nose for the past 3-4 days alond with a mild subjective fever. Pain is worse with movement. Took tylenol (2 pills q 4 hrs) yesterday without relief. Also tried his albuterol inhaler this AM without relief. No known trauma to the area. Denies chills, shortness of breath, or other areas of pain. No sick contacts. 
ROS: negative except as above
PMH: asthma
Meds: albuterol inhaler, tylenol
Allergies: NKDA
PSH: none
FH: father with high cholesterol and asthma, grandfather dies of heart attack
SH: Senior in high school and works as carpenter. Sexually active with girlfriend. Uses condoms and no concerns for STIs. Uses alcohol and smokes marijuana occasionally..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]subjective fever, m, 17 yo, stuffed nose, worse with deep inspiration, asthma, chest pain, one day history, Denies shortness of breath, tried albuterol without relief, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo M complains of left chest pain, sharp in character, non-radiating, not alleviated by anything and exacerbated by deep breathing and moving. Onset was yesterday morning. Tylenol and Albuterol inhaler did not relieve pain. He reports having a stuffy nose and muscle aches 3-4 days ago. No palpitations, no cough, no fever, no nausea or vomiting nor dizziness. No recent stressor, no h/o trauma. No changes in urination or bowel movements, no appetite changes. 
ROS: negative except as above
Allergies: none
Medications: Tylenol, Albuterol
PMH: Exercise-induced Asthma for 4 years now
PSH: none
SH: no smoking, occasional beers on parties; takes weed occasionally, last intake was last weekend; works as a carpenter's assistant; sexually active with 1 partner; does rock-climbing
FH:.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]M, 17 yo, stuffy nose 3-4 days ago, exacerbated by deep breathing, Exercise-induced Asthma, chest pain, Onset was yesterday, rock-climbing, Albuterol inhaler did not relieve pain, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Smith is a 17yr old M (whose mother gave consent for a history, physical examination, and treatment) is presenting with 1 day history 5-8/10 sharp left chest pain. He states that it is worsened with inspiration and movement and has not been relieved with tylenol or albuterol use. The pain does not radiate. He states that he went to a rock climbing gym 3 days ago and that he has had an improving illness involving stuffy nose and muscle aches for the last 3-4 days. 

ROS: negative except as above
PMH: Exercise induced asthma (last needed inhaler use 6 months ago)
PSH: none
Allergies: NKDA
Meds: albuterol, tylenol
Social: Denies tobacco use. Once monthly alcohol use. Endorses 2 occasions where he used marijuana at a party most recently 5 days ago. Denies other drug use. He is a carpenter's assistant..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]M, 17yr old, stuffy nose for the last 3-4 days, worsened with inspiration, Exercise induced asthma, chest pain, 1 day history, rock climbing gym 3 days ago, not been relieved with albuterol, 8/10, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 y/o M that comes to the office c/o chest pain that started yesterday morning. Described as constant, located on the left side, gets worse with inspiration, does not irradiate, 5/10 intensity when in rest, 8/10 intensity whith inspiration. Took tylenol and albuterol, but didn't alleviate the pain. Denies previous episodes. Also complains of feeling warm, having a runny nose, with whitish yellowish secretions and muscle ache for the last few days. Denies V/V, changes in stool, changes in urination, weakness, head aches, abdominal pain, or any other discomfort.
ROS: negative, except as above
PMH: Asthma with exercise
Med: Tylenol and albuterol
PSH: None
All: NKDA
FH: Dad has asthma and grandfather had MI
SH:Denies smoking. Uses marijuana, last time a week ago. Drink beer ocasionally. Sexually active with girlfriend, uses condoms. Is a senior in high school, also a carpinter asistant and rock climbs as hobby..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]feeling warm, M, 17 y/o, runny nose, with whitish yellowish secretions, worse with inspiration, Asthma with exercise, chest pain, yesterday, rock climbs, ""albuterol didnt alleviate the pain"", 8/10 intensity</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: my chest hurts 
HPI: 17 yo student c/o of acute chest pain that started yesterday morning. Pain is constant 7-8/10 severity, not associated with arm pain, does not radiate anywehere. Pain is worse with brreathing or moving. Pt tried to alliviate pain with tylenol q4 hours and albuterol but pain did not improve. Pt has had congested sinuses for 4 days that are improving. Pt had muscle aches for 4 days. No cough.
ROS: pt denies: headaches, weight changes, appetitie chages, diet changes, urinary changes, constipation, diarrhea 
Pt + for 2 days of feeling feverish, nasal congestion, muscle aches
PMH: exercise induced asthma 
Allergy-NKDA
Meds- albuterol for asthma
FH: dad-asthma, high scholesterol, grandfather MI 
SH: denies: smoking, traveling; occasional etoh use, tried marijuana, student and works as carpetner assistane, rock climbs, sleeps well
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]feeling feverish, 17 yo, congested sinuses for 4 days, 2 days of nasal congestion, worse with brreathing, exercise induced asthma, chest hurts, chest pain, started yesterday, rock climbs, albuterol but pain did not improve, 7-8/10</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17yo M w/ excerise induced asthma (no hospitalizations, last use inhaler 6m ago) coming in with L chest pain starting 1 day ago. Woke up with pain, worse w/ inhalation or movement, improves when sitting still. Describes pain as sharp. Tried tylenol q4h yestreday with no relief. Has also experienced ""stuffy nose"" and muscle pains for past several days, and endorses feeling warm with no objective fever and denies night sweats, chills, diarrhea, throat pain, constipation, change in urinary symptoms.

Of note, patient is an avid rock climber. Was in car accident as kid 

ROS: see above:
PMH: exercise induced asthma
PSH: none
Meds: none
Alg: none
FHx: grandfather MI at age 70
SHx: never smoker, drinks beer ~1x/month, weed 3-4x in lifetime..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]feeling warm, M, 17yo, stuffy nose for past several days, stuffy nose"", ""stuffy nose"", ""stuffy nose"" for past several days, pain, worse w/ inhalation, worse w/ inhalation, excerise induced asthma, chest pain, starting 1 day ago, rock climber, pain as sharp, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17-year-old male, has come to the outpatient clinic with chest pain. it started yesterday morning. the pain is located in the right chest , intensity is 5/10, the pain is aggravated by physical activity and relieved by nothing. he had nasal stuffiness and body aches the day before. pain increased on breathing. pt had  subjective fever. not relieved with tylenol
the pt denies cough, phlegm, sob, nausea, vomiting, bowel changes and sleep disturbances, no recent weight changes.no trauma and recent travel
ros: negative except as above
pmh: has exercise induced asthma psh: none
meds: tylenol and albuterol
allergy: nka no hospitalisations
ssh: sexually active with partner x 6 months and uses protection. denies smoking/EToH/illicit drug use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]subjective fever, male, 17-year-old, nasal stuffiness, exercise induced asthma, chest pain, started yesterday, denies sob</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 17 yo Male with PMHx of exercise induced asthma presenting in the ED for chest pain since yesterday morning. Mother gave permision to exam son over phone. Patient reports baseline sharp generalized chest pain since yesterday morning rating 5/10 in severity at rest and worsening to 8-9/10 in severity with exertion or changing position. Patient reports trying albuterol inhaler yesterday and 2 tablets of tylenol every 4 hours yesterday with minor relief in chest pain. Patient reports congested nose with rhinorrhea starting 3-4 days ago productive of white-yellow mucus without blood. Patient reports muscle aches and subjective fevers with onset of rhinorrhea but those symtpoms are improving. Pateint denies sick contacts. No surgical hx.
Med: Albuterol last used yesterday and 6 mo prior 
Allergies: NKDA
Social: 1 beer per month, denies tobacco or other drug use. feels safe at home 
Family: Dad- HLD, asthma, GF- MI.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]subjective fevers, Male, 17 yo, congested nose with rhinorrhea starting 3-4 days ago, exercise induced asthma, chest pain, chest pain, chest pain, since yesterday, since yesterday, albuterol inhaler with minor relief, sharp, 8-9/10</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 Y O MALE PRESENTED WITH COMPLAIN OF LEFT SIDED CHEST PAIN FOR LAST 1 DAY, CONSTANT, NON RADIATING, SHARP TYPE AGGRAVATED BY DEEP BREATHING AND MOVEMENT, RELIEVED BY LYING STILL. HE COMPALINS OF FEELING WARM FOR LAST FEW DAYS. HE ALSO REPORTS OF RUUNY NOSE AND MUSCLE ACHE FEW DAYS BACK. HE TOOK TYLENOL FOR HIS PAIN YESTERDAY BUT IT DIDNT RELIEVED THE PAIN. HE DENIES ANY SOB, DIZZINESS, COUGH,  SWELLING OF LIMBS, SWEATING, RACING OF HEART, RECENT ILL CONTACT.
ROS: NONE EXCEPT ABOVE
PMH: DIAGNOSED AS EXERCISE INDUCED ASTHMA UNDER INHALATION ALBUTEROL AS REQUIRED
MEDICATION: INHALTION ALBUTEROL AS REQUIRED
FH: FATHER HAS ASTHMA, HYPERLIPIDEMIA, GRADFATHER DIED OF HEARTATTACK
SH: SEXUALLY ACTIVE 1PARTNER, USES CONTACEPTION.
      USES MARIJUWANA LAST USED 1 WEEK BACK, NON SMOKER, NO ETOH USE
PSH: NONE
ALLERGIES: NKA.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]FEELING WARM, MALE, 17 Y O, RUUNY NOSE FEW DAYS BACK, AGGRAVATED BY DEEP BREATHING, EXERCISE INDUCED ASTHMA, CHEST PAIN, FOR LAST 1 DAY, DENIES SOB, SHARP</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Kane Smith is a 17 yo M who presents with sharp, pleuritic L sided chest pain that is not position dependent that began yesterday morning. Notes that he has been sick with a stuffy nose and muscle aches for the past 3-4 days. States albuterol and Tylenol have not helped. Worse with deep breathing and movement. Denies trauma to chest. Notes he feels warm but denies chills, night sweats, SOB, orthopnea, abd pain, nausea, vomiting, blood in stool, constipation, diarrhea, or numbness or tingling. PMH: exercise-induced asthma PSH: none Allergies: none Meds: Albuterol, Tylenol FH: Dad - asthma, high cholesterol, Grandpa - MI Denies tobacco or cocaine usage, EtOH: occasionally Sex: with girlfriend, uses condoms Healthy diet Exercise: rock climbing Occupation: Senior in high school, carpenter assistant.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]feels warm, M, 17 yo, stuffy nose, pleuritic, Worse with deep breathing, exercise-induced asthma, chest pain, began yesterday, denies SOB, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: Chest pain
HPI: Patient has had a 1 day history of chest pain. The pain is localized to one location on his L chest, and is tender to touch. The pain is also worse when he takes in a deep breath. The pain is not associated with food intake. The pain is non-radiating and constant throughout the day, and is described as soreness. He also describes a 3-4 day history of stuffy nose, muscle aches, and feeling ""warm."" He is also a regular rock climber, and goes often (2-3x/week). He has no SOB outside of difficulty with deep inspiration, and denies any other symptoms.
ROS: Otherwise negative
PMH: Exercise induced asthma
PSH: None
Meds: Inhaler, Tylenol
Allergies: None
SHx: Alcohol 1x/month, non-smoker, no illicit drug use. Sexually active with girlfriend. Senior in HS, works as a carpenter assistant, goes rock climbing at least 2-3x/week.
FHx: Grandpa survived HA.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]feeling ""warm, history of stuffy nose, worse when he takes in a deep breath, Exercise induced asthma, Chest pain, chest pain, 1 day history, no SOB, rock climber, rock climbing</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17yo M presents with 1 day of sharp L sided CP worse on inspiration and movement. Tylenol and albuterol did not relieve the pain. He reports a recent viral URI for the past 3-4 days accompanied by subjective fever. He denies SOB, N/V, cough, changes with food intake, odynophagia, stomach pain, rashes, joint pains, bowel or urinary changes. He has a history of exercise-induced asthma for which he uses an albuterol inhaler as needed, but states that this pain feels completely different. The patient requests a school excuse note. 

ROS: (-) except as above
PHx: exercise induced asthma
FHx: dad- asthma and hypercholesterolemia; grandpa- MI
Surgical HX: none
Meds: albuterol inhaler PRN
Allergies: none
SoHx: EtOH: 1-2 beers 1x mo; tobacco (-); illicit drugs: THC <1x/mo. The patient is sexually active with his girlfriend and uses condoms for protection..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]subjective fever, M, 17yo, recent viral URI, worse on inspiration, exercise-induced asthma, exercise induced asthma, CP, 1 day of, denies SOB, albuterol did not relieve the pain, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 17 yo M, c/o left parasternal chest pain, that started suddenly yeasterday morning,the pain is sharp in quality it is always there, not progressive, aggravated by deep breathing and movement, alleviated by rest, the pain is not radiating. he denies any cough or SOB, used pain relief but it didnt help. he usually do climbing in his free time but he doesn't recall any stress on his muscles or History of trauma, patient also had Common cold and stuffy nose 3 days ago an it is getting better. 
he denies any swelling or tenderness at his calf, no palpitation, neck swelling, hurtburn, no nausea, vomiting, bowel or urinary habits change, no change in weight or appetite, sweating more than usual. 
ROS: - except as above 
PMH: exercise induced asthma but he is off inhalers now as it is improved 
FH: father has asthma, grandfather had MI 
SSH: no smoking. social EtOH, smoking weed occasionally last time last weekend.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]M, 17 yo, Common cold and stuffy nose, aggravated by deep breathing, exercise induced asthma, chest pain, yeasterday, denies SOB, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: ""I've had this very sharp pain in my chest and it hurts when I take a deep breath.""
HPI: Patient is a 17yo who presents with sharp, pleuritic, non-radiating left sided chest pain since yesterday morning. The pain is a 5-6/10 at rest and worsened with movement and deep breaths to a 7-9/10. Denies any precipitating factors. He recently had a runny nose and muscle aches. Has been feeling warm. Has taken Tylenol w/ no relief. Denies shortness of breath, palpitations, nausea, vomiting, abdominal pain, cough, weakness, wheezing, sick contact, headache. No history of blood clots and no recent travel. No leg pain.
ROS: negative except as in HPI
PMH: exercise-induced asthma
PSH: denies
FH: Dad w/ asthma and HLD; Paternal grandfather w/ MI years ago
All: denies
Med: Tylenol; albuterol inhaler
SH: denies tobacco use; drinks a couple of beers at parties; denies drug use; sexually active w/ girlfriend; uses condoms; no history of STD.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]feeling warm, 17yo, recently had a runny nose, hurts when I take a deep breath, pleuritic, worsened with deep breaths, exercise-induced asthma, pain in my chest, chest pain, since yesterday, Denies shortness of breath, sharp, sharp, 7-9/10</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: patient is a 17 year old man presenting with 2 days of chest pain. The pain began yesterday morning when the patient woke. It is located to the left of the patients sternum. The pain is made worse with deep breathing, and has not been relived with tylenol or albuterol. He also reports that for the 3-4 days prior, he had nasal congestion, subjective fevers, and muscle aches. 
ROS: denies headaches, shortness of breath, abdominal pain, back or joint pain, changes in urinary or bowel habits
PMH: exercise induced asthma  Meds: albuterol, tylenol
Allergies: none PSH: none
FH: father with ashtma and hyperlipidemia, grandfather with a recent MI
Soc: no tobacco, alcohol one drink per month, no drug use. Participates in rock climbing. Sexually monogamous with girlfriend, uses condoms. Works part time as carpenter..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]subjective fevers, man, 17 year old, nasal congestion, worse with deep breathing, exercise induced asthma, chest pain, began yesterday, denies shortness of breath, rock climbing, not been relived with albuterol</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 17 yo M c/o RUQ chest pain when he woke up yesterday morning. pain is worse with deep breaths, sharp , 5-6/10 when sitting, 7-9/10 when deep breathing. no radiation of pain . pt used tylenol and albuterol which did not help, while moving and deep breathing makes it worse. he has also had a runny nose and muscle aches 3-4 days ago. no associated N/V, weight loss, or recent travel. he has had a mild fever but no chills.
ROS: negative except as above
PMH: evercised induced asthma
allergy: NKDA
meds: tylenol OTC for pain
FH: Dad- asthma , hypercholesterolemia ; Grandad- heart attack
SH: non smoker, 2 beers/ month, no recreational drug use, sexuially active with gf only, condom use , 1 partner over the past 1 yr.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]fever, M, 17 yo, runny nose 3-4 days ago, pain is worse with deep breaths, 7-9/10 when deep breathing, deep breathing makes it worse, evercised induced asthma, chest pain, when he woke up yesterday, albuterol did not help, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: This is a 17 y.o M who presents with sharp chest pain that started suddenly yesterday and has been constant since then. The pain is worse with movememnt and is pleuritic in nature, improving with leaning forward adn worse with deep breaths. nothing makes the pain better, treid tylanol and albuterol inhaler that did not help. No radiation of pain. Pt admits for feeling a little warm but denies SOB, palpitations, shoulder pain, N/V, sweating, heat intolerance, increased anxiety, or abnormal skin or hair changes, or any LE edema, or recent travel. pt had recent URI recently for 4 days with stuffy nose
ROS- otehrwise WNL
PMH - exercise-induced asthma
PSH - none
Meds; albuterol, tylanol as needed. 
NKDA
FH - asthma and hyperlipidemia in father. and MI in GF at 70
SH - eats regular diet, exercises by climbinng often., no EToh, tobacco, street drug use. Sex active with GF - uses condoms. no recent travel.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]feeling a little warm, M, 17 y.o, recent URI, stuffy nose, pleuritic, worse with deep breaths, exercise-induced asthma, chest pain, started yesterday, denies SOB, albuterol inhaler did not help, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo m c/o L upper chest pain for 1 day that started suddenly. It is  sharp, constant, nonradiating,exacerbated by movements and taking deep breath, alleviated by nothing. 3-4 days ago he had flu like symptoms.Associated with fever but did not measure. He has been doing exercises and at last he did 3 days ago. He denies SOB, weakness, cough, previous episode, any trauma, sore throat. 
ROS:Negative except as above
Allergies:NKDA
Medication:tylenol but did not relieve pain
PMH:exercise induced asthma
PSH:None
SH:sexually active with girlfriend, uses condom regularly, no smoking, once in a while uses ETOH, uses weed sometimes
FH:F:HLD, asthma
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Associated with fever, m, 17 yo, flu like symptoms, exacerbated by taking deep breath, exercise induced asthma, chest pain, 1 day, denies SOB, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient with a history of L chest pain for 24 hours, worse with inspiration. Patient woke up with severe pain in L chest, describes difficulty with movement and worse on inspiration. Patient works as a carpenter and does a lot of lifting. Did not work yesterday. Avid rock climber, went rock climbing the day before onset of pain but denies trauma or fall. Describes some rhinorrhea and congestion, muscle aches, subjective warmth though did not take temperature at home. No sick contacts. History of exercise induced asthma, however rarely uses inhaler, albuterol did not help symptoms. - smoking, alcohol, drugs..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]subjective warmth, rhinorrhea and congestion, worse with inspiration, worse on inspiration, exercise induced asthma, chest pain, pain in chest, for 24 hours, works as a carpenter and does a lot of lifting, rock climbing, albuterol did not help</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: Chest Pain
HPI: Mr. Smith is a 17 year old male with a one day history of chest pain. Localizes t the left side of chest. Says that it is a sharp pain that is worse with breathing. Tried tylenol and albuterol inhaler which did not help. Deep breathing makes it worse. Slightly better with leaning forward. No specific time of the day. Very severe. Also reports a URTI over the past 3-4 days with nasal congestion 
ROS: Has had fever, and chest pain. No shortness of breath, no nausea, vomitting, consipation, diarrhea.
PMH: Exercise induced asthma, no surgeries, no allergies, takes tylenol and albuterol inhaler as needed.
PSH: No smoking, alcohol occasionally, no drug use, is sexually active with GF. Uses condoms consistenly. No STD. Exercises regularly. Normal balanced diet.
FH: Mom healhy, Dad asthma and HLD, GPA MI.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]fever, male, 17 year old, URTI over the past 3-4 days, worse with breathing, Deep breathing makes it worse, Exercise induced asthma, Chest Pain, chest pain, chest pain, chest pain, one day history, No shortness of breath, albuterol inhaler which did not help, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Smith is a 17 yo M w/PMH of asthma who presents with 1 day of deep chest pain in the left upper quadrant that began when he awoke yesterday. The pain is 6/10 at rest and 7-9/10 with breathing. He denies cough or sputum or recent trauma. He has tried tylenol for the pain which has provided little relief. He has never had symptoms liks this. He has also felt warm and had a runny nose for 3-4 days. Pt denies N/V, chills, night sweats, abdominal pain, radiating pain down arms or into jaw, illegal drug use, or changes in bowel or uniary habits. 

ROS: negative except as noted above 

PMH: Exercise induced Asthma diagnosed 4 years ago 
PSH: none 

FH: Father - asthma, HLD, Grandfather - MI 
SH: Drinks EtOH occasionally, non smoker, does not use illegal drugs, sexually active w/girlfriend of 6 months. 

Meds: Tylenol, Albuterol
Allergies: NKDA.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]felt warm, M, 17 yo, runny nose, Exercise induced Asthma, chest pain, 1 day</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Kane smith, 17 yo old male presented with chest pain of one day history, there is no previous episodes. The pain is in his left chest and does not radiate. Patient mentioned he woke up yeterday and suddening starting having the pain. Patient could not quantify the amount of pain but admits its sharp in nature, associated with stuffy nose, muscleache and worsened by deep breath. Patient tried taking tylenol but does not alleviate the pain. 
ROS all negative except for the ones listed above.
PMH: exercise induced asthma no surgical or hospitalizations
Meds: tylenol for the pain since yesterday, asthma inhaler
FH: ashsma, hypercholestle in father. Grandfather w/ previous history of MI
SH: works as carpentor assistant. sexually active with one girlfriend, use of condoms. Does not smoke, social ethanol use no illict drug use..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]male, 17 yo old, stuffy nose, worsened by deep breath, exercise induced asthma, chest pain, pain is in his chest, one day history, yeterday, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Kane Smith is a 17 y/o male who presents with constant, left sided chest pain since yesterday morning that worsens with deep inspiration associated with a subjective fever. He has tried Tylenol and Albuterol inhaler with no relief. He denies the pain radiating anywhere. He can't think of any inciting events and has no prior hx of such pain. Of note, he states that he has 3-4 days of stuffy nose and muscle aches. He denies sick contacts, recent travel, or trauma to chest. No family hx of sudden cardiac death and denies drug use apart from marijuana every ""blue moon.""

ROS: Neg except as stated above
PMH: Exercise induced asthma
FH: Dad-asthma
Surgeries: None
Meds: As stated above
Allergies: None
Beer: 1x/month. Rarely smokes marijuana. Denies other drug use. No tobacco use
Senior in high school with good grades. Lives with mother, father and older brother.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]subjective fever, male, 17 y/o, 3-4 days of stuffy nose, worsens with deep inspiration, Exercise induced asthma, chest pain, yesterday, Albuterol inhaler with no relief</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17yo m presents with 1 day h/o sharp chest pain.  Intensity 7-8/10 with deep breath or movement, pain localized to left upper chest does not radiate, began when pt woke up yesterday and has not changed since onset.   No recent h/o trauma or injury.  Recent URI 3-4 days ago with congestion and myalgias. 
ROS: negative for sore throat, chills, N/V, diarrhea, constipation, lymphadenopathy 
PMH: exercise induced asthma, well controlled
Medications: Tylenol yesterday for pain, Albuterol for asthma (not needed in 6 months)
FH: Father HTN and asthma, grandfather MI
SHx: Pt is avid rock climber, no tobacco use, occasional EtOH use at parties, tried marijuana a few times consumed via smoke inhalation..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]m, 17yo, URI 3-4 days ago with congestion, 7-8/10 with deep breath, exercise induced asthma, chest pain, pain chest, 1 day h/o, began yesterday, rock climber, sharp, 7-8/10</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mr. Smith is a 17 year old male presenting to clinic with sharp left sided chest pain since yesterday morning that has been constant. Pain does not radiate and and is worse with deep breathing and movement. He has never felt this before. He denies SOB, N/V, diarrhea, palpitations, or a sore throat. Denies difficulty urinating. Tried albuterol and tylenol without any relief.
PMHx: Exercise induced asthma controlled with albuterol
FHx: Dad has asthma and hyperlipidemia. Grandfather had MI and is alive
No meds other than albuterol
No surgeries or allergies
Denies smoking tobacco. Drinks once per month socially. Smokes marijuana rarely. Lives with parents and works as a carpentry assistant for a few months..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]male, 17 year old, worse with deep breathing, Exercise induced asthma, chest pain, since yesterday, denies SOB, Tried albuterol without any relief, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: THE PATIENT IS A 17 YEAR OLD MALE THAT COMPLAINS OF CHEST PAIN. THE PAIN STARTED A DAY AGO AND THE PAIN IS OVER THE LEFT CHEST WALL AND CAUSES DECREASED RANGE OF MOTION IN THE LEFT ARM. THE PAIN INCREASED WITH DEEP BREATHS AND DECREASED WITH REST THE PATIENT HAD AN UPPER RESPIRATORY INFECTION 4 DAYS AGO THAT WAS UNTREATED
ROS: SAME AS HPI
PMH: EXERCISE INDUCED ASTHMA TREATED WITH ALBUTEROL
MEDS: ALBUTEROL, TYLENOL
FH: HIS DAD HAS ASTHMA AND HIS GRANDFATHER HAD A HEART ATTACK.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]MALE, 17 YEAR OLD, HAD AN UPPER RESPIRATORY INFECTION 4 DAYS AGO, INCREASED WITH DEEP BREATHS, EXERCISE INDUCED ASTHMA, CHEST PAIN, PAIN CHEST, STARTED A DAY AGO</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 year old male presenting with sharp stabbing chest pain on left side that started yesterday morning. It's a constant pain but doesn't radiate. It's worse with taking a deep breath or moving, and he tried taking Tylenol and using his inhaler but it didn't help. No previous similar pain. Associated symptoms include stuffy nose and muscle aches for past 3-4 days, feels warm but hasn't checked temperature. Denies nausea, vomiting, dyspnea, changes in urine or bowel function, night sweats, chills. Past medical history: exercise induced asthma diagnosed 4 years ago, uses inhaler as needed, last use 6 months ago. No surgeries, no medications daily, no allergies. Family history: father has asthma and HTN, grandpa had MI. Drinks beer at parties 1x/month, never smoked cigarettes, smokes weed at parties. Sexually active with girlfriend, uses condoms, never tested for STIs..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]feels warm, male, 17 year old, stuffy nose for past 3-4 days, worse with taking a deep breath, exercise induced asthma, chest pain, started yesterday, ""inhaler didnt help."", sharp, stabbing</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo male complains of chest pain that started yesterday accompanied by stuffy nose and muscle ache, no runny nose or throat pain
descibes a sharp pain, constant, mid sternal pain, worsened after deep breathing , was not relieved by tynelol or albuterol
no similar pain in the past
mentions rock climbing 3 days ago
denies palpitations, sweating, cough, shortness of breath
no recent long flight or travel
ROS - felt warm, no chills, no nausea or vomiting, no abdominal pain, no change in bowel habits or urinary habits
PMH - exercised induced asthma diagnosed 4 yers ago
medication - albuterol as needed
allergies - none
SH - senior class student, brother and sisters, parents are married, no h/o smoking or drugs, drinks beers occasionally at parties, sexually active with girlfriend uses condoms
FH - father with asthma and cholesterol, mother healthy.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]felt warm, male, 17 yo, stuffy nose, worsened after deep breathing, exercised induced asthma, chest pain, started yesterday, denies shortness of breath, rock climbing, not relieved by albuterol, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 y.o patient presents w/ c/o chest pain started yesterday morning on awakening. Pain is localized to Left chest wall (T2-T4) and is sharp and non radiating. IT is worse with deep breathing and movement and the pain has been constant. He tried telenol and his inhaler which did not help and change in position does not affect pain (eg leaning forward). The pain is the same as when it started and he did not experience any trauma but does heavy lifting at work. He has had a stuffy nose and body aches for the past 3-4 days which is better today. ROS (-)
PMH: exercise induced asthma
Allergies: NKDA
MEds: albuterol inhaler and tylenol q 4 hours yesterday 
PSH: none
FH: father asthma and HLD, grandfather had MI
SH: drinks beer on occasion, nonsmoker, uses marijuana at parties last used last week, sexually active with Girlfriend and uses contraception, no STI screens..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]17 y.o, stuffy nose, worse with deep breathing, exercise induced asthma, chest pain, started yesterday, heavy lifting at work, tried inhaler which did not help, sharp</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo male presents with chest pain since yesterday morning. Patient awoke with left-sided chest pain, described as diffuse, non-pinpoint, and like a 'sharp knife stabbing him.' Pain is constant, 5/10 when not moving but 8/10 with deep breath or movement. Tried taking Tylenol and albuterol inhaler with no relief. Also had congestion, rapid onset of diffuse muscle aches, and subjective fevers for multiple days before. Denies sick contacts, shortness of breath, nausea/vomiting, sore throat, cough. 

ROS: As per HPI
PMH: Exercise-induced asthma
PSH: None
FH: Father - asthma; grandfather - heart attack
Medications: Tylenol, albuterol inhaler as needed
Allergies: NKDA
SH: In high school. Denies tobacco use. Drinks alcohol occassionaly on weekens with friends. Smokes weed on weekends. Sexually active with girlfriend only..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]subjective fevers, male, 17 yo, congestion days before, 8/10 with deep breath, Exercise-induced asthma, chest pain, since yesterday, Denies shortness of breath, Tried taking albuterol inhaler with no relief, sharp, stabbing</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 17 yo m c/o right sided chest pain started yesterday morning , sharp , non radiating ,constant , 4/10 at rest  and 8/10 with movement , aggrab by deep breathing and movement , no allev , takes tylenol doesnt help ,has fever ,h/o of stuffy nose and muscle ache in past 4 days .Denies any prev similar attack , palp , SOB , cough , HA , dizziness, HA 
ros neg 
PMH asthma med albuterol inhaler , tylenol 
PSH , NONE  ,
FH granddad had heart attack , dad asthma 
sh carpenter , etoh ocassionally , use weel last used last weekend , no smoking 
sex with gf using condoms.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]fever, m, 17 yo, stuffy nose in past 4 days, aggrab by deep breathing, asthma, chest pain, started yesterday, Denies SOB, sharp, 8/10</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: Chest Pain. HPI:17yo male presenting with new onset chest pain for one day. Pain is localized to the left upper chest. It is constant, sharp, and 6/10 at rest and 8/10 w/ deep breaths. Palpating the area reproduces the pain. He denies radiation, trauma, or an inciting event.Also,reports a runny nose and muscle aches for the past 3-4 days. He has tried tylenol and his albuteral inhaler without relief. ROS: negative: cough, sore throat, lymphadenopathy, shortness of breath, palpitations, rashes, change in bowel/bladded habits, & back pain.Positive: runny nose, muscle aches
PMH:Pt has exercise induced asthma with a prn abuterol inhaler, not used for 6 months before now. NKDA, no surgeries
FMH:Dad, alive, asthma & hypercholesterolemia. Mom, alive and healthy. Grandfather alive, hx of MI. Sister,seasonal alergies
SH:Senior in high school, carpenters assistant. Occational EtOH and cannabis use. No Tobacco. 1 sexual partner, uses condom.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]male, 17yo, runny nose past 3-4 days, runny nose, 8/10 w/ deep breaths, exercise induced asthma, chest pain, for one day, negative shortness of breath, albuteral inhaler without relief, sharp, 8/10</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 35 yo F c/o mens cycles dysregularities
- started 6 m ago. LMP 2 m ago, has menorrhagea
- before 6 m, cycles were regular, 3-4 d/m. G0P0. No hot flashes. No vaginal discharge. 
- sex active with boyfriend, no contraception, wants to be pregnant 
- 10-15 p/last months
- no N/V, change in bowel habits, urination 

ROS as above
All: NKDA
Meds: none
PMH:none
PSH: none
FH: breast and cervical cancer h/o in family.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, menorrhagea, LMP 2 m ago, no contraception, 35 yo, 6 m, 6 m</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Tompkins is a 35 yo G0P0 woman with irregular, heavy periods over the past 6 months. Menarche was at 12, with periods every 30-35 days, lasting for 3 days, without pain. Now her periods occur every other month and last for 7 days, with heavy bleeding requiring her to change tampons every 2 hours. She had unprotected sex for 9 years with her ex-husband but never became pregnant and eventually adopted 2 children. She never pursued an infertility work-up. She is sexually active with her current boyfriend without birth control and has not become pregnant. She has gained 10-15 pounds in the past 6 months and feels tired. No hirsutism, acne, spotting, changes in bowels. 
ROS: otherwise negative. 
OBGYN history: Last pap 6 months ago, no hx of abnormal paps. No hx STIs. 
PMH: none
Meds: none
Surgeries: none
Allergies: none
FH: Aunt with breast cancer @ 51, grandmother with cervical cancer @ 62
SH: No tobacco or drugs. EtOH occ..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Ms, woman, gained 10-15 pounds, heavy periods, irregular periods, heavy bleeding, change tampons every 2 hours, without birth control, tired, never became pregnant, infertility, 35 yo, 6 months, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 35 yo, F, c/o irregular and heavy period* 6 mos
- since 6 mos ago, no ppt factors, needs to change pads/few hrs, heavier in first day, no dysmenorrhea, LMP 2 mos ago
- associated w/black pigmentations in hands and neck * 1 yrs, gain 10-15 lbs/6 mos, feeling fatigue because pt has 2 kids to take care
- denial cold/heat intilerance, swellings, depressed mood, anhedonis, skin/hair changes, acne, breast tenderness, vision changes, nausea, vomiting
ROS: no changes in appetite, bowel or urinary habits
PMH/FH/Meds: None, NKA
PSH/hosp: two nl vaginal delivery
SH: clerk ,etoh occ, no tobacco, illict drug use. diet nl, monogamous w/boy friend, couldn't conceive w/o condoms.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, gain 10-15 lbs, irregular period, heavy period, LMP 2 mos ago, fatigue, ""couldnt conceive"", 35 yo, 6 mos, 6 mos</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Case of a 35 yo F presenting for heavy menses. The patient had menarche at 12 yo. She used to have regular period lasting 7 days/ 4 weeks with 3 tampons/day. For the past 6 month she had only 2 periods with heavy bleeding  changing tampons every couple of hourse, but no clots.  The patient denies abdominal pain, no spotting between periods and no post-coital bleed. She rhad 10 lbs weight gain in the past 6 month with no change in appetite along with fatigue. She reports darkening of her skin on both hand and L neck for the past year. She denies change in vision, vaginal discharge or itching. She reports being infertile without investigation. No pap smear or mammography done. 
ROS: negative except as above
PMH: Infertile
PSH: None
Medications/Allergy:NKFDA
FH: Grandmother had cervical ca and aunt had breast ca
SH: Social worker. No smoking, occasional EtOH. No illicit drug use. Sexually active with boyfriend of 1 year no condomns..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, weight gain, heavy menses, heavy bleeding, changing tampons every couple of hourse, no condomns, fatigue, infertile, Infertile, 35 yo, 6 month, 6 month</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms Tompkin is  35 yoF with ""problems with periods"". The last five months she has noticed irregularity with her cycles and heavier bleeding. She started menstruation at 12 and her cycles were every 30-35 days. She went through 3 pads per day and had moderate bleeding. In the past five months she has only had two periods, and her last period was 2 months ago. She now changes her pad every couple hours and notices ""a lot of blood"". She has not had any increased pain with menstruation. She has a 10 pound weight gain in the past six months, and increased fatigue. Her last pap smear 9 months ago was normal. She has a history of infertility. Her mother and sister have regular periods

ROS: no nipple discharge, breast tenderness, vaginal pain, itching, discharge or dryness, no dry skin, no hair loss, no urinary syptoms

PMH: none
PSH: none
Meds: none
FH: grandomther - cervical cancer, aunt - breast cancer
SH: sexually active, no condoms.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Ms, F, weight gain, irregularity with her cycles, heavier bleeding, changes her pad every couple hour, last period was 2 months ago, no condoms, fatigue, infertility, 35 yo, five months, five months, six months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 year-old female presents with heavier and longer periods onset 6 months ago. Previously they were 3-4 days with 4 tampons this first day tapering down to 1 near the end. Now they last 7 days with tampons changed every few hours, her last one was 2 months ago and she's had 2 in the last 5 months. She denies any pain but does report fatigue and a 10-15 pound weight gain. She has no change in her vision. Unable to get pregnant. No irregular hair growth. No h/o STDs. 

Gyn: periods began age 12 were irregular then placed on birth control at age 12 to regulate. stopped 11 years ago. Pap smear 6 months ago normal (no abnormal)
PMH: none
PSH: none
Allergy: NKDA
FH: Aunt breast cancer 51 maternal, grandmother cervical cancer 62 maternal
Med: none
SH: alcohol 1-2 beers rarely, tobacco none, drugs none, work: scheduling administrator, sexyally active with boyfriend (monogamous).
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, weight gain, heavier periods, tampons changed every few hours, last one was 2 months ago, fatigue, Unable to get pregnant, 35 year-old, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Angela Tompkins is a 35yo F who presents to clinic complaining of ""period problems."" She states that her menstrual flow is heavier than usual. She usually uses 4 pads/day at the beginning of period, tapering to 1 by the end of period. Now she has to change pad every 2 hrs. Her LMP was 2 months ago. Periods are regular, occurring every 4-5weeks and lasting 3-4days. She has never been pregnant, stating ""I can't get pregnant."" This change in flow has never happened before. Endorses acanthosis nigrDenies hair loss, fevers, abd pain, joint pain.
PMH: none
PSH: none
SexualHx: active w/ boyfriend, no H/o STIs, no longer uses condoms
Allergies: none
Meds: none
SocialHx: 2 adopted children; nonsmoker, 1-2 beers/month, no illicit drug use..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, menstrual flow is heavier, change pad every 2 hrs, LMP was 2 months ago, no longer uses condoms, ""I cant get pregnant"", 35yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: Abnormal Menses
35 yo F with 6 months of irregular and heavy periods, shs has had 2 periods in 5 months, LMP 2 months ago. The bleeding is heavier than her normal period, using 7 pads/day instead of her normal 3, but there are no clots. Menarche was at age 12, and she has a history of irregular periods requiring OCPs. Menses were previously every 4-5 weeks, with 3 days of bleeding and mild cramping. She notes a 10lb weight gain in last 6 months, fatigue of 2 years duration and darkening of the skin over her knuckles and neck. She was unable to concieve after trying for 9 years. At present the patient has no pain with her periods, no vaginal dryness, no hot flashes, hirsutism, sleep changes, acne, breast discharge/pain, consipation or swelling.
ROS: No headache.
PMHx: None, no meds, NKDA. No Surgeries. SHx: Employed, drinks rarely, no tobacco or durg use. FHx: Maternal Grandmother Cervical CA, Maternal aunt Breast CA. OBGYN: G0,.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, weight gain, Abnormal Menses, irregular periods, heavy periods, 2 periods in 5 months, bleeding is heavier, 7 pads/day, LMP 2 months ago, fatigue, unable to concieve, 35 yo, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35yo F presents with irregular periods. She has had 3 periods in the past 5 months, irregular onset, lasting 7 days, needs to change tampon every few hours for the first day. In the past, her periods were regular, every 5 weeks, lasted 3-4 days, 4 tampons on first day. LMP was 2 mos ago. Periods associated w minor cramping only. Also reports gaining 10-15 lbs in the past 6 months, but no increased appetite. No acne, fatigue, lightheadedness, headache, fever, hirsutism, voice changes.

OBGYN Hx: Menarche age 12. Had irregular periods then and was put on oral contraceptive age 13-24; periods were regular then and remained regular after that. Tried to get pregnant for many yrs but never pregnant. No hx of STIs, tested negative 1 yr ago, no new partners since then. Sexually active with 1 male partner; no condoms or other contraceptive use.
PMH: no meds, allergies, health issues, or surgical hx
SH: occasional alcohol, no tobacco/drugs.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, gaining 10-15 lb, irregular periods, change tampon every few hours, periods irregular, LMP was 2 mos ago, no condoms, no contraceptive use, Tried to get pregnant but never pregnant, 35yo, 5 months, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo F comes into the office complains of heavy menses.  It started 6 months ago, when her period started to get heavy and she use to use 3-4 pads per day now increased to changing pads every couple of hours. Menses use to be 3-4 days now lasts 7 days.  Menarche was 12 years old, no pregnancy, normal pap smear 6 months ago.  Associated with dark spots on skin, fatigue, 10-15 lbs weight gain in last 6 months unable to get pregnant.  Denies changes in vision, neck lumps, fever, night sweats, abdominal pain, changes in stool caliber, bowel movement, urination, nausea vomiting, changes in breast, breast discharge, changes in hair.
ROS-none except listed above
PMH-NC; MEDS-NC; NKDA
Hospitalization/PSH- NC
family history- aunt died of breast CA; grandma died of cervical CA
SH- social woker scheduler, no smoking, occasional alcohol, no illict drug use, sexually active with boyfriend, no condom no use of STD, lives with 2 adopted children.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, weight gain, heavy menses, period heavy, changing pads every couple of hours, no condom use, fatigue, unable to get pregnant, 35 yo, 6 months, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Tompkins is a 35 yo F who presents due to a h/o irregular, heavy, and painful periods for the past 6 months. She has had 2 periods in the last 5 months, with her LMP being 2 months ago. She had her menarche at age 12, began taking birth control pills at age 13 to regularize her periods, and stopped taking birth control 11 years ago. She attempted to get pregnant with her ex husband for a period of 9 years, but was not able to. She is currently sexually active with her boyfriend, and they do not use protection because she ""cannot get pregnant."" She denies any irregular bleeding prior to the last 6 months, dyspareunia, problems with blood sugar, painful defecation, changes in bladder habits, abnormal discharge, itching, or any past h/o STIs. 

Social Hx: lives a stressful life with her job, and 2 adopted children, denies smoking, drug use, or drinking
FHx: None.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Ms, F, heavy periods, irregular periods, LMP being 2 months ago, do not use protection, get pregnant not able to, cannot get pregnant, 35 yo, 6 months, 5 months, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 35 yo F presenting with period problems. She states that she has had heavy period flow for past 6 months. Previously her menstrual period occured every 4-5 weeks, lasting 3-4 days and requiring 3-4 pads/day. Now she states that she has had 2 periods in last 5 months, lasting 7 days and requiring up to 7 pads per day. She also notes some fatigue and states she has gained 10 pounds in the past 6 months. She denies any vaginal discharge, dysmenorrhea or any breast tenderness/discharge. 
ROS: negative except as above
Medications: none
Allergies: NKDA
PMHx: none
PSHx: none
FHx: grandmother died from cervical cancer. Aunt died from breast cancer at 51
SHx:2 adopted children, no tobacco or illicit drug use. Drinks alcohol socially on occasion. Sexually active with boyfriend. Does not use contraceptives.
OB/GYN: LMP - 2 months ago. Never pregnant. Pap smear 2 months ago - normal. no vaginal discharge or associated symptom.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, gained 10 pounds, heavy period, Now lasting 7 days, Now up to 7 pads per day, Does not use contraceptives, fatigue, 35 yo, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Tompkins is a 35 yo Female presenting for problems with her periods. Reports she has been having irregular heavy periods for the last 6 months. Used to have periods every 4-5 weeks lasting 3-4 days, she would need 4 tampons on day 1 and then tapered down. Over the last 5 months she has had 2 periods with the last one 2 months ago. She goes through a tampon every 2 hours for the first day and her periods last 7 days. Has light cramping with her periods which has not changed. Has noticed skin discoloration on the back of her neck and the knuckles of her hands over the last 1-2 years. Has history of trouble getting pregnant. Tried for 9 yrs with research into the best strategies and could never get pregnant. Was never evaluated for this issue. Not on any contraception, no history of STDs, last pap 6 months ago was normal and has no history of abnormal paps. 
FH: cervical and breast cancer
SH: never smoker, 1-2 alcoholic drinks a week.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Female, heavy periods, irregular periods, tampon every 2 hours, periods last 2 months ago, Not on contraception, history of trouble getting pregnant, could never get pregnant, 35 yo, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 y/o female with on significant past medical history presents with heavier menstrual cycles. Her last regular menstrual period was 6 months ago. Her periods were previously on regular 1 month cycles. Her periods are still on 1 month cycles but she expereinces heavier bleeding with no pain. Has not noticed any vaginal discharge or clots. Denies any inciting factors. Does not think she is pregnant as she previously tried for 9 years and was unable to become pregnant. Has been having unprotected sex for the past year. Also reports gaining 10 pounds in the last 6 months. No fevers, chills, chest pain, shortness of breath, night sweats, hot flashes.

PMH: None
FMH: Aunt with breast cancer and grandmother with cervical cancer
Social: Never tobacco user. No alcohol or illicit drug use
Surgery: None.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, gaining 10 pounds, heavier menstrual cycles, heavier bleeding, unprotected sex, unable to become pregnant, 35 y/o, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI  40 y/o F c/o iregular periods for 6 monts, Right now she has period every 2 month but havier than before, last for 7 days and change tampons every 3 h on first day. NO tissue  coming out,  No fever, no constipation, no change in urinary habits. NO palpation.
PMH try to be pregnat for 9 y and could not . Adoppted two kids
PSH none
SF parents in good healt but aunt died of brest ca and grandmother hed cervical ca.
SH sexualy active with husband no history of STD.
SOcial  h drinks 1 glass of beer evry night but no tabbaco prodact nor illicit drugs
Married, has to adopted daughters.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, iregular periods, period havier, now 7 days, now change tampons every 3 h on first day, try to be pregnat for 9 y and could not, 6 monts</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo F presenting for heavy periods. For the past 6 months she has noticed an increased length and heaviness of periods. Previously periods were 3-4 days in length requiring 4 tampons on first day, 1 subsequent days; now with 7 day periods requiring change of tampon every couple of hours. No spotting between periods. She denies dizziness, SOB, N/V, abdominal pain, or clotting problems, but does endorse fatigue. Denies soaking through clothing. Patient also stating she is unable to get pregnant after years of attempts with her ex-husband. 
ROS: per HPI
PMH: none
PSH: none
Gyn: 12/irreg prior to BC/3-4 days, now 7 days; no h/o STI, Pap smear 6 months ago normal, sexually active with boyfriend, previously used condoms, but no longer
Allergies: NKDA
Med: none
FHx: aunt with breast cancer, grandmother with cervical cancer
Social: administrator, denies tobacco and drug use, social drinker, lives at home with her 2 adopted girls.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, heavy periods, increased length and heaviness of periods, now with 7 day periods, now requiring change of tampon every couple of hours, previously used condoms, but no longer, fatigue, unable to get pregnant, 35 yo, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 year old F complaining of missed period for the past 2 months. Reports that for the past 6 months, had heavy menses and irregular, was given Orthotricycline (OCP) by MD to help regularize menses, last dose taken 11 years ago, then menstruation became regular. Patient is divorced with husband, been trying to get pregnant and has adopted two kids. Had a boyfriend, sexually active, no condom or protection. Reports weight gain 15 lbs for the past 6 months, feeling of tiredness. Denies any depression, weight loss, hair changes, voice changes. Adopted 2 kids.
ROS: none
PMH: none
FH: Aunt has breast Ca. grandmother has cervical cancer. 
OB/Gyne: LMP 2 months ago, Menarche 12 years old, initially irregular, then became regular. Uses a lot of pad every couple of hours during the first day of mens. Denies spotting but reports mild cramping or dysmenorrhea. 
SH: denies smoking but has 1-2 beers occasionally. no illict drug,masters scho.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, weight gain, heavy menses, menses irregular, Uses a lot of pad every couple of hours, no condom, no protection, tiredness, 35 year old, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo F, presents with 6 months of oligomenorrhea and heavy menses. She has had only 2 menses during this perios, which lasted 7 days, and required changing pads every hour the first day. No clots seen. No previous history of amenorrhea. She reports a 10 pounds increase in weight but no change in appetite. Lives with her two adopted children (3, 4 years-old). Has seen a physician few years ago for check up and repors having been found to have infertility. Reports hyperpigmentation of her left neck and finguer knukles. No hirsutism. no cold intolerence, no tremors. No headache or visual changes, no galactorrhea. Has not had fever/chills, abdominal pain or changes in bowel movement. No urinary symtoms.
ROS: 
Allergies: none
PMH: infertility
PSH: none
SH: lives with 2 adopted daughters, works as sche.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, increase in weight, oligomenorrhea, heavy menses, 6 months only 2 menses, lasted 7 days, changing pads every hour, infertility, infertility, 35 yo, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Tompkins is a 35 y.o. F with 6 months of heavy periods. Last normal period was 2 months ago. LMP May 27, which lasted for 7 days. Used to only last for 3-4 days, and used to be regular. No intermenstrual bleeding. No bleedng or pan with sex. No vaginal d/c, odor, or pruritis. Also reports fatiues, weight gain, and rash on neck and fngers x2 years Reports abd cramping, but denies any other pan including in joints. No other bruisng, f/c, SOB, CP, palpitiations, change n BM/voiding, appeitite, mood or anxiety.

PMHx: difficulty conceiving. No hx STI, last pap smear nml a month ago, menarh 12 y.o. Adopted 2 children.
No PSHx, meds, allergies.
FHx: aunt breast CA, grandma cervical ca.
social hx no tobacco or drugs. occasonal beer. sexually active with one male partner. no condoms or contracepton..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, weight gain, heavy periods, Last period was 2 months ago, no condoms, no contracepton, fatiues, difficulty conceiving, 35 y.o, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 y/o F presents to the clinic for heavy periods 6 months in duration. Pts previous periods were regular, but she reports now that she has had 2 periods in 5months. She reports heavy bleeding on the first day of her period, now requiring 7 tampons on the first day where previously she required 3 -4. Pt has some minimal  cramping, and some skin discolouration on her 2nd knucles as well as on her L neck. Pt reports feeling fatigued for 2 years, and 10 lb weight gain with balanced diet. She reports that she believes she is infertile after failing to concieve for years. 
OBGYN: LMP 2 months ago, heavy flow, 7 tampons used for 1st day, Menarche at 12 y/o, G0P0, no pain during sex and no postcoital bleeding, last pap 6 months ago (normal), no hx of abnormal pap
ROS: Negative except as above
PMH and PSH: None
FH: Aunt died of breast cancer, grandmother died of Cervical cancer 
SH: Rarely drinks alcohol, sexually active with Boyfriend,.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, weight gain, heavy periods, heavy bleeding, heavy flow, now requiring 7 tampons on the first day, 7 tampons used for 1st day, LMP 2 months ago, fatigued, infertile, failing to concieve, 35 y/o, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 35 year old female who presents with change in menstruation. 6 months ago she started having heavier periods lasting 7 days (changing tampon every 2 hours). She has only had two during the past 6 months. Previously her periods were every 4-5 weeks, lasting 3 days without spotting or excessive cramping using 3 tampons per day. her last pap smear was 6 months ago and it was normal. no breast tenderness or discharge. tested for STIs (negative). no decrease in libido, vaginal dryness, no dysperunia, dyschezia, frequency, dysuria, incontinence, difficulty passing urine. sexually active with 1 male partner. 2 lifetime sex parterns; both men. never pregnant; tried for 9 months but couldn't get pregnant. no change in vaginal discharge (amount/smell/color). dark velvety rash bilateral knuckels and left side of neck. 10 pound weight gain with poor diet. no PMH/PSH, allergies, or meds; family hx and social hx noncontributory.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, weight gain, heavier periods, changing tampon every 2 hours, ""couldnt get pregnant"", 35 year old, 6 months, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Thompkins a 35 year old female comes to the office due to dysfunctional uterine bleeding. She states that during the last 5 months she started having heavy bleeding that is continous and intermittently without any pattern, she states that she needs to change her tampons constantly, she denies pain. Before this her menstruation used to be normal at intervals of every 30 to 35 days, lasting 3  days. Menarche was at 12 years old. 
ROS: No pain, No fever, denies bruises in other parts of body or blood dyscrasias.
Allergies: NKDA
Medications: Denied
PMHx: There is a story of infertility that has not had a workup diagnosis
PSHx: Denied
SH: Works in social security, denies smoking and drinks ocasionally, denies drugs. Sexually active with her husband. Uses no contraception
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, dysfunctional uterine bleeding, heavy bleeding, change her tampons constantly, Uses no contraception, infertility, 35 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Tomkins is a 35 F w no PMH who presents today w/heavy periods. She has only had 2 periods in the past 5 months. When they did occur, they were heavy and lasted for 7 days, previously they were for 3 days and came monthly. She has never had any spotting inbetween her periods, no abnormal Pap smears, no hx of any STDs. Further she has had no vaginal discharge or pain. In her prior marriage, she had difficulty geting pregnant but never sought any medical attention. She is currently sexually active w/ her new boyfriend only and, they do not use contraception. Ms. Tomkins further denies any changes to her bowel or urinary habits. No HA, cold intolerance, no belly pain, or hair loss. The only associated symptom is unintentional weight gain. She reports that she eats out alot and doesnt have time to exercise. She works as a scheduler for a social worker, has 2 kids, rarely drinks (beers), & does not smoke or do any illict drugs..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, weight gain, heavy periods, 2 periods in the past 5 months, periods heavy, periods 7 days, do not use contraception, difficulty geting pregnant, 35</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Angela Tompkins is a 35 year old female presenting with heavy periods. Menarche at 12 with abnormal periods for first year, started on OCP at that time and had regular periods every 4-5 weeks lasting 3-4 days requiring 4 tampons daily. stayed regular after stopping OCPs 11 years ago. Last normal period was 6 months ago. Since then has had 2 periods in 5 months, each lasting 7 days, requing multiple changes in first few hours. LMP was 2 months ago. She had tried to get pregnant with her ex-husband but was unable to. Has 2 adopted children. Normal Pap smear 6 months ago. Endorses 10-15 weight gain in 6 months and eating more. Notes rash on fingers and face for past year.
PMH: health.
PSH: none
Meds: none. NKDA
FH: aunt w/ breast cancer. grandmother w/ cervical cancer
SH: etoh 1-2 on rare occasions. no tobacco. no drugs. lives w/ 2 adopted kids. Sexually active with boyfriend. Stopped using condoms in past year..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, weight gain, heavy periods, requing multiple changes in first few hours, LMP was 2 months ago, Stopped using condoms, get pregnant unable to, 35 year old, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: The patient is a 35 year old F presenting with heavy irregular periods for the past 6 months. Prior to that her periods were normal, but now they last 7 days, she uses 7 tampons the first day and 1-2 the last. Her LMP was May 13th, 2 months ago. She has minimal cramping with her periods, no abdominal pain, no pain with defecation, no pain with urination. She was sexually active trying to get pregnant for years in the past and was not able to. She is currently sexually active with one male (her boyfriend), does not use condoms, does not have pain with sex, and was tested for STIs in the past year and did not have any. No history of uterine fibroids or ovarian cysts. No nausea or vomiting, +fatigue, + weight gain, +decreased appetite. No abnormal nipple discharge or hair growth.
PMH: none
Fam Hx: none
Social: negative for smoking
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, + weight gain, irregular periods, heavy periods, uses 7 tampons the first day, LMP 2 months ago, does not use condoms, +fatigue, trying to get pregnant not able to, 35 year old, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 year old female presents to the clinic today due to heavy menses, and mentioned that she would have to change her pads every couple of hours because it would soak right through. Patient denied pain with menses or any pain at all, denied vaginal discharge. Patient mentioned that she was fatigued, but it mainly had to do with taking care of her two little girls.

Pap smear: No abnormal pap smear in past

Past medical history, Social history, sexual history are all normal..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, heavy menses, change her pads every couple of hours, fatigued, 35 year old</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: Irregular periods.
HPI: 35-yo female complaining of heavy and irregular periods for the past 6 months. She has had 2 periods in the past 6 months, lasting about 7 days. She would soak a pad every couple hours during that time. Has also noticed decreased energy. The patient reports some darkening of the skin around her knuckles and the back of her neck. 7-8 lbs. weight gain in past 6 months, appetite normal. Denies other skin changes. No changes in hair. Denies recent increases in stress, headaches. 
PMH: No significant PMH. No medications.
SH: Scheduler for a social work company. Has one beer on the weekends. Never smoker. Divorced. She has two children, ages 3 and 5, who are adopted. The patient states that she and her ex-husband tried to get pregnant for many years but were unsuccessful. No formal workup for infertility in either her or her ex-husband.
FH: Grandmother with cervical cancer. Aunt with breast cancer..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, weight gain, 7-8 lbs gain, Irregular periods, irregular periods, heavy periods, pad every couple hours, decreased energy, but unsuccessful tried to get pregnant, infertility, 35-yo, 6 months, 6 months, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 YO F , C/O IRREGULAR PERIODS SINCE 6 MONTHS. HER LMP WAS 2 MONTHS AGO . SHE ALSO HAS HEAVY BLEEDING DURING HER PERIODS USING MORE PADS THAN OFTEN.
HER MENARCHE WAS AT 12 YRS OF AGE.  HER PERIODS WERE REGULAR BEFORE.  SHE HAS NO BREAST TENDERNESS OR FULLNESS. 
SHE HAS GAINED 15 POUNDS RECENTLY, WITH PIGMENTATION IN HER NECK REGION. NO BOWEL HABIT CHANGES , NO VOMITING. SHE HAS 2 ADOPTED KIDS AND WAS UNABLE TO CONCEIVE A CHILD FOR 10 YRS
SHE DENIES ANY FEVR , SOB , BELLY PAIN . NO DISCHARGE VAGINA
PMH:NONE
ROS: NEG EXCEPT AS ABOVE
SSH:MONOGAMOUS WITH HUSBAND ,NO USE OF CONDOM
FH: BREAST CANCER IN AUNT, CERVIX CANCER IN GRANDMA
ALLERGY: NONE
MEDS: NONE
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, GAINED 15 POUNDS, IRREGULAR PERIODS, HEAVY BLEEDING, USING MORE PADS, LMP WAS 2 MONTHS AGO, NO USE OF CONDOM, UNABLE TO CONCEIVE A CHILD, 35 YO, 6 MONTHS</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: hpi- 35 F c/o irregular periods for the past 6 months, lmp was 2 months ago, and menarche at age 12, she states that her periods have been happening every other month as of the past 6 months but were regular previously, she states that her cycles are now 7 days in length and are heavy, requiring her to change her tampons every hr, she denies any cramping, vaginal discharge or spotting in between her cycles, last pap smear was 6 months ago and was normal, shehas been experiecing infertility issues for the past 9 years, she also states that she has gained approx 10-15 
ros- she denies breast tenderness, hirsutism, acne, headache, vision change
pmh/psh- none, no previous hospitalizations, surgeries, or trauma  
NKDA 
fh- aunt- breast ca, grandmother- cervical ca 
social hx- social worker coordinator, beer rarely/ no tobacco or illicit drugs 
sexual hx- active w/ boyfriend, irregular condom use 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, gained 10-15, irregular periods, cycles heavy, lmp was 2 months ago, irregular condom use, infertility, 35, 6 months, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo F presents with a 6m history of menorrhagia  (changes tampons every couple of hours), irregular periods (every other month), increased duration of periods (7d, vs the usual 3d). Also presents weight gain: 10 lb in 6m, but attributes to eating ""outside"" more often. Incapable of getting pregnant for 9 yr. Denies vaginal itching or discharge, cramps, spotting, changes in appetite. 1yr history of acanthosis nigricans in arms and neck. Denies weakness, fever, hair loss.
OB/GYN: LMP 5wk ago. Menarche 12y/o. G0. Last pap 6m ago, normal. 
PMH: Never experienced before. Denies other diseases.
NKDA. Takes no medications.
No recent hospitalizations, infections, trauma, surgery.
FH: Aunt, breast cancer. Grandmother, cervical cancer. Mom and dad healthy.
Sexual history: 1 partner in the past year, no contraception use. No STD history.
Social history: Alcohol1 beer sporadically. Denies smoking, drugs. Scheduling coordinator. Sedentary.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, weight gain, gain 10 lb, tampons every couple of hours, irregular periods, menorrhagia, LMP 5wk ago, no contraception use, Incapable of getting pregnant, 35 yo, 6m, 6m</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 YO F G2P2 C/O IRREGULAR PERIODS X 6 MOMTHS.IT STARTED SUDDENLY,IS PROGRESSIVE,WITH NO ALLIEVIATING/AGGRAVATING FACTORS.PT ALSO MENTIONS ACANTHOSIS NIGRICANS ON HER NECK .ALSO SHE GAINED 10-15 LBS IN 6 MONTHS UNINTENTIONAL.PT USUALLY FAST FOOD AND STRESSED OUT WITH KIDS AND JOB.SHE DONT EXCERCISE REGULARLY
PT DENIES BELLY PAIN,CHANGES IN SLEEP,CHANGES IN URINARY HABITS/BOWEL HABITS
OBG/GYN LMP 2 MONTHS AGO,IRREGULAR,7 TAMPOON OJN HEAVY DAY,NO CRAMPS,G2P2,PAPS SMEAR 6 MONTHS AGO NORMAL

.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, GAINED 10-15 LBS, IRREGULAR PERIODS, 7 TAMPOON OJN HEAVY DAY, LMP 2 MONTHS AGO, 35 YO, 6 MOMTHS, 6 MONTHS</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 year old woman presents with menstrual irregularity, menorrhagia. In past, patient's periods occurred 30-35 days apart, lasting 3 days and controlled with tampons. Last normal period 6 months ago. Over past 5 months, periods have been occurring every other month, last 7 days, and require tampon changes every ""couple of hours"" due to excessive bleeding. Patient reports feeling more tired over past few months. Patient has never been pregnant, despite trying to get pregnant for 9 years. No hx of STDs. Sexually active with male partner over past year. No changes in bowel habits. No fever/chills. No cold intolerance. No bleeding elsewhere in body. No extra tissue behind neck. Has gained 10-15 lbs over past 6 months. No excess hair on arms or legs
PMH: unremarkable
PSH: None
FH: Unremarkable
SH: Never smoker, occasional beer every few weeks. No rec drugs. Eating out more often recently.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]woman, gained 10-15 lbs, menstrual irregularity, menorrhagia, tampon changes every ""couple of hours, excessive bleeding, tired, never been pregnant, despite trying, 35 year old, 6 months, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 y/o F c/o menstrual cycle abnormalities. 6 mo ago she began to have irregular cycles and increased flow, 2 periods in the last 5 mo that last for 7 d and day 1 requires 7 pads/d and the need for pads lessens as the days go on. Previously her cycles occurred every 4-5 wks, lasted 3-4 d, and she used 3-4 pads/d. LMP was 5 mo ago, menarche was at age 12 yrs, pt has never been pregnant, she took OCPs as a teen for 11 yrs for irregular periods (orthotricyclin). Denies vaginal discharge or dryness, dyspareunia, itchiness, SOB, mouth ulcers, HA.
ROS neg except as above
PMH none, NKDA, Meds none
Received the HPV vaccine
PSH/HOSP/Travel/Trauma none
FMH aunt had breast cancer and mother had cervical cancer
SH social worker administrator, denies smoke, EtOH, REC drug use
Sex hx active with boyfriend in past year, don't use condoms, no h/o STI or HIV.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, menstrual cycle abnormalities, irregular cycles, increased flow, 7 pads/d, ""dont use condoms"", 35 y/o, 6 mo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Tompkins is a 35 yo F who presents with irregular and heavy periods for the last 5 months. Prior to this, her periods came every 30-35 days and she used 4 tampons on the first day. Now they occur every other month, and she requires a tampon change every 2 hours. She also reports a history of infertility. She tried to get pregnant for 9 years and was unable to, she has two adopted daughters. She has no associated pain, nausea, vomiting, diarrhea, or constipation. Reports no burning or pain with urination. She has gained 10-15 lbs over the last 6 months, with more eating out. No changes in hair or hair loss. 
ROS-  otherwise negative 
PMH - none PSH - none 
FH - parents healthy - aunt had breast cancer - gma had cervical cancer 
no medications, no allergies 
Social - never smoker, no maijuana or illicit drugs. drinks alcohol rarely. lives with boyfriend and two daughters. monogamous. Has never had an STD and does not use condoms.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, gained 10-15 lbs, irregular periods, heavy periods, periods every other month, tampon change every 2 hours, does not use condoms, infertility, tried to get pregnant unable, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 YO FEMALE PRESENTS W/ IRREGULAR HEAVY PERIODS FOR THE PAST 6 MONTHS, HER LAST PERIOD WAS 2 MONTHS AGO AND SHE ONLY HAD 2 PERIODS IN THE PAST 5 MONTHS, EACH PERIOD LASTS 7 DAYS W/ PADS CHANGING EVERY 2 HRS, DENIES DYSMENORRHEA AND DYSPAREUNIA, NO VAGINAL DYSCHARGE OR PELVIC PAIN, LAST PAP WAS NML 6 MONTHS AGO. SHE ALSO COMPLAINS OF DARKNESS OF SKIN AROUND KNUCKLES AND NECK. SHE HAD PRIMARY INFERTILITY FOR 9 YEARS OF UNPROTECTED SEX W/O CONCEPTION W/ PREVIOUS HUSBAND. SHE IS G0P0 WITH 2 ADOPTED CHILDREN.
ROS NEGATIVE EXCEPT ABOVE
PMHX, SHX, MEDS, ALLERGIES: NONE
FHX:  GRANDMOTHER W/ CERVICAL CANCER, AUNT W/ BREAST CANCER
SHX: DENIES SMOKING AND ILICIT DRUG USE, OCCASIONAL BEER, UNPROTECTED SEX W/ BYFRIEND ONLY, HIGH FAT DIET, NO EXERCISE..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]FEMALE, IRREGULAR HEAVY PERIODS, ONLY HAD 2 PERIODS IN THE PAST 5 MONTHS, PERIOD LASTS 7 DAYS, PADS CHANGING EVERY 2 HRS, UNPROTECTED SEX, INFERTILITY, 35 YO, 6 MONTHS</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 35 yo F with heavy uternine bleeding. Last normal period was 6 month ago. LMP with heavy bleeding 2 months ago. No clots. Changes tampon every few hours, previously 4/day. Menarche at 12. Minimal cramping. Never been pregnent, tried previously but unsuccesful. Two adopted children and feels fatigued at home. Last PAP 6 months ago was normal, never abnormal. Gained 10-15 lbs past few months, eating out more though. Hyperpigmented spots on hands and LT neck that she noticed 1-2 years ago. No breast changes. ROS: neg except above. PMH: none. Allergies: none. Meds: none. PSH: none. FH: aunt died of breast cancer. SH: state social worker; no smoking or drug use; beer or two on weekends; sexually active with boyfriend of 14 months, used condoms at first but no longer uses them, no concerns for STDs.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, Gained 10-15 lbs, heavy uternine bleeding, heavy bleeding, LMP 2 months ago, condoms no longer uses, fatigued, Never been pregnent, tried previously but unsuccesful, 35 yo, 6 month</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo F presenting with 6 months of heavy periods. She reports having her most recent normal period (4-5 tampons for the first day, then fewer over following days) 6 months ago. Since then, she has been experiencing heavy periods (8-10 tampons for the first day, then fewer) occuring once every 2 months. She denies any other discharge, any fevers, any abdominal pain, and any constipation. She notes 10-15 lbs of weight gain over the past 6 months, as well as discoloration of her neck and hands over the past year. She denies any hot flashes, constipation, or changes in diet/exercise habits.
PMH: None.
OBHx: Denies, tried unsuccessfully for 9 years to become pregant)
GYNHx: Last pap smear 6 months ago, no history of abnormal paps. Menstrual history per HPI. Denies history of fibroids
PSH: None
Meds: None
All: NKDA
FH: Breast cancer in aunt, cervical cancer in grandmother
Sh: Lives at home with 2 adopted children.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, weight gain, heavy periods, heavy periods, 8-10 tampons for the first day, tried unsuccessfully to become pregant, 35 yo, 6 months, 6 months, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35-year-old female with 6 month history of heavy, irregular menstrual periods. She is P0, with two adopted children, she has tried to get pregnant in the past, trying for 9 years with her ex husband. Her menstrual periods previous to this year were once every 4-5 weeks, lasted a few days, and used 4 tampons the first day, tapering off for the other days. Now she has had 2 periods in the past 5 months, using a tampon every two hours, and her period often only lasts a day. She has no pain, light cramping. No fever, chills, nausea. She has had some feeling of tiredness but no new hair growth or cold/heat intolerance. She has gained 10-15 pounds in the past 6 months. 
PMH/surge: denies
social: Diet: says she is eating a little more ""easy"" food. Never smoker, 1-2 beers very rarely  Sexually active boyfriend no condom use.
Meds: none currently, previously took contraceptive pills with no side effects
allergies: none.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, gained 10-15 pounds, irregular menstrual periods, heavy periods, tampon every two hours, no condom use, tiredness, P0 tried to get pregnant in the past, trying for 9 years, 35-year-old, 6 month, 5 months, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms Tompkins is a 35 year old woman presnting with a 6 month history of abnormal menses. Pt says that her menses have become heavier over the past 6 months and can require changes in tampons every couple of hours. She has not noticed any clots. They have also become irregular and her last menstrual period was 2 months ago. The pt has not had an increase in cramps during her menses and has not felt any abdominal fullness. Menses started at age 12 and had been regular until 6 mo ago. Of note, pt believes she cannot get pregnant because she tried to conceive for years unsuccessfully with ex-husband. 

ROS: Weight gain of 10-15 lbs over 6 months, denies hot or cold intolerance, denies fevers, chills, headaches. 
PMH: No previous medical problems, no medications.  
Allergies: NKDA
FH: parents healthy, breast cancer in aunt, cervical cancer in grandmother. 
SH: occasional alcohol, - smoking, - illicits. Pt sexually active w boyfriend..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Ms, woman, Weight gain, gain of 10-15 lbs, abnormal menses, menses heavier, changes in tampons every couple of hours, menses irregular, last menstrual period was 2 months ago, cannot get pregnant, tried to conceive for years unsuccessfully, 35 year old, 6 month, 6 months, 6 mo, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: This is a 35yo F who presents with abnormal periods. Patient states 6 months ago she noticed increased bleeding with her periods. They now last 7 days (previously 3 days) and she now is changing her tampon with increased frequency. She denies bleeding anywhere else (ginvival), denies bruises, vaginal discharge. Patient states she tried to have a child with her exhusband for 9 year but was unable to, she never saw a doctor about this problem. She is currently sexually active with her boyfriend, and has never had an STI. Her last pap smear was 6 months ago and was regular. Menarche at age 12, periods previously occurred every 4-5 weeks

denies PMH, PSHx, meds, allergies
FH: grandmother - cervical cancer at 65; aunt - breast cancer at 51
Social: denies tobacco or recreational drug use, occasinal alcohol use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, increased bleeding, now last 7 days, changing her tampon with increased frequency, abnormal periods, tried to have a child but was unable to, 35yo, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo F with heavy periods for the past 5 months. Periods now occur every other month, last 7 days, and increased flow requiring a tampon change every other hour. Previous periods occurred every 30-35 days, lasted 3 days, and only required a couple of tampons daily. Her last regular menses was 6 months ago. LMP was 5 weeks ago. Menarche was at 12 yo. Pap smear 6 months ago was normal, no abnormal results. Also has 9 years of infertility, requiring her to adopt. No workup previouusly done for this. Sexually active with one male partner, unprotected sex. 
Denies urinary frequency, dysuria, nocturia, appetite changes. 
PMH none
Allergies none
Meds none
FH none
Denies alcohl, drug, smoking.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, heavy periods, increased flow, tampon change every other hour, LMP was 5 weeks ago, unprotected sex, infertility, 35 yo, 5 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC-period problems
hpi-Angela Tompkins is a 35 yo female who presents for period problems. She has had heavy period for the past 6 months. Her LMP was 2 months ago, with last normal period being 6 months ago. Her periods now last 7 days, and require 7 tampons on the first day up from 4 previously. She had menarche at age 12, has not experienced vaginal pruritis, dryness, or burning. Never been pregnant, has had no vaginal discharge or bleeding between periods, had a normal Pap smear 9 months ago, and has not noticed breast lumps. She has not had thought of depression.
ROS:+ fatigue, weight gain (10-15 pounds over 6 months), dry skin; - for dyschezia, constipation, diarrhea, fever
pmh-none
psh:none
SH:sexually active with boyfriend, monogomous, no male condom use; no cigarettes, alcohol socially 0/4 CAGE, no drugs; social worker
FH:mom&dad alive and well; aunt died breast cancer, grandma cervical cancer
meds:none
Allergy:none.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, weight gain, gain 10-15 pounds, heavy period, require 7 tampons, LMP was 2 months ago, no condom use, fatigue, 35 yo, 6 months, 6 months, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 33 yo F c/o problems with periods.
-has had heavy periods for 6mo, used to use 3-4 tampons/day now changes tampon every couple of hours
LMP 2 months ago, periods used to occur every 4-5 weeks regularly and last 3 days, now has only had 2 periods in the last 5 months, and they last 7 days
-no dysmenorrhea, no intermenstrual/postcoital bleeding, no dyspareunia, no abdominal/pelvic pain
-fatigue, weight gain 10lbs in 6mo, hyperpigmentation over knuckles and side of neck
PMH: no medical conditions, no meds, PSH none, allergies none, last pap smear 6mo ago normal, possible infertility 
FH aunt breast cancer died 51, grandmother died cervical cancer 65 
SH non smoker, occasional EtOH, no recreational drugs, poor diet/exercise, sexually active with boyfirned, no use of condoms, 2 partners in 10yrs, no STIs.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, weight gain, gain 10lbs, heavy periods, changes tampon every couple of hours, LMP 2 months ago, no use of condoms, fatigue, infertility, 33 yo, 6mo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Angela Tompkins, a 35-year-old female, with c/o irrgualr uterine bleeding. For the past 6 motnsh she ahs noted heavyier periods and irregulites in her period frequency. her LMP was 2 months ago and she had to change her tampons ""every few hours."" Normally her peirods came regularly every 4-5 weeks last 3-4 days and she would use 4 tampons on the heaviest days. She also notes mild abdominal crmaping. She notes infertilliy after trying wiht he husband for several years. she has notice a 10-15 pound weght gain
ROS - for Nausea vomiting, chest pain, vaginal discharge, dysuria, diarreha constipation, heat intolerance. 
PMHx, PSHx NA
Allergies NKDA
Meds: NA
Fhx: + for grandmother with cervical CA, aunt with breast CA
OBGYN: G0. two adopted children
Social, works in administration. drinks occationally denies tobacco and illict drug use
Sexual Hx: Sexually active with husban, no longer uses condoms, No STI hx in her or her partner.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, weght gain, 10-15 pound gain, irrgualr uterine bleeding, heavyier periods, irregulites in her period, change her tampons ""every few hours, LMP was 2 months ago, no longer uses condoms, infertilliy, 35-year-old, 6 motnsh</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 YO F C/O MENSTRUAL PROBLEMS
5 MONTHS OF HEAVY FLOW, IRREGULAR, INFERTILITY, 10 LBS WEIGHT GAIN, DARKNESS NECK AND KNUCKLES
DENIES HEADACHE, LIGHTHEADEDNESS, SOB, CHEST PAIN, ABD PAIN, CHANGES IN BOWEL URINARY HABITS 
ROS: NEGATIVE EXCEPT ABOVE
PMH: NONE
OBGYN: MENARCH 12 YO, LMP 2 MONTHS AGO, MENSES BEFORE 3/30 MODERATE FLOW, CURRENT 7/60 HEAVY FLOW. LASP PAP 6 MONTHS AGO NORMAL, PREGNANCIES 0 
PSH: NONE 
FH: AUNT BREAST CA, GRANDMOTHER CERVICAL CA 
MEDS: NONE
ALL: NKDA
SH : SCHEDULING COORDINATOR, DENIES SMOKING, ETOH OCCASIONAL, DENIES DRUGS, NO DIET OR EXERCISE, SEXUAL ACTIVITY NO BARRIER CONTRACEPTION 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, WEIGHT GAIN, 10 LBS GAIN, HEAVY FLOW, FLOW IRREGULAR, LMP 2 MONTHS AGO, NO BARRIER CONTRACEPTION, INFERTILITY, 35 YO, 5 MONTHS</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Tompkins is a 35 yo F presenting with heavy menstruation. Her sx began 6 mo ago. Previously she had her period every 4-5 weeks, lasting 3 days. Now her periods have become irregular, lasting 7 days. Also, she previously used 3 pads a day for her periods, she now uses about 7 pads. Her last menstrual period was 2 mo ago and she had her first period at age 12. She has not complained of any vaginal itchiness, discharge, dryness. She does not experience intense cramps during her cycle. No spotting is noted. She has tried to get pregnant for 7 years with no success. Last Pap smear was 6 mo ago - normal

ROS: 10 lb weight gain in 6mo; eats out often; decreased energy. Discoloration of knuckles and neck 
PMH/PSH: None
Allergies: NKFDA
Meds: None
Fam hx: GM- cervical CA; Aunt - breast CA
Social: divorced, 2 adopted daughters; works in social work. No smk/drugs, rare alcohol use
sexual hx: sex with bf, no condom.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, weight gain, heavy menstruation, periods irregular, Now lasting 7 days, now uses about 7 pads, last menstrual period was 2 mo, no condom, decreased energy, tried to get pregnant for 7 years with no success, 35 yo, 6 mo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo F presenting with 6 mos of heavy periods. She used to have periods every 4-5 weeks lasting 3-4 days now has had 2 periods in the last 5 months with increased tampon use. She denies passage of large clots. No dysmennorhea. She has been more fatigued over the past 2 years. No alleviating or aggravating factors. She has had a 10 lb weight gain in the past year and attributes it to eating out more. She has low fruit and vegetable intake. No abdominal pain. 
ROS: No h/a, visual changes, n/v, constipation, diarrhea, melena, hematochezia, dysuria, vaginal discharge, leg edema
PMH: None
PSH: none
FH: Gma died of cervical cancer, aunt died of breast cancer
SHX: works for state social services, has 2 kids (adopted), has never been able to get pregnant
No tobacco use, social ETOH use, no OCP or barrier protection, sexually active with boyfriend only
NL pap smear 6 mos ago
Meds: none.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, 10 lb weight gain, heavy periods, 2 periods in the last 5 months, increased tampon use, no OCP or barrier protection, fatigued, 35 yo, 6 mos</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 YOF C/O HEAVY MENSTRUAL BLEED, HER CYCLE HAS BECOME IRREGULAR,  SHE BLEEDS HEAVILY FOR 7 DAYS AND HAS 2 CYCLES X 6M. THIS IS NOT A/W ANY PAIN OR FEVER. SHE ADMITS FAMILY HISTORY OF ENDOMETRIAL AND BREAST CANCER, GAINING 10LB IN THE PAST 6 MONTHS, STRESS AND FEELING TIRED, INFERTILITY( PAST 9 YEARS BUT SHE HAS 2 CHILDREN).  SHE DENIES ANY HEAT INTOLERANCE, VOICE CHANGES , OR TRAUMA, LIGHTHEADEDNESS, BOWEL CHANGES OR URINARY CHANGES, USING OCPS.
ROS: NEGATIVE EXCEPT ABOVE
PMH: NONE   PSH: NONE  MEDS: NONE   ALLERGIES: NONE   
SSH: NON SMOKER DRINKER OR DRUG USER
SEXUALLY ACTIVE WITH  BOYFRIEND WITHOUT ANY PROBLEMS
UTD WITH SCREENINGS.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, GAINING 10LB, HEAVY MENSTRUAL BLEED, CYCLE HAS BECOME IRREGULAR, BLEEDS HEAVILY FOR 7 DAYS, TIRED, INFERTILITY, 35 YO, 6M</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Tompkins is a 35 yo F c/o dysmenorhea. She noticed her menstrual cycle stop 6 months ago with breakthrough bleeding occuring every few months with alot of blood. 
-Her LMP was 2 months ago using several pads and lasting a week. Did not have fatigue during this time. 
-She ALSO GAINED 10 PUNDS DURING THIS TIME. aLSO, noticed dark skin changes on her knuckles and neck over the past 2 years.
-unable to conceive a child with no protection for 9 years
-ros therwise negative 
- works as an analyst, adopted 2 children with boyfriend, sexually active with no protection, no hx of STIS
PMh/PSH: NONE, NO MEDS, NO ALLERGIES
-FAM HX OF OVARIAN CANCER AT 65 IN GRANDMA AND BREAST CANCER AT 51 IN AUNT
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, GAINED 10 PUNDS, alot of blood, LMP was 2 months ago, no protection, unable to conceive, 35 yo, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo F c/o menorrhagia.
-began 5 weeks ago, LMP 6 month ago, before that  perioids are regular, 3/30days, 4 pads on the heavy day, now every other months, lasting 7 days and pad change every several hours
-noted skin pigmentation on the dorsal hands and wt gain of 10-15 lbs over past 6 months, no pain, no itching
-history of difficulty pregnancy for 9 yr
-no pain or spotting during the peroids, no pain or bleeding the sexual intercourse, no vaginal discharge, no belly pain, no prevous pregnancy, no abortion, 
-normal PAP smear, sexually active with boyfriend, no condom use or OCP
ROS: no fever, no night sweats, no cold intolerance, no dry skin, no voice change, no change in urination or bowel movement, no change in sleep, no fatigue,no felling of depresion
PMH/PSH:nONE. All:NKDA. Meds:None. FH: Mother with breast Ca, prandmorther with cervical Ca. SH: coordinaotr, occasional EtOH., living with 2 adopted children,no abuse.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, wt gain, gain of 10-15 lbs, pad change every several hours, perioids every other months, no condom use, no OCP, 35 yo, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Miss. Tompkins is a 35 y/o female with no sig. PMH who presents with painless vaginal bleeding onset 5 months ago gradually worsening. Prior menstrual cycles utilized 3 tampons and not as severe. LMP 2 months ago. No hx of sti/std. Last pap smear 6 months ago normal. FHx significant for grandmother with cervical cancer. Ho social hx of smoking. Started menses at 12 y/o with menstrual cycles occuring 4-5 weeks. Sexually active with boyfriend with no contraception. Denies abdominal pain, nausea, vomting, pain with urination or defecation, pain with sexual intercourse, trauma to area, changes in hair, HA, visual changes, breast discharge..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, LMP 2 months ago, no contraception, 35 y/o, 5 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 year old female c/o heavy menstrual bleeding over the past 6 months. LMP reported as 2 months ago. Pt states she normally gets her menses every 4-5 weeks and they last 3 to 4 days; Pt states she normally uses 4 pads on the first day then it slowly tapers down to one. Pt however states that she has been skipping periods and that she now uses 7 pads on first  day which is unsual for her. Pt denies any pelvic pain. Associated sxs consist of 10-15 lbs weight gain over the past 6 months along with feeling tired more often and a dark rash over the neck and hands. Pt denies any abnormal vaginal discharge. Pertinent negatives includes no breast discharge or tenderness, no hot or cold intolerance, no abdnormal hair growth, no HA or vision problems; CP/SOB. 

PMHx is unremarkable. No current meds; No recent hospitalizations or past surgeries. 
Social hx: EtOH: 1-2 beers/ month; no tobacco or other drugs; no recent travels; pt is.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, weight gain, heavy menstrual bleeding, skipping periods, 7 pads on first  day, LMP reported as 2 months ago, tired, 35 year old, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI:A 35 yo F present with problems in her mentrual period. For the last 6 months is being hevier. Before use 4 tampons and now change tampons every hr. Feel tire. GAin weight 10-15 lbs last month. Denies other complaints.
ROS: negative except as above.
OBGYN: LMP 2 month ago, mense regular 4 TPD,  now change tampons every hr, No STD hx, LPS 6 month ago was normal and no previous positive sresults. No contraception. G0P0
ALL: none
Meds: None
PMH: none
PSH: none
FH: Aunt breats cancer, grandmother cervical cancer
SH: administrator, no smoke, ocassional etOh, no drug, no excersice, diet, new boy freind since last year no contraception use, previous boyfriend triend to get pregnant for 9 yaer witout sucess..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, GAin weight 10-15 lbs, problems in her mentrual period, mentrual period hevier, now change tampons every hr, now change tampons every hr, LMP 2 month ago, no contraception, triend to get pregnant for 9 yaer witout sucess, 35 yo, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 year old F presents with irregular periods. states that her periods used to be regular every 4-5 weeks lasting 3 days but for the past 6 months her periods are irregular, she has only had 2 periods in the last 5 months and they have been heavier than usual requiring more tampons and lasting for 7 days. reports weight gain of 10 lbs in the past 6 months and a new dark skin rash on her hands and neck but denies any fevers, chills, abd pain, bleeding off cycle, spotting, discharge, breast lumps, nipple discharge. has been unable to get pregnant for 9 years of trying. no obvious improving or worsening factors

pmh none
psurg none
all none
meds none
obgyn: menarche 12, last pap was 6 months ago was normal, 
fhx: cervical cancer in grandmother (65 yrs old), aunt with breast cancer (51)
soc: etoh 1-2x monthly, no tobacco or illicit drugs,works as social work scheduler,sexually active with boyfriend uses condoms occasionally,no STDhx.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, weight gain, gain of 10 lbs, irregular periods, periods are irregular, requiring more tampons, uses condoms occasionally, unable to get pregnant, 35 year old, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Angela Tompkins, 35, 6 month history of heavy periods
LMP: 5 weeks ago, changing tampon every couple of hours, periods are lasting for 7 days. She denies bleeding or pain during intercourse. She denies any abdominal pain or fullness. She denies cramping. 
Patient has infertility and has two adopted children, ages 3 and 5. Patient has gained 10-15 pounds in the last 6 months. She denies a change in appetite though she has been eating out more frequently. Patient has never had an STI. She has no previous mammogram. Her last pap smear was 6 months ago and was normal. 
PMH: None
FH: Mom: cervical cancer, Aunt breast cancer
SH: Patient is a scheduling coordinator. 
ROS: Patient denies changes in vision, headache, night sweats, changes in urinary habits, changes in bowel habits. She denies joint pain..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Ms, gained 10-15 pounds, heavy periods, changing tampon every couple of hours, LMP: 5 weeks ago, infertility, 35, 6 month, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: The patient is a 35 yo G0P0 obese female with no significant PMH who presents of heavy and irregular periods starting 5 months ago. She states her periods have been coming once every two months, and last 7 days. The bleeding is heavy, with her having to change her tampon every two hours during the first day. Her periods were previously regular, occuring every 30-35 days, and lasting 3 days. She also states that she has never been pregnant despite trying for several years previously. Menarche was at ge 12. No pain or cramping during her periods. ROS: postive for fatigue. Negative for nausea, vomiting, diarrhea, constipation, CP, SOB. PMH: none Med: none Allergies: none FH: parents healthy, mat aunt died from breast cancer. mat GM died from cervical cancer. PSH: none SH: works as a scheduling coordinator. Has two adopted daughers, ages 3,5. No smoking, occasional alc. Sexually active with boyfriend, no condom use. no STI.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, heavy periods, irregular periods, periods have been coming once every two months, periods last 7 days, bleeding is heavy, change her tampon every two hours, no condom use, fatigue, never been pregnant despite trying, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Angela Tompkins is a 35yo female having irregular, heavy menstrual cycles. It began 6 months ago. Previously her periods occured every 4-5weeks needing 4 tampons at the heaviest flow. Now, she has periods irregularly and changes multiple tampons every few hours. Menarche at 12 years old but needed OCPs to control periods since 13 until she stopped. She tried to conceive for 9 years with prior husband off birth control without success. The patient last had a period 2 months ago. No abnormal discharge. Normal pap. Sexually active. No STIs as of 6 months ago. Increased in weight 10-15 lbs. Denies nausea, vomiting, polyphagia, polydypsia, ulcers, changes in hair, voice depening, palpitations, breast swelling or exudate.
ROS: Neg exept above
PMH, allergies, meds: none, no surgeries
FHx: Aunt died of breast CA,  grandmother had cervical cancer
Social: - smoke, drugs, + 1-2 beers during outings, monogamous, sexually active, 2 adopted sons.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, Increased in weight, irregular menstrual cycles, heavy menstrual cycles, periods irregularly, changes multiple tampons every few hours, last had a period 2 months ago, tried to conceive without success, 35yo, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: Problem with periods
HPI: Pt is a 35-year old G0P0 F that comes into the office with a CC of irregular periods of 5 months durations. Periods come every 2 months. Lasts 7 days. Heavy bleeding (changes tampons q1-2h during first day). Mild cramping with periods. Hx of infertility and does not use condoms with bf. No clots. No urinary complaints; 10-15lb weight gain over 6 months. No cold or heat intolerance. LMP was 2 months ago. No nausea or vomiting; no pain with sex. No history of STD's. Last pap was normal (6 months ago). 
ROS: negative unless indicated above
Allergies: NKDA
Meds: None
Surgical: None
PMH: None
Social History: Lives with bf and 2 children (adopted). Divorced. No history of STD's. No tobacco. No drugs. Drinks 1-2 beers/month. 
Family Hx: Aunt deceased- breast cancer; Grandmother deceased-Cervical cancer
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, weight gain, irregular periods, Heavy bleeding, changes tampons q1-2h, LMP was 2 months ago, does not use condoms, infertility, 35-year old, 5 months, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Angela Tompkins is a previously healthy 35 yo F presenting with irregular periods and increased mensrtrual bleeding.  In the last 6 months she has noticed increased bleeding especially on the first day of her period so that she now uses 7 tampons/day verses her normal 3.  Her periods have also become irregular with only 2 in the last 6 mo.  Her last period was 2 mo ago.  Her periods were previously ever 4-5 wks.  She also endorses fatigue which has preceded the menstrual symptoms by couple years.  She is sexually active with her boyfriend.  Denies dyspareuna, cervical or vaginal tenderness, or easy bruising.  She has also no notice changes in facial hair or a deeping voice. Endorses 10 pound weight

PMH: none
FH: Breast cancer - aunt; Cervical cancer - Mom
SH: No smoking history, rare alcohol use, no substance use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, irregular periods, increased mensrtrual bleeding, increased bleeding, uses 7 tampons/day, periods irregular, last period was 2 mo ago, fatigue, 35 yo, 6 months, 6 mo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Tompkins is a 35 year old previously healthy female who presents with chronic dysmenorrhea, most notable over the past  6 months. She reports her periods are very heavy and she sometimes skips her period. She is currently sexually active with her boyfriend and they dont use condoms because she states "" I cant get pregnant"" She explains she was with her ex husband for 9 years and could not get pregnant during that time. She was as young as a teenager when her periods were irregular, skipping months. she started taking birth control at this time which resulted in normalization of her periods, but stopped when she saw she was unable to get pregnant. She has some cramping that goes along with her periods. Denies SOB, chest pain, nausea vomiting, fever and chills

PMH: no history of STIs
Meds: None
Social: 2 adopted kids. Has 1 partner. does not use condoms. alcohol 1-2 drinks/ mo.
Family: no family history of bleeding disorders.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Mrs, female, periods are very heavy, sometimes skips her period, dont use condoms, does not use condoms, cant get pregnant, could not get pregnant, unable to get pregnant, 35 year old, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo, F, nulipara, c/o  heavy menses X 3mo
-started 3 mo ago, volumous brigh red mesntrual flux, w/o clot, no foul smeal, no alleviated , constant in all last months, no associated with abdominal pain, dysmenorrha, or dyspareunia, no spots, menarche at 
-also refers unvoluntary wt gain (10-15 Lb /6mo), and some dark color in hand and left neck
-denies hot/cold intolerance, denies skin changes, changes in sleep, cough, fever, changes in bowell/urination 
PMH- none ALL= none ALL NKA
FH- mother- cervical ca , aunt- breast ca
SSH- monogamous w boy frined, no smoker, illict drugs or ETOH, 
worsk as skeduller administration.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, wt gain, gain (10-15 Lb, heavy menses, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 35 YO F C/O PERIOD PROBLEMS X 6 MONTHS. IT STARTED SUDDENLY, SHE HAD HER LAST PERIOD 2 MONTHS BACK THAT LASTED FOR 7DAY AND SHE SOAKED A PAD AFTER EVERY AN HOUR. SHE REPORTS TIREDNESS, WEIGHT GAIN 10-4LBS IN 6 MONTHS WITHOUT ANY CHANGE IN HER APPETITE. SHE REPORTS BLACK DISCOLORATION OVER HER NECK. SHE IS TRYING TO CONCIEVE, MONOGAMOUS WITH HUSNBNAD NOT USING ANY CONTRACEPTION. SHE DENIES LOW MOOD, EXERTION SOB,SLEEPING PROBLEM, COLD INTOLERANCE, CHANGE IN BOWEL/URINARY HABITS.
ROS: -VE EXCEPT AS ABOVE 
PMH/PSH: NONE
MEDS: NONE
ALLERGY: NKDA
FH: NONE
OBS & GYN: SHE ADOPTED 2 KIDS, NO VAGINAL DISCHARGE, BEFORE 6 MONTHS HER CYCLES WERE REGULAR 
SSH: 1-2 BEERS/WEEK, DENIES SMOKING/ILLICIT DRUG USED.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, WEIGHT GAIN, GAIN 10-4LBS, PERIOD PROBLEMS, LASTED FOR 7DAY, SOAKED A PAD AFTER EVERY AN HOUR, LAST PERIOD 2 MONTHS BACK, NOT USING ANY CONTRACEPTION, TIREDNESS, 35 YO, 6 MONTHS, 6 MONTHS</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Tompkins is  35 year old female complaining of period pains. She notes that for the past 6 months her periods have been irregular and she has had heavy flow. Her periods used to be regular, every 4-5 weeks lasting 3-4 days. however she has recently had periods every 2  months, and they now last longer. she must change her pad or tampon every 2 hours due to heavy flow. She notes new, light cramping while on her period now. 
ROs: Patient elicits that she has had a recent weight gain of 10-15 lbs in recent months, due to eating habit chages. She denies any headaches, vision problems, trouble swallowing, chest palpitations, abdominal pain except for period cramping, bowel changes. 
PMH: None
PSH: None
Allergies:  No known allergies
Meds: None
Mentrual history: LMP was 2 mo ago. No prior pregnancies, patient elicits that she ""cannot get pregnant"" as she has never gotten pregnant despite years of trying with no contraception.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, weight gain, periods have been irregular, periods heavy flow, periods have been irregular heavy flow, periods, LMP was 2 mo ago, no contraception, cannot get pregnant, 35 year old, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Tompkins is a 35 yo F presenting with a change in her menstruation. She normally has monthly periods that last about 3 days and require about 3 tampons per day, but she has only had 2 periods over the last 6 months, with the most recent lasting about 7 days and requiring a nw tampon every 3 hours. She denies pain except for her normal menstrual cramps. She endorses an unintentional weight gain of about 10 pounds over the last 6 months as well as fatigue. She had attempted to conceive for 9 years with her ex husband unsuccussfully and believes she cannot get pregnant and for this reason does not use contraception with her new boyfriend. 
PMH: None
ROS: Otherwise -
NKDA
No meds or vitamins
No hospitalizations, trauma, recent illness
Family Hx: Cervical cancer in grandmother (age 65), breast cancer in aunt (age 51)
Sexually active with boyfriend, no condoms for 10 months
Social: Denies tobacco, drugs, rarely will have 1 drink.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, weight gain, gain of about 10 pounds, nw tampon every 3 hours, change in her menstruation, does not use contraception, no condoms, fatigue, attempted to conceive unsuccussfully, 35 yo, 6 months, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo F complains of heavy menses since the past 5 months. She reports she used to have regular periods 6 motnhs ago, they were every 30 to 35 days, lasting 3 days, she used 4 tampons daily. Her last normal menstrual period was 6 motnhs ago, since then she has had heavy menses, she uses tampons every 2 hours. She also reports dark lesions in her neck and hands since the past 1 to 2 years. She has never been able to be pregnant despite regular sexual activity. She denies constipation, cold intolerance, loss of hair. She has 2 adopted daughters. Denies nipple discharge, vaginal dryness or itching. She has gained 10 to 15 pounds in the last 6 months.
ROS> Negative except as above
PMH> None
Medication> None
Allergies> NKDA
PSH> None
FMH> Aunt died of breast cancer, grandmother died of cervical cancer
SH> Denies tobacco, alcohol ocassionally, denies illicit drug use. Sexually active with his husband, no contraceptive methods used.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, gained 10 to 15 pounds, heavy menses, heavy menses, tampons every 2 hours, no contraceptive methods, never been able to be pregnant, 35 yo, 5 months, 6 motnhs</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 year old female presents with 6 months of dysmennorhea. Prior to 6 months she had regular periods monthy with 3-4 days of menstrual flow. However, she now reports that she has had 2 periods in the past 5 months, that last 7 days with heavy flow on day 1 requiring tampon changes every 2 hours. Her cramping is very light. She is not taking any medications. She also reports 10-15 lb weight gain in the past 6 months. She denies any constipation, brittle hair, dry skin, or new hair growth. She also states that she does not use contraception because she cannot get pregnant. She tried for 9 years in a previous relationship to get pregnant but was never successful. She denies history of STI. She denies pain during sex, abdominal pain, fever, chills. She is up to date on cervical cancer screenings. 
No PMH or PSH
Social: drinks 1-2 beers rarely, no tobacco or illicit drugs; lives with 2 adopted children, relationship with boyfriend.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, weight gain, 2 periods in the past 5 months, heavy flow, periods last 7 days, tampon changes every 2 hours, does not use contraception, cannot get pregnant, tried to get pregnant but was never successful, 35 year old, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: Irregular periods
HPI: Ms. Tompkins is a 35 yo F with pmh of irregular periods who presents with irregular periods. She states that in the last 6 months her periods are irregular, only having 2 in the last 6 months with heavy bleeding. She states she used to have irregular periods at age 12, was controlled with birth control that she stopped 11 years ago. Denies pain. 2 sexual partners, male. Has intercourse twice a week. Denies history of stds. States she is unable to become pregnant, has tried for years. Reports weight gain and skin darkening. She is up to date on health screening and has had normal pap smears, last one 6 months ago.
ROS: negative except as stated above
PMH: None
Past surgical history: None
Meds: None
Allergies: None
Family history: breast cancer in aunt, cervical in grandmother
Social: Drinks alcohol occasionally, 1-2 times a  month. Denies tobacco or recreational drug use. Lives with 2 adopted daughters..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, weight gain, Irregular periods, irregular periods, periods irregular, heavy bleeding, unable to become pregnant, 35 yo, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Tomkins is a 35 y/o G0P0 female with concerns of heavier periods for the past 6 months. Patient notes normal periods prior to this, and states that she must know change her tampons every couple of hours. Patient denies any pain or discomfort associated with menses. Patient notes that she had unprotected sex with her ex-husband for 9 months and was unable to get pregnany. Patient denies nipple discharge, vaginal discharge, post-coital bleeding, dysuria, burning while urinating. Patient also denies fevers, chills, dizziness, lightheadedness, headaches, N/V. 
Allergies: None
Meds: None
PMH, PSH: None
FH: Grandmother with cervical cancer and Aunt with breast cancer
SH: Works as social work scheduler. Never smoker. Occasionally drinks 1-2 beers. No recreational drug use. Sexually active with no boyfriend; does not use protection..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, heavier periods, know change her tampons every couple of hours, does not use protection, unable to get pregnany, 35 y/o, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: cc: ""heavy periods""
Ms. Tompkins, a 35-year-old G0P0 female, presents with heavy periods for the past 6 months. They have been heavy, lasting for 7 days. She uses about 7 tampons on the first day and tapers down till 1 on the 7th day. LMP was 2 months ago. She's had only 2 periods since the past 5 months. Prior to 6 months ago, she's been having her regular monthly periods with normal flow. She's been trying for the past 9 years to conceive with her ex-husband but didnt. She has two adopted daughters. Divorced 2 years ago. Denies n/v, no diarrhea/constiption. No fever or chills. Positive for weight gain of 10-16lbs in the last 6 months.
ROS: neg except per hpi
ObGyn: G0P0, sexually active with 1 partner since the past year. 2 lifetime. STDs: none. Papsmear- 6 months ago, no abnormal ones. bc-none
Allergies:none
PMH/PSH: none
Meds: none
Social: never smoked, ETOH rarely, no IDU
FHx: aunt- breast cancer, grandma-cervical cancer.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, weight gain, gain of 10-16lb, heavy periods, heavy periods, LMP was 2 months ago, trying to conceive didnt, 35-year-old, 6 months, 6 months, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Obese 35yo F c/o heavy and irregular periods.  She report her periods have started becoming irregular 6 months ago. Her LMP was 2 months ago.  She has no pain other than normal cramps.  Her periods normally last 3 days but now last 7 days.  She changes her tampon q2hr.  She also reports 10lb weight gain in past 6 months. She denies urinary changes, bowel changes, fevers, chills, hirsutism, abdominal pain, or h/o STI's, pregnancy.  She has never been able to get pregnant; tried for 9 years with ex-husband.
ROS: negative except for above
allergies: none
PMH: none
PSH: none
FH: grandmother died of cervical cancer age 65; aunt died of breast cancer age 51
SH: no tabacco use, no illicit drug use, occasional beer every other month. sexually active with boyfriend only, has 2 adopted daughters..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, weight gain, irregular periods, heavy periods, periods irregular, changes her tampon q2hr, LMP was 2 months ago, never been able to get pregnant, 35yo, 6 months, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 35 F presents with irregular and heavy periods for the last 6 months. Since 6 months ago, her periods have gotten heavier, to where she is changing her tampons every 1-2 hours. The periods also last 7 days. She denies any abdominal cramping or pain. Her LMP was 5 weeks ago. Her periods used to be regular and occur every 30-35 days. She reports no vaginal discharge or spotting in between periods. She reports a weight gain of 10-15 lbs in the last 6 months. No fevers/chills/nausea/vomiting/diarrhea/constipation. She denies hot flashes, night sweats, CP, SOB. Pt report history of infertility after inability to conceive for 9 years
OBGYN: Denies history of cysts, fibroids. She has never been pregnant. She's had irregular periods for 11 yrs treated with OCP
PMH/SH: none
Meds: none
NKDA
FH: aunt with breast cancer, died at 51. Grandmother with cervical cancer.
SH: denies tobacco use, drinks 1 beer every few weeks, denies drug use..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, weight gain, gain of 10-15 lbs, heavy periods, irregular periods, periods heavier, changing her tampons every 1-2 hours, LMP was 5 weeks ago, infertility, inability to conceive, 35, 6 months, 6 months, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 year old female presents with menstrual period irregularities. She has been having heavy flow for the past 6 months and changing pads every few hours. Her periods have increased from month to every other month and the length has increased from 3 days to 7 days. She has also been feeling tired. She has been unable to get pregant for the past 9 years and has adopted children; this was never investigated. She has also noticed darkening of her skin in her hands and her neck. Denies vaginal dryness, itching. 

ROS: negative except as above
PMH/PSH: none
Allergies: none
Medications: none
FH: parents are healthy; breast cancer in aunt and cervical cancer in grandmother
SH: never smoked, drinks occasionall, never used drugs. Sexually active with boyfriend..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, period irregularities, heavy flow, changing pads every few hours, periods have increased from month to every other month, tired, unable to get pregant, 35 year old, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 y/o F with a 6 month history of heavy periods. Prior to the 6 months, she would use up to 4 pads/tampoons on the first day, now she has to change it every 2 hours. Her period used to come once a month, but now comes every other month. She has never been pregnant although she tried to becoming pregnant for 9 years with her ex-husband. She is sexually active with her boyfriend, no longer use a condom. She also reports gaining 10-15 pounds in the past 6 months. She attributes that to eating out more. Denies exercise, although she notes that she has to follow her two daughters around. 

PMH: None
Meds: None
Allergies: None
PSh: None
FH: Aunt died of breast cancer, and grandmother died of cervical cancer
SH: Drinks 1-2 beers rarely; denies tobacco or drug use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, gaining 10-15 pounds, heavy periods, pads/tampoons change it every 2 hours, no use a condom, never been pregnant tried to becoming pregnant, 35 y/o, 6 month, 6 months, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo f come to the clinic with c/o irregular periods since 6 months, gradual onset associated with heavy bleeding on first day as she chages tampons every hr but no passage of clots, occassional abd cramps during her period. she feels tired but no chest pain, sob. She has gained 10 - 15 pounds in past 6 months and she has not conceived even with a trial of 9 years for conception. she has no changes in mood, no hot flashes and she is sexually active with her boyfriend. there is no fever, heat or cold intolerance. 
ROS: - EXCEPT AS ABOVE
MH: non
PSH: none
SH: sexually active with husband, doesnt use contraceptives as trying to conceive, doesnt smoke, no rec drugs, occassional drinker, 
ALL: NKA
F.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]f, gained 10 - 15 pounds, irregular periods, chages tampons every hr, doesnt use contraceptives, tired, not conceived even with a trial for conception, 35 yo, 6 months, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 35YO FEMALE PRESENTS FOR HEAVY MENSTRUAL PERIODS FOR THE LAST 6 MONTHS. PATIENT STATES THAT HER FLOW HAS BEEN HEAVY, OCCURS EVERY COUPLE MONTHS AND NOW LASTS 7 DAYS. PREVIOUS CYCLES OCCURED EVERY MONTH AND LASTED 3 DAYS. PATIENT DESCRIBES INCREASED FATIGUE AND 10LB WEIGHT GAIN IN THE LAST 6 MONTHS. SHE DENIES ANY ABDOMINAL PAIN, CHEST PAIN, FEVER/CHILLS, NAUSEA OR VOMITING.  
ROS: NEGATIVE EXCEPT AS ABOVE.
OB-GYN: LMP 5 WEEKS AGO, OCCURS EVERY OTHER MONTH, LASTS 7 DAYS, 1 TAMPOM EVERY COUPLE HOURS FOR THE FIRST FEW DAYS OF CYCLE 
PMH: NONE
ALLERGIES: NKDA
MEDICATIONS: NONE
SHX: NONE
FAMILY HX: AUNT - BREAST CANCER, GRANDMA - CERVICAL CANCER 
SH: NO ALCOHOL.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]FEMALE, WEIGHT GAIN, 10LB GAIN, HEAVY MENSTRUAL PERIODS, FLOW HEAVY, 1 TAMPOM EVERY COUPLE HOURS, LMP 5 WEEKS AGO, FATIGUE, 35YO, 6 MONTHS, 6 MONTHS</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI - 35 year old G0P0 presented with 6 month history of oligmenorrhoea with increase in bleeding. Previously her menstrual cycles were 4-5 weeks, regular and 5 days of menstruation. Currently she has only had 2 menstrual peroids in the last 6 months with bleeding being much heavier and longer (7 days). She denies any significant dysmenorrhoea. She denies headaches, visual changes, lactation or breast changes or hot flashes. She denies vaginal dryness and dyspareunia. She noticed a change in her skin over the last 1 year and has gained 10-15 pounds in the last 6 months. She feels tired but denies SOB or lightheadedness. Reports previously subfertile. 
ROS - negative except above. 
Allergies - none 
Meds - none 
PMHx - none 
PSHx - none 
SHx - sexually active with husband, no previous history of STIs. Has 2 adopted children at home ages 3 and 5. 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]gained 10-15 pounds, oligmenorrhoea, increase in bleeding, 2 menstrual peroids in the last 6 months, bleeding being much heavier, bleeding longer, tired, 35 year old, 6 month</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo female patient presenting for problems with her period for the past 6 months. The patient reports heavy flow and that she needs to change her tampon every 2 hours. Last menstrual period was 2 mo ago. She didn't have similar problems before. Her menstrual cycle is regular. Her first menses occured at the age of 12. No vaginal discharge or blood clots reported. Multiple failed attempts of getting pregnant reported. Her last pap smear was normal  6 months ago. She reports weight gain of 10 pounds recently with an increased appetite. No cold intolerance, tremors, low mood, constipation, or bloating reported. She reports being anxious at work.
ROS: as listed above
PMH/PSH: none
Medication and allergies: none
FH: negative for spontaneous abortions or heavy bleeds
SH: non smoker, occasional drinker, no illicit drug use, she lives with her 2 adopted daughters, divorced, sexually active with her boyfriend with no contraceptive use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, weight gain, gain of 10 pounds, problems with her period, heavy flow, change her tampon every 2 hours, Last menstrual period was 2 mo ago, no contraceptive use, Multiple failed attempts of getting pregnant, 35 yo, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35-year-old female complaining of problems with her periods. Patient states that for the last 6 months her periods have been irregular and heavy. 2 periods in 5 months each lasting 7d, very heavy especially on day 1 changing tampons every few hours. Never experienced this before, periods previously normal. Denies nausea/vomiting/change in appetite/bowel/bladder habits. Denies pain w/intercourse/vaginal discharge. Does state that she ""is unable to get pregnant"", tried for years with ex-husband, not sure why. Over the last two years she has noticed increased fatigue dailiy and darkening of skin on her neck/knuckles. Denies increased thirst/ cold/heat intolerance. Monogamous w/boyfriend does not use protection
PMH: unknown repro issue
PSH: none
Meds: none
NKDA
Fam: denies endocrine/repro
Social: desk job, only exercise is chasing adopted kids, doesn't pay attention to her diet, rare beer, denies drugs/tobacco, 1 cup coffee daily.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, problems with her periods, periods have been irregular, periods have been heavy, 2 periods in 5 months, lasting 7d, changing tampons every few hours, does not use protection, fatigue, unable to get pregnant, 35-year-old, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo F c/o having problems with her periods
She has been having an increase on the bleeding recently, denies dyspareunia, nausea or vomiting
Has increased the number of tampoons due to the bleeding 
Has gained weight due to a recent vacation overseas, feels fatigued and tired
She has 2 little girls at home that are adopted as she cannot get pregnant 
Has bleeding after itercourse

ROS: Negative Except as above
OBGYN: P-0, P0, increased in number of tampoons, cannont get pregnant, No h/o STD's
Meds: None
Allergies: None
SH: Negative
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, gained weight, increase on the bleeding, increased the number of tampoons, increased in number of tampoons, fatigued, tired, cannot get pregnant, cannont get pregnant, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC; abnormal periods
HPI: the patient is a 35 yo G0 woman with no past medical history presenting with abnormal periods for the past 6 monsths, baseline periods every 4-5 weeks for 3-4 days using 4 tampons,  last 6 months periods do not come monthly,  heavy last 7 days with multiple tampon changes up to every hour on the girst day. NO clots whith periods, abdominal pain, vaginal discharge or odor. Last pap smear 9months ago normal, never had abnormal pap, no history of sexually trasmitted infections. Patient previously on othrotrycyclen birth control periods, last used 11 years ago, wstopped to try to have children but unsuccessfull, adopted 2 kids
ROS: no fevers, nausea, vomiting, diarrhea, brest tenderness, hirsutism, chest pain, shortness of breath, palpitations  Past meedical history: none, PSH none, Meds: none Allergies: none FAm mom in good health, grandmother with cervical cancer, aunt with breast cancer, no alcohol/drugs.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]woman, abnormal periods, abnormal periods, periods heavy, 7 days, multiple tampon changes up to every hour, try to have children but unsuccessfull, 35 yo, 6 monsths</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 35 YO F PRESENTED WITH C/O IRREGULAR PERIOD X 6 MONTHS ASSOCIATED WITH HEAVY BLLEDING DURING MENSTRUATION. PREVIOUSLY HER PERIODS WERE REGULAR OCCURING EVER 4-5 WEEKS BUT NOW IN THE PAST 6 MONTHS SHE HAS HAD ONLY 2 PERIODS. SHE ALSO COMPLAINS OF TIREDNESS IN THE LAST 2 YRS HAVING TO TAKE CARE OF 2 ADOPTED CHILDREN. SHE WANTS TO GET PREGNANT BUT IS UNABLE TO CONCEIVE. HER APPETITE IS NORMAL BUT REPORTS WEIGHT GAIN IN THE LAST 6 MONTHS. SHE HAS A RASH IN HER NECK AND ARMS THAT SHE THINKS IS DUE TO SUNBURN.
SHE DENIES FEVER, ABDOMINAL PAIN, CHANGES IN BLADDER AND BOWEL HABITS.
ROS: NEG EXCEPT AS ABOVE
ALLERGIES: NKA/NKDA
MEDS: NONE
PMH/PSH: NONE
FH: AUNT HAD BREAST CANCER, GRANDMOTHER HAD CERVICAL CANCER
SH: MONOGAMOUS WITH BOYFRIEND, DOESNT USE CONDOMS, NONSMOKER, DOESNT CONSUME ETOH
OB/GYN: LMP 2 MONTHS BACK
UP TO DAT EWITH SCREENING.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, WEIGHT GAIN, IRREGULAR PERIOD, HEAVY BLLEDING, LMP 2 MONTHS, DOESNT USE CONDOMS, TIREDNESS, UNABLE TO CONCEIVE, 35 YO, 6 MONTHS, 6 MONTHS, 6 MONTHS</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Angela Tompkins is a G0P0 35 year old female with a past medical history of infertility (unclear if from her or exhusband) who presents with heavy menstrual bleeding. Her periods started at the age of 12 and typically occurred every 30-35 days with 3 days of bleeding and about 4 tampons per day. She previously was on birth control for irreglar periods at menarche but stopped years ago. Over the last six months she is having irregular periods that last for 7 days, occur every other day, and require her to change tampons every 2 hours. She has fatigue and 15 lbs weight gain but no fever, chest pain, palpitations, heat or cold intolerance, vaginal discharge, dysuria, urinary frequency, urine color change, nausea, vomit, diarrhea. Last pap 6 months ago normal. 
PMH: Infertility (? from her or exhusband)
No prior surgeries
Meds: none
Allergies: none
FH: Aunt died of breast cancer at 51, grandma of cervical cancer at 62..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, weight gain, heavy menstrual bleeding, irregular periods, tampons every 2 hours, fatigue, infertility, Infertility, 35 year old, six months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: heavy irregular periods
HPI: Angela Tompkins is a 35 year old female with no PMH who presents with 6 months of heavy, irregular menstrual bleeding. Normally, her periods last for 3-4 days and occur every 4-5 weeks with minimal pain. Over the last 6 months, she has had only 2 periods, and they lasted for 7 days with very heavy bleeding (tampon change every 2 hours). Menarche was at age 12 with irregular periods that became regular with oral contraceptives (OCPs). She stopped taking OPCs 11 years ago to become pregnant, but she and her husband could not conceive. She has also noted weight gain of 10-15 lbs in 6 months despite normal appetite. Notes dark patches on neck/hand. Feels more tired than usual. Denies abdominal pain, headaches, and any other bleeding. Normal bowel movements and urination. Had normal paps.
ROS: neg except per HPI
PMH: no
PSH: no
Meds: no
Family: Aunt -breast cancer. Grandmother -cervical cancer. 
Soc:.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, weight gain, irregular periods, heavy periods, heavy menstrual bleeding, irregular menstrual bleeding, last 6 months 2 periods, periods lasted for 7 days, heavy bleeding, tampon change every 2 hours, tired, 35 year old, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 35 YO F C/O PERIODS PROBLES X 6 MONTHS.
- LMP WAS 2 MONTH AGO, SHE HAS 2 MENSES IN LAST 5 MONTHS
- MENSES WERE HEAVY, GAINED 10 -15 LBS X 6 NMONTHS, HAS HYPERPIGMENTATIONS ON HANDS AND NECK
- DENIES SKIN DRYNESS, BOWEL MOTIONS CHANGES, HEAT/COLD INTOLERANCE, BREAST TENDERNESS, MORNING SICKNESS
- TRIED TO GET PREGNANT UNSUCCESSFLLY. SHE PRACTICE SEX WITHOUT CONDOMS . NO OCPS
ROS: AS IN HPI
PMH: NONE
ALLERGY: NKDA
MEDS: NONE
FH: AUNT WITH BREAST CANCER, GRAND MOTHER WITH CERVICAL CANCER
SH: DRINKS ALCOHOL OCCASIONALLY, SEXUALLY ACTIVE WITH HER BOYFRIEND ADOPTED 2 KIDS
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, GAINED 10 -15 LBS, MENSES HEAVY, LMP WAS 2 MONTH AGO, SEX WITHOUT CONDOMS, SEX NO OCPS, TRIED TO GET PREGNANT UNSUCCESSFLLY, 35 YO, 6 MONTHS, 5 MONTHS, 6 NMONTHS</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo F c/o Irregular periods for 6 months. Occurs around every 8 wks now, lasts 7 days, change pads every hrs. Not on contraception, sexually active with boyfriend. Pap smear 6 months back was normal. Noticed darkening of skin, gained 10 pounds over 6 months, feels fatigued. Usually eats outside. No change in vision, headache, discharge from breast, strias in belly. No hot/cold intolerance, hirsutism, dysparunia, abdominal discomfort, vaginal discharge, hot flashes. NO change in desire of sex, axillary or pubic hair changes.
ROS: negative except as above
Allergies: none
Meds: none
PMH/PSH: none
FH: Aunt died of breast cancer, grandmother died of cervical cancer
SH: Sexually active with boyfriend, no contraception, no smoking/etoh/drugs
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, gained 10 pounds, Irregular periods, now, lasts 7 days, periods every 8 wks, Not on contraception, no contraception, fatigued, 35 yo, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Tompkins is a 35 yo F who presents with menstrual irregularities. She previously had normal periods, but has only had 2 periods over the past 6 months. Her LMP was 2 months ago. Her periods have been very heavy during this time, and she is changing her tampon every 2 hours for  the first couple days. She is sexually active with her boyfriend, and they are not using any form of contraception as the paitent believes she cannot get pregant. She reports trying for 2 years with her ex husband with no success, but had no infertility workup. She has gained 10-15 lbs over the past 6 months with no change in diet or appetite and feels more fatigued. She denies hirtuism, virilization, cold intolerance, hair changes, vaginal or nipple discharge. Denies history of STIs or abnormal paps
PMHx- none
Meds - none 
Allergies - none
FH - breast cancer in aunt, grandmother with cervical cancer
SH - rare alcohol no smoking.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, gained 10-15 lbs, menstrual irregularities, only had 2 periods over the past 6 months, periods have been very heavy, changing her tampon every 2 hours, LMP was 2 months ago, not using contraception, fatigued, cannot get pregant, infertility, trying for 2 years with no success, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 yo F with no PMH presents for ""problems with her periods."" She states that beginning 6 months ago periods became heavier, lasting 7 days, and requireing more frequent change of her tamponds than usual. She has only had 2 periods in the last 6 months and LMP was 2 months ago. Menarche 2 months ago. Before this change, periods used to come every 4-5 weeks, lasting 3-4 days, and requiring only 4 changes of tampons. No excessive cramping noted before or after this change. Patient has never been pregnant before. No change in appetite but has gained 10-15 pounds since 6 months ago. She also has a non-pruritic rash on her hands and neck.
ROS: no headaches, breast tenderness or discharge, no intermenstrual spotting, no vaginal discharge, no palpitations, changes in bowel or urinary habits
PMH: none
past surgical history: none
Meds: none
Allergy: NKDA
FH: breast cancer in aunt, grandmother with cervical cancer
sH: no smoking or drinkin.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, gained 10-15 pounds, periods heavier, more frequent change of her tamponds, LMP was 2 months ago, 35 yo, 6 months, 6 months, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 35 year old patient complaining of irregular and heavy periods for the past 6 months, use 7 tampons first day of period. her LMP 2 months ago. additional 10 pound ogf weight gain, and fatigued. she is sexually active, monogamous, doesnt use barrier or oral contraceptives. she had a past husband and they never had kids although they tried, never check out the reason of infertility. 
ROS: no change in apettie, no vision changes, no fever, no vaginal discharge
PMH: none, PsHX: none, medications: none, allergies: none, FH: aunt died f breast cancer, grandmother died of cervical cancer, SH: no acohol, no smoking, no drug use, no excersise, normal diet.
OBGYN: menache: 12 year, periods now irregular 2 periods in the past 2 months, lmp 2 months ago, current monogamous relationship with her boyfriend, no contraceptive use. last pap smear 6 months ago normal.occupation in scheduling in social worker office.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]weight gain, irregular periods, heavy periods, 7 tampons first day, periods now irregular, LMP 2 months ago, lmp 2 months ago, doesnt use barrier or oral contraceptives, no contraceptive use, fatigued, never had kids although they tried, infertility, 35 year old, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 F G0P0 woman comes in with 6 months history of heavier periods lasting 7 days and using tampons every 4 hours.  Previously this was 3 days and 4 tampons per day. There is no dysparunia or vaginal discharges.  She does not experience any abdominnal pain during or after menstrual cycles. NO history of other bleeding.  History of 15 lb weight again in past 6 months.  No fevers or systemic symptoms.  NO breakthrough bleeding between periods.  NO OTC meds. No hormone supplementation or OCPs. NO hx of STI in past. 
ROS: negative. NO constitutional symtpoms. 
FMHX: Grandmother has cervical Ca. Aunt had breast Ca and passed at age of 50.
PsHX: none.
Meds: None
Allergies: none
Social Hx: divorced with new partner.  Sexually active with only 1 partner.  No contraception.  2 adopted DTRs. works in a social work setting.  Moderate alcohol intake. No history of abuse..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]woman, weight again, heavier periods, using tampons every 4 hours, No contraception, 35 F, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 YO F complains of polymenorrhea x 6 months. She reports periods are irregular, every other month lasting for 7 days, previously was every 30-35 days for 3 days.  Uses tampons every couple hours on the first few days of her cycle, but previously was using 4 tampons on the first day of her cycle. No pain, or cramping. No cold intolerance, dry skin, constipation. No deeping of her voice, or facial hair growth. Reports unintentional weight gain, 10 pounds x 6 months. Per patient she can not get pregnant. No fever, chills, headache, breast tenderness, breast discharge, or abdominal pain.
ROS: none except as above. 
Allergies: None
Medications: None
PMH: None
PSH: None
FH: Parents healthy. Aunt breast cancer. Grandmother cervical cancer.
SH: Sexually active with partner. 2 adopted kids. Employed. No tobbaco, or drugs. Is a social drinker.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, weight gain, polymenorrhea, periods are irregular, 7 days, tampons every couple hours, can not get pregnant, 35 YO, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 35 YO F C/O MENSTRUAL ABNORMALITIES FOR 6 MONTHS. HAS HEAVY PERIODS, USES MORE TAMPONS THAN BEFORE, BUT HAD ONLY 2 PERIODS IN THE LAST 6 MONTHS. LMP; 2 MONTHS AGO. MENARCHE: AT 12 YO. PATIENT DENIES DYPARUNIA OR DYSMENORREA, OR SPOTTING. PATIENT GAINED 10LBS IN LAST 6 MONTHS. PATIENT HAS SKIN RASH ON HANDS AND NECK FOR 1 YR, BUT DENIES ANY JOINT PAIN, STIFFNESS, FEVER, CHANGES IN URINARY OR BOWELS HABITS. PT HAS NO COLD INTOLERANCE, PALPITATIONS OR SOB. PT HAS NO HAIR CHANGES. NO MISCARRIAGES OR ABORTION
ROS: NEGATIVE EXCEPT AS ABOVE
PMH: NEGATIVE, EXCEPT INABILITY TO GET PREGNANT IN THE LAST 10 YRS.
SH: SEXUALLY ACTIVE WITH BOYFRIEND OF MORE THAN YR, NO PROTECTION.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, GAINED 10LBS, MENSTRUAL ABNORMALITIES, HEAVY PERIODS, USES MORE TAMPONS, ONLY 2 PERIODS IN THE LAST 6 MONTHS, LMP; 2 MONTHS AGO, NO PROTECTION, INABILITY TO GET PREGNANT, 35 YO, 6 MONTHS</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: A 35 Y O F C/O HEAVY BLEDING X 6 MO, USING TAMPONS FOR EVERY 1 HR. ALSO NOTICE CRAMING PAIN DURING HER MENSES.SHE IS NOT TAKING ANY MEDICATIONS.
SHE REPORTS SHE IS GETTING ALL THE TIME.AND SHE GAINED 10 - 15 LBS WEIGHT IN THE PAST COUPLE OF MONTHS.
SHE DENIES ANY CHANGES IN HER HAIR, ANY RACING OF HEART OR SWEATING.SLEEP AND APETITE ARE GOOD.
SHE ADOPTED 2 KIDS.
ROS- NEG EXCEPT ABOVE
FH- MOTHER ATTAINED MENOPAUSE AT THE AGE OF 51.
PMH $ PSH- NONE
SH- NON SMOKER, DRINKS ALCOHOL OCCASSIONALLY.
NO ILLICIT DRUG UASAGE
LAST PAP SMEAR WAS 6 MONTHS AGO AND IT WAS NL..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, GAINED 10 - 15 LBS, HEAVY BLEDING, TAMPONS FOR EVERY 1 HR, 35 Y O, 6 MO</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: A 35  YO C/O HEAVY PERIOD * 6 MONTHS THAT LASTS FOR 7 DAYS AND IRREGULAR AND CHANGING PADS EVERY 2 HRS. NO ABD PAIN NO PAIN WITH SEX NO PAIN WITH MENSRUATION , NO SPOTTING BETWEEN PERIODS , NO HEAIR GROWTH CHANGES, NO FEVER, AND THE PT MENTIONED  GAINING WT 10- 15 IBS * 6 MONTHS 
SHE HAS 2 ADOPTED CHILDEREN WITH NP PREGNANCIES, DID PAP SMEAR 6 MONTHS AGO AND WAS NORMAL.
ROS -VE EXCEPT ABOVE
PMH, PSH , DRUGS NONE , NKDA
FH AUNT HAD BREST CASNCER AT AGE 51 AND GRAND MOM HAD CERVICAL CANCER AT AGE 62 
SHE HAS A BBOYFRIEND SINC 1 YR AND DRINL ETOH 2 TIMES AMONTH.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]GAINING WT, GAINING 10- 15 IBS, HEAVY PERIOD, PERIOD IRREGULAR, CHANGING PADS EVERY 2 HRS, 35  YO, 6 MONTHS, 6 MONTHS</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Tompkins is a 35 yo female who presents with 6 months of heavy periods. Her periods are now 7 days duration from originaly 3 days duration, and she is now using tampons every couple of hours. Her periods are now every other month. She does not have any pain or any other associated sx. Last PAP was 6 months ago and reportedly normal. She has felt more tired than normal. She has gained 10-15lbs in 6 months but attributes that to eating out more often. First menses was at 12 years old, was placed on OCPs at age 13 due to irregular periods and was on these meds for 11 yrs. She has never been pregnant and has been told she was unable to get pregnant.
PMH. Meds. Surg. Allerg-none
ROS neg
Soc-no tobacco, alcohol, drugs. Has 2 adopted daughters. One male sexual partner, no condom use for 1 yr. Works as a social work scheduler from home..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, gained 10-15lbs, heavy periods, tampons every couple of hours, no condom use, tired, unable to get pregnant, 35 yo, 6 months, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35yo f complains of HAVING HEAVY MENSTRUAL PERIODS. HER LAST MP WAS 6M AGO. BEFORE MP WAS FOR 3-4DAYS EVERY 5W, PT USED 4 PADS FOR THE FIRST DAY AND 1-2 PADS FOR THE REST OF THE DAYS. NOW MP LAST 7DAYS, PT CHANGES PADS EVERY 2 HOURS. PT REPORTS HAVING CRAMPY PAIN DURING THE PERIODS, 2/10. PT IS SEXUALLY ACTIVE WITH BF FOR THE LAST YEAR, NO CONTRACEPTION. PT ALSO NOTICED SKIN DISCOLORATION IN THE NECK AND HANDS. PT GAINED 10-15 LBS FOR THE LAST 6M. PT HAS NEVER BEEN PREGNANT. PT DENIES ANY BOWEL MOVEMENT CHANGES, MOOD CHANGES, HIRSUTISM OR COLD OR HOT INTOLERANCE.
ROS - NEG EXCEPT AS ABOVE
ALLERGIES - NKDA
PMH, PSH - NONE
MEDICATIONS - NONE
FH - AUNT HAS BREAST CANCER, GRANDMOTHER CERVICAL CANCER 
SH - DRINKS 1-2 BEERS ON THE WEEKENDS, NO ILLICIT DRUGS, NO SMOKING.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]f, GAINED 10-15 LBS, HEAVY MENSTRUAL PERIODS, CHANGES PADS EVERY 2 HOURS, NOW MP LAST 7DAYS, NO CONTRACEPTION, 35yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 35 y/o woman presents with period concerns. States that 6 months ago her periods became irregular and now also has increased bleeding. Last period was two months ago and before that one 4 months ago. Periods now last for 7 days at a time and require very frequent changing of tampons. Has a minimal amount of cramping during periods and cramping is overall unchanged. Reports weight gain during this time. No changes in facial or pubic hair growth. No breast tenderness or nipple discharge. No nausea or vomiting or vision changes. Describes a history of infertility with prior husband.
PMH and PSH none
Meds and allergies none
SH - works as an administrator; divorced; lives with two adopted children; sexually active with boyfriend and does not use barrier contraception; no tobacco products, no recreational drug use; rare alcohol use 
FH none
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]woman, weight gain, history of infertility, period concerns, periods became irregular, increased bleeding, Periods now last for 7 days, now very frequent changing of tampons, Last period was two months ago, does not use barrier contraception, 35 y/o, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: angela tompikins is a 35 y/o F with 6 months of irregular periods.  she had normal periods prior to 6 months ago.  her LMP6 onths ago 7 days of bleeding changing her pad every hour, menarche ar 12yrs old.  G0P0 w/ 2 adoptoded daughters.  She reports feeling fatigued, and weight gain of 10 ponds in ths last 6 months without trying.  she is sexually active with her boyfriiebds and stopped using condoms 6 months ago. she reports no cold intolderence or constipation.
ROS negative excepyt as above
PMh: none
PSH:none
FMH: aunt with breast cancer, grandmother with cervical cancer parents are healthy
SH: lives with boyfriend and 2 adopted children, clerk at a social work agency. drinks socially, no etoh or drug use. diet is mixed without eating vegetables or fruits often. Gained 10 pounds despite skipping meals, does not exercise, but is more tired than usual;.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, weight gain, Gained 10 pounds, irregular periods, 7 days of bleeding, changing her pad every hour, stopped using condoms, fatigued, tired, 35 y/o, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: - 35 yo F presents with problems with her menstrual flow
- Her usual periods are regular every 4-5 weeks, normal flow using 4-5 pads/ day
- Over the past 5 months she had only two mestrrual periods, but heavy and changing pads every 1-2 hours
- She has mild cramp, but no abnormal vaginal discharge
- She noticed darkening of her  nuckles and neck, and gained 10 lbs over the past 5 months
- Denies headache, change in her vision, cold intolerance, skin change, nipple discharge, constipation.
- she is not taking any meds; no allergies
- PMH/ PSH: none
- Sexually active with boy friend, no condom use. social drinker, no tabacco or illicit drug use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, gained 10 lbs, past 5 months she had only two mestrrual periods, periods heavy, changing pads every 1-2 hours, problems with her menstrual flow, no condom use, 35 yo</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Tompkins is a 35 y/o G0P0 presenting with mennorhagia for past 6 months. She states the flow has been heavy and she goes thru 7 rampons/day. She has had 2 periods in the last 6 months. The last one was 2 months ago. She does not have pain with menstruation. Her last pap smear was 6 months ago and was normal. She denies abdominal pain, pain with intercourse. Prior to the past 6 months, she had periods every 4 weeks lasting several days and would go thru 4 tampons a day. She states she could not get pregnant for 9 years with her ex boyfriend. She currently does not use contraceptives. She has gained 15 lbs in the past few months. She denies fever, chills, fatigue, changes in vision or hearing, chest pain, SOB, abdomen pain. 
ROS otherwise (-)
PMH: Not significant. Meds: None. Surgery: None. Meds: None
FH: Aunt with breast CA. Grandma had cervical CA
SH: Denies smoking or illicit drugs use. Drinks 1-2 beers/month. No STD history..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]gained 15 lbs, mennorhagia, flow has been heavy, 7 rampons/day, 2 periods in the last 6 months, last one was 2 months ago, does not use contraceptives, could not get pregnant, 35 y/o, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Angela Tompkins is a 35 yo female presenting w/ abnormal menstraul cycles for the past 6 months. LMP was 2 months ago and she has only had 2 cycles in the past 5 months. She has had heavy flow during recent cycles and will last about 7 days. They used to only last 3-4 days and had regular intervals. She has hardly had any pain w/ her cycles. She used to take oral contraceptives but stopped eleven years ago to try and get pregnant. She has been unsuccessful and not been able to get pregnant despite having sexual intercourse with her boyfriend and trying ""for years"". She denies trying to become pregnant now and in the recent past. She has not restarted contraception since trying to become pregnant. She had her first pap smear 6 months ago that did not have any abnormal findings. She has regular obgyn follow up. Her aunt has breast cancer and her grandmother had cervical cancer. Family has not done any genetic testing..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]female, only had 2 cycles in the past 5 months, heavy flow, will last about 7 days, abnormal menstraul cycles, LMP was 2 months ago, has not restarted contraception, not been able to get pregnant, 35 yo, 6 months</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Loraine Wicks is a 67 y.o. woman here for difficulty sleeping past 3 weeks. Difficulty falling asleep, waking up early, and tossing and turning at the night. Notably, her son past away at the end of June. Her trouble sleeping started just after. Ambient at night has not helped. She notes that 4 days ago she saw her son Leonard sitting at the table, but knows it was not real. She also notes feeling tired and less interested in her hobbies such as scrapbooking. Her appetite has increased and she is eating more, but notes no changes in weight. She denies decreased concentration, feeling restless, or any suicidal ideation. She has good support at home from her husband and other family. Does not snore. Drink 1 cup of coffee in the morning. 
ROS: negative except as above
Medications: HCTZ, ambient last 5 days
PMHx: breast cancer 10 years ago
PSHx: lumpectomy, appendectomy 
Social: retired, no tobacco use. Liv.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]appetite has increased, eating more, son past away at the end of June, woman, tossing and turning, 67 y.o, Difficulty falling asleep, past 3 weeks, Ambient has not helped, feeling tired, less interested, saw her son knows it was not real, waking up early, denies suicidal ideation, difficulty sleeping, trouble sleeping</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67yo F presents with trouble sleeping. She reports trouble falling asleep, trouble staying asleep, and early morning awakening. Her trouble sleeping began 3 weeks ago. At that time, her son passed away and she has been very upset about that. She lives with her husband and say they rely on each other for support. Before 3 weeks ago, she slept well, going to bed at 10:45pm and sleeping 8 hours through the night. Good sleep hygeine, with no TV or screens before bed. Received Ambien from friend past 5 nights, did not help, has had hallucinations. 

PMH: HTN, Breast cancer (dx 10 yrs ago; in remission now)
PSH: Lumpectomy 10 yrs ago
Meds: HCTZ, Lisinopril, and for past 5 nights has tried Ambien.
Allergies: none
Fam Hx: Father died of stroke age 75; mother living with long hx Depression
Social: retired receptionist, drinks in moderation (2-3 glasses couple times/week), no tobacco, no drugs
Psych: Endorses signs of depression, deny SI.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]At that time, her son passed away, F, 67yo, trouble falling asleep, began 3 weeks ago, 3 weeks ago, Ambien did not help, with long hx Depression mother, early morning awakening, deny SI, trouble sleeping, trouble staying asleep, trouble sleeping</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 67 yo F presenting with insomnia x 3 weeks since the death of her son. Pt has difficulty falling asleep, tosses and turns while sleeping, wakes up early. Sleeps 4-5 hours/day. Nothing worsens/alleviates sx. Tried Ambien for 5 days but did noto feel like it helped and has stopped taking it. Patient reports feeling drained and tired from lack of sleep and eating more than usual. She reports seeing her son in the kitchen one day and also thinking she heard a party next door when there was none. she feels sad and has a loss of normal interests and low neergy, but does not feel any guilt, psychomotor agitation/slowing down, or any suicidal ideation. No fevers, cold sx, wt loss or wt gain, changes to elimination.
PMHx: high BP; remission from breast cancer. PSHx: lumpectomy with breast cancer 10 years ago, laparoscopic appendectomy in her 20s. Meds: HCTZ, lisinopril, ambien. FHx: high BP, depression. SHx: no smoking, alcohol, drugs..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]eating more than usual, x 3 weeks since the death of her son, F, reports thinking she heard a party next door when there was none, tosses and turns, 67 yo, difficulty falling asleep, x 3 weeks, Tried Ambien did noto feel like it helped, feeling drained, tired, low neergy, loss of normal interests, reports seeing her son in the kitchen one day, FHx depression, wakes up early, does not feel any suicidal ideation, insomnia, Sleeps 4-5 hours/day</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs Loraine Wicks a 67 Y old F pt presenting to the office with Insomnia. The condition started 3 Wks ago following the death of her son James. Pt also reports Auditory hallucinations of her son on two different occasions. There is also Loss of interest, Increased appetite and feeling of fatigue. Patient treid ambien but it didnt help.  Patient denies Feeling of Guilt, Suicidal Ideations ,Excessive caffeine intake. 
ROS Negative except as above 
PMH: HTN.
Meds: HCTZ, Lisinopril and Ambien, NKDA 
PSH: None, Hospitalizations: Non-significant 
Family H: Father had HTN, Mother Has Depression. 
Social H: Lives with her husband, Denies Smoking/Drugs. Etoh Occasionally
Sexual H: Monogamous with Husband 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Increased appetite, 3 Wks ago death of her son, Mrs, F, Auditory hallucinations, 67 Y old, started 3 Wks ago, treid ambien but it didnt help, fatigue, Loss of interest, Mother Has Depression, denies Suicidal Ideations, Insomnia</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 67 year old female with PMH of high blood pressure and breast cancer who comes in with difficulty sleeping. Problems began 3 weeks ago after her son passed away. She reports difficulty falling asleep, staying asleep and going back to sleep. She endorses multiples symptoms of depression including decreased sleep, energry, interest and appetite. Denies suicidal ideation or lack of will to live. PAtient reports good sleep hygeine with no tv, caffeine, excessive water or computer time before bed. Sh denies symptoms consistent with thyroid disease inclouding weight gain, skin changes hair changes or palpitations. Patient reports getting suport from family and friends and does not want to see a counselor. Pt also reports seeing her son once after he passed and hearing unexplained noises before falling asleep one night. Patient denies snoring
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]3 weeks ago son passed away, female, hearing unexplained noises before falling asleep one night, 67 year old, difficulty falling asleep, began 3 weeks ago, decreased energry, decreased interest, reports seeing her son once after he passed, Denies suicidal ideation, difficulty sleeping, difficulty staying asleep, difficulty going back to sleep, decreased sleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Wicks is a 67 yo F h/o HTN and breast ca in remission 10 y who p/w difficulty sleeping.  She states that she has been having difficulty falling asleep and staying asleep for the past three weeks with associated early awakenings, correlated with the tragic passing of her son in an MVA.  She has attempted 5 nights of ambien use without changes in her symptoms.  Denies snoring, weight gain/loss, other sx besides difficulty sleeping. She has been having some difficulty coping with this loss, but has a good support system in her family and husband.  No desire for additional counseling at this time. Denies depression, SI, guilt, psychomotor sx. Endorses increased appetite, difficulty sleeping, decreased energy, anhedonia.
PMH: htn, breast ca (10 yr remission)
PSH: lumpectomy, lap appy
MED: hctz, lisinopril
all: nkda
SH: no drug/tobacco use, no recent ETOH use but otherwise 2 drinsk 2-3nights/wk
FH: father (CVA), mother (MDD).
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, passing of her son, Ms., F, 67 yo, difficulty falling asleep, past three weeks, ambien use without changes in her symptoms, decreased energy, anhedonia, mother (MDD), early awakenings, Denies SI, difficulty sleeping, difficulty staying asleep, difficulty sleeping, difficulty sleeping</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo woman comes due to 3 weeks sleep disturbances, accompanied by loss of interest, changes in apettite, fatigue
she has problems falling asleep, and wakes up a lot of times at night
she ahs had visual and hearing hallucinations
her son died 3 weeks ago
ROS: no wieaght changes, skin probles, contipation urinary problems, weakness in limbs
PMH: htn
SH: none
alllergies: none
Meds: ACEI, HCTZ
FH: mother: depression, father: HTC, stroke
S:"" wine 2-3 glasses a week.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]son died 3 weeks ago, woman, hearing hallucinations, 67 yo, problems falling asleep, 3 weeks, fatigue, loss of interest, visual hallucinations, mother: depression, sleep disturbances, wakes up a lot of times at night</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo F presenting with 3 weeks of insomnia. Pt reports difficulty falling asleep, waking up early, and daytime somulance. Pt states her son passed away on Aug 31st of this year. She state feeling sad and missing him. She alos reports seeing him sitting at the breakfast table 3 days ago. She is aware that this was not really happening. She also mentioned hearing distant music and talking at neighbors house, but no one was there. Denies command voieces. 

Denies snoring, suicidal/homicidal thoughts, constipation, dry brittle skin, recent medication changes

PMH: HTN, breast cancer s/p lumectomy, radiation, and chemo. remission for past 10 years
PSH: lumectomy, lap appy
Meds: HCTZ, lisinopril
Allergies: NKDA
FH: father with HLD, HTN died from storke. Mother with h/o depression
Social: drinks 2-3 glasses of wine a week. Denies smoking, recreational drug use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]son passed away on Aug 31st, F, hearing distant music and talking at neighbors house, but no one was there, 67 yo, difficulty falling asleep, with 3 weeks, daytime somulance, reports seeing him sitting at the breakfast table 3 days ago aware that this was not really happening, Mother with h/o depression, waking up early, Denies suicidal/homicidal thoughts, insomnia</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo F presents with difficulty falling aslep and multiple night time awakenings for the last few weeks. This began after the death of her son a few weeks ago. She has been feeling depressed, fatigued, has increased appetite, and has decreased interest in daily activities. Denies guilt suicidal thoughts. Has a good support system of husband and friends. Has had one episode of seeing her son in the kitchen and has had one epidose of hearing noises. They did not send her any messages and she could not understand them. 
ROS - Denies nocturia, snoring, SOB at night, chest pain, changes to weight, heat or cold intolerance, changes to hair or skin, hoarseness, dizziness. 
PMH - Hypertension. Remission from breast cancer 10 yrs ago. 
PSH - Laparotomy for Appendectomy, 
Meds - HCTZ Lisinopril Sleeping meds. 
Allergies - None
Menstrual Hx - menopause at 50 years
Fhx - none
Shx - Retired. Denies alcohol drug and tobacco use,.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, death of her son a few weeks ago, F, one epidose of hearing noises, 67 yo, difficulty falling aslep, for the last few weeks, fatigued, decreased interest, one episode of seeing her son in the kitchen, Denies suicidal thoughts, night time awakenings</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo f c/o difficulty sleeping started 3 wks ago after her son passed away discribed as early awakining at 4 am and difficulty falling asleep daily activity difficult to do , assoc w polyphadia but no wight gain no bowel change in bowel habits no urinary symptoms , noe episode of delusion that son was at home but knows its no true (normal insght) no hallusination , no snoring no cough no palpitations no diaphoresis no headache no visual changes no urinary sym no weakness no numbness no tingling no diahrea no vomiting no heartburn 
mood sad normal affect no suicide no homocide judgement intact 
FH father has HTN  and dyslipidemia died of a strok mother has depression 
sexualy active w husband alon no condom use no smoking no recreational drugs no EtOH 
G1P1A0 normal vaginal delivery 
no previous hospitalisation no trauma no surg.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]polyphadia, 3 wks ago son passed away, f, 67 yo, difficulty falling asleep, started 3 wks ago, delusion that son was at home, mother has depression, early awakining, no suicide, difficulty sleeping</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Wicks is a 67 y/o F with a history of hypertension and breast cancer who presents with three weeks of difficulty sleeping. She states that this began after her son died in an accident. She has had increased sleep latency, increased night-time awakenings, and is waking up earlier in the morning. She also complains of loss of interest in usual activities, sadness, and anhedonia, but denies guilt, loss of concentration, suicidality or homicidality.
PMH: Hypertension, breast cancer s/p mastectomy and chemoradiation 10 years ago, remains in remission
PSHx: mastectomy, uncomplicated laparotomy for burst appendix
Fam Hx: father with hypertension deceased from stroke, mother living with history of depression
Social Hx: denies tobacco or illicit drugs, drank wine with meals before son's death CAGE: 0, retired receptionist, scrapbooks and reads in spare time, sexually active with husband - no sexual complaints, good support.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]three weeks son died, Ms, F, 67 y/o, increased sleep latency, with three weeks, loss of interest, anhedonia, mother history of depression, waking up earlier, denies suicidality, difficulty sleeping, increased night-time awakenings</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo female presents with new-onset trouble sleeping. Starte 3 weeks ago when son passed away. Has difficulty falling asleep and wakes up early. Still able to do daily activities but feels drained and low energy. States she has been feeling sad, has decreased interest in activities she used to enjoy, low energy, and is eating more than usual, but denies guilt, psychomotor slowing or self-harm intent or suicidality. Has been taking ambien, which she gets from a friend, for the past five days but has not helped with sleep. She states she has a good support system at home. Denies any recent illnesses, pain, or palpatations. PMHx hypertension, no past surgeries, takes lisinopril, HCTZ, and ambien. NKDA. Family history of depression (mother) and hypertension, hyperlipidemia, and stroke (father). Lives with husband and feels safe at home, is retired..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]eating more, 3 weeks ago when son passed away, female, 67 yo, difficulty falling asleep, Starte 3 weeks ago, ambien has not helped, feels drained, low energy, low energy, decreased interest, depression (mother), wakes up early, denies suicidality, denies self-harm intent, trouble sleeping</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Weeks is a 67 yo female with 3 weeks of trouble sleeping
difficulty sleeping started 3 weeks ago after death of son Leonard in MVA on Jan 31st
has difficulty falling asleep, usually takes 1 hr
early morning awakening, cannot get back to sleep, sleeping total of 4-5 hours per night
endorsed devastated, sad mood
associated with anhedonia, decreased energy, increased appetite, audiutory and visual hallucinations of son leonard and people having a party
denied guilt, decreased concentration, SI/HI, psychomotor agitation/retardation, anxiety, disorganized thinking, paranoia, delusions
denied nause, vomiting, shortness of breath
PMH: lumpactomy for breast cancer and lap appy. HTN. 
FH: father died from stroke, has HTN and HLD. mother still alive, had prior boutsw of dperession
SH: monoganous with husband. retired. social drinker. denied smokin or drug use
Meds: HCTZ and lisinopril.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, 3 weeks ago death of son, Ms, female, audiutory hallucinations, 67 yo, difficulty falling asleep, with 3 weeks, started 3 weeks ago, decreased energy, anhedonia, visual hallucinations, dperession mother, early morning awakening, denied SI, trouble sleeping, difficulty sleeping, sleeping total of 4-5 hours per night</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo F in office c/o trouble sleeping x 3 weeks. Pt reports prior to onset of symptoms her son died.Has tried Ambien with no relief.Pt sleeps 4-5 hours a night, has early morning awakenings, loss of interest, sadness, fatigue, and increase in appetite.Last night patient heard loud music which reminded her of her son , when she asked her neighbor whether there was noise was informed that there was none. Pt also reports seeing son sitting at table a few days ago but was aware that he was not there. Pt denies guilt, change in weight, suicidal ideation, change in skin/hair, intolerances to weather changes. 
ROS NEG except above 
PMH HTN x 15 years, Meds HCTZ, Lisinopril, NKDA
PSH/HOSP/Trauma none 
FH Father Hypertension, hypercholesterolemia, stroke . Mother has hx of depression
SH Pt is retired, lives with husband. Denies smoking, drinks 2-3 glasses of red wine a week, denies illicit drug use.sexually active with husband.NO hx of std.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increase in appetite, prior to onset of symptoms son died, F, Last night patient heard loud music was informed that there was none, 67 yo, x 3 weeks, Ambien with no relief, fatigue, loss of interest, reports seeing son sitting at table a few days ago but was aware that he was not there, Mother has hx of depression, early morning awakenings, denies suicidal ideation, trouble sleeping</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 year old female c.o trouble sleeping for past 3 weeks. 3 weeks ago her son died in a motor vehicle accident. She has trouble falling asleep, it takes over an hour, she awakens early at 4 am, and has multiple awakenings at night. She sleeps 4-5 hours per night. She is tired during the day. She denies day time sleeping. She drinks 1 coffe in the morning.Reports decreased sleep, anhedonia, decreased energy, increased appetite. Denies suicidal thoughts.  Retired and lives with husband, has good support system.  Describes good sleep hygiene. Denies snoring. /denies feeeling hot or cold, no skin or hair changes. 
PMH: HTN, in remission from breast cancer, surgical: lumpectomy, lap. appendectomy, meds: HCTZ, lisinopril, took ambein past 5 nights, counseled not to take prescription meds without doctors supervision, NKDA
SH: retired receptionist, lives w husband, no tobacco, 1-2 glasses of wine at dinner, not any etoh in past 3 weeks.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, 3 weeks ago her son died, female, 67 year old, trouble falling asleep, past 3 weeks, tired, decreased energy, anhedonia, awakens early, Denies suicidal thoughts, trouble sleeping, multiple awakenings at night, sleeps 4-5 hours per night, decreased sleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: 67 yo F complains of trouble sleeping
HPI: Sleeps only 4-5 hrs per night, has difficulty falling asleep, waking up early (4-5 am), and nighttime awakenings for 3 weeks. Patient reports dayttime fatigue and urge to nap Patient used to sleep within 15 min of laying in bed and slept for 8 hrs. No relief w/ Ambien. Recent death of son on February 14. Patient also reports feeling sadness, anhedonia, low energy, and increased appetite. No feelings of guilt, changes in concentration, or sucidial ideation or plan. Recent visual hallucination of son 4 days ago and auditory hallucination of neighbor's playing music last night. No changes in urine or BM, cold intolerance, or hoarseness of voice.
ROS: Negative except above
PMH: HTN, Breast cancer remission for 10 years
Meds: HCTZ, Lisinopril, Ambien
Allergies: NKDA
PSH: Lumpectomy 10 years ago, Laparatomy in 20s
FH: Mother had depression. 
SH: Red wine 2-3x/wk. No drug usage. Retired..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, Recent death of son on February 14, F, ""auditory hallucination of neighbors playing music last night"", 67 yo, difficulty falling asleep, for 3 weeks, No relief w/ Ambien, dayttime fatigue, low energy, anhedonia, visual hallucination of son, Mother had depression, waking up early, No sucidial ideation, trouble sleeping, Sleeps only 4-5 hrs per night, nighttime awakenings</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is 67 yr female presenting with trouble sleeping for 3wks. Has problem falling and staying asleep with tossing/turning. Wakes up early in the morning. Doesn't feel refreshed when waking up. Gets 4-5hrs of interuppted sleep. Normaly got 8hrs. Son died Jun19th. Describes mood as sad. Saw image of son last night and heard music from neighbors when there was no music. Hallucinations not frightenining. Tried Ambien last 5 nights-no relief. Increased appetite for carbs. Drinks 1cup coffee in the morning. No guilt/hopelessness. Low energy. Lack of interests. No suicidal ideation. Has good support with husband/friends. PMH:HTN/remission from breast cancer 10 yrs. MEDS: HCTZ/lisinopril/ambien. Allergy:none. Surghx: lumpectomy Famhx: Father-htn, high cholesterol, died of stroke. mom-hx of depression. Retired from receptionist. Likes to read/scrapbook. etoh-2-3glasses wine/week. No tobacco/drugs. No sick contacts/travel. ROS: pertinent listed..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Increased appetite, Son died Jun19th, female, heard music from neighbors when there was no music, tossing/turning, 67 yr, problem falling asleep, for 3wks, Tried Ambien no relief, Low energy, Lack of interests, Saw image of son last night, mom-hx of depression, Wakes up early, No suicidal ideation, trouble sleeping, problem staying asleep, Gets 4-5hrs of interuppted sleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo F presenting with trouble sleeping for the past 3 weeks. Reports difficulty falling asleep, early awakening, and feeling as if she is tossing and turning at night. Denies snoring. She lost her son three weeks ago, and since then she has been experiencing problems with sleep, depressed mood (""devastated""), loss of interest in scrapbooking. Has also had auditory and visual hallucinations related to son. Denies guilt, thoughts of hurting self or others. Has had increased appetite, but no weight gain. 
ROS: no fever, chills, abdominal pain, nausea, vomiting, diarrhea, constipation, blood in stool
PMH: breast cancer in remission for 10 years, HTN
PSH: lumpectomy, appendectomy 
Meds: hydrochlorothiazide, lisinopril, ambien (from friend)
Social History: never smoker, a couple glasses of wine 2-3 times per week (has not had a drink for past few weeks), no illicit drugs. Previous receptionist, retired for 2 years. Lives with husband.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, lost her son three weeks ago, F, auditory hallucinations, tossing and turning, 67 yo, difficulty falling asleep, past 3 weeks, loss of interest, visual hallucinations, early awakening, Denies thoughts of hurting self, trouble sleeping, problems with sleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: patient is a 67 yo F who presents with 3 week history of unable to sleep. Patient reports son passed away 3 weeks ago. Notes she usually sleeps from 11pm-6am and practices good sleep hygiene. Lately has been falling asleep at 12am, with tossing and turning at night, and waking up an hour earlier. Denies any apneic episodes, excessive use of caffeine, or naping during the day. Has tried alking ambien without alleviation. Notes sadness, lack of energy, and feeling tired. Reports visual disturbances. Denies any feelings of guilt, impairment of concentration, or changes in appetite. Denies any suicidal ideation. 
ROS: as stated in HPI
PMH: HTN and Breast cancer (in remission)
PSH: lumpectomy, abd laparotomy
Meds: HCTZ 25mg, lisinopril 20mg
Allergies: NKDA
FH: father had HTN, deceased of stroke, mother 90yo had depression
SH: good support system, retired, lives with husband, no tobacco, alcohol, or drug use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]son passed away 3 weeks ago, F, tossing and turning, 67 yo, usually sleeps from 11pm falling asleep at 12am, 3 week history, tried alking ambien without alleviation, lack of energy, feeling tired, mother had depression, waking up an hour earlier, Denies any suicidal ideation, unable to sleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Loraine Wicks is a 67 y/o F who presents with a chief complaint of ""trouble sleeping"" for the past 3 weeks.
- Difficulty falling asleep and staying asleep. 
- Coincided with son dying in an MVA (3 weeks ago).
- Lost interest in normal activities, describes a depressed mood and decreased energy. 
- Reports good social support network - husband and many friends.

PMH: HTN
PSH: none
FamHx: Dad- stroke, HTN, hyperlipidemia. Mom - depression.
SocHx: Retired, receptionist. Never smoker, occasional alcohol, no drug use..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Coincided with son dying 3 weeks ago, Ms, F, 67 y/o, Difficulty falling asleep, past 3 weeks, 3 weeks ago, decreased energy, Lost interest, Mom - depression, trouble sleeping, Difficulty staying asleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 y/o F presenting to clinic for 3 weeks of trouble sleeping, both in falling asleep and staying asleep
-Son died in MVC Oct 25th of this year. Pt has been ""devastated"" since then
-no hx of difficulty sleeping in the past
-no aggravating or relieving factors. No relief from Ambien she got from a friend
-admits to decreased interest, decreased energy, decreased appetite, and an overall ""sad"" mood
-denies SI/HI
-says she has a good support group (husband, family)
Denies fevers, chills, weight loss/gain, N/V, shortness of breath or chest pain
PMH: HTN 
PSH: denies
Meds: Ambien from a friend, HCTZ, Lisinopril
Allergies: NKDA
FH: denies mental health disase in family
Social: occasional wine 2-3x/week, less so recently, denies tobacco or drug use. Is married and lives with husband and children.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Son died Oct 25th, F, 67 y/o, trouble falling asleep, for 3 weeks, No relief from Ambien, decreased energy, decreased interest, denies SI, trouble sleeping, trouble staying asleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Wicks is a 67yo F presenting with 3 weels of insomnia. She reports difficulty falling asleep and wakes up at 3:30-4am. She reports 4-5 of sleep nightly. Caffeine intak is 1 cup of coffee/day.  Excessive daytime sleepiness but unable to fall aleep for a nap. Tried taking a friends Rx of ambien with no imporovemnt. assocaited symtpoms of anhedonia, decreased energy, increased appertite, and ""devastation"". She report a stressor caused by her son's death 3 weeks ago. Denies feeleing of guilt, SI, changes in weight, concentration or phychomotor movement. Reports a ""great support system"" by husband and friends
PMH: HTN
MEdications: HCTZ and lisinopril
Past Surgical Hx: None
Allergies: None
FH: Father - HTN and hyperlipedmia. mother- depression
social: reitred, regular diet, regualr exercise but recently none, denies tobacco and illicit drugs. drinks glass of iwne 2-3 times/week. sexually active with husband.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appertite, ""sons death 3 weeks ago"", Mrs, F, 67yo, difficulty falling asleep, with 3 weels, unable to fall aleep for a nap, Tried ambien with no imporovemnt, Excessive daytime sleepiness, decreased energy, anhedonia, mother- depression, wakes up at 3:30-4am, Denies SI, insomnia, 4-5 of sleep nightly</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 F with c/o trouble sleeping x 3 weeks.  She admits to drinking only 1 cup of coffee in the morning, but sleeps only 4-5 hours per night, difficulty falling asleep, and early awakening, decrease interest in daily activites, decreased energy.  She denies snoring, SOB, chest pain, palpitations, no weight changes.  She states that her son passed away 3 weeks ago, no suicidal ideation.

PMH:  hypertension, remission breast CA 10 years
Allergies:  NKDA
Medications:  HCTZ, lisinopril, ambien
Hospitalization:  lumpectomy, laparoscoy appendix burst
FH:  Father has hypertension & died of stroke, mother still living
SH:  retired, admits occasional walking as exercise, still sexually active with husband, non smoker, no illicit drugs, drinks red wine 2-3 week 0/4 CAGE.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]son passed away 3 weeks ago, F, 67, difficulty falling asleep, x 3 weeks, decreased energy, decrease interest, early awakening, no suicidal ideation, trouble sleeping, sleeps only 4-5 hours per night</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: MS. WICKS IS A 67 YO FEMALE PRESENTING WITH TROUBLE SLEEPING. SHE HAS DIFFICULTY FALLING ASLEEP. USED TO TAKE 15 MINUTES, NOW TAKES AN HOUR. TOSSES AND TURNS AND WAKES EARLIER AT 4-5 AM. FEELS DRAINED AND TIRED THROUGHOUT DAY. GOOD SLEEP HYGIENE. 1 CUP OF COFFEE IN MORNING. SON DIED RECENTLY. MOOD DEVASTATED, EATING MORE, UNINTERESTED IN ACTIVITIES SHE USED TO ENJOY. hAS GOOD SUPPORT SYSTEM WITH HUSBAND. SEEN LENORD IN KITCHEN FEW DAYS AGO. AUDITORY HALLUCINATIONS OF NEIGHBOR HAVING PARTY AT NIGHT. NO SUICIDAL IDEATION.
PMH: HTN, 10 YR REMISSION FORM BREAST CANCER
MEDS: HCTZ, LISINOPRIL, AMBIEN- STARTED 5 DAYS AGO, NOT HELPED SLEEP
FMH: DAD-HTN, HLD, STROKE. MOM-DEPRESSION
SEXUALLY ACTIVE WITH HUSBAND, NO PROTECTION. NO TOBACCO, DRUGS. GLASS OF WINE WITH DINNER 2-3 TIMES A WEEK..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]EATING MORE, SON DIED RECENTLY, FEMALE, AUDITORY HALLUCINATIONS OF NEIGHBOR HAVING PARTY AT NIGHT, TOSSES AND TURNS, 67 YO, USED TO TAKE 15 MINUTES, NOW TAKES AN HOUR, DIFFICULTY FALLING ASLEEP, AMBIEN- STARTED 5 DAYS AGO, NOT HELPED SLEEP, FEELS DRAINED, TIRED THROUGHOUT DAY, UNINTERESTED, SEEN LENORD IN KITCHEN FEW DAYS AGO, MOM-DEPRESSION, WAKES EARLIER AT 4-5 AM, NO SUICIDAL IDEATION, TROUBLE SLEEPING</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 y/o F c/o of difficulty sleeping for the past 3 weeks. She reports difficulty falling asleep, difficulty staying asleep, and waking up early in the morning without feeling rested. She denies that she snores. She reports drinking 1 cup of coffee daily and only 2-4 glasses of wine daily. She also report that her son died a few weeks ago and she has had difficulty dealing with his death despite a good social support system. She says last night she thought she heard voices from a neighbors' party despite that a party never occurred. Also days 4 days ago she ""saw her deceased son in the kitchen."" She denies nausea, vomiting, shortness of breath, chest pain, joint pain, new rashes, or trouble urinating or defecating. She takes Ambien for trouble sleeping but does not find it to be helpful.

ROS: otherwise -
PMH: breast cancer (in remission), hypertension
Meds: HCTZ, Lisinopril, Ambien
Allergies: NKDA
SH: social drinker, non-smoker.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]son died a few weeks ago, F, ""thought she heard voices from a neighbors party despite that a party never occurred"", 67 y/o, difficulty falling asleep, for the past 3 weeks, takes Ambien but does not find it to be helpful, ""saw her deceased son in the kitchen."", waking up early, difficulty sleeping, difficulty staying asleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: cc trouble sleeping
HPI 67 year old female presents with sleeping diffuculuties, loss of interest, feeling of saddness and visual hallucinations since her son passed away 3 weeks ago. Having trouble going to sleep and reports early morning awakening. Patient denies changes in psychomotor response or feelings of guilt. she has tried talking ambein for sleep but with no relief. She reports increased appeitite. Patient denies cold intolerance skin and hair changes, fatigue. 
ROS negative except for abvove
PMH HTN
Meds HCTZ lisinopril ambien 5 mg
Allergies none
HF HTN and stroke in father and MDD in mother
SH is retired lives with husband , decreased amount of walks recently since son passed loss interest, drinks alcohol 3x/weekly and denies tabacoo and illicit drug use. regular diet.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appeitite, son passed away 3 weeks ago, female, 67 year old, trouble going to sleep, tried talking ambein for sleep but with no relief, loss of interest, loss interest, visual hallucinations, MDD in mother, early morning awakening, trouble sleeping, sleeping diffuculuties</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: trouble sleeping
HPI: Loraine Wicks, a 67yoF c/o trouble sleeping for the last 2 weeks. Pts only son died on May 14th last month. Pt has feelings of sadness, loss of interest, decreased energy, increased and appetite. Denies feelings of guilt, loss of concentration, and also denies suicidal ideation. Sleep has been lasting about 4-5 hours a night. she has taken ambien the last few nights to try to improve sleep, but it has not been effective. She has trouble falling alseep, and trouble staying asleep, despite proper sleep hygiene.
Pt practices good sleep hygiene. Drinks only 1 cup of coffee/ day and has well balanced diet.
ROS a
PMH: HTN
MEDs: ambien recently.
ALLERGIES: n/a
FH: Dad: HTN, Hypercholesterolism, COD:stoke. Mom: depression
SH: no tobacco, social drinker, no recreational drug use. Married to husband and has friends and brothers locally - good support system..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, son died on May 14th last month, F, 67yo, trouble falling alseep, last 2 weeks, ambien has not been effective, decreased energy, loss of interest, Mom: depression, denies suicidal ideation, trouble sleeping, trouble sleeping, Sleep has been lasting about 4-5 hours a night, trouble staying asleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 y.o. F presents with difficulty sleeping. Started 3 weeks ago following the death of her son. Ambien did not help her sleep. She goes to bed at 11 and wakes up at 4-5 sleeping only 4-5 hours per night. She complains of waking up early, tossing and turning, and feeling fatigued throughout the day. Since her son passed away, he has lost interest in doing anything, been fatiged, and has been eating more. She states that she has been seeing and hearing things that are not there including her son at the kitchen table, and muffled voices and music at a neighbors party.

ROS: Negative except for above
Vitals: Hypertensive, otherwise WNL.
Surg: Lumpectomy, appendecotmy.
PMHx: HTN for which she takes HCTZ + lisinopril
Allergies: none

Soc Hx: Pt lives w/ husband, retired, no tobacco or illegal drug use. Drank wine 2 glasses 3 times per week prior to son passing away. Good support system. Sexually active with husband..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]eating more, 3 weeks ago following the death of her son, 3 weeks ago following the death of her son, F, hearing things that are not there including muffled voices and music at a neighbors party, tossing and turning, 67 y.o, Started 3 weeks ago, Ambien did not help her sleep, feeling fatigued, been fatiged, has lost interest, seeing things that are not there including her son at the kitchen table, wakes up at 4-5, waking up early, difficulty sleeping, sleeping only 4-5 hours per night</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: Trouble sleeping
Loraine Wickws, 67 F presenting w trouble sleeping for the past 3 wks. Difficulty getting to sleep, staying asleep, and wakes up earlier than usual. Son died 3 weeks ago. She feels devasted. Has lost interest in hobbies (romance novels). Eating more. Has been hearing voices and seeing her son for the past 2 weeks. No guilt, no psychomotor agitation, No suicidality, Feels drained, no memory changes. ROS: No hair changes, no cold intolerence.
PMH: HTN, breast Ca 20 y/o tx w bilateral mastectomy (PSH)
Medications: HCTZ, lisinopril, Ambien
FH: Dad - high cholesterol, HTN, died at 75 of stroke, Mom 90, depression.
SH: Regular diet, used to exercise by walking, Used to drink 1-2 glasses of wine per day, 2-3x/wk, No cigarettes, or drugs, sexually active w husband..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Eating more, Son died 3 weeks ago, F, hearing voices, 67, Difficulty getting to sleep, past 3 wks, Feels drained, lost interest, seeing her son, Mom depression, wakes up earlier than usual, No suicidality, Trouble sleeping, trouble sleeping, Difficulty staying asleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67-year-old female, has come to the physician's office because of trouble sleeping. Started 3 weeks ago for the first time after his son died and since it sarted it is getting worst. Describe as problems to fall to sleep and wake up early in the morning tht don't improves even when she took a ambien for the last 5 days. Also she reports feel tire during the day but can't take a nap because can't fall to slee. Refers feel sad, drained,  loss in interest, eating more and feel safe at home. Denied plan to harm herself or otherm headaches, weakness, nubness, adominal pain, chest pain, joint pain, changes in bowel or urinary habits, convulsions,changes in weight, fever o SOB. 
ROS: none except above
PMH: HBP
MED: HCTZ, beta blocker
ALL: NKDA
PS: none, no trauma
OBG: LMP at 52 y/o

SH: retired marriage with children, no smoke, 2-3 glass wine at weeks, no ilicit drugs, sexually active with husband, no STDs
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]eating more, 3 weeks ago son died, female, 67-year-old, problems to fall to sleep, Started 3 weeks ago, ""cant take a nap because cant fall to slee"", ""dont improves even when she took a ambien"", tire during the day, feel drained, loss in interest, wake up early, Denied plan to harm herself, trouble sleeping</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Wicks is a 67 year old female who presents with 3 weeks of trouble sleeping. She has been sleeping 4-5 hours per night since the death of her son Leonard on July 5. She reports that she has had trouble falling asleep, she tosses and turns, and is tired and has low energy during the day. She has been taking Ambien for the past 5 nights but has not seen an improvement. She has lost interest and has diffculty concentrating on her hobbies but is still able to complete her ADLs. She does not feel guilt. Her appetite has increased, but she denies weight gain. She denies suicidal and homicidal ideation and says her husband has been supportive. Denies cold intolerance, changes in skin or bowel habits.
PMH: HTN, breast cancer in remission for 10 yrs
Meds: HCTZ 25mg once daily, lisinopril 20mg once daily
SH: never smoked, occasional wine, none for past 3 weeks, no recreational drugs
FH: father died of stroke age 75, mother h/o depression.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]appetite has increased, death of her son Leonard on July 5, Mrs, female, tosses and turns, 67 year old, trouble falling asleep, with 3 weeks, taking Ambien has not seen an improvement, tired, low energy, lost interest, mother h/o depression, denies suicidal ideation, trouble sleeping, sleeping 4-5 hours per night</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 y/o female with 3 weeks of insomina. She has trouble falling asleep; it takes up to one hour to fall asleep. She wakes up often in the middle of the night tossing and turning without need to go to the bathroom. She also wakes up earlier than usual. Her sleep time is from 11pm till 4-5 am at this point. She often feels very tired in the morning and throughout the day. This has occurred every day for the past 3 weeks. She lost her son 3 weeks ago, and is dealing with that. She has a strong support system at home. She has not consumed more alcohol than usual. She has low interest in her activities, low energy, increased appetite, no suicidal ideation or homicidal ideation. She has auditory halcuinations thinking the neighbors are having a party. She has visual hallucination of seeing her son even though he is not there.
PMHx: HTN, breast cancer 10 years ago
PSHx: lumpectomy, appendectomy
Social: Lives w/ husband. 2-3 drinks per week..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, lost her son 3 weeks ago, female, auditory halcuinations, tossing and turning, 67 y/o, trouble falling asleep, takes up to one hour to fall asleep, with 3 weeks, for the past 3 weeks, feels very tired, low energy, low interest, visual hallucination, wakes up earlier than usual, no suicidal ideation, insomina, wakes up often in the middle of the night</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 year old F presening with a history of difficulty sleeping for the past few weeks. She states that it takes her longer to fall asleep, she tosses and turns throughout the night and she gets up earlier than usual. Her son recently passed away on September 30 which she associates with the onset of her trouble sleeping. Currently sleeping about 4-5 hours a night. Tried ambien, did not help. Has had visual hallucination of her deceased son. Increase in appetite over the past few weeks, has no energy, no longer takes evening walks, and has lost interest in her hobbies. Denies feeling guilt, She states she has a strong support system. Denies suicidal ideation. Denies, blurred vision, chest pain, SOB. 
PMHx: HTN, breast cancer; Meds: HCTZ, lisinopril; NKDA; Surg: lumpectomy, laparotomy for appendix; Gyn: G1P1, vaginal birth no complications; menopause age 52
FHx: father deceased age 75 stroke, HTN, hypercholest; mother depression.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Increase in appetite, son recently passed away, F, tosses and turns, 67 year old, longer to fall asleep, past few weeks, ambien, did not help, no energy, lost interest, visual hallucination of her deceased son, mother depression, gets up earlier than usual, Denies suicidal ideation, trouble sleeping, sleeping about 4-5 hours a night, difficulty sleeping</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 Y/O F C/O SLEEPING PROBLEMX 1 MONTH AGO AFTER HER SON PASSED AWAY. SHE HAD DIFFICULLTY FALLING ASLEEP, GETTING UP EARLY IN MORNING. REPORTS FEELING SAD ,SEEING HER SON 3 DAYS AGO AND HEARING SOME PARTY VOICES LAST NIGHT THAT NOONE ELSE CAN HEAR. SHE HAS POOR ENERGY, LACK OF CONSENTRATION, ANHEDONIA, BUT SHE CAN TAKE CARE OF HERSELF, AND HAS A GOOD SUPPORT FAMILY AND FRIENDS. ALSO REPORTS THAT SHE EATING MORE THAN USUAL. DENIES FEELING GUILTY, WEIGHT LOSS, CONTROLED BY SOMEONE ELSE, SUICIDAL THOUGHTS, 
ROS:NEGATIVE EXCEPT AS ABOVE/PMH: HTN/PSH:NONE/MEDICATIONS: HTCZ. LISINOPRIL/FH: MOHTER HAD DEPRESSION/ SH: NOT SMOKER. 2BEERS/ WEEK. USES APN FOR LASTFEW  DAYS.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]EATING MORE THAN USUAL, 1 MONTH AGO SON PASSED AWAY, HEARING SOME PARTY VOICES LAST NIGHT THAT NOONE ELSE CAN HEAR, 67 Y/O, DIFFICULLTY FALLING ASLEEP, X 1 MONTH, POOR ENERGY, ANHEDONIA, SEEING HER SON 3 DAYS AGO, MOHTER HAD DEPRESSION, GETTING UP EARLY IN MORNING, DENIES SUICIDAL THOUGHTS, SLEEPING PROBLEM</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI:67 Y F c/o trouble sleeping since last 3 weeks, son died in a motor vehicle accident 3 weeks ago when the symptoms started,takes AMPIEN for problem but not relieved completely. no compla complains of eating more since then, no complaints of,no weight gain, constipation.

PMH:kc/o high blood pressure takes HCTZ since last 15 years and LIsinopril since last 5 years, h/o breast cancer- lumpectomy 10 years ago
 h/o laparotomy for appendicitis at 20 years of age, no history of travel
FH: not significant

SH: retired receptionist, lives with husband,
      no smokig, drinks occasionally,  no recreational drugs
      sexually active with husband.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]eating more, son died 3 weeks ago, F, 67 Y, last 3 weeks, takes AMPIEN not relieved completely, trouble sleeping</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 year old woman with hypertension and history of breast cancer in remission here with difficulty sleeping for past 3 weeks since son passed away in MVA. 
-  prior to 3 weeks ago, slept 8 hours per night. 
- since son passed away, has taken1 hr to fall asleep, tossed and turned through the night, and wakes at 4-5 am. 
- no changes to sleep hygeine - no screen time, though decreasd exercise. 
- Denies feelings of guilt for son's loss, denies SI or thoughts of self-harm, has good social support network. 
- has had hallucination of son but knew it was just a hallucination. also 1 hypnogogic hallucination.
- no snoring, or morning headache, weight loss, or other systemic symptom
- took ambien for past 5 nights, without improvement. 

Meds - hctz, lisinopril, ambien (past 5 nights)
pmhx - breast cancer in remission, HTN. 
fam med - dad with CVA. 
Social - 1-2 glass wine/week, no tobacco or drugs. 
no allergies.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]3 weeks since son passed away, 3 weeks ago son passed away, woman, 1 hypnogogic hallucination, tossed and turned, 67 year old, 1 hr to fall asleep, past 3 weeks, prior to 3 weeks ago, ambien without improvement, hallucination of son, wakes at 4-5 am, denies SI, denies thoughts of self-harm, difficulty sleeping</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Wicks is a 61F w/ insomnia. Difficulty falling asleep, with frequent awakenings, only getting 4 hours total/night and feeling fatigued. Does not look at screens before bed or spend time in bedroom when not trying to sleep. She does not snore. Her son passed away on August 9th of this year, and she has been grieving. Reports sad mood, anhedonia, decreased energy, increased appetite. Denies psychomotor agitation/retardation, guiltyness, difficulty concentrating, and suicidal ideation. No history of mania. Also reports she ""saw her son"" in the living room, although she knew he was not there. Denies prior hallucinations, paranoid thinkings, ideas of reference, or thought broadcasting. No sensitivity to temperature, skin/hair changes, or cahnges in bowel movements. PMH: HTN, breast cancer, PSH: lumpetomy, laparotmy. Meds HCTZ, lisinopril, ambien. NKDA. SH: 2/3 ETOh/wk. No drugs or tobacco. FH: Mother depressed. Father: HTN. Sexual


.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, son passed away on August 9th, Ms., F, 61, Difficulty falling asleep, feeling fatigued, decreased energy, anhedonia, ""saw her son"" in the living room, although she knew he was not there, Denies suicidal ideation, insomnia, frequent awakenings, only getting 4 hours total/night</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Loraine Wicks is a 67 year old female with past history of hypertension breast cancer (in remission) presenting for evaluation of difficulty sleeping. She explains that she has difficulty both falling asleep and staying asleep that began 3 weeks ago. At this time, she explained that her son died unexpectedly. She has used ambien to help her sleep for the lat 5 nights, but it has not helped. She gets 4-5 hours of sleep. She indicates an increased appetite, but denies thoughts of hurting self/others, guilt or difficulty concentrating, fevers, chills, night sweats, changes in weight, chest pain, SOB, nausea, vomiting, changes in her hair. Social Hx: follows no particular diet, exercise - walks every day, but has not recently due to her son's death, caffeine - 1 coffee/day. Medical Hx: HTN, breast cancer (in remission). Allergies: none. Surg Hx: lumpectomy, appendectomy, Family Hx: mother - depression, Meds: hydrochlorothiazide, lisinopril.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, 3 weeks ago son died, female, 67 year old, difficulty falling asleep, began 3 weeks ago, ambien has not helped, mother - depression, denies thoughts of hurting self, difficulty sleeping, difficulty staying asleep, 4-5 hours of sleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo female presents with 3 weeks of insomnia with recent death of son. describes difficulty falling asleep and maintaining sleeps. wakes up multiple times during the night. thinks about son at night. no nocturia. no snoring. reports depressed mood, anhedonia, increase appettite, inability to enjoy activitie, fatigues. reports hearing a party that did not happen and seeing son in kitchen . denies fever, chills, night sweats, weight changes, palpitations, cold symptoms, changes in hair skin or nails, cold/heat intolerance, headaches, dizziness, numbness, weakness, tingling, nausea, vomiting, diarrhea, constipation or other chnages in urianry habits or bowel movements. PMhx: hypertension, breast cancer 10 y ago. PSHx: lumpectomy, laparotomy for appendix. FMHx: hypertension. high cholesterol, stroke in father. depression in mother. NKA. Takes HCTZ, lisniopril, and ambien from friend. No drugs or smoking. drinks 2-3 wine/wk. 0/4 cage. sex.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increase appettite, recent death of son, female, reports hearing a party that did not happen, 67 yo, difficulty falling asleep, with 3 weeks, fatigues, anhedonia, inability to enjoy activitie, seeing son in kitchen, depression in mother, insomnia, difficulty maintaining sleeps, wakes up multiple times during the night</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Wicks is a 76 yo F who presents with ""trouble sleeping,"" difficulty falling asleep, and early morning awakening. This started 3 weeks ago. Roughly 3 weeks ago her son passed away. In addition to sleeping difficulties, she has had decreased interest level, decreased energy, increased appetite, no suicidal thoughts, no guilty feelings. Has had visual hallucinations of her son, and has heard voices recently: she has never had previous episodes like this before. No skin/hair changes. She has tried ambien to help with sleep, but it has not helped. No other relieving or exacerbating factors. No increased anxiety or fluctations in mood, no intrusive thoughts. 
ROS: negative except for HPI
Medications: HCTZ for HTN, lisinopril
Allergies: NKDA
PMHx: breast cancer survivor (remission 10 years)
PSurghx: R. breast lumpectomy, laparotomy appendix as a teenager
Socialhx: ret. receptionist, 2-3 drinks/week, no illicit drugs,lives w/husband.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, 3 weeks ago her son passed away, Ms, F, has heard voices recently, difficulty falling asleep, started 3 weeks ago, ambien has not helped, decreased energy, decreased interest level, visual hallucinations, early morning awakening, no suicidal thoughts, trouble sleeping, sleeping difficulties</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is 67F who presents with trouble sleeping since 3 weeks ago. Patient states 3 weeks ago her son died suddenly in a MVA and since then she has had trouble sleeping as well as waking up multiple times throughout the night. She has tried taking Ambien but it has not helped. 4 days ago patient states she saw her son in her kitchen, admits she knows it is impossible he could be there. Additionally she heard sounds of party from neighbor previous night, though neightbor states there was no party. 
Patient has lost interest in her favorite activities since events of her son's passing, does not feel guilt, notes decreased energy levels, and increased appetite. Denies decrease in concentration, psychomotor retardation or thoughts of suicide. 1 cup coffee in morning.

ROS: Neg except as stated above
PMH: HTN, Remission Breast Cancer, NKDA
Meds: HCTZ, Lisinopril
EtoH - 2-3 glass wine/week (0/4 CAGE), denies smoking, drugs..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, 3 weeks ago her son died, F, heard sounds of party from neighbor previous night, though neightbor states there was no party, 67, since 3 weeks, tried taking Ambien but it has not helped, decreased energy levels, lost interest, saw her son in her kitchen, Denies thoughts of suicide, trouble sleeping, trouble sleeping, waking up multiple times throughout the night</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Wicks, 67 yo F presents with 3 week history of difficulty falling asleep, early awakenings, and tossing and turning. She gets 4-5 hours of sleep throughout the night, does not feel refreshed upon awakening, and is tired throughout the day. She tried taking Ambien for the last 5 days but it does not help. Her son passed away 3 weeks ago and she has been feeling sad. She has been seeing her son and hearing late-night parties, which she knows are not real. She also reports loss of interest, low energy, increased appetite. She has a good support system. She has a mild cough which she says is due to someone's perfume. Denies constipation, cold intolerance, hair/skin/nail 
ROS: negative except as above
PMH: HTN
PSH: none
Meds: hydrochlorothiazide, lisinopril
Allergies: NKDA
SH: lives with husband, no tobacco or drugs, couple glasses of wine 2-3 times per week, CAGE 0/4
FH: dad- HTN, high cholesterol, died of stroke; mom-depression.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, son passed away 3 weeks ago, Mrs., F, hearing late-night parties, which she knows are not real, tossing and turning, 67 yo, difficulty falling asleep, 3 week history, Ambien does not help, low energy, tired throughout the day, loss of interest, seeing her son nows are not real, mom-depression, early awakenings, gets 4-5 hours of sleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: Loaraine Wicks is a 67 y/o female who presents with trouble sleeping for the last 3 weeks. She said this trouble sleeping started around the time of the the death of her son. She used to get 8 hrs a sleep a night, but now she wakes up around 4AM or 5AM with about 3 hours of sleep completed. She has been more fatigued lately, and has had a lost of interest in activities. She had 1 episode of seeing a vision of her son that passed away. She has also had 1 episode of hearing voices outside her door, thinking that it was her neighbor. Ambien has not provided any relief. 
ROS: negative except above. 
Allergies: none 
Meds: hydroclorthiazide, lisinopril 
PMH: HTN
PSH: lumbectomy, appendix removal 
SH: retired, lives with husbadn, no smoking, drinks red wine about 2-3 times per week, no recreational drug usage. 
FH: father had HTN and high cholesterol, mother is 98 with hx of depression 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]3 weeks death of her son, female, 1 episode of hearing voices outside her door, 67 y/o, last 3 weeks, Ambien has not provided any relief, fatigued, lost of interest, 1 episode of seeing a vision of her son, mother hx of depression, wakes up around 4AM or 5AM, trouble sleeping, trouble sleeping, 3 hours of sleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Wicks is a 67 yo woman who presents to clinic with trouble sleeping for the past 3 weeks. She started having trouble sleeping after her son died in an accident. She reports that she has trouble both falling asleep and staying asleep and has been waking up early. She is getting about 4-5 hours of sleep a night. She also reports that she has been sad, had an increased appetite, lost interest in her acitivites, and had a low energy level. She reports that she has seen her son James at the breakfast table and heard a party she knows was not real. She denies any headaches, dizziness, SOB, CP, fevers, chills, nausea, vomiting, weight loss or gain. 
ROS: see above
PMSH: HTn for 15 years
Meds: HCTZ, lisinopril, ambien for the past week
PSH: None
FH: Father had HTN and HLD died of stroke, mother 90 and healthy with depression
SocHx: No tobacco or illicit drugs, 2-3 glasses wine/week, sexually active with husband, retired receptionist.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, 3 weeks after her son died, Mrs., woman, heard a party she knows was not real, 67 yo, trouble falling asleep, for the past 3 weeks, low energy, lost interest, has seen her son James at the breakfast table, mother with depression, waking up early, trouble sleeping, trouble sleeping, trouble staying asleep, getting about 4-5 hours of sleep a night</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo F, presents w/ 3 weeks of sleep disturbances.  takes an hour to fall asleep. multiple nightly awakenings, sleeps ~ 4-5 hr each night. no naps during the day. does not snore. 
reports that her son died 3 weeks ago in an MVA. has good support system (husband and close friends). reports this limits her daily activity.
tried sleeping pills but didn't help.
No intolerence to heat/cold. no nighttime sweats.
Meds: HCTZ, lisinopril.
Allergies: none
PMH: High BP, Breast cancer survivor (10 years)
PSH: rt. Lumpectomy 10 ya. Laparotomy and appendectoy in her 20s.
SH: no smoking or drug history. drinks wine 2-3 glasses a week.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]son died 3 weeks ago, F, 67 yo, takes an hour to fall asleep, w/ 3 weeks, ""tried sleeping pills but didnt help"", limits her daily activity, sleep disturbances, multiple nightly awakenings, sleeps ~ 4-5 hr each night</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI:67 YO F C/O DIFFICULTY IN SLEEPING X 3WKS, STARTED AFTER SHE LOST HER SON, DIFFICUTY IN FALLING ASLEEP, STAYING ASLEEP AND EARLY MORNING AWAKING, ASSOCIATED WITH FATIGUE, LOSS OF INTERST, FLASHBACKS OF HER SON SITTING IN FRONT OF HER, FEELING SAD INCREASE APPETITE. SHE DENIES COLD INTOERANCE ,CHANGE IN APPETITE, WEIGHT CHANGE, DECREASE CONCENTRATION, FEELING GUILTY, SUICIDAL THOUGHTS. SHE REPORTS THAT SHE HAD A GOOD SUPPORT FROM HER HUSBAND AND FRIENDS.
ROS:NO CHEST PAIN ,CHANGE IN BOWEL OR URINARY HABITS.
PMH:HTN X15 Y, COMPLIANT WITH TX.
MEDS:HCTZ.
SH:NO SMOKES, OCCASIONAL ETOH, NO ILLICIT DRUGS. SEXUALLY ACTIVE WITH HUSBAND.
OB/GY:LMP AT AGE 52..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]INCREASE APPETITE, 3WKS, STARTED AFTER SHE LOST HER SON, F, 67 YO, DIFFICUTY IN FALLING ASLEEP, X 3WKS, FATIGUE, LOSS OF INTERST, FLASHBACKS OF HER SON SITTING IN FRONT OF HER, EARLY MORNING AWAKING, DENIES SUICIDAL THOUGHTS, DIFFICULTY IN SLEEPING, DIFFICUTY STAYING ASLEEP</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67yo woman presents with 3 weeks of difficulty falling asleep.  3 weeks ago her son was killed in an auto accident.  Pt says that it takes her a long time to fall asleep as shes thinking about her son, and she tosses and turns.  Pt has tried to take naps during the day, but has been unable to fall asleep.  Pt endorses a good support network including a loving and understanding husband.  Pt endorses increased appetite lately.  No change in weight.  Pt describes herself as sad, but not depressed.  She has diminished interest in hobbies, but is socializing.  Pt tried ambien to sleep but it didn't help.  Pt denies chest pain, SOB, fever, chills, nausea, vomiting, abdominal pain.  PMH sig for HTN treated with lisinopril and HCTZ, and pt is a 10yr breast CA survivor s/p lumpectomy.  Pt doesn't smoke, occassional EtOH use, no illicit drugs. Home BPs measurements have been good..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, 3 weeks ago her son was killed, woman, tosses and turns, 67yo, difficulty falling asleep, takes her a long time to fall asleep, with 3 weeks, tried to take naps during the day, but has been unable to fall asleep, ""tried ambien to sleep but it didnt help"", diminished interest</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67-year-old female, has come to the physician's office because of trouble sleeping. Patient said her only son died 3 weeks ago unexpectedly in an MVA. Since then she's been feeling sad, eating more, has lost interest in hobbies. Patient describes difficulty falling asleep, tossing and turning and waking up early. Patient also says she saw her son at the kitchen table 4 days ago, but knows he wasn't there. She also states she heard loud ""party like noises"" from neighbor's house 2 nights ago, but neighbor did not have a party. Patient tried ambien for last 5 days but hasn't helped. No fever, chills, nausea, vomiting, chest pain.

ROS negative except as noted above
PMH - HTN, breast cnacer
PSH - lumpectomy, lap appendectomy
Meds - hctz, lisonpril, ambien
FH - Father - HTN, HLD, Mother - dperession
Social - never smoker, drinks a couple glasses of wine 2-3 nightsper week, no drugs, lives at home with husband..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]eating more, son died 3 weeks ago, female, heard loud ""party like noises"" from neighbor\s house 2 nights ago, but neighbor did not have a party, tossing and turning, 67-year-old, difficulty falling asleep, ""ambien hasnt helped"", has lost interest, ""saw her son at the kitchen table 4 days ago, but knows he wasnt there"", Mother - dperession, waking up early, trouble sleeping</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Wicks is a 67 year old woman with history of HTN who presents for difficulty sleeping for 3 weeks. 3 weeks ago her only son Leonnard died. She thought she saw him once in the kitchen after he died and she has also heard a party at her neighbor's that wasn't there. These false perceptions do not bother her. Her primary issue is diffuclty sleeping. She goes to bed at 11 PM, falls asleep at midnight, and has poor sleep. Awkaens at 4 or 5 AM. Also has very low energy throughout day but performs daily tasks like cooking. Has a good support system of family and friends. Tried ambien for 5 nights which did not help. She has no thoughts of suicidality or self harm. No nightmares. No nausea, no chest pain, no difficutly breathing. 
family history of HTN and CVA in father, depression in mother
Allergies: none
Meds: HCTZ, lisinopril, ambien (for last 5 days)
Surg Hx: lumpectomy, laparotomy
Soc: no smoking, occasional etoh, no drugs.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]3 weeks ago her only son Leonnard died, Mrs., woman, ""heard a party at her neighbors that wasnt there"", 67 year old, goes to bed at 11 PM, falls asleep at midnight, for 3 weeks, Tried ambien which did not help, low energy, aw him once in the kitchen after he died, depression in mother, Awkaens at 4 or 5 AM, no thoughts of suicidality, difficulty sleeping, diffuclty sleeping, has poor sleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67yo F c/o trouble sleeping x3weeks. Pt states her son passed away 3 weeks prior when her insomnia started. She states she has trouble falling asleep, and trouble staying asleep. States she feels ""tired and groggy"" in the morning upon waking. States feelings of sadness and devastation since losing her son, states loss of interest in hobbies, low energy, increased appetite. +ve Visual hallucinations of son x1. +ve auditory hallucinations (hypnogogic) prior to falling asleep x1. Denies weight changes, feelings of guilt, lack of concentration, psychomotor retardation. Denies skin/hair changes. No change in caffeine intake.
PMH: HTN, Breast CA remission
Allergies and Meds: NKDA, HCTZ, Ambien for sleep
FH: Dad-Stroke, deceased. Mother-Depression.
SH: retired, married. Denies smoking, drugs. Drinks socially on weekends..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, son passed away 3 weeks prior, F, auditory hallucinations x1, 67yo, trouble falling asleep, x3weeks, 3 weeks prior insomnia started, feels ""tired, low energy, loss of interest, Visual hallucinations of son x1, Mother-Depression, trouble sleeping, trouble staying asleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Wicks is a 67yo who presents for difficulty sleeping. She reports that for the past 3 weeks, she has been experiencing difficulty falling asleep and staying asleep. October 13, her only son Leonard passed away. Since then, she has been experiencing increased appetite and difficulty sleeping. She has tried taking ambien. Endorses feeling down. Denies any feelings of guilt. Denies any thoughts of hurting herself or others. Endorses audio and visual hallucinations. Thought she saw her son sitting at the table, and thought she heard voices like her neighbor was having a party when she was not. Denies that hallucinations have told her to hurt herself or others. 

PMH: high blood pressure
PSH: laparotomy for appendicitis, mastectomy for breast cancer (14 years in remission)
FH: none
Social: lives with husband, strong support network, feels safe at home
Substance Use: no smoking, drinks 1-2 drinks per week
Work: retired.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, October 13, her only son passed away, Ms, audio hallucinations, heard voices like her neighbor was having a party when she was not, 67yo, difficulty falling asleep, past 3 weeks, visual hallucinations, saw her son sitting at the table, Denies any thoughts of hurting herself, difficulty sleeping, difficulty staying asleep, difficulty sleeping</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67yo F presents with difficulty sleeping for 3 weeks after loosing her son. she has difficulty falling asleep, staying asleep and has early morning awakening. she gets about 4/5 hours of sleep a night and feels drained throughout the day. she also reports hearing muffled voices (like a lot of people having a party) that was not actually happening, she also reports seeing her dead son for a few seconds. she also has increased appetite, loss of  interest in things she liked to do and anhedonia. shes in menopause and has had a mammogram last year and apapsmear 2 years ago. she had 1 child by normal vaginal delivery

PMH Hypertension, 10 years in remission from breast cancer
PSH: lumpectomy 10 years ago, laparotomy for appendicitis
SHX she doesbt smoke or use illicit drugs but she drinks a few glasses of wine 2-3 times a week
mother had depression, father died of stroke

.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, 3 weeks after loosing her son, F, hearing muffled voices that was not actually happening, 67yo, difficulty falling asleep, for 3 weeks, feels drained, loss of  interest, anhedonia, reports seeing her dead son, mother had depression, early morning awakening, difficulty sleeping, difficulty staying asleep, 4/5 hours of sleep a night</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: A 67 YO F COMPLAINS OF TROUBLE SLEEPING SINCE 3 WEEKS AGO. SHE RELATE THE ONSET OF SYMPTOMS WITH THE LOSS OF HER SON THIS PAST NOVEMBER. SHE REFERS ANHEDONIA, DEPRESSED MOOD, FEELING DRAINED AND HAVING EXPERIENCED INCREASED APPETITE. SHE DENIES SUICIDE THOUGHTS, NO PSYCHOMOTOR RETARDATION OR AGITATION, RASHES OR COLD INTOLERANCE. SHE USUALLY TAKES A RELAXING BATH BEFORE GOING TO SLEEP AND USED TO SLEEP FOR 7-8 HRS PER NIGHT, BUT NOW IS ONLY GETTING 4-5 HRS. SHE HAS TRIED AMBIENS FOR THE PAST 5 NIGHTS BUT THEY ARE NOT OF MUCH HELP. SHE DENIES HAVING ANY OTHER STRESSES AT HOME AND REPORTS THAT HER HUSBAND IS VERY SUPPORTIVE.
ROS: SAME AS ABOVE
PMH: ARTERIAL HYPERTENSION.
NKDA
MEDICATIONS: AMBIEN, HCTZ AND LISINOPRIL
PSH: C-SECTION FOR PREGNANCY.
FH: FATHER HAD ARTERIAL HYPERTENSION AND HYPERCHOLESTEROLEMIA PASSED AWAY OF STROKE. MOTHER SUFFERS FROM DEPRESSION
SH: RETIRED. LIVES WITH HUSBAND. ETOH 2-3CUPS OF WINEX3 PER WEEK..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]INCREASED APPETITE, LOSS OF HER SON THIS PAST NOVEMBER, F, 67 YO, SINCE 3 WEEKS AGO, AMBIENS NOT OF MUCH HELP, FEELING DRAINED, ANHEDONIA, MOTHER SUFFERS FROM DEPRESSION, DENIES SUICIDE THOUGHTS, TROUBLE SLEEPING, SLEEP ONLY GETTING 4-5 HRS</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 y/o F comes to the clinic c/o trouble sleeping. Started 3 weeks ago, for the first time, since it started is getting worst. Refers that she only sleep 4-5 hours, awake at 3- 4 am and is no able to fall asleep agian. Refers not feeling rested during the day and can not takes nap.  Refers her son died a months ago, and she feels devasted about this. Refers increased appetite, refers an episodes that she saw her dead son in the kitchen and loss of interest in her daily activities. No suicidadal ideation and refers that her husband and friends are very supportive. Denies fever,  nausea, vomiting,  problem with concentration,  recent infections, weakness, nuimbness, changes in GI/GU or pain in chest, abdomen, or joints.
ROS: none, except as above. PM: HTN for 15 years; All: NKDA; Med: HCTZ, lisinopril; FM: father died of a stroke and mother has MDD. OB: Menopause 53 y/o. SH: retired, drinks 3-4 cup of wines per week, no recreational drug.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, son died a months ago, F, 67 y/o, Started 3 weeks ago, can not takes nap, not feeling rested during the day, loss of interest, saw her dead son in the kitchen, mother has MDD, awake at 3- 4 am, No suicidadal ideation, trouble sleeping, sleep 4-5 hours</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: The patient is a 67 yo woman with trouble sleeping. Her son was killed in an MVA 3 weeks ago, and since that time she has had difficulty falling and staying asleep and early morning awakening. No schedule change and normal healthy sleep hygeine. She has tried ambien the past few nights but did not feel that it helped. Since her son's death, she has had decreased energy, loss of sleep, increased food intake, and sadness. She denies psychomotor agitation or retardation, worthlessness or guilt, and suicidal ideation. Normal concentration.  She denies being hot or cold, weight loss or weight gain, changes in timing, consistency, or color of bowel movements, hair or skin changes.]
ROS PMH: HTN, breast cancer in remission for 10 years
PSH: laparotomy for appendectomy, mastectomy
Meds: HCTZ, lisinopril, ambien
Allergies: none
Family: Father stroke age 75, HTN, HLD, Mother depression
No smoking, EtOH 2x/wk., no drugs, sex with husband.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased food intake, son was killed 3 weeks ago, ""sons death"", woman, 67 yo, difficulty falling asleep, 3 weeks ago, and since that time, tried ambien did not feel that it helped, decreased energy, Mother depression, early morning awakening, denies suicidal ideation, trouble sleeping, difficulty staying asleep, loss of sleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt. is a 67 y/o causcaisun female coming in for 3 week hx. of trouble sleeping. She states she has also had hallucinations for the past 4 days. Her son recently passed away 3 weeks ago in a MVA and ever since then she has had trouble going to sleep, waking up early, feeling tired all the time, eating more. She states usually she is a happy person but has been down recently. She sleeps about 4-5 hrs a night now. She has good sleep hygeiene. She has tried ambien but doesnt help. Hallucinations she states she saw her son 4 days ago, and last night she heard music and partying when there wasnt any. She has lost interest in her hobbies as well. Denies suicidality. No psych hx. Good support systems.

PMH: High blood pressure, breast cancer in remission
PSH: Lumpectomy, laparotomy for appendix
FH: mom- depression
SH: retired receptionist. Normal diet and exercise. No smoking, alcohol some CAGE neg.
Meds: HCTZ, lisinopril
Allergies: None.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]eating more, son recently passed away 3 weeks ago, female, heard music and partying when there wasnt any, 67 y/o, trouble going to sleep, 3 week hx, tried ambien but doesnt help, feeling tired all the time, lost interest, Hallucinations she states she saw her son 4 days ago, mom- depression, waking up early, Denies suicidality, trouble sleeping, sleeps about 4-5 hrs</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo F presents to the clinic with the c/o decreased sleep for the last 3 weeks which happened after her son died on June the 6th. 
PREVIOUSLY SHE MANAGED TO SLEEP FOR A GOOD 8 HOURS, SLEEPING AT 11PM AND WAKING UP AT 7AM. CURRENTLY SHE gpes to bed at 11pm and falls asleep at midnight afte much tossing and turning, wakes up at 4am, sometimes will wake up in between, no snoring, restless sleep. activities before sleeping are dinner and conversation with husband. coffee intake is 1 in the morning. interest has gone down, crying spelLs, no feeling ofguilt, decreased energy and fatigued, decreased ability to concentrate, apetite has gone up, no weight changes, no  suicidal ideations. denies any skin /hair chnages no constipation. 
PMH HTN, Regression for Breats cancer 
PSH lumpectomy, laparatomy for appendix removal
FH father died of stroke mum had depression
SH unremarkable, good relationsip with husband
DRUGS,HCTZ,AMBIAN,LISINOPR
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]apetite has gone up, son died on June the 6th, F, tossing and turning, 67 yo, gpes to bed at 11pm and falls asleep at midnight, for the last 3 weeks, decreased energy and fatigued, interest has gone down, mum had depression, wakes up at 4am, no  suicidal ideations, decreased sleep, sometimes will wake up in between, restless sleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Wicks is a 67 year old female who presents to the clinic due to difficulty sleeping. This has been occurring for 3 weeks in which she has difficulty falling asleep and staying asleep. She recently lost her son unexpectedly in a MVA and has been grieving. Since his death, she has been having trouble sleeping. She used to get 8 hours now she gets 4-5 hours and is not able to take naps. She tried taking Ambien which she got from a friend which has not helped her sleep. She has also had visual hallucinations of her son and auditory hallucinations of others. 
Depression screening: no suicidal ideation. Has had anhedonia, increased appetite, trouble sleeping
ROS: neg
Allergies: NKDA
Meds: HCTZ, Lisinopril, Ambien
MH: Hypertension, Remission of Breast Cancer 10 years ago
SH: Lumpectomy, Laparotomy (appendix)
Social: Retired Receptionist, lives with husband Rober, sexually active, never smoked, EtOH: 0/4 CAGE , no recreational drugs.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, recently lost her son, Mrs., female, auditory hallucinations of others, 67 year old, difficulty falling asleep, occurring for 3 weeks, not able to take naps, Ambien has not helped, anhedonia, visual hallucinations of her son, no suicidal ideation, difficulty sleeping, difficulty staying asleep, trouble sleeping, used to get 8 hours now she gets 4-5 hours, trouble sleeping</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 y female presents to the clinic  compaling of trouble sleeping.  she states that her son passsed away 3 weeks ago on april 16 and she is devastated. she states that she has a strong support system and  is still able to spend time withy friends and husband whi sis very supportive at the moment. denies inabillity to concentrate, eight gain, cold intolerance. admits to fatigue and being emotionally drain. states that she is sad but not depress. denies suicidal ideation.  denies nausea, vomiting. states that she is still able to cook and clean. 
pMH: HBP contoilled, remission for breat cancer 10 years ago. 
allergies: none
meds: ATCZ, linopril, ambien for sleep.
PH: father died at 75 of stroke, had HBP, and dyslipedemia. mother is healthy. 
social history: no ciggarretes, drinks wine 2-3 times a week 0/4 cage. no drugs
sexual history: sexually active with husband.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]son passsed away 3 weeks ago, female, 67 y, fatigue, emotionally drain, denies suicidal ideation, trouble sleeping</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo female presenting with 3 wk history of difficulty falling asleep/staying asleep coinciding with passing of her son Leonard 3 wks ago. She has not had issues with sleeping in the past, has tried Ambien without success during this episode, and is unclear why it is happening. ROS -: headache, chest pain, cough, wheeze, abdominal pain, numbness/tingling. She describes her sleep hygiene as unchanged: consisting of dinner at 6.30, spending time with husband until 10.30, then washing and sleeping without TV or exposure to electronics. Recently, she is eating more food, not exercising as much with her walks, and had 2 episodes of seeing ""visions"" of her son and hearing a neighbor's party. PMH: HTN, breast cancer in remission Meds: HCTZ, lisinopril. No allergy. Surgery: lumpectomy and laparotomy for appendicitis in past. Social: retired 2 yrs ago, healthy diet, no smoking/drugs, 2-3 red wine cups/wk. Not sucidal/diminished will to live..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]eating more food, passing of her son 3 wks ago, female, ""episodes of hearing a neighbors party"", 67 yo, difficulty falling asleep, 3 wk history, tried Ambien without success, episodes of seeing ""visions"" of her son, Not sucidal, difficulty staying asleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Loraine Wicks 67yo F with PMH HTN on HCTZ and lisinopril presents with 3 weeks history of difficulty sleeping. She has difficulty falling asleep and remaining asleep. She tosses and turns at night. She takes 1 hr to fall asleep and gets about 4-5hrs of sleep a night. She has tried ambien for 5 days; it does not help. She is a retired community college receptionist and spends her days doing house chores. She recently picked up scrapbooking and reading, but has been less interested in doing so lately. She admits to increased appetite, though with no weight changes, and decreased energy levels. Her son recently died and she admits to seeing/hearing things that she knows are not real. Her concentration is normal and she does not feel guilty. She had a lumpectomy 10years ago for breast cancer and is in remission, laparotomy for appendicitis many years ago. FHx: father- HTN/HLD, died of stroke. mother-healthy, depression in the past..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, son recently died, F, hearing things that she knows are not real, tosses and turns, 67yo, difficulty falling asleep, takes 1 hr to fall asleep, 3 weeks history, tried ambien for 5 days; it does not help, decreased energy, less interested, seeing things that she knows are not real, mother depression in the past, difficulty sleeping, difficulty remaining asleep, gets about 4-5hrs of sleep a night</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HOI: 67 y/o F c/o difficulty falling asleep and staying asleep for the last 3 wks. She is also c/o hearing voices and visual hallucinations. She sleeps an average of 4 hrs, is fatigued, and has no energy to do her daily activities. Pts son recently died in a car accident and she is depressed since then. No suicidal thoughts or ideation, feelings of guilt, appetite problems, diarrhea, tremors, heat intolerance or excessive caffiene intake. Pt started taking Ambien from a friend recently and symptoms excaerbated since then. ROS: Negative except as above. PMH: CA Breast, Hypertensive for the last 15 yrs. Menopause 20 years ago. PSH: B/L mastectomy. Medications: HCTZ, Lisinopril, AMBIEN
Allergies: NKDA. SH: Pt is  aretired receptionist and vdoes not use any alcohol, illicit drugs or tobacco. FH: Mother has depression amd father had stroke, HTN..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]son recently died, F, hearing voices, 67 y/o, difficulty falling asleep, started taking Ambien from a friend recently and symptoms excaerbated since then, for the last 3 wks, fatigued, has no energy, visual hallucinations, Mother has depression, No suicidal thoughts or ideation, difficulty staying asleep, sleeps an average of 4 hrs</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Wicks is a 65 y.o. F with a history of 3 wks of insomnia after suffering the loss of her only child 3 weeks ago in an MVA.  trouble falling sleep, taking approx 1 hour and waking up in the early morning not being able to go to bed. Getting about 4-5 hrs as opposed to regular 8 hours. No excessive worries or intrusive thoughts overnight. NO changes in sleep habits. Good sleep hygeine--1 cup of coffee per day. Has tried ambien a few nights and does not notice a changeShe does feel sad and have loss of interest in regular acitviites, decreased energy, increased appetite. No suicidal ideation. No fevers, weight changes. No cold or heat intolerance, skin changes, hair changes. 
PMH: r Breat ca-10 yrs remiss, s/p surg, chem, rad. HTN
PSH: ex lap for append, R lumpect
Meds: HCTZ, lisinopril. Recent ambien
FH: Mom depression- unsure of tx
SH: good support sys, lives w/ husb. No tobacco, 2-3 wine/wk, less since incident. Retired..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, loss of her only child 3 weeks ago, Ms., F, 65 y.o., trouble falling sleep, history of 3 wks, tried ambien and does not notice a change, decreased energy, loss of interest, Mom depression, waking up in the early morning, No suicidal ideation, insomnia, Getting about 4-5 hrs as opposed to regular 8 hours</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 67,f,c/o trouble sleeping for the past 3 weeks since his only son passed away due to car accident. She goes to bed at 10PM and have difficulty of maintaining sleep. She reports early morning awakening and felt tired during the day. She talks with his husband before sleeping. She also noted seeing his son and hearing noises at night but which apparently are not present at that time. She also noted increased in appetite but no weight changes.  Patient has a good support system. No snoring, no SOB, no orthropnea, no paroxysmal nocturnal dyspnea. 
ROS: No weight changes, no loss of interest, no urinary or bowel problems
Allergies: NKDA
Medications: HCTZ, Lisinopril, NBN
PMHx: HTN, Breast CA on remission x20yrs
PSHx: Bilateral Mastectomy 20 years ago
SHx: Lives with husband, retired for 2 years, 2-3glasses of redwine/wk, no tobacco, no illicit drugs
FHx: Father died at 75 due to stroke and with HTN; Mother 90 with Depression
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased in appetite, 3 weeks since his only son passed away, f, hearing noises at night but which apparently are not present, 67, past 3 weeks, felt tired, noted seeing his son, Mother 90 with Depression, early morning awakening, trouble sleeping, difficulty of maintaining sleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI - 67 yo F c/o insomnia for 3 weeks. It started after death of her son. Is costant and   feels tired, Has drowsiness during a day. has increased apetite. Has difficulty to fall asleep, awakes during night and also earlier at morning.No change of body weight, headache, nause/vomiting, change of vision. No cold intolerance. No chest pain, palpitations, shortness of breath.
ROS - Negative except as above
Allergy - NKDA
Meds - Hydrocholothiazide, Licenopril
PMH- Breast cancer 11 years ago. Hypertension. Lapratomy in the past.
FH - High BP and died from stroke. Mother had depression.
SH - Retired college receptionist. Drinks 1-2 glass vine 3 times per week. No smoking or illicit drug use..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased apetite, for 3 weeks started after death of her son, F, 67 yo, difficulty to fall asleep, for 3 weeks, feels tired, drowsiness during a day, Mother had depression, awakes earlier at morning, insomnia, awakes during night</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo F comes to the clinic with a complaint of difficulty to sleep. She recalls it starting 3 weeks ago. At that date, she lost her sudden unexpectedly after a car accident. She isn't doing any strenuous activity or having heavy meals before bedtime. She has trouble starting sleeping and takes about 1 hour to fall asleep. She also wakes up many times a night. She recalls no snoreing or shortness of breath in the middle of the night. No nightmares. She feels sad, has low energy and has lost interest in most of the activities she used to take pleasure on. She tried to use Ambien with no help. She didn't contemplate suicide. No guilty feelings. She has no change in skin or hair, no changes in her bowel movements, no intolerance for extreme weather.
ROS: None except above
PMH: Hypertension treated. Breast cancer 10 y ago.. Takes HCTZ and enalapril. Ambien.  NKDA.  PSH lumpec. and apendect. 
FH: Mom had Depression..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]F, 67 yo, trouble starting sleeping, takes about 1 hour to fall asleep, starting 3 weeks ago, tried to use Ambien with no help, low energy, lost interest, Mom had Depression, difficulty to sleep, wakes up many times a night</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Loraine Wicks is a 67 y/o AAF who presents with trouble sleeping for the last 3 weeks after the recent dead of her only son who past in a MVC. She reports 4/5 h of sleep per night, difficulty falling asleep and not feeling rested upon waking. She feels devastated and drained and had increased appetite for a couple weeks with no changes in weight. She also reports decreased intrest in reading which she used to enjoy very much. Denies feelings of guilt, headaches, changes in vision. Positive for visual and auditory hallucinations.

PMHx: HTN for 15 years, controlled with HCTz and lisinopril
PFHx: Father - HTN, high cholesterol; stroke (deceased); Mother - depression
Social: no smoking or illegal drugs; couple glasses of wine 1-2/wk; lives with husband and receives support from him and friends
No allergies
No surgical history.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, 3 weeks after the recent dead of her only son, AAF, auditory hallucinations, 67 y/o, difficulty falling asleep, last 3 weeks, not feeling rested upon waking, feels drained, decreased intrest, visual hallucinations, Mother - depression, trouble sleeping, 4/5 h of sleep per night</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo female comes to office complainong of trouble sleeping. she has trouble going to sleep, and wakes up early. This started 3 weeks ago suddnely after her son died in a MVA. She only sleep 4-5 hours a day, without any naps. She reports good sleep hygiene. She reports depressive symptoms of decrease sleep, energy, interest in fond activitys of scrap booking and reading. She doesn ot have any suicidal ideations. Sher concentration and memory are good. She hears her son James make coffee sometimes. She also heard loud music/party where there wasn't one. Her mom had history of depression. Denies chest pain, SOB, Urinary symotoms, bowel changes. 
ROS: as per HPI
PMHx: none, PMSHx; none
NKDA, screening recently normal, no smoking or illicity dugs, drinks 2 glasses of wine 2-3 x week, CAGE neg
famil Hx: mom had depress, dad has high BP and cholesterol
Social Hx: lives iwth husband, feels safe, he is supportive 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]3 weeks ago son died, female, ""heard loud music/party where there wasnt one"", 67 yo, trouble going to sleep, started 3 weeks ago, without any naps, decrease energy, decrease interest, mom had history of depression, mom had depress, wakes up early, interest doesn ot have any suicidal ideations, decrease sleep, trouble sleeping</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo F presenting with trouble sleeping for 3 wks and fatigue. Her son died 1 month ago in an MVA. She reports early awakening, loss of interest in daily activities, low energy, increased apetite. No guilt or psychomotor retardation, no suicidal ideation. Reports seeing visions of her son and hearing muffled voices and music that she knows are not there. Voices are not saying anything. Tried ambien but nothing makes sleeping problems better or worse 
ROS: Denies headache, dizziness, weight change, chest pain, palpitations, SOB, cough, abdominal pain, hematuria, hematochezia, muscle aches/paines, hair loss. 
PMHx: HTN, breast ca in remission 10 yrs
PSHx: lumpectomy, laparotomy for appendicitis
Meds: HCTZ, lisinopril, Ambien x 5 days
FH: noncontributory
GYN: G1P1, normal vaginal delivery. Menarche 13, Menopasuse 52
SH: Drinks 2 glasses red wine couple times/wk. No smoking/illicit drug use. Retired. Sexually active w/husband.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased apetite, son died 1 month ago, F, hearing muffled voices and music that she knows are not there, 67 yo, for 3 wks, Tried ambien but nothing makes sleeping problems better, fatigue, low energy, loss of interest, seeing visions of her son, early awakening, no suicidal ideation, trouble sleeping</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 YO post-menopausal female with a history of HTN presenting with about 3 weeks of difficulty sleepng. She notes that on 11/15/17 her son passed away. Since that time she's been having difficulty falling asleep and staying asleep. She also has had fatigue/reduced energy, increased eating, depressed mood, with reduced interest in doing enjoyrable activities. She denies suicidal thoughts. No difficulty concentrating. She has never had anything like this before, although she notes her mother has Major Depressive Disorder. She notes ample family support in this difficult time.No difficulty sleeping with menopause changes. 

ROS: No headahce, vision changes, palpitations, abdominal pain, urinary or BM changes. 
PMH: HTN - on HCTZ and lisinipril
PSHx: none
FHx: dad - HTN, HLD, stroke; Mother - MDD
Social: lives with family. Ample family support..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased eating, on 11/15/17 her son passed away, female, 67 YO, difficulty falling asleep, with about 3 weeks, fatigue, reduced energy, reduced interest, mother has Major Depressive Disorder, Mother - MDD, denies suicidal thoughts, difficulty sleepng, difficulty staying asleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 y.o female c/o poor sleeps for past month. Pt notes her son, leonard, died in a MVA x3 weeks ago and hasn't been able to get good sleep since. Pt also endorses anhedonia, poor concentration, and fatigue. Pt notes she is only able to get 4-5 hours of sleep every night. Pt has tried ambien pill w/o releif. No snoring per husband. Pt notes good sleep environment. One cup of coffee in the AM only, no energy drinks or eating close to bedtime. Denies any Fever, chills, night sweats, weight loss, GI or GU sxs. 
ROS: negative except as above.
Allergies: NKDA
Meds: HCTZ, Ambien
PMH: breast CA survivor currently in remission. x10 years. 
PSH: Appendectomy x20 years ago. Lumpectomy x10 years ago.
OB: G1P1A0 one uncomplicated normal spontaneous vaginal delivery at term.
FH: Paternal HTN, HLD, and CVA. Mom and 5 brothers in goo dhealth.
SH: No tobacco or drugs. Drinks 2-3 glasses wine per week .No travel. retired ocupation..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]son died x3 weeks ago, female, 67 y.o, past month, 3 weeks ago, tried ambien pill w/o releif, fatigue, anhedonia, poor sleeps, ""hasnt been able to get good sleep"", 4-5 hours of sleep every night</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo F presents with 3 weeks of trouble sleeping
- lost son 3 weeks ago
- notes waking too early and tossing and turinin in sleep
- get 4/5 hours sleep a night
- loss of interest in previou activities as reading
- increase in appetite
-note low energy throughout day
- no suicidal ideation
has tried taking ambien for sleep no help
- hearing voices next door, with no command
-seeing images of her son in dining room,
PMH of HTN, no PSH, on HCTZ, lisinopril , NKDA
SH of retired , nonsmoker, no alcohol, use to drink 2/3 cups of wine
FH of depressin in mother, father passed of stroke
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increase in appetite, lost son 3 weeks ago, F, hearing voices next door, tossing and turinin, 67 yo, with 3 weeks, ambien for sleep no help, low energy, loss of interest, seeing images of her son in dining room, depressin in mother, waking too early, no suicidal ideation, trouble sleeping, get 4/5 hours sleep a night</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 67 yo F c/o 3 weeks of trouble sleeping and feeling ""drained"" with associated early waking, increase in appetite, reduced intrest in activities, no guilt. Onset of insomnia associated with son's death. Associated visual and auditory hallucinations of seeing son and hearing party. Has insight into hallucinations. Denies suicidal or homocidal ideation. No changes in weight, able to carry out activites of daily living. This has never happened before, no history of psychiatric hospitilizations.

ROS: negative except for above
Allergies: none
Meds: HCTZ, lisinopril, ambien for past 5 nights - did not help sleep.
PMH: HTN, breast cancer in remission - 10 years
PSH: lumpectomy, laparatomoty (for appendicitis)
Social: Used to drink 2/3 times per week, now stopped. No smoking/drugs. Lives with husband, retired.
FH: Father - passed at 75 from stroke, had HLD, HTN. Mother - history of depression. 5 brothers - no known issues..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increase in appetite, ""3 weeks sons death"", F, auditory hallucinations, 67 yo, c/o 3 weeks, ambien did not help sleep, feeling ""drained"", reduced intrest, visual hallucinations of seeing son, Mother - history of depression, early waking, Denies suicidal ideation, trouble sleeping, insomnia</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: a 67 yo female patient complains of difficulty sleeping for the past 3 months , her son has passed away on february. she doesnt drink caffiene products or smoke before sleep nor watch TV , she now sleeps 4-5 hours per night when she used to sleep 8 hours before, she has difficulty falling asleep and mainatining asleep, she tried Ambien for 5 days but it didnt work ,she denies snoring and night mares however she mentions that she gets auditory hallucination before she fell asleep one night but denies any hallucinations on waking up, she denies any daytime sleepinessl.patient hasnt had changes in weight, apetite,skin or hair,no costipation.however sh complain of sad mood,loss of interest and fatigue.
Allergies:NKDA
meds: Hydrochlorothiazide, Ambien, lisinopril
PMH:HTN , breast cancer 8 years ago and in remission
PSH: lumpectomy for breast cancer, laparotom
SH:retired,non smoker, 2-3 wine week(CAGE 0/4  Fh:dad stroke,mom depression.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]her son has passed away on february, female, gets auditory hallucination, 67 yo, difficulty falling asleep, tried Ambien but it didnt wor, fatigue, loss of interest, mom depression, difficulty sleeping, sleeps 4-5 hours per night when she used to sleep 8 hours before, difficulty mainatining asleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: This is a 67 year old woman with HTN and remote breast cancer history who presents with 3 week history of insomnia. Of note, these symptoms began same day her son died tragically. She reports multiple SIGECAPS symptoms including decreaed energy, difficulty enjoying activites, and increased appetite. She denies SOB, CP, edema, nausea, and bowel/bladder symptoms. 
ROS: Negative except per above.
Allergies: None
Meds: HCTZ, lisinopril. Tried ambien from friend 5x
PMH: HTN, Br Ca 2011
PSH: Lumpectomy 2011, Laparoscopic appendectomy in 20s.
SH: Lives with supportive husband. Is retired receptionist. Walks daily at baseline. No tobacco, 1-2/week redwine, 0/4 CAGE.
FH: Mother with depression (alive). Father with stroke (deceased).
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, began same day her son died, woman, 67 year old, 3 week history, decreaed energy, difficulty enjoying activites, Mother with depression, insomnia</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Wicks is a 67 yo F who presents with difficulty sleeping. 3 weeks ago her son died, since then she's had difficulty falling and staying asleep, tosses and turns in bed, sleeps 4-5 hrs previously 8 hrs per night. She feels devastated and tired but endorses a strong support system, denies suicidal ideation. She endorses losing interest in hobbies and increaed appetite. Last night she heard noises from neighbor's yard that were not present, and few days ago saw image of her son in the kitchen but knows these are not based in reality. Denies intrusive thoughts, auditory hallucinations, skin and hair changes, weight gain. Tried ambien without effect.
ROS: negative except as above
PMH: Htn, remission from breast cancer 10 yrs ago, Meds: ambien, hydrochlorothiazide, lisinopril; NKDA
FHx: noncontributory
SHx: retired, strong support network, denies tobacco, EtOH, illicit drugs; 1 cup coffee per morning.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increaed appetite, 3 weeks ago her son died, Ms, F, ""heard noises from neighbors yard that were not present"", tosses and turns, 67 yo, difficulty falling asleep, Tried ambien without effect, tired, endorses losing interest, saw image of her son in the kitchen but knows these are not based in reality, denies suicidal ideation, difficulty sleeping, difficulty staying asleep, sleeps 4-5 hrs</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 y/o F complains of problems sleeping for 3 weeks. the symptoms started after her son died. she used to sleep 8 hours a night, now she sleeps 4 hours a night, feels tired and sleepy during the day. She tried some medications for her sleep, but nothing helped. patient feels sad, complains of lack of interest and energy. increased appetite, with no weight changes. reports visual and auditory hallucinations about her dead son, however she knows they are not real.no suicidal nor homicidal ideation.does not feel guilty. No hot or cold intolerance. no changes in her bowel habits. drinks 1 cup of coffee a day.
ROS:negative except as above
Allergies:none
Medication:HCTZ, Lisinopril,Ambien.
PMH:Hypertension,breast cancer
PSH:lumpectomy,laparotomy with removal of the appendex in her 20s
SH:no smoking.2-3 drinks a week. no illicit drugs. sexually active with her husband.
FH:mother had depression. Father had stroke.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, 3 weeks after her son died, F, auditory hallucinations, 67 y/o, for 3 weeks, tried some medications for her sleep, but nothing helped, feels tired, sleepy during the day, lack of energy, lack of interest, visual hallucinations, mother had depression, no suicidal ideation, problems sleeping, sleeps 4 hours a night</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI 67yo F with c/o imsomnia. She cannot fell asleep and wakes up earlier than usual for 3 weeks. Since his son James passed away on April 16, her imsomnia started. Ambian does not help her sleep that much. she hear some playful music but other people did not hear that. She also see visual hallusination of her late son. Family and friends are all supportive and she does not feel hopelessness or suicidal thoughts. Appetite is increasing and weight is the same. no chill, no fever. Duration of sleep is 4-5 hours.
ROS n.p. other than mentioned above
PMH HTN PSH Father HTN, Hypercholeterolemia, stroke Allergy NKDA, Med HCTZ statin, smbian Sx -cig, ETOH 2-3 wine/night but after her son's death she stopped drinking. illegal drug(-).
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Appetite is increasing, son passed away on April 16, F, hear some playful music but other people did not hear that, 67yo, cannot fell asleep, for 3 weeks, Ambian does not help, visual hallusination, wakes up earlier than usual, does not feel suicidal thoughts, imsomnia, imsomnia, Duration of sleep is 4-5 hours</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yr old w f presented with isomnia dec energy low mood inc apetite norma wt has experience hallucinations has seen his decesaed son in home taht dies 3 weeks ago aloso been hearing voices which others dont , dec intersest in daily activities has no feeling of guilt no suicida ideation no memmoer loss, .HAS HTN FROM 15 YRS ON hctz NAD LISINOPRIL FROM 5 YRS on bre=ast ca remission from 10 yrs  takin ambian for sleep from 5 days has appendicetomy done at 20 yrs no traum urination and bowel movemment fine no cold intolerance hair thining dry skin or hoarese voice , FHX mother healty 90 as high cholestrol father died of stroke LMP at age of 52 G1P1A0, SSEXUALLY ACTIVE ONLY WITHY HUSBAND NEVER TESTED FOR STDS, NON SMOKER DRINKS OCCASIONALY 2 GLASS WINE WITH DINNER NO REC DRUGS RETIRED RECEPTIONIST.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]inc apetite, son dies 3 weeks ago, f, hearing voices which others dont, 67 yr old, dec energy, dec intersest, hallucinations has seen his decesaed son, no suicida ideation, isomnia</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 67 yo woman who lost her only son 3 weeks ago and now presents with trouble sleeping x3 weeks. She has never had trouble sleeping before. She has trouvble sleeping and when she sleeps, wakes frequently. Get about 4-5 hours of sleep daily. she denies and loss of interest and suiidal thoughts. she sometimes sees her son standing on the kitchen but know it isnt real. She is married and lived with her husband.
PMH_ hypertensive x 15 yrs on HCTZ and lisinopril-compliant. Had breast cancer but has been on remission for 10 years.
SH: no tobbaco, no etoh, no recreatonal drugs.
FH: mpther had depression and is alive and well..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]lost her only son 3 weeks ago, woman, 67 yo, x3 weeks, sees her son standing on the kitchen but know it isnt real, mpther had depression, wakes frequently, denies suiidal thoughts, trouble sleeping, trouvble sleeping, 4-5 hours of sleep daily</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Wicks is a 67 year old woman with history of hypertension on HCTZ/Lisinopril who presents with 3 week history of poor sleep. Her son died three weeks ago, and ever since she has been unable to fall asleep, stay asleep, and she feels as if she spends all night tossing/turning. She also endorses seeing her son at times but she knows he isn't there. She also endorses one episode of auditory hallucinations at night when she thought she heard a party going on only to discover there was not one. She denies any other medical symptoms at this time, including chest pain, shortness of breath, nausea, vomiting, diarrhea, constipation, changes in urination, abdominal pain, or headaches. She denies suicidal ideation or homicidal ideation. She also denies difficulty concentrating, psychomotor agitation/retardation. She endorses an increased apetite with no associated weight changes. She has tried ambien for five nights with no benefit..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased apetite, son died three weeks ago, Mrs., woman, one episode of auditory hallucinations at night when she thought she heard a party going on only to discover there was not one, tossing/turning, 67 year old, unable to fall asleep, 3 week history, tried ambien with no benefit, ""seeing her son at times but she knows he isnt there"", denies suicidal ideation, poor sleep, unable to stay asleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Lorainne Wick is a 67 y.o. female who presents due to trouble sleeping.  She states that she has problems falling asleep as well as waking up early.  She usually goes to sleep with the help of a warm bath, doesn't watch TV before sleepign, and takes no naps during the day.  She drinks one cup of caffeine in the morning. These symptoms are occuring following the death of her son on Dec. 10 from a MVA.   She has had decreased sleep, decreased interest level in things she once enjoyed, decreased energy, increased appetite. She has no thoughts of active or passive suicide or self harm.   ROS is neg for fever, skin changes, hair changes, pain, heat/cold intolerance, lumps, or swelling.  She has a good support system

Med:  HTN
Medications: HCTZ, lisionpril
PSH: none
FMH: Mom with depression

Social: no smoke, alcohol +, CAGE -, sexually active with husband, does not exercise since death..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, death of her son on Dec. 10, female, 67 y.o., problems falling asleep, decreased energy, decreased interest level, Mom with depression, waking up early, no thoughts of active or passive suicide, trouble sleeping, decreased sleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Loraine Wicks, a 67-year-old female, presents because of trouble sleeping. She has had trouble falling and staying asleep for the last 3 weeks, and recently experienced the death of her son on August 29th. Her mood is ""devastated"" and she feels ""drained"" and uninterested in her normal activites and has been eating more than usual. 3 days ago she also experienced seeing her son at the kitchen table and heard what she described as a party later than evening, but she knows that both of these things did not actually happen. She has no previous episodes like this and her FH is negative. She denies thoughts of hurting herself or others, denies psychomotor changes, denies difficulty concentrating. She reports a good support  system at home with her family. She has good sleep hygiene.

ROS:negative
FH:non-contributory
SH: normally 1-2 glasses of wine, none last few weeks, no tobacco, no recreational drugs
SurgH: negative
PMH: none.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]eating more, death of her son on August 29th, female, heard what she described as a party later than evening these things did not actually happe, 67-year-old, trouble falling asleep, last 3 weeks, feels ""drained"", uninterested, experienced seeing her son at the kitchen table these things did not actually happe, denies thoughts of hurting herself, trouble sleeping, trouble staying asleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Wicks is a 67 year old woman with a history of HTN and breast cancer who presents with difficulty sleeping. This began 3 weeks ago at the time of her son's death. She has trouble falling asleep, staying asleep, and wakes up early in the morning. Her mood is sad. She has decreased interest in her normal activites, fatigued. Denies feeling guilty, decreased concentration or attention, feeling hyperactive or lethargic, denies suicidality. She reports having 1 auditory and 1 visual hallucination in past few days. No prior mood disorders.
Denies - HA, weight change, vision changes, chest pain, SOB
PMH: HTN, breast cancer 10 years prior
PSH: lumpectomy, laparotomy for appendectomy
Medications: HCTZ, lisinopril, ambien x5 days
Allergies: NKDA
FH: father died of stroke at 70, HTN, HLD. mother with prior depression
SH: lives with husband, drinks less than 7 drinks per week, never smoker, no drugs
ROS: as above, otherwise negative.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]""3 weeks ago time of her sons death"", Ms, woman, 1 auditory hallucination, 67 year old, trouble falling asleep, began 3 weeks ago, fatigued, decreased interest, 1 visual hallucination, mother with prior depression, wakes up early in the morning, denies suicidality, difficulty sleeping, trouble staying asleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HO1 67 F presenting with difficulty sleeping past 3 weeks, diufficulty initialting sleep and getting up early. previosuly no similar episodes . son passed away 3 weeks ago and has been notices lack of energy and low mood since visual and auditory hallucinations once since then.lack of interest in daily activities,no change in weight but has been eating more than usual.
denies snoring.or any urinary or bowl complaints.
ros -ve except as above 
pmhx htn on medication past 15 year s
pshx nil 
fhx mother alive and well has a history of major depression 
medications lisinopril and hctz 
shx non smoker 
drink 2-3 glasses of wine a week cage 0/4 monogamous with hysband retired receptionist excersise regularly till 3 weeks ago.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]eating more than usual, son passed away 3 weeks ago, F, auditory hallucinations, 67, diufficulty initialting sleep, past 3 weeks, lack of energy, lack of interest, visual hallucinations, mother history of major depression, getting up early, difficulty sleeping</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67year old female with pmh of breast cancer in remission 11yrs presents with difficulty sleeping. Patient notes poor sleep began 3 weeks ago. Baseline sleep 8hrs, but now only gets 4-5hrs sleep, difficulty failing asleep as well as waking up early. Bed hygiene- only uses bed for sex and sleep, no changes in last 3 wks. NOtes lows of her son Leonard january 31 at around the same time. Notes decreased interest in hobies, denies hopelessness/guilt, notes decreased energy, increased appetitie, denies suidical ideation of hx of suicide attempts. Notes ""saw Leonard"" 4 days ago, and heard muffled voices from neighbor (neigbor denies). Denies command hallucinations. Pt has triend ambien without relief, nothing helps, nothing makes worse. Denies drug/substance use, 1 cup of coffee in morning. Per pt, husband denies snoring, no daytime fatigue

pmh- htn, br cancer
psh - laparotomy appendix
med - hctz, lisinopril, ambien
famhx- mom depression.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetitie, lows of her son around the same time, female, heard muffled voices from neighbor (neigbor denies), 67year old, difficulty failing asleep, began 3 weeks ago, triend ambien without relief, decreased energy, decreased interest, saw Leonard"" 4 days ago, mom depression, waking up early, denies suidical ideation, difficulty sleeping, Baseline sleep 8hrs, but now only gets 4-5hrs sleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo F present with trouble sleeping. Pt states that it began 3 weeks ago and describes as difficulty falling asleep, waking up early, and tossing and turning at night. Never had this problem before, tried taking a friends ambien, and it did not help. Pts son died on Aug 17 in an MVA. Pt states that she has a sad mood, loss of interest in activites, decreased energy level, difficulty sleeping, increased appetite, and hallucinations of seeing son, and hearing people next door.

ROS: negative except for above
allergies: none
meds HCTZ 25 mg QD, lisinopril 20 mg QD
PMH: HTN (15 years), in remission for breast cancer (10 years), ruptured appendicitis
PSHx: lumpectomy, laperatomy in 20s
FH: father with HTN, hypercholesterolemia, died of stroke, mother with DM
SH: married (45 years), drinks EtOH 2-3 times per week (-) cage, good support system, denies tobacco and recreational drug use.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, son died on Aug 17, F, hallucinations of hearing people next door, tossing and turning, 67 yo, difficulty falling asleep, began 3 weeks ago, ambien did not help, decreased energy level, loss of interest, hallucinations of seeing son, waking up early, trouble sleeping, difficulty sleeping</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yr old woman presents today with difficulty sleeping over the last 3 weeks. she has difficulty falling asleep and maintaing sleep, she has fairly normal sleep hygine practices and does not consume excessive caffinated beverages of note she has a history of traumatic event and now feels tired , has excessive thoughts of her son who passed has a depressed mood and has no issues with memory or concentration she does  not complain of suicidal thoughts but has occasional hallucinations hearing and seeing things that arent there
pmh: HTN x 5 yrs on HCTZ and lisonopril, breast CA in remission
psh: lumpectomy 10 years ago, laparotomy for appendicitis in her 20s
DH: no allergies
social: doesnt smoke 
father HTN, mother: depression.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]woman, hearing things that arent there, 67 yr old, difficulty falling asleep, last 3 weeks, tired, seeing things that arent there, mother: depression, not complain of suicidal thoughts, difficulty sleeping, difficulty maintaing sleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67-year-old female, has come to the physician's office because of trouble sleeping. She said that everything happened 3 weeks ago. At holidays, during Christmas her son died in a car accident. She feels devastated. He is retired and lives with her husband, no alcohol. no smoking. 
ROS as in HPI
Allergies:NKDA
Meds: ACTC, NBN for sleeping
PMH: HTN
PSH: Lumpectomy(breast cancer)
FMH: Mother 90 yo, episodes of depression, Father passed away and had HBP, hypercholesteremia..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]during Christmas her son died, female, 67-year-old, 3 weeks ago, Mother episodes of depression, trouble sleeping</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patien F 62 yo, C/C: Sleeping problems
-Started 3 weeks ago, wake up many times at night  relate  with her son died, she is eating more than normal 
-She is feeling very sad, she was taking Ambien for sleep but did not work.
-PMH: HTN
-PSH: none
MEds: HCTZ and lisinopril
-ALLs: NKDA
-FH: father HTN, High cholesterol died of stroke, mother Depresion 
ROS:  denied constipation, weight change and headache 
SH: ETOH, 3 or 4 glass of wine 2 or 3 times a week, walking sometime, sexual active with husband, she is retired.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]eating more, relate  with her son died, F, 62 yo, Started 3 weeks ago, Ambien did not work, mother Depresion, Sleeping problems, wake up many times at night</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 year old female presenting for trouble sleeping that started 3 weeks prior. She has toruble falling asleep, has been moving alot during sleepin and has early morning awkening. Assocaited with feeling tired throughout the day. prior to symptoms, her son passed away 3 weeks prior from an accident. associated with increase appetite 4 days ago, saw deceased son in kitchen, and 3 days ago heard loud music . Denies changes in concentration, interest, no suicidal thoughts, no guilt. Failed to relieve with ambiant and no exacberaing fact. Drinks 1 cup of coffee
ROS Denies headhace, nausea, vomiting, chest pain, SOB, Abdominal pain, changes in bowel and bladder, numbness and tingling in extremities
Alleriges NKDA
Medication HCTZ, lisoranil, ambiant
PMH Hypertension, Breast cancer 
PSH Lumbectomy with radiation and laptromy for appectectomy
FH - non-contributor
SH retired, denies tobacco and recreational drug use, ocassial drinking,.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]son passed away 3 weeks prior, female, 67 year old, toruble falling asleep, started 3 weeks prior, Failed to relieve with ambiant, feeling tired, saw deceased son in kitchen, early morning awkening, no suicidal thoughts, trouble sleeping, moving alot during sleepin</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67-year-old female, has come to the physician's office because of trouble sleeping.
pt had this issue for 3 weeks. trouble falling asleep and wake up at night. fatigue. visual and auditory hallucinations for a few days
sadness, no interest in recent activity, low energy, increase in appetite.
pmhx: high cholesterol. b/l mastectomy for 
meds: ambien, hctz, lisinopril
fmhx dad stroke and htn and high cholesterol
depression screening: sadness, no interest in recent activity, low energy, increase in appetite. no suicide, difficulty concentraitin or guilt..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increase in appetite, increase in appetite, female, auditory hallucinations, 67-year-old, trouble falling asleep, for 3 weeks, fatigue, low energy, low energy, no interest, no interest, visual hallucinations, no suicide, trouble sleeping, wake up at night</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Wicks is a 67 y/o f presenting with a 3 week history of difficulty sleeping. She states that she gets 4-5 hours per night of restless, intermittent sleep. She has tried taking Ambien for the last 5 nights but that has not helped. She states that her son died in an MVC a few days before this problem started and that she has been devastated since his accident. She notes that four days ago she saw and heard her son in the kitchen even though she knew it wasn't really him, and then the next night heard a party going on next door which didn't really happen. She states that she is really depressed, has lost interest in her daily activities, has no energy, is feeling slow, and has an increased appetite. She has a good support system but would be open to seeing a psychiatrist/psychologist. ROS is negative except as per mentioned above..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, son died a few days before this problem started, Ms., f, ""heard a party going on next door which didnt really happen"", 67 y/o, 3 week history, tried taking Ambien but that has not helped, has no energy, has lost interest, ""she saw and heard her son in the kitchen even though she knew it wasnt really him"", difficulty sleeping, gets 4-5 hours per night of restless, intermittent sleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 y/o F c/o insomnia for the past 3 weeks. Her son passed away in a MVA 3 weeks ago and she is upset over her loss. She has difficulty falling alseep and wakes up at odd hours (4/5am). She has lost interest in daily acitivies and feels fatigued. She notes an increased appetite and no changes in weight. She states she often hears noises from her neighbors home right before falling alseep. She is in remission from breast cancer. She does not nap in the day. She denies loss of concentration and feelings of guilt. She has a good support system at home and lives with her husband. Denies skin changes and cold intolerance. 
ROS: negative except above
Allergies: NKDA
Medications: HYdrochlorothiazide, Lisinopril, Ambien
PMH: breast cancer, HTN
PSH: lymphectomy of breast, Laparotomy for  burst appendix
FH: Father passed of stroke, Mother alive and healthy
SOcial: does not smoke, drinks 2/3 glasses of wine a week(CAGE negative),.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, son passed away 3 weeks ago, F, 67 y/o, difficulty falling alseep, past 3 weeks, feels fatigued, lost interest, wakes up at odd hours (4/5am), insomnia</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67 yo f presents with trouble sleeping for past few weeks, related to death of only child, a son, in an MVA. Since the MVA on July 30th, 2019, pt has had difficulty falling asleep, as well as increased early morning awakenings.  Pt reports lack of interest in things she typically does, decreased energy, increased appetite, no weight gain.  Denies SI.  Pt has extended support system of of, family and close friends. No CV sx. No Chest sx. No ABD sx or constipation.

PMH: HTN x 15 years, Breast Cancer (in remission x 10 years)
Allergies: NKDA
Meds: HCTZ, Lisinopril, Ambien
PSH: Lumpectomy, Appendectomy in 20s
SH: married x 15 years. no smoking, no ETOH, no drugs. Retired..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]increased appetite, death of only child on July 30th, f, 67 yo, difficulty falling asleep, past few weeks, decreased energy, lack of interest, early morning awakenings, Denies SI, trouble sleeping</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Identity: Loraine Wicks, a 67-year-old female
CC: trouble sleeping
HPI: For the past 3-weeks she has had trouble falling asleep, she is waking up earlier and is also experincing ""tossing and turning"", where she awakens feeling poorly rested - she is not waking to use restroom. This is affecting her life and ability to do things around the house.
Of note, her son unfortunately passed away 3 weeks ago.
In addition to trouble with sleep, she has lost interest in things she enjoy, her energy is poor, her appetite is increased.
Denies any guilt over son's death, reports no trouble with concentration, denies psychomotor slowing, and denies any acitve/passive suicidality or intent to harm others.
Pt. tried Ambien from friend 5 days ago, and 4 days ago reports AVHs.

She lives at home where she feels very safe with her extremely supportive husband.
She says she has a strong support group. Safety plan was discussed. 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]appetite is increased, son unfortunately passed away 3 weeks ago, female, tossing and turning, 67-year-old, trouble falling asleep, past 3-weeks, energy is poor, lost interest, waking up earlier, denies any acitve/passive suicidality, trouble sleeping, trouble with sleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Loraine Wicks is a 67 yo F with a history of HTN, breast cancer s/p lumpectomy in 2009 who presents to the offive with trouble sleeping. She reports her son dying 3 weeks ago, after which she has difficulty falling asleep and staying asleep. She reports her mood is down but is still able to do chores. Denies feelings of guilts or concentration issues. Her appetite has increased but no weight change. She reports seeing her son last night even though she knows he died. Denies memory loss, nocturia, constipation, skin changes, or TV watching in bed. Denies suicidal i
PMH: HTN, breast cancer s/p lumpectomy
Medications: HCTZ, lisinopril
Allergies: NKDA
FH: Father with HTN, HLD, and died of stroke. Mother with depression.
PSH: Lumpectomy in 2009. Laparatomy around 20 yo for appendiceal perforation.
SH: Retired. Lives with husband. Drinks 2 glasses of wine 2-3 times per week. Denies tobacco or illicit drug use.
ROS: wnl except as above..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]appetite has increased, son dying 3 weeks ago, F, 67 yo, difficulty falling asleep, reports seeing her son last night even though she knows he died, Mother with depression, Denies suicidal i, trouble sleeping, difficulty staying asleep</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 67 yo F, G1P1, c/o trouble sleeping for the past 3 weeks, Pt is tossing and turning at night, has trouble falling asleep, staying asleep and wakes up early in the morning. Total hours of sleep are usually 4-5. Pt's son died 3 weeks in MVA. Since then pt reports seeing her son 4 days ago at the kitchen counter, reports hearing strange muffled noises in the distance. Pt feels extremely devastated and sad due to the death of her son, she has no suicidal ideation. She eats a balanced diet and her appetite has increased, she has a great support system however she has lost interest in things that were once pleasurable and is fatigued throughout the day. Denies weight or skin changes.
ROS:  Negative except for above
Allergies: NKDA; Medications: Lisinopril, HCTZ, Ambien to help with sleep in the past 4 nights which had no affect. 
PMH: Hypertension, complient with medication and monitors BP regularly. Breast CA
FH: mom with depression.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]appetite has increased, son died 3 weeks, F, reports hearing strange muffled noises in the distance, tossing and turning, 67 yo, trouble falling asleep, past 3 weeks, Ambien had no affect, fatigued, lost interest, reports seeing her son, mom with depression, wakes up early, no suicidal ideation, trouble sleeping, trouble staying asleep, hours of sleep are usually 4-5</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 67F w/ PMH of breast CA in remission, presenting w/ insomnia for 3 weeks. Pt has troubles falling asleeping and wakes up early. No changes in sleeping habits, sleeps around 11pm, drinks 1 cup of coffee per day. Increased appetite, no changes in weight. Reports fatigue and decreased interest, but no difficulties concentrating. Feels sad about son passing away 3 weeks ago, no suicidal ideations. Has good support system w/ husband and family. hallucinations Started taking Ambien 5 days ago for insomnia, no improvement. Denies fevers, chills, chest pain, SOB, back pain, leg edema. PMH: breast CA in remission for 10 yrs s/p chemoradiation and surgery PSH: lumpectomy, laparotomy for ruptured appendix, Meds: HCTZ 25mg, lisinopril 20mg, Ambien 5mg, Social: No tobacco, 3-4 wine/week, no illicit drugs. Sexually active w/ husband, no protection. Menopause at age 52. FH: Grandfather stroke, HTN. Grandmother w/ depression..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Increased appetite, son passing away 3 weeks ago, F, 67, troubles falling asleeping, for 3 weeks, Started taking Ambien no improvement, fatigue, decreased interest, wakes up early, no suicidal ideations, insomnia</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Wicks is a 67 year old F PMH HTN, Breast CA (in remission 10 years) who presents with sleep isues in the setting of the loss of her son. Her son passed away October 20th (3 weeks ago) and since then she has had trouble initiating sleep, waking early, tossing and turning. Her bed partner (husband) has not had sleep disturbance. She has tried taking ambien x5nights without relief. Over the last 3 weeks, her sleep issues have been stable. Before, she was getting 8 hours, now 4 hours of sleep/night. She is fatigued and unable to take naps. She reports no changes in diet/increased caffeine. Incr appetite, dec energy, no suicidal no wt change,  PHQ2 1/2 (positive for anhedonia).suppor
PMH: HTN, breast ca
PSH: lumpectomy, laparotomy (appendicitis)
Fhx: father stroke HTN, HLD, mother w/ depression
shx: lives w/ husband, feels safe, is retired. No smoking, 1-2 glasses wine 2-3x/wk, no drugs
Meds: HCTZ, lisinopril, ambien 
all: none
RO.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Incr appetite, son passed away October 20th, loss of her son 3 weeks ago, Ms., F, tossing and turning, 67 year old, trouble initiating sleep, Over the last 3 weeks, unable to take naps, tried taking ambien without relief, fatigued, dec energy, anhedonia, mother w/ depression, waking early, no suicidal, sleep isues, sleep issues, now 4 hours of sleep/night</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: Headache
HPI: Ms Maddon is a 20 year old female who presents with a headache that began suddenly yesterday morning. It is unlike any headache she has previously experienced that she describes as ""the worst headache of her life."" She tried sleep, tylenol, and ibuprofen and found no relief. She endorses photophobia, nausea, and 3 episodes of vomiting. She may have had a subjective fever this moroning. She denies any recent illness and sick contacts. She denies phonophobia, aura preceeding the headache onsent, and cannot think of anything the alleviates the pain. She reports no trauma.
Meds: OCP
PMH: none
PSH: none
SH lives with roommate, works at sporting good store, no tobacco, 3-4 EtOH on weekends, marijuana use 3-4 times per week.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]tylenol no relief, ibuprofen no relief, 20 year old, yesterday, vomiting, nausea, lives with roommate, female, photophobia, denies any recent illness and sick contacts, subjective fever</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo F presented for headache of 1 day duration. Pain is 8/10 in intensity and it is the first episode of such pain. Pain is contant and alleviated by dimming the light and lying in the bed. It is aggravated by light and walking. There weren't any associated aura, weakness, numbness. there wear mild runny nose during the episode. The patient has a family history of her mother who suffers from migraine. there is associated decreased appetite as well. the patient feel warm but didn't measure the fever. No chills, night sweats. there is asssociated nausea and the patient vomitted 3 time since yesterday. the patient tried ibuprofen but the pain didnt go away.
ROS: negative except as above
Allergies: NKDA
Medications: OCPs since 2 yrs, ibuprofen
PMH: negative
PSH: negative
FH: mother has migraine
SH: marjuana 3-4 times a week, no tobbaco, alcohol occasionally.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]ibuprofen pain didnt go away, 20 yo, 1 day duration, vomitted, nausea, runny nose, mother migraine, family history migraine, mother migraine, FH migraine, F, aggravated by light, feel warm</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Madden is a 20 yo African american female with no PMH that presents with 1 day complaint of headache
- located throughout head
- Constant in duration
- Dull in characteristic, achy
- Alleviated by nothing, tried ibuprofen and tylenol with no effect
- Aggravated by movement
- Nonradiating
- constant in timing
- 9-10/10 on pain scaleAssociated with malaise, mylagias, nausea, and vomiting
ROS: denied fevers, chills, head trauma, double or blurry vision, discharge from ear or ringing in ear, throat pain, SOB, dyspnea, chest pain, palpitations, abdominal pain, diarrhea, constipation, rashes, pain in joints or bones, dizziness or loss of consciousness
PMH: denied
Surgical hx: denied
MEdication: generic birth control pill
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]ibuprofen no effect, tylenol with no effect, 20 yo, 1 day, mylagias, headache located throughout head, vomiting, denied rashes, nausea, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Stephanie Madden is a 20 year old female pressening for a headache that started yesterday morning. States she woke up with heachache
-Descrbed as dull, constant ache, all over. Worst headache of life. Endorses photohobia. Also states she feels warm all over and nausease and vomiting. 
-No CP, SOB, numbess/tingling. 
-No relief with Ibuprofen, tylenol, or sleep. 
-Denies any sick contacts or recent travel. 
PMHx: None
PSHx: none
Meds: Birth control-the pill
Allergies: None
Social: Never smoker. Drinks 2-3 beers on weekends. Smokes marijuana. Lives in apartment with roomate..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]No relief with Ibuprofen, No relief with tylenol, 20 year old, yesterday, headache all over, vomiting, nausease, Lives in apartment with roomate, Ms, female, photohobia, Denies any sick contacts, feels warm</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20y/o F presents with c/o headache sx 1 day, sudden onset, woke up from sleep, sates its dull psychadelic HA, diffuse over head, associated with neck stiffness, 8/10 intensity, worsens with bending forward and tying shoes, tylemnol didnt help,. Had associated vomiting yesterday 3 episodes, initially food then green material. Has photophobia no phonophobia, feels mildly warm, body aches. 
ROS None except as above. 
PMH PSH Hosp None
FH Mother migraine Father High CHOL
SH works as sales person, lives with friend, no sick contacts. 
denies smoking but uses alcohol 3-4beers/wines/week. CAGE negative. Uses marijauna 3-4times /week.
Menstrual cycles regular..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]tylemnol didnt help, 20y/o, 1 day, body aches, headache diffuse, neck stiffness, vomiting, lives with friend, Mother migraine, FH migraine, F, photophobia, no sick contacts, feels warm</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 y/o female presents with c/o 2 days of constant global HA associated with photophobia, nausea and 3 episodes of vomiting. She woke up with the headache 2 days ago and states it is now 8/10 and makes her tired and sleepy. She has used Ibuprofen and tylenol without relief. She usually gets one or two headches a year, but she usually just needs to sleep and they go away. She also notes she has felt warm, and has a scratchy throat and has had a decreased appetite, but denies sore throat, fever , sick contacts, abdominal pain, CP, SOB< focal wekness, or numbness, visual chnages, or problems hearing. 
Medical history: none
Surgical history: none
Social history: THC smoker 3-4 times a week, Alcohol, 2-3 drinks a wekend, sexually active with one partner and uses barrier protection consistently..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]used tylenol without relief, used Ibuprofen without relief, 20 y/o, 2 days, 2 days, global HA, vomiting, nausea, scratchy throat, female, photophobia, denies sick contacts, felt warm</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: PT IS 20 YO F C/O HEADACHE FROM YESTERDAY WHICH IS GETTING WORSE. PT NOTES THAT ITS THE WORST HEADACHE OF HER LIFE. ITS ALL OVER THE HEAD. ITS DULL, AND CONSTANT.PT USED TYLENON BUT DIDNT WORK. PT FELT WARM INSIDE. HEADACHE GETS WORSE BY BENDING OVER AND WALKING. PT HAS N/V WITH NO BLOOD. PT HAD PHOTOPHOBIA. PT STARTED TO HAVE URI SYMPTOMS YESTERDAY. PT REPORTS NECK AND SHOULDER PAIN AND STIFFNESS. 
ROS NEG EXCEPT AS ABOVE
PMH NEG
MED OCP 
ALLERGIES  NKDA
FH MOTHER HAD MIGRAINE
PSH NEG  
SH SEXUALLY ACTIVE WITH BOYFRIEND WITH CONDOM. NEG FOR TOBACCO, OCCASIONAL ALCOHOL AND RECREATIONAL DRUGS: LAST TIME A COUPLE OF DAYS BEFOR HEADACHE.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]TYLENON DIDNT WORK, 20 YO, YESTERDAY, YESTERDAY, HEADACHE ALL OVER THE HEAD, NECK PAIN, NECK STIFFNESS, V, N, URI SYMPTOMS, FH MIGRAINE, MOTHER MIGRAINE, F, PHOTOPHOBIA, FELT WARM</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo F with c/o Headache for 1 day.  She states this head ache is nthing like her usual headaches that she gets 1-2x a year. This one has been associated with nausea and vomiting. she has vomited 3x yesterday food then green liquid (no blood). today she has had no new episodes. She has subjective fevers, and has had a runny nose since yesterday. The headache is located all over the ghead and she describes it as a dull constant HA that has woserned. Ibuprofen/ tylenol provided little relief. Walking and bending forward made it worse. She states light hurts her eyes but doesnt hurt her haead. Noise does not worsen it
ROS: as per HPI
PMH: none
PSH: none
Meds: birth control pills for 2 years. 
Social: single, Sports store employee, non smoker, ocasional EtOH on weekends. 2-3 joints of marihuana no other drugs
Sexual: LMP 1 week ago, normal, uses condoms and BC.
FH: mom has migarine HA, Dad HLD.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]tylenol provided little relief, Ibuprofen provided little relief, 20 yo, 1 day, headache is located all over, vomiting, vomited, nausea, runny nose, mom has migarine, FH migarine, F, light hurts her eyes, subjective fevers</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 YO F C/O severe constant ache headace that started suddenly after she woke up 1 day ago. The headache is 8/10, and is persistent despite tylenol, ibuprofen, and sleep, and increases with walking and bending forward, and is associated with photophobia.  She also c/o subjective fever, nasal congestion, rihnorrhea, and scratchy throat, and she vomited digested food and green fluid 3 times since yesterday, denies blood in vomit. Denies changes in vision, seizures, head trauma, dizziness, LOC.
ROS negative except above
PMH/PHS NONE
MED oral contraceptive pill, NKDA 
ILL contacts NONE
OBGYN LMP 2 WEEKS ago, q 28 days, last 4-5 days, moderate flow, G0P0A0.
SH denies smoking, drinks 2-3 beers/week, smokes marijuana 2-3 times/week. Sexually active with 1 partner, uses condoms consistently..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]persistent despite tylenol, persistent despite ibuprofen, 20 YO, started 1 day ago, vomited, nasal congestion, rihnorrhea, scratchy throat, F, photophobia, subjective fever</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Stephanie Madden is a 20 year old female who presents for the evaluation of a headache. Stephanie reports the headache as progressively worsening, bilateral, 8/10, and as an achy pain not relieved by tylenol, ibuprofen, or sleep. She report rhinorrhea and sore throat that began yesterday as well as three episodes of emesis today. She reports neck stiffness and photophobia. She denies any confusion or exposure to sick contacts. She has headaches in the past but this is the worst she has felt. She denies visual or auras and denies any motor weakness or numbness. 
Past Medical History: None 
Meidcations: Oral Contraceptives, Tylenol, Ibuprofen 
Surgeries; None 
Hospitalizations None
Never pregnant before 
Family History Migraines in mother, High cholesterol in father 
Social History: 3-4 marijuana cigarettes/week, 2-3 glasses of alcohol on weekend outings, sexually active with one partner, uses barrier contraception, works in retail.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]not relieved tylenol, not relieved ibuprofen, 20 year old, yesterday, neck stiffness, emesis, rhinorrhea, sore throat, Migraines mother, Family History Migraines, female, photophobia, denies exposure to sick contacts</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo F c/o headache since she woke up yesterday, holocranial, 8/10, dull, constant, worsen when walking and bending over, took Tylenol and Ibuprofen without any improvement. Patient reports this it the first time shes had a headache like this. Associated with nause and vomiting, #3 times since yesterday. Reports fever since this morning and feeling fatigued and achy. Disturbed by light and loud noises. Denies rash, recent travel, ill contacts, cough, chest pain, SOB, recent URI, changes in bowel movements, changes in urinary frequency.

ROS: as per HPI. PMH: None. PSH: None. Allergies: NKA. Medications: OCP for the past 2y. FH: Father had hypercholesterolemia; mother has migraines. SH: Works in a sporting good store. Sexually active with boyfriend, uses condoms consistently. Drinks 2-3 drinks/weekend. Smokes 3-4 ciggarettes of marijuana/week. Patient eats a healthy diet and exercises regularly..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Tylenol without improvement, Ibuprofen without improvement, 20 yo, yesterday, yesterday, achy, headache holocranial, vomiting, Denies rash, nause, mother migraines, FH migraines, F, Disturbed by light, Denies ill contacts, fever</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20YO female 
CC: Headache
HPI: pt reports waking up yesterday morning with a severe headache that has worsened. She states her head hurts all over. She has nausea and vomiting that began yesterday with the headache. She also has a rhinorrhea that began at the same time as the headache. The headache is worse when walking or bending over. She denies vision changes or hearing changes but she does have photophobia. She states she occasionally has headaches, but never this severe.
ROS: negative except as noted above
PmHx: none
Meds: birth control pills
FH: dad: high cholesterol; mom: migraines
Social: works at a sporting good store, does not use tobacco products, occasional alcohol use on the weekends; smokes marijuana 3-4x per week, last use a few days before headache began; sexually active with one male partner, uses condoms.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20YO, yesterday, yesterday, headache all over, vomiting, nausea, rhinorrhea, mom: migraines, FH migraines, female, photophobia</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20yo female patient comes to the clinic with complains of headcahe for 2 days, the pain is dull and achy and its very severe, she has sensitivity to light it affected her job, and doesnt radiates, nothing improves it even with tylenol and it gets worse with walking and bending forward, no history of head trauam, she felt nauseated and vomited 3 times, no blood in vomitous, it is her first episode
ROS: negative except as above
PMH: none
PSH: none
Med: none
FH: mom had migraines, dad has cholestrol
SH: works in a sport store, no smoking, drinks 2-3 beers a week, sexually active with BF of 1y, they use comdoms, no std history
allergies
GYN: lmp was2 weeks ago and it is regular and she uses 3-4 pads.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]nothing improves it even with tylenol, 20yo, 2 days, vomited, vomitous, nauseated, mom migraines, FH migraines, female, sensitivity to light</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 y/o female presents with headache for the past day. She states she woke up with a headache yesterday morning and denies any precipitating factors. Pain is dull and achy, constant, but gradually getting worse. States she also felt warm this morning, fatigued, and has full body aches. Vomitted 3 times since yesterday, not bloody. States emesis was mostly food and last 2 were green. Eye pain, worse with bright lights. Denies any numbness, tingling, weakness, dizziness, lightheadness. 
ROS: Denies any vision or hearing loss. 
Pmhx: none
Surgical history: none 
Medications: OCP x 2 years 
Allergies None 
Fmhx: Mother has migraines, father has hyperlipidemia. 
Social history: Balanced diet, exercises 2-3 times a week, smokes marijuana 3-4x a week, no tobacco use, drinks 2-3 beers/glass of wine on the weekend. Normal caffeine intake. Works at a sports store. Sexually active with one partner. Never been tested for STDs. Uses condoms..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20 y/o, past day, yesterday, body aches, Vomitted, emesis, Mother migraines, Fmhx migraines, female, worse with bright lights, felt warm</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Madden is a 20 y/o F who presents with a headache of 1 day. Started yesterday AM, has been constant since then. It is all over, a dull constant ache. She has tried ibuprofen and tylenol which have not helped, and it is worse with walking and bending over. It does not radiate, but she does describe neck pain/tightness. She describes warmth, but no fever, a runny nose, severe nausea accompanied by vomiting, body aches, and the light hurts her eyes. She denies vision changes, hearing changes, ringing in her ears, and focal neurologic deficit, SOB, cough, chest pain, trouble swallowing, change in bowel or bladder habits, denies any numbness in extremities. 
PMH: no 
Psurgery: no
Meds: OCPs 
Allergies: NKDA 
FH: F - hypercholesterol, M - migraines 
Soc: never tobacco use, drinks 2-3 drinks on weekends, smokes marijuana 3-4 joints/week, is sexually active with one partner, no STDS, no pregnancies.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]ibuprofen not helped, tylenol not helped, 20 y/o, 1 day, yesterday, body aches, headache all over, neck pain, neck tightness, vomiting, nausea, runny nose, FH migraines, M migraines, F, light hurts her eyes, warmth</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo female with complaints of severe HA. No hx of headaches previously. Described as dull, throbbing, bilateral constant ache. She woke up with it yesterday morning and has take 4 ibuprofen, 2 tylenol, and slept without resolution. Sensative to light, not to sound. No changes in vision or aura. Denies ringing in ears or dizziness. Associated with vomitting, denies abdominal pain, constipation, or diarrhea. 
PMH: denies
PSH: denies
Meds: OCP for 2 years. 
All: denies
Fam: dad HLD, mom migraines
Soc: denies tobacco, 2-3 alcoholic drinks on the weekends, smokes 3-4 marijuana joints per week.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]ibuprofen without resolution, tylenol without resolution, 20 yo, yesterday, vomitting, female, Sensative to light</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Stephanie Madden is a 20 year-old woman presenting with the chief complaint of headache. The headache started yesterday morning. She has associated nausea, vomiting x1, subjective fever, and photophobia. She has never had a headache like this before. She has tried over the counter pain relievers and these did not help. Moving around worsens her headache, and bright lights hurt her eyes. The pain is all over her head and is constant. 

PMH: none
Surgical history: none
Meds: birth control pills
NKDA
FH: Mother has migraine headaches. Father has dyslipidemia..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]over the counter pain relievers did not help, 20 year-old, yesterday, pain is all over her head, headache over her head, vomiting, nausea, FH migraine, Mother has migraine, woman, photophobia, bright lights hurt her eyes, subjective fever</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: Headache
HPI: 20 yo F presents with a headache described as a dull, constant ache that started yesterday morning. She has had nausea and vomiting with the headache. She reports it is the ""worst headache of her life"" and it is all over. She has photophobia and reports the pain is worse when bending forward or walking. She feels achy and has nuchal rigidity. Felt like she had a fever but did not check it. Tried Tylenol, ibuprofen and sleep all without help. She gets rare headaches in the past but nothing this bad. 
PMH: None, Meds: OCP. NKDA
PSH: None
FH: Mother with migraine headaches. Father with high cholesterol. Others healthy.
SH: Lives at home with a roommate, works as a salesperson in a sport store. Does not smoke, drinks 2-3 cups of wine on weekends. Smokes 3-4 joints a week..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Tylenol without help, ibuprofen without help, 20 yo, yesterday, achy, headache all over, headache all over, nuchal rigidity, vomiting, nausea, Lives at home with a roommate, Mother with migraine, FH migraine, F, photophobia, Felt like she had a fever</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Madden is a 20 y/o F presenting for headache since yesterday morning. Episode occurred suddenly w/ no premonition, aura, visual changes. Pain is dull, constant ache that has worsened since yesterday. Pain is equal on both sides of the head. Patient has never experienced this before. No changes in health except the patient felt more tired than normal. She has vomited 3x since onset, kept down down fluids but no food. Patient felt warm but did not take her temperature. Patient has photophobia and pain with flex/extension of neck. Patient is achy all over, has scratchy throat, no rash or cough. No numbness/tingling, no focal deficits. No prior medical history, patient takes oral contraceptives. Has tried Tylenol and Ibuprofen for headache, no relief. Fhx of migraines in mother. Patient reports no worsening stressors lately. LMP 2 weeks ago, no pain w/ menses. Drinks 2-3 drinks on weekends, smokes marijuana 3-4 times/week..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Tylenol no relief, Ibuprofen no relief, 20 y/o, yesterday, achy all over, pain neck, vomited, no rash, scratchy throat, Fhx of migraines, migraines in mother, F, photophobia, felt warm</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: pt is a 20 yr female with 1 day of head ache of entire head and neck stiffness. positive subjective fevers, nausea, and vomiting. feels achy all over. lethargic. pain is dull ache and 8/10. no vision change. sensetive to light. worse with walking and bending over. tried ibuprofen, tylenol, and sleep that did not work. No aura.  nosicik.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]ibuprofen did not work, tylenol did not work, 20 yr, achy all over, head ache of entire head, neck stiffness, vomiting, nausea, female, sensetive to light, subjective fevers</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo F presenting to clinic with complain to headache. Patient describes that the headache ""hurts all over"" and began yesterday morning. It has been a constant dull/aching pain. She states that the pain hurts ""really bad"" and is very worried.  She reports trying Tylenol, ibuprofen, and sleeping it off without any improvement in the pain. Walking and bending forward makes the pain worse. She endorses associated photophobia, subjective fever, and N/V. She also recently experienced rhinorrhea and sore throat. She denies any chills, dizziness, vision changes, cough, SOB, chest pain, numbness/tingling, or changes in urination/bowel movements.
Denies any sick contact or recent travel.
Denies PMH.
Denies any PSH.
NKDA.
Meds: Birth control pill.
Fam Hx: Mom - migraines. Dad - HLD.
Soc Hx: Lives with roommate in apt. Works in sales. Drinks 2-3 beers/weekend. Denies smoking. Uses MJ 3-4x/wk. Sexually active with males.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Tylenol without any improvement, ibuprofen without any improvement, 20 yo, yesterday, headache all over, V, N, rhinorrhea, sore throat, Lives with roommate in apt, Mom - migraines, migraines Fam Hx, F, photophobia, Denies any sick contact, subjective fever</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI:a 20 yr old F pt c/o headache , generalised, x 1day, worsening with walking and bending forward, fever x1 day, vomiting x3 ep with food particles, h/o runny nose and sorethroat
no tearing eye, asso with discomfort to briht lights
ROS:-ve except above
ALL: none
MEds: none
PMH/PSH: none
FH: migraine in mother, hpercholesterolemia in father
SH:marijuana on weekends, sexuallly active with boyfriend.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20 yr old, 1day, headache , generalised, vomiting, runny nose, sorethroat, migraine in mother, FH migraine, discomfort to briht lights, fever</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Stephanie Madden is a 20 yo f who woke up yesterday morning with a headache. She says it is dull, non-pulsatile and constant. It was a level 2/10 at first but has risen to a 8/10 currently. This is the first time this has happened. Walking and bending over make it worse. She has tried ibuprofen, Tylenol, and sleeping with no improvement. She also has photophobia, nausea, vomiting, neck pain with movement, and feels warm. Denies changes in vision, aura, confusion. Denies trauma. 
ROS: denies diarrhea, numbness, tingling, lightheadedness, dizziness, or syncope
PMH: none
Meds: OCPs (2 yrs)
Allergies: none
FH: mother with migraines, dad with HLD, sister is healthy
SH: drinks 2-3 beers/weekend, 3-4 joints per month, no tobacco use, sexually active with boyfriend (uses condoms and OCPs), works at a sporting good store
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]ibuprofen no improvement, Tylenol no improvement, 20 yo, yesterday, neck pain, vomiting, nausea, mother migraines, FH migraines, f, photophobia, feels warm</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 Y/O F pt attending with headache, one day Hx, 8/10 in severity ,  no similar episodes before, not radiating, all over the head, no increased lacrimation.
+ve Temperatures, +ve photophobia, +ve Vomiting,+ve Neck stiffness. No night sweats. No weakness or numbness or blurring of vision. No weight loss. No recent travel or camping. 
Recent history of runny nose and sore throat. Generalized body aches.
ROS: Nil
PMH : nil
PSH: nil
No allergies.
Meds: OCP for 2 years.
SH : works in sports shop, non smoker, ETOH socially. sexually active with men.
Gyn Hx: LMP 2/52, no reecent pap smear, no pregnancies.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20 Y/O, one day Hx, Generalized body aches, headache all over the head, +ve Neck stiffness, +ve Vomiting, Recent runny nose, Recent sore throat, F, +ve photophobia, +ve Temperatures</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Madden 20yoF w/ HA of 1d duration. ""Really bad"" hurts all over, dull ache, getting worse, not relieved by sleep, tylenol, ibuprofen. Worsened with walking. Sensitive to light and neck stiffness. Vomitusx3 yesterday. No prior episodes. No sick contacts. NKDA. On OCP, no other Rx. Non-contributory PMHx. No hospitalizations, UTD immunizations, no trauma, no surgeries. ROS: + subjective fever, + nausea, - syncope, - dizziness, - abd pain, - rashes, - discharge, -dysuria. FamHx: Migraines, HLD. Ob: G0. Sex: Active with 1 male, never been treated for STD, consistent condom use. Soc: Denies tobacco, drinks 2-3 beers on weekends, frequent marijuana use, counselled..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]not relieved tylenol, not relieved ibuprofen, 20yo, 1d duration, HA all over, neck stiffness, Vomitus, - rashes, nausea, FamHx: Migraines, F, Sensitive to light, No sick contacts, subjective fever</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: a 20 year old F with a 2 day history of the worst headache shes every had. She reports taht is started yesterday when she woke up at 3/10 and has steadily progressed to 8/10. The pain is all over her head and she describes it as a dull ache. The headache gets worse with walking or bending over and has not been improved by ibuprofen, tylenol, or sleep. She has had headaches before but this is much worse. She endorses photophobia and nausea with 3 episodes of emesis yesterday. She denies any aura and endorses a subjective fever. She endorses general fatigue and soreness in neck and shoulders.
ROS: negative except as above
PMH: negative
PSH: negative
Medications: oral contraception
Allergies: NKDA
Family Hx: mother has migraines, father has hyperlipidemia
Social Hx: denies Tb use, endorses EtOH 2-3 drinks on weekend, endorse marijuana use 2-3 smoking it 2-3 times per week, she is sexually active with one male partner.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]not been improved by ibuprofen, not been improved by tylenol, 20 year old, 2 day, yesterday, yesterday, headache all over her head, emesis, nausea, mother migraines, Family Hx migraines, F, photophobia, subjective fever</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 YEAR OLD FEMALE WITH A HISTORY OF HEADACHE SINCE YESTERDAY MORNING ACCOMPANIED WITH NECK STIFFNESS. Tylenol and motrin did not help, pain worsened with walking and bending forward. Endorses nausea, vomtiing, warm to the touch, photophobia. Denies blurred visions, vision changes, sick contacts, head trauma, urinary symptoms, bowel movements changes, palpitations, shortness of breath, chest pain, weight changes, or eye discharge. There is no previous medical or family history or previous surgeries. Mom has a history of migraines, dad has high cholesterol. Takes oral contraceptives for the last two years. Patient smokes 3-4 joints of marijuana every week, no tobacco use. Works as a sales person.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]motrin did not help, Tylenol did not help, 20 YEAR OLD, YESTERDAY, NECK STIFFNESS, vomtiing, nausea, Mom migraines, FEMALE, photophobia, Denies sick contacts, warm to the touch</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 y o F c/o sudden onset of severe headache when she woke up from sleep, the worst of her life like a bad hangover  since yesterday, dull constant, worsened by walking and bending , not relieved with Ibuprogen, Tylenol not providing much relief. She has associated photosensitivity, and has had 3 episodes of vomiting since yesterday.  A/w runny nose. She feels achy all over, feels warm but hasnt mesaured her temperature. She denies ill contacts, LOC, seizures, weakness, numbness, tingling, rash or drowsiness. ROS is otherwise neg
PMH / PSh - nil
NKA
Meds - OCP x 2 years
FH - migraine in mother, Dyslipidemia in fatehr
Obs / Gyn NC
SH - NO smoking, No EtOH,  4 joints / week
Sexually active with bf.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]not relieved with Ibuprogen, Tylenol not providing much relief, 20 y o, yesterday, achy, vomiting, denies rash, runny nose, migraine in mother, FH - migraine, F, photosensitivity, denies ill contacts, feels warm</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 20 year olf female with no past medical history who presents with headache 
- Reports global headache described as dull and constant rated a 8/10 in severity 
- Assocaited photophobia vomiting, with an episode of bilious emesis 
- Assocaited neck and shoulder stiffness
- Reports Subjective fever 
- LMP 2 weeks ago 

-ROS: headache, vomiting, photophobia. Denies phonophobia, changes in vision, weakness, numbness or tingling sensation. 

Medical History: None 
Family History: Mother-migraines, father-hyperlipidemia 
Social History: Seuxally active with boyfriend uses contraception, smokes marijuana 2-3 times per week, denies tobacco use, 2-3 drinks of alochol on the weekends 
Surgical History: None 
Medications: Birth Control.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20 year olf, global headache, neck stiffness, vomiting, vomiting, emesis, Mother-migraines, Family History migraines, female, photophobia, photophobia, Subjective fever</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Stephanie Madden is a 20 year old F with a 2 day history of dull, aching headache. It was present on waking yesterday morning and has been constant, progressively worsenign. She reports feeling feverish, photophobia, and exacerbation with walking, bending over. +n/v with 3 episodes of greenish vomitus. No relief with ibuprofen or tylenol. PMH of headaches which last minutes and are much less severe. PSH none. 2-3 beers on weekends. non-smoker. 3-4 joints marijuana  weekly. monogaous with boyfriend and uses condoms and OCPs..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]No relief with ibuprofen, No relief with tylenol, 20 year old, yesterday, v, n, F, photophobia, feverish</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Madden is a previously healthy 20 y/o female presenting for headache. Pt says this is the worst headache she has ever had, and describes pain as dull and constant. Pain started yesterday morning, and has progressively worsened to an 8/10. She has had associated nausea and vomiting (3x yesterday). Pain is worse with bending forward and walking, and ibuprofen and sleep have not helped with improving pain. She has been achy all over, with neck pain and runny nose as well. She endorses photophobia, but denies phonophobia. She has not taken her temperature, but says she has felt warm. She denies any head trauma.
ROS: negative except as stated above
PMhx: none, PShx: none
Meds: birth control, ibuprofen as needed
Allergies: NKDA
Fam hx: mom migraines, dad HLD
Social: lives with roomate, works at sporting goods store, no smoking, drinks 2-3 beers every weekend, smokes 3-4 joints per week, sexually active with boyfriend, uses condoms.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]ibuprofen have not helped, 20 y/o, yesterday, achy, neck pain, vomiting, nausea, runny nose, lives with roomate, mom migraines, Fam hx migraines, female, photophobia, felt warm</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: headache
HPI: Mrs Madden is a 20 yo F presenting with 1 day hx of headache and states ""I have never felt this bad"". Headache is diffuse, dull ache in quality, and constant for past 24 hrs. No provoking factors/settings noted. She endorses photophobia, feeling ""warm"" this morning, nausea, and 3 episodes of vomittus without blood. She denies loss of consciousness. Tylenol, Ibuprofen, and sleep have not alleviated the pain.
ROS: negative except as stated above
Meds: Ibuprofen and Tylenol as needed, regular OCP
Allergies: NKDA, no other allergies
PMH: none
PSH: none
Social: lives with roomate who is not sick, no tobaccuse use, 2-3 glasses of wine per weekend, 3-4 marjuana joints per week (counseled on cessatino)
OBGYN: LMP 2 wks ago, regrular periods, staes she is not pregnante
Sex: sexually active with 1 male partner.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Tylenol not alleviated the pain, Ibuprofen not alleviated the pain, 20 yo, 1 day, Headache is diffuse, headache diffuse, vomittus, nausea, lives with roomate, F, photophobia, roomate who is not sick, feeling ""warm""</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Sephanie madden is a 20 yo female presenting with headache. Pain began 1d ago. Pain is diffuse over head. Has been worsening since onset. Described as a dull ache. Pain is not relieved with ibuprofen or sleep. Worsend with walking, bending over. Eye pain is reported with bright light. Patient endorses subjective fever and fatigue. 3x vomiting and nausea since onset of headache.  Denies weight changes, numbness, tinghling, vision changes, hoarsenenss.  muscle weakness, abdonminal pain, chest pain. no head trauma
PMH: none
Allergy; None
medications: taking Oral contraceptive pill daily Surgery: None
No recentillness or hospitalizztion. No recent travel
Family: Mother sufferes from migraines. Father hypercholesteroemia
Social;Alcohol 2-3 drinks on weekends. Smokes 3-4 joints of marajuana weekly. No tobacco use. Lives with roomate works at sport store. Sexually active with men, uses condoms. No sexual transmitted infec tions in past..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]not relieved with ibuprofen, 20 yo, 1d, headache diffuse, vomiting, nausea, Mother migraines, Family migraines, female, Eye pain bright light, fever</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Madden is a 20 y/o F complaining of Headaches.

HPI: She woke up yesterday morning with a headache 8/10 in severity. She reports it hurting all over. She has tried tylenol, ibuprofen, and sleep but no relief. It seems to be worse when she is ambulating, or bending forward. She preferred the room light to be turned off in the exam room. She had nausea/vomiting yesterday which was non-bloody.

ROS: WNL except as above
PMH: None
PSH: none
FH: Migraine headache in mother, high cholesterol in father
SH: No Tobacco use, Drinks 2-3 cups of wine on the weekends, smokes 3-4 joints of marijuana per week. Is sexually active with a male partner. She takes birth control and he uses condoms every time. She has never been pregnant.
Medications: Ibuprofen, Tylenol
Allergies: NKDA.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]ibuprofen no relief, tylenol no relief, 20 y/o, yesterday, yesterday, Headaches all over, vomiting, nausea, Migraine mother, FH: Migraine, Mrs, F, preferred the room light to be turned off</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI - 20 y/o F c/o headache
- Patient reports dull, constant, ache, 8/10 headache that began yesterday morning. Patient notes that headache is worsening.
- Patient was woken from sleep due to headache.
- Aggravating factors include light, bending over, along with walking
- Patient notes no relieving factors after using tyelenol, ibuprofen and sleeping
- Affirms fever, vomiting and feeling sick
- Denies nausea, chest pain, shortness of breath, bowel or urinary complaints, visual field changes, hearing changes, gait imbalance
- LMP 2 weeks ago, regular 28-30 day cycles, not related to headache
ROS - as per HPI. 
ALLERGIES - NKDA
MEDs - OCPs for birth control
PMHx - Noncontributory
PSH - Noncontributory
FM - Mother has h/o migraines. Father has high cholesterol 
SH - Drinks 2-3x on the weekend, denies tobacco usage, affirms marijuana usage 3-4 times per week.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]no relieving tyelenol, no relieving ibuprofen, 20 y/o, yesterday, vomiting, FM migraines, Mother has h/o migraines, F, Aggravating factors include light, fever</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20-year-old female, has come to the doctor's office complaining of a headache of one day hx. Pian on all head, 8/10 pain scale, dull type, pegressive , constand, and no past episodes. Aggravating by walk and bending over, only minimal relieve with Ibuprofen an tylenol. Also present nauseas, vomiting, nasal discharge, general malayse, and ST. LMP 2 weeks ago. G0P0A0. no trauma. Use a OCP for birht control. 
ROS: negative exept as above
PMH: none
Allergies: NKDA
FH; father hight cholestreol mother migrane
SH: marihuana occationally.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20-year-old, one day, headache all head, vomiting, nauseas, nasal discharge, ST, mother migrane, FH migrane, female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Stephanie Madden is a 20 year old female who presents with a severe headache. She awoke yesterday morning with the headache, and it has been constant since then. It is now an 8/10 in pain, and feels dull. She has thrown up three times since then, and it has not improved with over the counter medications. She says that the headache is worse with bright lights, and denies any changes in vision. She denies any recent trauma, liquid running out of her nose with leaning forward, and denies sick contacts. She is unsure of whether she has had a meningitis shot. She has had headaches in the past, but never any of this severity.

Medications - Daily oral contraceptive pill use
PMH - None
Surgical history - None
FHx - Mother has migraine disorder, dad has hyperlipidemia
Social - Smokes 3-4 joints weekly, no tobacco, 2-3 beers or wine on weekends, uses condoms consistently with boyfriend.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]not improved with over the counter medications, 20 year old, yesterday, thrown up, unsure of meningitis shot, Mother migraine, FHx migraine, female, worse with bright lights, denies sick contacts</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 Y OLD F C/O HEADACHE X 2 DAYS 
- STARTED SUDDENLY , CONSTANT , ALL OVER THE HEAD , SHE STATED IT AS VERY SEVER , PREGRASSIVE , NOT ALLEVOIATED BY ANYTHING , EXACERBATED BY MOVING , BENDING FORWARD 
- ASSOCIATED BY VOMITING 3 TIMES , FOOD CONTENT , NAUSEA , AND FEELING WARM 
- SHE FEELS SCRACHY THROAT AS WELL WITH RUNNY NOSE 
- NO TRAUMA , NO LOC, NO WEAKNESS ,
- NO AURA BEFOREE THE HEADACHE 
- NO EYE TEARING , 
ROS : NORMAL EXCEPT AAS ABOVE 
PMH  PSH  : NON
MEDS : OCP FOR 2 Y , TYLNOL 
ALLRGEY : NKDA  
FH : MOTHER HAS MAGRAINE 
SH : NOT SMOKER , COUPLE OF BEERS IN THE WEEKENDS , AND MARIOGGNA USE.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20 Y OLD, HEADACHE ALL OVER THE HEAD, VOMITING, NAUSEA, SCRACHY THROAT, RUNNY NOS, MOTHER HAS MAGRAINE, FH MAGRAINE, F, FEELING WARM</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20y/o F c/o headaches
started when she woke yesterday and is dull and constant, described as the worst headache she has felt and diffuse throughout the head
ibuprofen and tylenol does not make it better, worse with bending and walking
+ve neck pain, fever, nausea and vomiting of food contents and greenish substance, 
+ve hx of photophobia
no hx of visual changes, nasal or ear discharge, cough, chest pain or weight changes, no weakness, tingling or numbness in body parts
no past hx of similar complaints, no HTN, DM or high cholesterol
NKA, no medication use besides ibuprofen and tylenol
mother had migraines and father has high cholesterol
LMP was 2wks ago, regular at 28 days and lasts 5-6days, no dysmenorrhea
no tobacco use, 2-3 beers on weekends and marijuana 3/4 times a week
works at a sporting goods store.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]tylenol does not make it better, ibuprofen does not make it better, 20y/o, yesterday, headaches diffuse, neck pain, vomiting, nausea, mother migraines, F, photophobia</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: ""ive been having a headache since yesterday""

HPI: Patient is a 20 yo female presenting to the office with fever, aches, and headache since yesterday. She endorses sever neck/head pain when moving her neck from side to side. She also endorses nausea and vomiting. She also admits feeling warm. The pain is severe but she is unable to rate it on a 1-10 scale. She does not have any sick contacts. She endorses photophobia but does not have any worsening with sound. She beleives her vaccines are up to date. 

ROS: see above HPI
Allergies: NKDA
MedS:  OCP for 2 years
PMHx: none
FMHX: dad has HLD, mother has migraines
SHX: lives with room mate, blanced diet, runs 3x /wk, 2-3 drinks on weekend, no smoking, marijuana 3x/wl, sexually active with oone partner condoms 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20 yo, yesterday, yesterday, aches, neck pain, vomiting, nausea, lives with room mate, FMHX migraines, mother migraines, female, photophobia, does not sick contacts, fever, feeling warm</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20yo F with no PMH who presents with headache starting yesterday morning.  Pt had flu-like symptoms of muscle/joint aches, subjective fever, runny nose, throat soreness.  Developed a gradually worsening to 10/10 holocephalic headache associated with neck stiffness.  Sleep, NSAIDs, and tylenol have not helped.  In the past 24hr patient has vomited gastric contents 3 times.  She denies recent travel or sick contacts.  Pt reports living in an apartment with a roommate.
ROS: No weakness, numbness.  Otherwise negative.

PMH: none
PSH: no surgeries
Rx: Patient takes OCPs.  OTC analgesics as above.  No other meds.
Allergies: none
Social: living in apartment.  no sick contacts
Family: Mother with migraines, father with HLD
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]NSAIDs have not helped, tylenol have not helped, 20yo, yesterday, muscle/joint aches, holocephalic headache, neck stiffness, vomited, flu-like symptoms, runny nose, throat soreness, living in an apartment with a roommate, Family migraines, Mother with migraines, F, denies sick contacts, no sick contacts, subjective fever</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: Ms. Madden, a 20 yo F, presents to the office with c/o headade:
-started yesterday morning and progressively worse
-never had this headache before
-generalized 8/10 headache without improvement when taking tylenol or ibuprofen
-pain increased with walking, bending forward
-no relieving factor, dull, constant pain, no radiation, bright light can elicit pain, nause and vomiting nonbloody emesis X2 yesterday
ROS: negative except the above
PMHx: none
PSHx: none
FHx: mom with migraine, dad with hypercholesterolemia
Meds: OCPs for 2 years
Allergies: none
SHx: sale peronnel at local store, lives with a roomate in an apartment, drinkes 2-3 beers/ wine over the weekend, no tobacco use, 3-4 marijuana uses/ week, last use was few days ago
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]without improvement when taking tylenol, without improvement when taking ibuprofen, 20 yo, yesterday, yesterday, generalized headache, vomiting, emesis, nause, lives with a roomate in an apartment, mom migraine, FHx migraine, Ms, F, bright light can elicit pain</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 20 YO F COMPLINS OF SEVERE HEADACHE SINCE YESTERDAY WITH SEVERITY 8/10. IT IS ASSOCIATED WITH NAUSEA AND VOMITING FOIR THE SAME TIME. SHE USE TO GET SAME HEADACHE 2 TIMES A YEAR SINCE MANY YEARS BUT NOT SEVERE AS THAT TIME. NO INFECTION, JAW PAIN, EAR PAIN. MILD FEVER SINCE YESTERDAY. NO HISTORY OF EYE AND EAR DISCHARGE. 
MEDICATION: OCP
ALL. NKDA
FH: MOTHER HAS MIGRANE. FATHER HAS HYPERCHOLESTEROLEMIA.
SH: SEXUALLY VACTIVE WITH BOYFRIEND.NO SMOKING, 2 GLASS OF WINE AT WEEKEND, EXERCISE REGULARLY, HEALTHY DIET
PMH: NONCONTRIBUTORY
PSH: NONE..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20 YO, YESTERDAY, VOMITING, NAUSEA, MOTHER HAS MIGRANE, FH MIGRANE, F, FEVER</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 20 yo F with c/o ""worst headache ever"" since she woke up yesterday morning. The pain has been a constant 8/10, dull, constant ache in her entire head. She also reports neck stiffness. The pain has not responded to tylenol, ibuprofen, or sleep, and is worse with walking, bending forward. Pt also reports some photophobia but denies phonophobia. She denies any history of headaches, but reports her mother gets migraines. Denies sick contacts. Pt works in sales at a sports store. Pt reports feeling warm and achy but denies fevers. Denies PMhx, Surgical history. Reports OCP use x 2years. Denies tobacco use. EtOH: 2-3 drinks on weekends. Marijunana use: 3-4 joints/day x few years.  ROS otherwise negative. Denies any recent trauma. LMP 2 weeks ago..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]has not responded to tylenol, has not responded to ibuprofen, 20 yo, yesterday, achy, headache entire head, neck stiffness, mother migraines, F, photophobia, Denies sick contacts, feeling warm</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yr old f c/o headache since yesterday morning.It started suddenly,is continous and progressively worsening,dull/aching pain,8/10,radiate to neck,exacerbated by light,leaning and bending  forward,associated with nausea and 3 episodes of non bloody vomiting.She has been fever since yesterday morning,had runny nose and scratchy throat.She has been using oral conntraceptives pills for birth control.
She denies sick contacts,rash,trauma,change in sleep/weight
ROS:Negative except as hpi
fh:mother had migraine and father had HLD
SSH:Denies smoking,drinks alcohol 2 -3 glasses on weekends cage 1/4,smoke weed,sexually active,protected intercourse.
PMH/PSH/MEDS:oral contraceptives pills for birth control.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20 yr old, yesterday, yesterday, vomiting, denies rash, nausea, runny nose, scratchy throat, mother migraine, fh migraine, f, exacerbated by light, denies sick contacts</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 20 yo F presenting with 1 day of headache as well as upper respiratory symtpoms including sore thraot, body aches, and rhinorrhea. This started yesterday and is bilateral. She rates it an 8/10 and describes a dull and constant ache. She also reports having nausea, vomiting, and sensitivity to light and sound. Sleeping and NSAIDs has not helped the pain. She denies any fevers, SOB, CP, diarrhea, blurry vision, weakness, or numbness. She has never had this before
ROS: negative except as in HPI
PMH: none
PSH: none
NKA
Meds: OCPs, NSAIDs
FH: Dad with HLD, mom with migraines
SH: Does not smoke, drinks 2/3 beers on weekends. smokes 2/3 marijuana cigarrettes per week. Sexually active with boyfriend and use condoms consistently
OBGYN: LMP 2 weeks ago, nml menstrual periods no irregularities
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]NSAIDs has not helped, 20 yo, 1 day, yesterday, body aches, vomiting, nausea, upper respiratory symtpoms, sore thraot, rhinorrhea, FH migraines, mom migraines, F, sensitivity to light</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: This is a 20 year old woman that presents with new onset HA 1 day ago that is dull and constant in nature. It is an 8/10 on severity that worsens with light, walking, and bending over. She did not experience any aura prior to her headace. She states that she has associated nausea and vomiting, and she is unable to keep down any food. She denies back pain, change of bowel symptoms, or urinary symptmos. She has not had any viual changes or changes to her hearing. She states that she's had headaches before but never this bad. Worse with movement and bending. Denies: chest pain, chortness of breath, endorses congestion and sore throat.  no changes to urinary or bowel symptoms. no lightheadedness or weakness. Mild fever.
Med History: noncontributory
Family history: mother has migrains, father has HLD
Soc: lives in an apartment with roomate. no tobacco. Drinks 2-3 times per week. Regular marijuana user. 
No surgical history..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20 year old, 1 day, vomiting, nausea, congestion, sore throat, lives in an apartment with roomate, migrains Family history, mother has migrains, woman, worsens with light, fever</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: patient is a 20 y/o FM who complains of bilateral dull, constant headache which woke her up in the morning yesterday. She denies any past history of headaches and also denies stress in her life. She furthermore denies preceeding ssx consistant with an aura. She reports neck stiffness with her headache and cannot rate the pain; stating that she ""feels really bad"". She reports feeling ""warm"" recently. She denies any recent travel or sick contacts and is sexually active with protection during intercourse. 
ROS: denies abdominal pain, weakness, numbness, blood in her stools. 
PMH: denies
PSH:denies
Allergies:NKDA
Meds OCP history for 2 years 
FH: mother had migraines, father has high cholesterol.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20 y/o, yesterday, neck stiffness, mother migraines, FH migraines, F, denies sick contacts, feeling ""warm</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. MAdden is a 20yo previously healthy female presenting with headache for 1 day. The headache started yesterday and she states she has never felt this bad before. She has also been experiencing nause, vomiting, rhinorrhea, and full-body aches. Has had subjective fevers but not taken her temp. Also reports neck stiffness and pain. She tried tylenol and ibuprofen but neither helped. Nothing makes it better. Bending over, walking, and bright light makes it worse. Vomit is nonbloody, but she reports it has been green. Unable to keep down food. Denies diarrhea or constipation, no visual disturbances, no phonophobia. Denies sick contacts.
ROS: negative except otherwise stated in HPI
PMH: none
Medications: combined oral contraceptive pill
FHx: mother with migraines.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]ibuprofen neither helped, tylenol neither helped, 20yo, 1 day, yesterday, body aches, neck stiffness, neck pain, vomiting, Vomit, Unable to keep down food, nause, rhinorrhea, mother migraines, FHx migraines, Ms, female, bright light makes it worse, Denies sick contacts, subjective fevers</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo F complains of HA that started yesterday morning. This is the first time she has ever experienced this. She describes the pain as all her whole head, dull in nature, 8/10 in severity and constant since yesterday. There were no precipitating factors, and nothing makes it better despite trying ibuprofen. Patients reports HA is worse when waking up and bending over to tie her shoes. She says shes felt warm yesterday, and experienced nausea and vomiting with onset of the HA. She denies any chills, sweating, SOB, dizziness, or ill contacts. 
ROS: negative except for above. 
PmHX: none
Allergies: NKDA, NKFA
Meds: Birth controll pills for the last two years 
FMhx: mom - migraines; Dad -high cholesterol 
SoHx: patient is sexually active with boyfriend of 1 year and tested negative for STDs; + EtOH - 2-3 beers or wine on weekends;  - smoking tobacco product; + marijuana - smokes 3 to 4 joints weekly, but hasn't since onset of HA.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]nothing makes it better ibuprofen, 20 yo, yesterday, yesterday, yesterday, HA whole head, vomiting, nausea, mom migraines, FMhx migraines, F, denies ill contacts, felt warm</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Stephanie Madden is a 20 year old female with a two day history of a headache.
- Headache since yesterday morning upon waking.
- Nausea and vomited three times with greenish vomitus.
- Photophobia.
- Feels hungover.
- Minimal improvement with tylenol and ibuprofen.
- Pain is worse with bending over.
- No dizziness, vision problems, or problems with balance.
- Subjective fever no chills. No diarrhea/constipation. 

ROS: negative except for as stated above. 
PMH: none.OBGYN: G0, sexually active with one partner, always uses condoms.
Medications: oral contraception pills.PSH: none.Allergies: none.Sochx: no tobacco, drugs, alcohol 2-3 times on weekends. lives with roomate feels safe at home.FamHx: father hypercholesterolemia, mother with migrains..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20 year old, two day, yesterday, vomited, vomitus, Nausea, lives with roomate, mother migrains, FamHx migrains, female, Photophobia, Subjective fever</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20yo F presents with 1 day history of headache. Patient describes headache as ""really severe,"" all around her head and into her neck, with accompanying nausea, 3x emesis, and photophobia. Patient has never had a similar headache. Patient has tried sleeping/ibuprofen/tylenol with no relief. Pain increases with bending over or flexing neck Headache is getting worse. Patient states she was febrile yesterday, but did not record her temperature. Patient has a dry cough that she attributes to a perfume in the waiting room, as well as a scratchy throat and post nasal drainage. Patient's only med is combination OCP. Family history positive for maternal migraines and paternal hyperlipidemia. Patient is otherwise healthy, and has had no surgeries or allergies. No exacerbation with teethbrushing, no tearing. No sick contacts. ROS otherwise negative. Marijuana use 3x wek.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]ibuprofen with no relief, tylenol with no relief, 20yo, 1 day, headache all around her head, Pain neck, emesis, nausea, scratchy throat, nasal drainage, maternal migraines, Family history migraines, F, photophobia, No sick contacts, febrile</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20yoF with no significant PMHx presents with headache. Dull achy quality all over head. Started yesterday in the AM and has been constant since. Pain level is 8/10, no alleviated by OTC pain meds. Better when in a dark room resting. Sleep has not helped. Worse when walking or leaning forward. No radiation of pain. Other symptoms include nausea, vomiting (3x since yesterday, food and then bilious). Did not get meningococcal vaccinations, has felt subjective fevers at home. Reports neck pain/stiffness. First headache. No association with new foods, meds, or menstrual cycle.

PMHx - none, no surgeries
Meds - OCPs, no allergies
FHx - mother with migraine headaches
Social - taking online classes, no tobacco, ETOH or other drug use..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]no alleviated by OTC pain meds, 20yo, yesterday, headache all over head, neck pain, vomiting, nausea, Did not get meningococcal vaccinations, FHx migraine, mother with migraine, F, subjective fevers</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 Yo F c/o Bl headache . Onset > yesterday morning after waking up . Feels like the worst hang over. constant . 8/10. no radiation. aggravated by walking around , bending down . Tried ibuprofen sleep and tylenol , not getting better. ROS : POS :  feeling of tiredness PHOTOPHOBIA , n/ vomittng x 3 . food and green voit.. rhinorrhea , 
no hematuria sensitivity to sound, aura, loss of consiousness , eye pain , NO  PMH , ALLERGIES , using OCP x 2 years. no hospitalizations, trauma . FH ; MIGRAINES 
 lmp : 2 weeks ago , menarche 13 . period 4-5days Q month . works as sporting goods. no smoking , drinks alchohol 2-3 drinks / week .Cage . does not need it as eye opener . marijauna . 2-4 / week . 1 sexual partner.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]ibuprofen not better, tylenol , not better, 20 Yo, yesterday, vomittng, n, rhinorrhea, FH ; MIGRAINES, F, PHOTOPHOBIA</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: This is a 20 Female with a headache that started yesterday when she woke up.  She describes the headache as severe, 8/10 in severity.  It isa dull, constant ache that is all over her head, but it does not radiate anywhere else.  Walking and bending over and bright lights make it worse. She has some nausea and vomiting.  She vomited 3 times since yesterday.  There is no bllod in the vomit.  

PMH: none
PSH: none
Meds: birth control
Allergies NKDA
Family history: migranes mother
ETOH minimal, no smoking marijuana 3-4 times per 
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20, yesterday, headache all over her head, vomiting, vomited, nausea, migranes mother, Family history migranes, Female, lights make it worse</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Stephanie Madden is a 20 yo F with a CC of heacahe. It started yesterday AM, waking her up. Worse headache of her life. Pain is located all over her head. It is dull, constant, achy. Progressed from 2-3/10 to 8/10. She has photophobia, nausea, vomitting (three times yesterday). Nothing improves the pain. Walking and bending over make the pain worse. Also has neck stiffness, and aches in her neck and shoulders. No recent travel or sick contacts. Has felt warm. Also reports runny nose and scratchy throat. No current life stressors.

ROS: denies chills, night sweats, vision changes, sound sensitivity, lacrimation, chest pain, shortness of breath, numbness, tingling.
PMH: none
PSH: none
Meds: OCP (alesse generic)
ALL: NKDA
FH: Mom - migraines
Dad - Hypercholesterolemia
SoH: sales in sporting goods, has BF, sexually active, uses condoms, 2-3 drinks per week. Denies Tob. Smokes 3-4 MMJ joins per week..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20 yo, yesterday, heacahe over her head, neck stiffness, aches in her neck, vomitting, nausea, runny nose, scratchy throat, FH migraines, Mom migraines, F, Ms, photophobia, No sick contacts, Has felt warm</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo F presents with ""head hurting"" all over. Pain began yesterday morning suddenly and has progressively worsened. The pain is dull and constant and bending over exacerbates the pain. The pt has tried ibuprofen and sleeping with no alleviation. She has also experienced subjective fevers, Nausea and vomiting yesterday, but the vomiting has ceased. She also has had scant rhinorrhea that began with the headache. She denies any headache like this before, stress at work, and trauma. Not associated with menstruation.
ROS: denies ear pain, sore throat, weakness, LOC. 
Pmhx: none
Med: OCP for 2 y
Allergies: none
SH: none
OBgyn: LMP 2 weeks ago, no issues
SH: never smoked, 2-3 beers on weekend, no drug use. sexually active with bf of 1 year.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]ibuprofen no alleviation, 20 yo, yesterday, ""head hurting"" all over, vomiting, Nausea, rhinorrhea, F, subjective fevers</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 20 y/o F complaines of progressive headache that started yesterday morning and is getting worse.  She describes the pain as all over her head and dull constant ache in nature.  Rated 8/10 w/ no radiation.  Walking, bending over and lights make the headache worse.  She has tried Ibuprofen, tylenol and sleeping by they have not improved the pain.  She also reports being achy all over since yesterday.  She reports significant nausea with her headaches.  She reports a subjective feeling of warmth and an achy neck.

ROS: Denies travel, recent illnesses, previous episodes, cough, sick contacts, rashes, urinary or bowel changes
Meds: Birth control pill
FH: Mother with migraines, dad w/ high cholesterol
Social: 2-3 beers on weekend, 3-4 joints per week, sexually active w/ boyriend and use condoms
GyN: LMP 2 weeks ago with 28 day regular cycles.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Ibuprofen not improved the pain, tylenol not improved the pain, 20 y/o, yesterday, achy, headache all over her head, achy neck, Denies rashes, nausea, FH migraines, Mother with migraines, F, lights make the headache worse, Denies sick contacts, subjective feeling of warmth</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo f present with vomiting that while she was a sleep yesterday morning.it has progressive gotten worse and it a constant headache.the pain is a dull 8/10 and iit is associated with vomiting and the vomit dosesnt have blood in or foul smell.he tried taking ibrubrofen which produced minimal relive . she also dscribe photophobia
ROS
PMH none 
PSH none 
ALLERGIES 
MED ibuprofen for headcahe 
SH she has been taking OCP for the past 2 years 
FH mother had migrane headche.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20 yo, vomiting, vomiting, FH migrane, mother had migrane, f, photophobia</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Mrs. Madden Is a 20 y/o  patient who c/o of headache since yesterday morning which started yesterday morning at 2/10 and has progressed to 8/10. Pain is exacerabted by bending forward, and lights. It was not alleviated with tylenol, ibuprofen or sleeping. She reports photophobia and 3 episodes of vomiting and generalized myalgias but denies auras. Patient also reports runny nose and sore throat and generalized fatigue for the past few days. She deniess episodes of diarrhea, recent travel or sick contcts.
Past Med Hx: None
Gyn: LMP 2 weeks ago, regular cycles, last 4-5 days without pain
Allergies: NKDA
Medications: oral contraceptives.
Sugeries: None
Family History: mother has migraines, father as hyperlipidemia
Social: salesperson, lives in apartment with roommate, sexually active with boyfriend only-they use condoms regularly, no tobacco, 2-3 glasses wine on weekend CAGE 0/4, 3-2 joints marihuana throughout the week.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]not alleviated with tylenol, not alleviated with ibuprofen, 20 y/o, yesterday, yesterday, myalgias, vomiting, runny nose, sore throat, lives in apartment with roommate, Family History migraines, mother has migraines, exacerabted by lights, photophobia, deniess sick contcts</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo female c/o headache since yesterday morning. She states that it started when she awoke in the morning, did not wake her from sleep. She states tht it is a dull constant ache throughout her head, 8/10 in severity. She describes it as ""the worst headache of my life."" She denies head trauma. She endorses nausea and emesis since teh headache began. She denies blurred vision or visual changes, she denies pressure behind her eyes. She endorses photophobia, and states that walking or bending over makes her headache worse. She does endorse subjective fever, denies chills. She denies any past episodes similar to this. She took ibuprofen and tylenol with no relief.
PMH: none
PSH: none
Meds: OCP, ibuprofen, tylenol; allergies: NKDA
FH: mom: migaraines
SH: 2-3 drinkes on weekends, nonsmoker, smokes 3-4 joints of marijuana per week, works at sporting goods store.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]ibuprofen no relief, tylenol with no relief, 20 yo, yesterday, headache throughout her head, emesis, nausea, mom: migaraines, FH migaraines, female, photophobia, subjective fever</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo F complaing of severe headache x1 day. Previously would have 2-3 mild headaches per year. Pain is dull and constant, and felt throughout her head. No associated aura. Endorses photophobia, nausea, and vomiting. NSAIDS are not improving pain. PAin was worse when patient woke up this AM, and does not worsen with sitting up. Was able to get full night's sleep last night , no issues with falling asleep. Endorses rhinorrhea and sore throat x1day. Endorses subjective fever. Denies nightsweats. No increased lacrimation.
PMH: none; no surgicl hx; Family hx: mother with migraines, father with hyperlipidemia; Meds: OCPs;
NKDA; Social: lives with roomate, drinks 2-3 ETOH drinks per week, denies tobacco use, smokes 2-3 marijuana cigarettes per week
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]NSAIDS are not improving pain, 20 yo, 1 day, 1day, headache throughout her head, vomiting, nausea, rhinorrhea, sore throat, lives with roomate, mother migraines, Family hx migraines, F, photophobia, subjective fever</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20yo F,C/O SUDDEN BILATERAL HEADACHE, PROGRESIVELY WORSENING,X1DAY,DULL,AND CONSTANT ,USED TYLENOL BUT NO RELIEVE. ASS NECK PAIN AND FEVER, RUNNING NOSE ,PHOTOPHOBIA,,SCRATHY THROAT 
PT VOMITTED -3 EPISODES ,INITALLY CONTAINED RECENTLY INGESTED MEAL BUT NOW GREENISH
ROS= NEGATIBVE EXCEPTA AS ABOVE
MEDS ==OCP
ALLEG=
PMH
NONE
FH=MOTHER MIGRAINE ,FATHER HIGH CHOLESTEROL
SH=2-3 WINE ON WEEKEMDS,NO SMOKING.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]TYLENOL BUT NO RELIEVE, 20yo, NECK PAIN, VOMITTED, RUNNING NOSE, SCRATHY THROAT, MOTHER MIGRAINE, FH MIGRAINE, F, PHOTOPHOBIA, FEVER</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: stephanie madden is a 20 year old female presents today with sever headache of 2 days duration. Never had this pain before and has nausea and vomitting, vomitting 3 times yesterday. Pain is 8/10, constant dull ache that is all over and is worse with bending over, walking and lights. tried taking ibuprofen and sleeping but did not help. She says she felt feverish but did not check her tempertare. 

ROS: none except above
PMH: none
allergies: none
meds: ibuprofen and OCPS
FH: father has high chol and mother has hx of migraines
SH: sexually active with 1 partner, drinks 2-3 alcoholic drinks on the weekend, smokes marijuana 3-4 times a week.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]ibuprofen but did not help, 20 year old, 2 days duration, headache all over, vomitting, nausea, mother migraines, female, worse lights, feverish</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Madden is a 20 year old female who presents with headache x 1 day. She states that it is a dull constant pain that involves the whole head, associated with fever, neck stiffness, photosensitivity and vomiting x 3 episodes. 
ROS: Positive for generalized muscle aches, but no blurry vision, red eyes, strange smelling sensations or generalized body weakness, coughing, SOB, chest pain
PMH: non-contributory
Meds: Oral contraceptive pills
Allergies: None known
FH: Mother has migraine headaches, father has hypercholesterolemia
SH: She doesn't smoke and uses EtOH occasionally. In a monogamous relationship with her boyfriend and uses condoms.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20 year old, muscle aches, headache whole head, neck stiffness, vomiting, Mother has migraine, FH migraine, female, photosensitivity, fever</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: A 20 year old female patient presented complaining of a headache, that started yesterday morning, sudden in onset, continuous, and getting worse. It is localized to the entire of head, with 8-9/10 intensity, dull in quality, not radiated or shifted. Not relieved by ibuprofen, aggravated when walking around or with bright light. She also felt warm yesterday, and had 3 episodes of vomiting, the vomitus was food, and green in color, with no blood. She has runny nose since yesterday. Her headache is not related to menses. No similar pain episodes in the past. No history of weakness, or numbness
ROS: negative except as above
Allergy: NKDFA
Medications: OCPs, and ibuprofen
PMH and PSH: none
Family hx: her mother has migraine headaches
Ob/GYN: LMP was 2 weeks ago, regular cycles every 30 days with 4-5 days of bleeding
SH: does not smoke, drinks 2-3 glasses of alcohol on weekends, smokes week 3-4 times/week, working at a store.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Not relieved by ibuprofen, 20 year old, yesterday, headache entire of head, vomiting, vomitus, runny nose, Family hx migraine, mother has migraine, female, aggravated with bright light, felt warm</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Stephanie Madden 20 y/o F with CC of headache
HPI: work up yesterday morning with HA. 2/10 onset, progressed to 8/10. Constant. Describes as dull/aching, b/l and diffuse. Also endorses radiation to neck. No relief from ibuprofen, Tylenol or sleeping. Exacerbated by walking, bright lights. Denies halos. Has vomitted 3x, bilious, no blood. Endorses cough, sore throat, diffuse achiness. No influenza vaccine this year. Denies sick contacts.
ROS: as above, also ""feels warm."" No changes in appetite, no changes in vision/hearing, no changes in memory/speech, denies palpitations, chest pain, denies SOB, abdominal pain, changes in bowel habits, changes in urinary frequency.
PMH: none. PSH: none. Meds: OCP. Allerg: none. FH: dad has high cholesterol, mom migraines. SH: takes online classes and works at sporting goods store, denies cigs, 4-5 marijuana joints/week, 2-3 drinks every weekend, sexually active with boyfriend, always uses condoms..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]No relief from ibuprofen, No relief from Tylenol, 20 y/o, yesterday, diffuse achiness, HA diffuse, headache diffuse, radiation to neck, vomitted, cough, sore throat, mom migraines, FH migraines, F, Exacerbated by bright lights, Denies sick contacts, feels warm</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo female who presents with headache. Pain is reported to be ""all over"". Pt awoke with it yesterday morning and it has progressively worsened since that time. Pain desribed as dull ache. Associated with n/v and URI symptoms which began at same time. Walking around or bending forward worsen the discomfort. Pt tried ibuprofen and tylenol which did not relieve the pain. No known recent sick contacts. No history of similar symptoms. Pain 8/10 at this time.

PMH: negative
Medications: oral contraception used for past 2 years. ibuprofen and tylenol for headache occassionally.
No drug allergies.
FH significant for mother with headache migrains. 
Social history: neg for tobacco use. Pt does report smoking 3-4 joints during the week. Pt was advised to discontinue. Drinks 2-3 glasses of wine on weekends..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]tylenol did not relieve, ibuprofen did not relieve, 20 yo, yesterday, headache all over, v, n, URI symptoms, mother migrains, FH migrains, female, No sick contacts</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Madden is a 20 year old female who presents today with sudden onset holocranial headache that started yesterday morning. She states that she was awoken with intense pain. She states that the pain is dull and constant. There is not a specific area of the head that hurts the most. She does state she has some neck stiffness and pain. She has photophonia, nausea, decreased appetite, 3 episoes of vomiting. Denies phonophobia, diarrhea, constipation. States that she has had body aches since yesterday as well. She has not experienced anything like this before. She does get about 2 headaches a year, but are different than the one she is experiencing now. She does not recall any sick contacts. She has been taking birth control pills for 2 years. NKDA. No significant medical history. Mom has a history of migraine headaches that are well controlled with medications. Does use marijuana occasionally, but denis injection drug use..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20 year old, yesterday, body aches, holocranial headache, neck stiffness, neck pain, vomiting, nausea, Mom migraine, female, photophonia, does not recall any sick contacts</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Patient is a 20yo F presents for evaluation for HA. HA has been present for 1 day in duration. Unable to define to to single lobe, notes it is present in front, back, and on sides of head. It has been worseing since onset, and has been constant. Has tried ibuprofen and tylenol to abate discomfort but to no avail. Sleep did not abort HA. Pain is worsened with walking and bending over to tie shoes. Denies photophobia, sensitivity to sound, and aura. She notes nausea with nonbloody vomiting. She has been unable to work due to the pain.
ROS: no D, CP, SOB, Abd pain, weight changes, night sweats
PH: none
Meds: OCP (2years)
FH: F - HLD. M - Migraines
SurgH: none
SocH: works as sporting goods store. ETOH 2-3x week. Tob - none. Majijuana - 3-4x week.
Allergies: none.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]ibuprofen to no avail, tylenol to no avail, 20yo, 1 day in duration, HA front, back, and on sides of head, vomiting, nausea, M - Migraines, FH Migraines, F</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 20 yo F c/o headache since yesterday. it is severe throbbing in nature, not localized, associated w/ 3 episodes of vomiting and nausea. no relation to menstrual cycle. it is aggravated w/ bright light. and relieved in a dark room. no relief from tylenol ibuprofen or sleep. there is also associated runny nose and itchy throat. denies any ear pain. ROS: negative except as above PMH&PSH: none FH: mother has migranes. SH: no tobacco use. drinks 2-3 beers on weekend, uses marijuana 2-3 times a week. sexually active w/ boyfriend. uses condoms and is on OCP's since 2 years..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]no relief from tylenol, no relief from ibuprofen, 20 yo, yesterday, vomiting, nausea, runny nose, itchy throat, mother migranes, FH migranes, F, aggravated bright light</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 y/o F with headache by 2 days in the context of rhinorrhea and ""scratchy throat"" as well as generalized malaise, HA began yesterday morning, no head trauma or LOC, not worsened by laying down but also not relieved, began at a 2/10, pain all throughout head, has been a constant dull ache which has worsened to an 8/10 today, worsened by movement, photophobia present, n/v present, not experiencing much relief with tyenol or ibuprofen, slept but this did not relieve the headache 
ROS: as above, endorses subjective fever today, no abdominal pain, no headaches brought on by sneezing, coughing or bm, no focal neuro symptoms
PMHx: none
Medications: as above, OCP
NKDA
PSHX: none
FHx: mom with migraine dad with HLD
SHx: smokes 3-4 joints of marijuana/day, no other recreational drug use, no smoking tobacco, 2-3 wine/beer drinks on weekends, sexually active with 1 partner, uses protection, LMP 2 weeks ago.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]not experiencing much relief with tyenol, not experiencing much relief with ibuprofen, 20 y/o, yesterday, v, n, rhinorrhea, scratchy throat, FHx migraine, mom with migraine, F, photophobia, subjective fever</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Stephanie Madden is a 20 yo female with no significant PNH reporting to clinic with a headache. The headache began yesterday morning a few minutes after she woke up (but was not the cause of her awakening). Since then the pain has increased from a 3 to a 10/10, currently feeling like the ""worst pain in my life"". She has never had anything like this before. She has tried ibuprofen and tylenol and bed rest without improvement; pain is worsed by lights, bending over and walking around. She has intense nausea/vomiting (3x) but denies visual problems like blurriness or double vision. She has no concerns about incontinence of urine or stool. Denies recent changes in weight. Patient reports feeling mildly warm recently. vaccines up to date
FH: father high cholesterol, mother migraines
Medical: no other history
Social: alcohol 3 drinks weekly, no smoking, occasional marijuana, sexually active with men on BC and condoms, no hx of STIs.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]ibuprofen without improvement, tylenol without improvement, 20 yo, yesterday, vomiting, nausea, mother migraines, migraines FH, female, pain is worsed by lights, feeling mildly warm</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Madden is a 20 yof female with a 2 day history of worst headache of her life. Her headache began 2 days ago when she woke up. She reports that it has worsened in intensity to the point where is feels like an 8/10. The pain is global throughout her head and is  described as dull, throbbing, and constant. She endorses photophobia, nausea, vomiting with 3 episodes yesterday. She denies any hematemesis, weakness, numbness, tingling, or diarrhea. She denies any chils, or night sweat. She does endorse rhinorrea, sore throat. Denies LOC or falls..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20 yo, 2 day, 2 days, headache globa, headache throughout her head, vomiting, nausea, rhinorrea, sore throat, f, photophobia</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo F complaining of severe headache starting yesterday morning when she awoke from sleep. It is progressive, dull, and constant. Worse with bending forward and walking. No relief with ibuprofen, tylenol, sleep changes. Assoicated with nausea and vomiting, achiness especially in neck and shoulders, photophobia, runny nose, scratchy throat. Feels slightly warm but has not measured temperature. Denies visual changes, aura, numbness, weakness. No stresNo sick contacts. Last menstrual period 2 weeks ago and has regular periods. Never been pregnant
PMHx: none
Med: OCP, ibuprofen, tylenol
PSHx: none
NKDA
FHx: Mom- migraine
SHx: 2-3 beers on weekends. Never smoker. Smoke 3-4 joints of marijuana a week. Sexually active with boyfriend and they use condoms. Works at sporting good store..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]No relief with ibuprofen, No relief with tylenol, 20 yo, yesterday, achiness neck, vomiting, nausea, runny nose, scratchy throat, Mom- migraine, FHx migraine, F, photophobia, No sick contacts, Feels warm</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 22 yo F with sudden onset severe persistent headache since yesterday morning, woke her up. Worse with leaning forward, achy, diffuse covering whole head. Reports 3 episodes of nonbloody nonbilious vomiting and nausea, photophobia, myalgias. No sick contacts, no rash, no arm weakness or sensory changes. Does have scratchy throat and rhinorrhea, no nasal congestion. Ibuprofen, Tylenol, sleeping has not helped. Felt warm at home, no temp taken. On OCPs. Gets tension type headaches occasionally but this is unlike those. No hx of migraines although mother has migraines. No scik contacts, no recent travel.
ROS: no chest pain, SOB, cough, abd pain, diarrhea, constipation, leg swelling, urinary symptoms
PMH: none
Meds: OCPs; no allergies
FH: mom migraine, dad HLD
Surg; None
Soc: no smoking, occasional alcohol, smokes marijuna 3x week; sexually active with 1 male partner, uses condoms consistently
OB: LMP 2 weeks ago, 4-5 days flow.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Ibuprofen has not helped, Tylenol has not helped, 22 yo, yesterday, myalgias, headache whole head, vomiting, no rash, nausea, scratchy throat, rhinorrhea, mother has migraines, FH migraine, mom migraine, F, photophobia, No sick contacts, No scik contacts, Felt warm</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Madden is a 20y/o F who presents with headache. Reports that dull, constant aching headache all over that began yesterday morning. She has never had pain like this before. Rated as 8/10. Has tried ibuprofen, tylenol and sleep with no relief. Pain is worst with walking and bending over. Associated with nasuea and vomiting, had green emesis x 3 yesterday. Eyes are sensitive to bright lights, but not vision changes or blurred vision. Reports body aches, but no rashes. Recently had running nose, congestion and scratchy throat. No recent falls. No warning of headache, no eye pain or tearing. Denies fever, chills, weight loss. Reports decreased appeitite since yesterday. Denies numbess, tingling, weakness, changes in bowels, changing in urination.  
PMH: none
PSH: none
FH: dad - high cholesterol, Mom - migrained
SH: non smoker, drinks on weekends, smokes 3-4 joints, wokrs at sporting goods, sexually active with 1 partner, on pill.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]ibuprofen no relief, tylenol no relief, 20y/o, yesterday, body aches, headache all over, vomiting, emesis, no rashes, nasuea, running nose, scratchy throat, Mom - migrained, FH migrained, F, sensitive to bright lights</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Stephanie Madden, a 20-year-old female presenting with headache.
-started yesterday morning
-all over, constant, dull ache
-hast trried ibuprofen,k tylenol, and sleep without improvment
-walking and bending over worsen the apin
the pain wwas worse this mroning
she has a history of mild headaches 1-2 times per year, but nothing htis bad
says this si the worse headache of her life
ROS: Nausea and vomiting, light hurts eyes, sick to stomach, overall body aches
no chest pain, shortness of breath, congestion, constipation or diarrhea, weakness, or irine changes
PMHx: healthy, only takes oral contraceptive pill
PSHx: none
FHx: Mom- migraines
Social Hx: drinks 2-3 beers on weekends, smokes marijuana 3-4 times per week, lives with roommate.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]ibuprofen without improvment, tylenol without improvment, 20-year-old, yesterday, body aches, vomiting, Nausea, lives with roommate, FHx migraines, Mom- migraines, female, light hurts eyes</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is a 20 yo female with chief complaint of headaches. She reports it began yesterday morning with a dull, constant , achy pain that progresses since then. She reports neck and shoulder pain, sensitivity to light, and hurts when she bends or walks. She also endorses vomiting and feeling warm. She denies abdominal pain, weakness or numbness of extremities. She denies any sick contacts however reports having a runny nose and scratchy throat that started yesterday morning. 

pmh: none, states she is healthy
psh: none
pfh: mother with history of migraines and father with hypercholesteremia 
Obgyn: she reports her menstrual cycles is regular and normal flow 
soc: works at sporting good store, lives at an appartment with her roommate. 
Meds: ocp use
Allergies: nka.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20 yo, yesterday, neck pain, vomiting, runny nose, scratchy throat, lives at an appartment with her roommate, pfh migraines, mother migraines, female, sensitivity to light, denies any sick contacts, feeling warm</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Female patient of 20 yo, that comes to the office c/o headache since yesterday. Patient refers that the headache is still the same episode and that is getting worse. Also refers that is present all the time, and is the 1st time that have an episode like this. No alleviates w/AINES and sleep. Get worse when patient bends her head foward and when walks. Also refers nausea and vomiting in 3 ocasions, of food content at first an that now is a greenish sluid. Patient also refers that does not have appetite, decrease in elergy level, and that takes OCP's for the past 2 years. ROS: dneied except as above mentioned. no PMHx, no surgeries, no hospitalizations. Meds: OCP's for the past 2y. FH: mother has migraine and dad high cholesterol levels. Shx: takes alcohol 2-3 beers on weekends, no tabacco use and use marihuana for the past years, being the last time 4 days ago. LMP: 2 weeks ago, and work in a sport store..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20 yo, yesterday, vomiting, nausea, mother migraine, FH migraine, Female</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 y female here in the clinic with c/o headache since yesterday , she states pain stated in the morning when she woke up , pain is getting progreesively worse , took tylenol and ibuprofen which didn't help with the pain , pain she describes aas all over the head and never had thia type of pain before , she also vomited x 3 , denies any blood in the vomit , she has no appetite , walking and bending over making the pain worse, photophobia + ,  
ros ; NEG except mentioned in HPI 
PMH : None   PSH : None 
All : Nka     Meds : OCP
SH : works at sporting goods , no smoking , occasional beer use , uses joints 3-4 times a week ,.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]""ibuprofen didnt help"", ""tylenol didnt help"", 20 y, yesterday, stated in the morning when she woke up, headache all over the head, vomited, vomit, female, photophobia</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 year old female. Complains of headache today, worst she has ever experienced. Described as dull and constant, worsened by walking around and bright light. Also has nausea and vomiting 3 episodes- food at first, now bilious. She also has fever today with myalgia. Previous episodes of headache but never this severe. No weaknes or numbness. No decrease in visual acuity or double vision noted. 
ROS- negative except above
Allergies- NKDA
Medications- Oral contraceptive pills for 2 years. Took ibuprofen, tylenol but no improvement
PMH/PSH- non contributory
FH: father has hyperlipidemia. Mother has history of migraines
SH: non smoker. Drinks alcohol 2-3 times a week. Lives with room mate.Works in sporting goods store.
Sexually active and uses condoms
OG: regular menstrual cycles.
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]ibuprofen no improvement, tylenol but no improvement, 20 year old, myalgia, vomiting, nausea, Lives with room mate, Mother migraines, female, worsened by light, fever</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI :  Pt presents with headache with photophobia. complains of a stiff neck and body aches. Hurts all over her head. NO Weakness. numbness or tingling. No recent ill contact, flu or ear infectionm no recent travel , no Trauma and no stress. She complains of severe N/V and no weight losss
PMH : none
ALlergy NKDA
Medication - Oral Contraceptive
Family Health : kMOm has migranes and dad has hypercholestrolemia
OBGYN : LMP 2 weeks ago and regular 
Social and sexual : No smoking 2- 3Etoh per week 
3-4 joinjts of marijyuanna a week 
active iwth BF.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]body aches, headache all over her head, stiff neck, V, N, MOm has migranes, Family Health migranes, photophobia, No recent ill contact</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 20 yo F headache from yesterday norning with vomiting and nausea, photophobi, 8/10 no radiation, worse with time and bending forward  lending, neck pain , nofever,
pmh:no admiton in hospital, no weakness and numbnesss
FH: father hyperlipidemia , mother migrine headach
SH, sexually active with boyfriend for 1 year use OCP
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20 yo, yesterday, neck pain, vomiting, nausea, mother migrine, FH migrine, F, photophobi</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: The patient is a 20 year old female who presents with a severe headache. She has no PMH. She states that the headache started yesterday morning and has since been worsened. She reports that she has severe photophobia. She has never had a headache this bad in the past. She reports that nothing is helping her severe pain. She has tried ""ibuprofen, tylenol, and trying to get some sleep, but none of those helped."" She takes birth control pills. She states that she has been nauseas for the past day, and she has vomited 3 times yesterday. Feels feverish. No night sweats. She denies any diarrhea, constipation, chest pain, abdominal pain. 
PMH: No allergies. Her only medication is birth control. 
PSH: no surgeries. No trauma. No pregnancies
Social hx: No tobacco use. She drinks 2-3 drinks every other weekend. She reports that she has not thought about cutting back. No travel history. Does not live in close quarters
FMH: Mother had migraines.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]ibuprofen none of those helped, tylenol none of those helped, 20 year old, yesterday, vomited, nauseas, Mother had migraines, FMH migraines, female, photophobia, feverish</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: CC: headache
HPI: Ms. Madden is a 20yo F who presents to the clinic with 1 day hx of dull constant headache that has gotten progressively worse and ranks it 8/10 pain. She has tried taking tylenol, ibuprofen, resting and sleeping, but has had little relief. She has also experienced nausea, vomitting, and subjective fevers and chills. Has been vomiting mostly food and also green sputum, denies any blood. Also complains of scratchy throat, runny nose, body aches, photophobia, and phonophobia. Denies any exposure to anyone with recent illness.
PMH: none
Meds: OCPs x2 years
All: NKDA
PSH: none
SH: lives at home with roommate, works as salesperson at sporting goods store. denies tobacco, ethanol, or drugs. 
FH: mother with migraines, father with hyperlipidemia.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]tylenol little relief, ibuprofen little relief, 20yo, 1 day, body aches, vomitting, vomiting, nausea, scratchy throat, runny nose, lives at home with roommate, mother with migraines, FH migraines, F, photophobia, Denies any exposure to anyone with recent illness, subjective fevers</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo f with h/o headache since waking yesterday. Headache is dull and constant without radiation. No previous episodes. Symptoms are progressive. Patient unable to quantify headache intensity. Headache is associated with nausea and vomiting (3X yesterday, green, nonblood), as well as decreased appetitie and URI symptoms including sore throat, fever and running nose. Denies sick contacts, urinary or bowel changes, photophobia, cough, dyspnea and chest pain.
ROS negative except as above. 
PMH/Surgeries: none, no surgeries/hospitalizations
Allergies: NKDA
Meds: OCPs
FH: migraines (mom)
SH: works at sporting goods store, lives with roomate, no tobaco or illicit drug use, drinks 2-3 beers/week, smokes marijuana 3-4 times/week, runs 1x/week for exercise, balanced diet.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20 yo, yesterday, vomiting, nausea, URI symptoms, sore throat, running nose, lives with roomate, FH: migraines, migraines (mom), f, Denies sick contacts, fever</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Madden is a 20yo F who presents for 1 day of severe headache which she describes as the ""worst hangover of her life"" (without alcohol use). The pain is generalized in her head and is dull, 8/10 intensity. Ibuprofen and tylenol have not relived the pain. The pain is worse while walking and while bending over. She has nausea for the past 2 days and vomited 3x (food, then green on subsequent vomit, no blood). No changes in stool. She notices no weakness or loss of sensation during this time. No known sick contacts
PMH: None
ALLERGIES: NKDA
MEDS: OCPs x 2 years, no side effects
PSH: None, no prior hospitalizations
FH: Mother has migraines, Dad has high cholesterol
Social: Lives with roommate, smokes marijuana 2-3x/week (discussed reduction), drinks 2-3 alcoholic beverages per day on weekend (CAGE 0/4), sexually active with men, monogamous with 1 boyfriend, uses OCPs and condoms. Works at sporting store..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]tylenol have not relived, Ibuprofen have not relived, 20yo, 1 day, headache generalized in her hea, vomited, nausea, Lives with roommate, Mother migraines, FH migraines, F, No known sick contacts</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Madden is a 20 yo woman with a c/o of headache. The headache came on suddently, and was present when she awoke 1 day ago. She has body aches all over. Not improved with ibuprofen or tylenonl. It is worse when tying her shoes. She has vomitted 3x, non bloody non bilioius. No other bleeding. Endorses photophobia. No hx of migraines. This is the worst headache of her life. Denies loss of conciousness. Pain is 'bad' did not provide a number on 1-10. Up to date on vaccinations. Denies sick contacts.
ROS: no chest pain, no ringing in ears, no SOB, no problems walking. No skin changes or hair changes
PMH: none
Past Surg Hx: none
Fam hx: Mom migranies, dad high cholesterol
Social: Denies smoking, no concern for etoh abuse. monogamous with one male. Uses condoms. 
Meds: In addition to above, uses oral contraceptive pills.
Gyn: No changes to menstural cycle

.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Not improved with ibuprofen, Not improved with tylenonl, 20 yo, 1 day, body aches, vomitted, Fam hx migranies, Mom migranies, woman, photophobia, Denies sick contacts</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI: 20yo F complains of intense headache for the past day
- Had previous headaches before but nothing like this
- Headache is all over the head and constant
- Associated with nause and vomit x 3 of gastric contents with no blood
- Today she has photophobia and feels hyperthermia
ROS: Denies vision or Hearing changes, no tinnitus, double vision or vertigo, no chest pain or palpitations, no changes in weight or appetite, slept normal through the night.
PMH: Denied
Surgeries: Denied
Allergies: Denied
Medications: Birth control pill
OBGyn: Regular menses, with normal flow (3-4 towels on heaviest day) G0, LMP 2 weeks
SH: Sales person, lives with roomate, drinks 2-3 beers or wine on weekends, doesnt smoke, smokes 3-4 marihuana per week. Sexually active with boyfriend uses condoms.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20yo, past day, Headache is all over, vomit, nause, lives with roomate, F, photophobia</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: HPI:20yo c/o headach which started 1 day ago, its all over the head, constant and progressively worsen, associated nausea, no vomitting. family hx of migraine. patient says these is the worse headach in her life.hx of OCP used. she is on Ibuprofen.
ROS:as above
ALLERGY:
PMH:
PSH:
FH/SH:
SH:
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20yo, 1 day ago, headach all over the head, nausea, family hx of migraine</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20yo female came in with constant headache started yesterday morning. It involves the whole head and it is dull pain. It gets worse with walking and bending over. It is associated with 3 vomiting episodes. the vomitus was in green color. She complains of photophobia and neckstiffness. Denies of fatigue, weight loss but she noticed poor appetite. She has whole bodyache started yesterday. She feels warm. Denies of trauma, changes in bowel/urinary habits
ROS none except the above
PMH none 
current medications OCPs for 2yrs
PSH : none
SOCIAL hx : denies smoking, 2-3 beer or wine on the weekends, marijuana for 3-4 times a week last marijuana was 4 days ago and she used marijuana for few years. 
Sexual hx.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20yo, yesterday, bodyache, headache whole head, neckstiffness, vomiting, female, photophobia, feels warm</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms Madden is a 20yr old female who presents today with a chief complaint of headache x1 day duration. She describes the pain feels ""like the worst hangover"" she's ever had, however she has not been drinking. She first noticed the headache when she first woke up yesterday morning. Associated symptoms include nausea, vomiting, photophobia, and ""feeling warm"". She denies noticing any preceeding symptoms such as blurred vision. She tried Ibuprofen and tylenol which failed to improve her symptoms. Walking and bending over makes her headache worse. Denies sick contacts. PMHx is unremarkable. She is on combination OCPs. NKDA, no hx of surgeries. LMP was 2 weeks ago. She is sexually active with one partner and uses condoms consistently. Denies tobacco use, drinks 2-3 glasses of wine/week. FHx is positive for mother with a hx of migraine headaches..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Ibuprofen failed to improve, tylenol failed to improve, 20yr old, x1 day, yesterday, vomiting, nausea, mother migraine, FHx migraine, female, photophobia, Denies sick contacts, feeling warm</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 yo f c/o bilateral Headache in all the head (the worst of her life) graded 8/10 constant since yesterday morning, the pain radiates to the neck and shoulder. the pain does not improve with acetaminophen and ibuprophen. the pain worsen when movement of the neck and limited neck movility. Associated vomits in 3 episodes since yesterday with food and green content. Denies rash in the skin, recent travel or contact with sick person, change in urine or bowel movements.
ROS: none except as above.\
PMH/PSH: none.
Meds: acetaminophen and ibuprofen. oral contraceptives. NKA
SH: Alcohol 2-3 glasses of wine on weekends. Marijuana ocassional on weekends. Denies tobacco use. Sexually active with boyfriend use condoms

.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]pain does not improve with acetaminophen, pain does not improve with ibuprophen, 20 yo, yesterday, Headache in all the head, pain radiates to the neck, vomits, Denies rash, f, Denies contact with sick person</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 year odl female c/o headaches x few hrs. Headches is dull in nature with associated fever and vomiting. Headache is worse in the morning and on bending over. Ibuprofen does not make it better. She also complains of neck pain when she moves the neck.She takes oral contraceptives for contraception. Feels better with the light turnes out. Positive history of migranes in mother
LMP 2 weeks ago
ROS: no change in bowel or urinary habits. No cough, breathlessness or palpitations. No abdominal pain. no numbnes or weakness
Medication:OCP
allergies: none
PMH: none
PSH: none
FH: history of migraines in the mother. Father has high blood cholesterol
SH: works in a gym goods store. No tobacco. Takes marijuana 3-4 times a week . Last use was 3 days ago
.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Ibuprofen does not make it better, 20 year odl, neck pain, vomiting, migranes in mother, migraines mother, FH: history of migraines, female, Feels better with the light turnes out</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Pt is 20 yo F w headache since yesterday morning. Pt states that she woke up w a dull headache of her entire heard, that is progressively getthing worse. Has neck pain, subjective fever. Tried ibuprofen, tylenol, sleeping with little relief. Walking , bending over makes it worse. Has had nausea, vomitting x3 of food and green colored. Sensitive to light, not sound, no auras. States ""this is the worst headache of my life""

PMH: none
Meds: OCP
PSH: none
Allergies: none
Family: mother migraines, father high cholesterol
SH: in high school, 2-3 glasses of wine per week, smokes 3-4 joints of cannabis/wk
ROS: denies weight change, appetitie change, recent travel, sick contacts, cough, bowel/urinary changes.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20 yo, yesterday, headache entire heard, neck pain, vomitting, nausea, mother migraines, Family migraines, F, Sensitive to light, denies sick contacts, subjective fever</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 F no PMH, lives w/ roommate in apartment has severe headache and photosensitivity x2 days. URI symptoms x2 days, as well. No sick contacts. UTD on vaccines. No hx spinal Surgery or instrumentation..
Extract phrases from this text which may help understand the patient's medical condition.[/INST]20, 2 days, 2 days, URI symptoms, lives w/ roommate in apartment, F, photosensitivity, No sick contacts</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: 20 y/o F with no PMH is presenting with 1 day history of headache. Patient said is started yesterday morning as a dull headache that has been constant since then. Patient also has had some nausea, and 3 episodes of vomiting with no blood in the vomit. Patient is also sensitive to the light. Patient has tried tylenol and ibuprofen which has not helped. Patient says that she feels warm but denies chills, chest pain, or neck pain. 
ROS: NEgative except for above. 
NEgative PMH, Surgical Hx. 
PAtient is on OCP
Patient's Mom has a Hx of migraines. 
She smokes 3 joints of marijuana every week. 
EtOH use soical.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]tylenol has not helped, ibuprofen which has not helped, 20 y/o, 1 day, vomiting, nausea, Mom has a Hx of migraines, F, sensitive to the light, feels warm</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Ms. Madden is a 20 yo female presenting w/ the worst HA of her life, unlike anything that she has had before. It is a dull + constant pain, it has gotten progressively worse, started yesterday morn. It is a diffuse pain felt around her head and is nonpulsating. She has photophobia but no phonophobia, has nausea, and vomited 3x yesterday. No sick contacts. Felt warm earlier. No chills, fatigue, CP, SOB, abd pain, or rashes. No sx before the onset of this HA. Ibuprofen, tylenol, sleep have not helped. Walking + bending over makes the pain worse. She has had HA before once or twice a yr but they are usually very mild. 
Meds: OCPs
FH: mother w/ migraines, dad w/ HPL
Social alcohol use, 3 or 4 marijuana joints per week, no tobacco use
PMH: none significant.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]tylenol not helped, Ibuprofen not helped, 20 yo, yesterday, HA around her head, HA diffuse, vomited, No rashes, nausea, mother migraines, FH migraines, Ms, female, photophobia, No sick contacts, Felt warm</s>"
"<s>[INST]<<SYS>>You are a resourceful medical assistant. Please ensure your answers are unbiased. Make sure the answers are from the text provided.<</SYS>>Patient Note: Stephanie madden is a 20 year old woman complaining of headache. Pain began yesterday morning and has been getting worse. Dull constant ache bilaterally, worse with walking, bending over, no alleviating factors. Did not respond to ibuprofen, Tylenol, or sleep. Complains of photobia, but not phonophobia, no aura. Subjective fever today. Neck stiffness. Nausea and vomiting. No dizzyness or lightheadedness, no weakness, no sick contacts.
ROS: otherwise negative
PMH: none
PSH: none
Hosp: none
Med: Birth control pill
Allergies: none
Soc: works at sporting good store, lives with roomate, no tobacoo, etoh 2-3 drinks on weekends, marijuna 3-4 joints a week, sexually active and uses condoms.
Extract phrases from this text which may help understand the patient's medical condition.[/INST]Did not respond to ibuprofen, Did not respond to Tylenol, 20 year old, yesterday, Neck stiffness, vomiting, Nausea, lives with roomate, photobia, no sick contacts, Subjective fever</s>"