en/validation_en_ordered.csv

id,text,labels
274_73,"[['QUESTION', 'TYPE:', 'DIGESTIVE', 'SYSTEM'], ['CLINICAL', 'CASE:'], ['A', '52-year-old', 'man', 'with', 'no', 'concomitant', 'diseases', 'comes', 'to', 'the', 'emergency', 'department', 'for', 'melena', 'of', '24', 'hours', 'evolution', 'without', 'hemodynamic', 'repercussions.'], ['He', 'denies', 'taking', 'nonsteroidal', 'anti-inflammatory', 'drugs.'], ['The', 'hematocrit', 'is', '33%', 'and', 'the', 'rest', 'of', 'the', 'laboratory', 'tests', 'are', 'normal.'], ['The', 'upper', 'gastrointestinal', 'endoscopy', 'performed', 'urgently', '6', 'hours', 'after', 'admission', 'shows', 'a', 'normal', 'stomach,', 'without', 'blood', 'or', 'hematic', 'debris', 'and', 'an', 'excavated', 'ulcer', 'of', '8', 'mm', 'in', 'diameter', 'in', 'the', 'anterior', 'face', 'of', 'the', 'duodenal', 'bulb', 'with', '""visible', 'vessel""', 'at', 'its', 'base', 'and', 'without', 'active', 'bleeding.'], ['Which', 'of', 'the', 'following', 'statements', 'is', 'true?'], ['1-', 'In', 'the', 'initial', 'endoscopy', 'it', 'is', 'indicated', 'to', 'apply', 'an', 'endoscopic', 'therapy', 'and', 'subsequently', 'to', 'establish', 'endovenous', 'treatment', 'with', 'high', 'doses', 'of', 'a', 'proton', 'pump', 'inhibitor.', 'This', 'strategy', 'has', 'been', 'shown', 'to', 'reduce', 'the', 'risk', 'of', 'hemorrhagic', 'recurrence', 'and', 'mortality.'], ['2-', 'In', 'the', 'initial', 'endoscopy,', 'given', 'the', 'absence', 'of', 'active', 'bleeding,', 'endoscopic', 'therapy', 'is', 'not', 'indicated.', 'Subsequently,', 'to', 'reduce', 'the', 'risk', 'of', 'hemorrhagic', 'recurrence,', 'intravenous', 'treatment', 'with', 'high', 'doses', 'of', 'a', 'proton', 'pump', 'inhibitor', 'should', 'be', 'started.'], ['3-', 'n', 'initial', 'endoscopy,', 'endoscopic', 'therapy', 'is', 'indicated.', 'Subsequent', 'treatment', 'with', 'high', 'doses', 'of', 'a', 'proton', 'pump', 'inhibitor', 'has', 'not', 'been', 'shown', 'to', 'be', 'of', 'any', 'additional', 'benefit.'], ['4-', 'Since', 'this', 'is', 'a', 'complicated', 'ulcer', '(hemorrhage)', 'the', 'best', 'therapeutic', 'option,', 'once', 'the', 'hemorrhagic', 'episode', 'is', 'resolved,', 'is', 'a', 'vagotomy', 'and', 'pyloroplasty.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '1'], ['This', 'is', 'a', 'grade', 'IIa', 'ulcer', '(Forrest', 'classification),', 'with', 'a', 'high', 'risk', 'of', 'recurrence.'], ['Therefore,', 'endoscopic', 'treatment', 'and', 'hospitalization', 'with', 'intravenous', 'treatment', 'with', 'PPIs', '(in', 'our', 'setting', 'it', 'is', 'usually', 'omeprazole)', 'for', 'at', 'least', '72', 'hours', 'is', 'clearly', 'indicated.'], ['Surgery', 'is', 'indicated', 'in', 'massive', 'bleeding', 'or', 'bleeding', 'refractory', 'to', 'medical', 'treatment.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
233_104,"[['QUESTION', 'TYPE:', 'HEMATOLOGY'], ['CLINICAL', 'CASE:'], ['In', 'a', '29-year-old', 'woman', 'the', 'following', 'parameters', 'are', 'found', 'in', 'the', 'course', 'of', 'a', 'routine', 'blood', 'test:', 'Hb', '11.5', 'g/dL,', 'MCV', '70', 'fl,', 'MCH', '28', 'pg,', 'Ferritin', '10', 'ng/mL,', 'leukocytes', '5,200/mm3,', 'platelets', '335,000/mm3.'], ['Physical', 'examination', 'is', 'normal.'], ['The', 'most', 'indicated', 'examination', 'in', 'this', 'situation', 'is:'], ['1-', 'Gynecological', 'examination.'], ['2-', 'Fecal', 'occult', 'blood', 'test.'], ['3-', 'Radiological', 'study', 'of', 'the', 'digestive', 'tract.'], ['4-', 'Hemoglobin', 'electrophoresis.'], ['5-', 'Cooms', 'test.'], ['CORRECT', 'ANSWER:', '1'], ['The', 'most', 'frequent', 'cause', 'of', 'microcytic', 'iron', 'deficiency', 'anemia', 'in', 'young', 'women', 'is', 'chronic', 'gynecologic', 'leaks.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
315_136,,
235_107,"[['QUESTION', 'TYPE:', 'HEMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '71-year-old', 'man', 'presenting', 'with', 'severe', 'pancytopenia', 'without', 'presence', 'of', 'immature', 'cells', 'and', 'with', 'a', 'bone', 'marrow', 'study', 'suggestive', 'of', 'severe', 'aplastic', 'anemia.'], ['What', 'would', 'be', 'the', 'fundamental', 'therapeutic', 'approach?'], ['1-', 'Treatment', 'with', 'methylprednisolone', 'at', 'a', 'dose', 'of', '1', 'g/kg/day', 'for', '5', 'days.'], ['2-', 'Study', 'of', 'siblings', 'and', 'if', 'any', 'of', 'them', 'is', 'HLA', 'compatible,', 'allogeneic', 'transplantation', 'of', 'hematopoietic', 'progenitors.'], ['3-', 'Immunosuppressive', 'therapy', 'with', 'cyclosporine', 'and', 'antithymocyte', 'immunoglobulin.'], ['4-', 'Hemotherapy', 'support.'], ['5-', 'Chemotherapy', 'and', 'if', 'response', 'autologous', 'transplantation', 'of', 'hematopoietic', 'progenitors.'], ['CORRECT', 'ANSWER:', '3'], ['Severe', 'aplastic', 'anemia', 'and', 'not', 'a', 'candidate', 'for', 'allogeneic', 'transplant', 'because', 'of', 'his', 'age.'], ['Antisuppressants', 'seem', 'to', 'be', 'the', 'most', 'suitable.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
429_114,,
540_4,,
266_138,"[['QUESTION', 'TYPE:', 'PNEUMOLOGY'], ['CLINICAL', 'CASE:'], ['In', 'a', 'patient', 'with', 'mild', 'chronic', 'obstructive', 'pulmonary', 'disease', '(COPD)', 'in', 'stable', 'phase,', 'polyglobulia', 'and', 'respiratory', 'insufficiency', 'are', 'evident.'], ['In', 'the', 'chest', 'X-ray', 'there', 'are', 'no', 'notable', 'alterations.'], ['Which', 'of', 'the', 'following', 'procedures', 'would', 'you', 'consider', 'performing', 'first', 'to', 'rule', 'out', 'the', 'coexistence', 'of', 'other', 'diseases', 'that', 'may', 'justify', 'the', 'findings', 'described?'], ['1-', 'Respiratory', 'polygraphy.'], ['2-', 'Echocardiogram.'], ['3-', 'Thoracic', 'computed', 'tomography.'], ['4-', 'Pulmonary', 'scintigraphy.'], ['5-', 'Bone', 'marrow', 'puncture.'], ['CORRECT', 'ANSWER:', '1'], ['The', 'approach', 'is', 'questionable', 'due', 'to', 'lack', 'of', 'sufficient', 'data.'], ['The', 'correct', 'answer', 'could', 'be', 'respiratory', 'polygraphy,', 'especially', 'in', 'the', 'case', 'of', 'an', 'obese', 'patient,', 'which', 'we', 'do', 'not', 'know,', 'but', 'it', 'could', 'also', 'be', 'correct', '2', '(echocardiogram)', 'in', 'the', 'case', 'of', 'suspicion', 'of', 'associated', 'cardiopathy,', 'less', 'frequent', 'but', 'also', 'possible.'], ['The', 'association', 'of', 'COPD', 'with', 'OSAHS', 'is', 'a', 'frequent', 'cause', 'of', 'COPD', 'deterioration,', 'greater', 'than', 'that', 'which', 'would', 'correspond', 'to', 'functional', 'impairment.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O']]"
13_150,"[['QUESTION', 'TYPE:', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', 'one-and-a-half-year-old', 'boy', 'presents', 'to', 'the', 'emergency', 'department', 'with', 'abdominal', 'pain', 'and', 'jaundice.'], ['On', 'examination,', 'an', 'abdominal', 'mass', 'is', 'palpated.'], ['An', 'ultrasound', 'shows', 'the', 'presence', 'of', 'a', 'common', 'bile', 'duct', 'cyst.'], ['What', 'therapeutic', 'approach', 'should', 'we', 'adopt?'], ['1-', 'A', 'percutaneous', 'puncture', 'will', 'be', 'performed', 'for', 'peritoneal', 'lavage', 'to', 'check', 'that', 'the', 'cyst', 'contains', 'bile', 'in', 'order', 'to', 'leave', 'a', 'drainage', 'to', 'improve', 'abdominal', 'pain.'], ['2-', 'Radical', 'resection', 'of', 'the', 'entire', 'bile', 'duct', 'is', 'indicated', 'to', 'replace', 'it', 'with', 'a', 'loop', 'of', 'bowel.'], ['3-', 'An', 'exploratory', 'laparotomy', 'and', 'drainage', 'of', 'the', 'cyst', 'will', 'be', 'indicated', 'and', 'when', 'the', 'dilatation', 'subsides', 'the', 'drainage', 'will', 'be', 'removed.'], ['4-', 'A', 'cholangioresonance', 'will', 'be', 'performed', 'to', 'delimit', 'the', 'cyst', 'and', 'a', 'laparotomy', 'will', 'be', 'indicated', 'for', 'resection', 'of', 'the', 'cyst', 'and', 'anastomosis', 'of', 'the', 'biliary', 'tract.'], ['5-', 'HIDA', 'scintigraphy', 'is', 'necessary', 'to', 'delimit', 'the', 'cyst', 'and', 'to', 'be', 'able', 'to', 'perform', 'percutaneous', 'drainage', 'safely.'], ['CORRECT', 'ANSWER:', '4'], ['I', 'believe', 'that', 'the', 'correct', 'answer', 'is', '4', 'the', 'common', 'bile', 'duct', 'cyst', 'is', 'a', 'rare', 'pathology', 'but', 'its', 'treatment', 'is', 'surgical', 'and', 'consists', 'of', 'resection', 'of', 'the', 'cyst', 'and', 'hepaticojejunosotomy.'], ['Cholangioresonance', 'is', 'necessary', 'to', 'choose', 'the', 'appropriate', 'technique', 'for', 'the', 'four', 'existing', 'classes', 'of', 'common', 'bile', 'duct', 'cyst', '(Todani', 'classification).']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
299_104,"[['QUESTION', 'TYPE:', 'INFECTIOUS', 'DISEASES'], ['CLINICAL', 'CASE:'], ['A', '46-year-old', 'male', 'parenteral', 'drug', 'user', 'came', 'to', 'the', 'emergency', 'department', 'with', 'fever', 'with', 'chills,', 'mental', 'confusion,', 'diffuse', 'myalgias', 'and', 'intense', 'pain', 'in', 'the', 'left', 'hand', 'of', '24', 'hours', 'of', 'evolution', 'without', 'clear', 'local', 'phlogosis', 'signs.'], ['She', 'does', 'not', 'refer', 'any', 'traumatic', 'history.'], ['Examination', 'revealed:', 'temperature', '38.9°C,', '120', 'beats', 'per', 'minute,', 'respiratory', 'rate', '30/min,', 'blood', 'pressure', '90/54', 'mm', 'Hg.'], ['Laboratory', 'tests', 'showed', 'leukocytosis', 'with', 'left', 'deviation', '(25,000', 'leukocytes/mm3,', '80%', 'neutrophils);', 'increased', 'creatinine', '(1.6', 'mg/dL)', 'and', 'CK', '(138', 'U/L).'], ['Among', 'the', 'following,', 'which', 'is', 'the', 'most', 'likely', 'diagnosis:'], ['1-', 'Streptococcal', 'necrotizing', 'fasciitis.'], ['2-', 'Gangrene', 'due', 'to', 'Clostridium', 'spp.'], ['3-', 'Mycobacterial', 'cellulitis.'], ['4-', 'Erysipelas.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '1'], ['I', 'have', 'my', 'doubts', 'between', '1', 'and', '2;', 'exceptionally', 'C.', 'botulinum', 'can', 'infect', 'traumatic', 'or', 'puncture', 'wounds', 'in', 'IVDUs', 'using', 'brown', 'heroin', 'or', 'cause', 'sinusitis', 'in', 'cocaine', 'addicts.'], ['On', 'the', 'other', 'hand,', 'the', 'case', 'may', 'refer', 'to', 'a', 'severe', 'sepsis', 'with', 'poor', 'initial', 'manifestation', 'at', 'first', 'sight,', 'with', 'incipient', 'rhabdomyolysis', 'and', 'muscle', 'pain,', 'in', 'this', 'case', 'it', 'may', 'be', 'a', 'necrotizing', 'fasciitis,', 'where', 'the', 'most', 'frequently', 'implicated', 'germ', 'is', 'S.', 'pyogenes.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
16_131,"[['QUESTION', 'TYPE:', 'DERMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '62-year-old', 'man', 'with', 'a', 'history', 'of', 'significant', 'alcohol', 'abuse,', 'carrier', 'of', 'hepatitis', 'C', 'virus,', 'treated', 'with', 'Ibuprofen', 'for', 'tendinitis', 'of', 'the', 'right', 'shoulder,', 'goes', 'to', 'his', 'dermatologist', 'because', 'after', 'spending', 'two', 'weeks', 'on', 'vacation', 'at', 'the', 'beach', 'he', 'notices', 'the', 'appearance', 'of', 'tense', 'blisters', 'on', 'the', 'dorsum', 'of', 'his', 'hands.'], ['On', 'examination,', 'in', 'addition', 'to', 'localization', 'and', 'slight', 'malar', 'hypertrichosis.'], ['The', 'most', 'likely', 'diagnosis', 'is:'], ['1-', 'Epidermolysis', 'bullosa', 'acquisita.'], ['2-', 'Porphyria', 'cutanea', 'tarda.'], ['3-', 'Phototoxic', 'reaction.'], ['4-', 'Contact', 'dermatitis.'], ['5-', 'Acute', 'intermittent', 'porphyria.'], ['CORRECT', 'ANSWER:', '2'], ['Porphyria', 'Cutanea', 'Tarda:', '60%', 'of', 'patients', 'with', 'PCT', 'are', 'male,', 'many', 'of', 'them', 'drink', 'alcohol', 'in', 'excess,', 'women', 'who', 'develop', 'it', 'are', 'usually', 'treated', 'with', 'drugs', 'containing', 'estrogens.'], ['Most', 'are', 'males', 'with', 'signs', 'of', 'iron', 'overload,', 'this', 'overload', 'reduces', 'the', 'activity', 'of', 'the', 'enzyme', 'uroporphyrinogen', 'decarboxylase,', 'which', 'leads', 'to', 'the', 'elevation', 'of', 'uroporphyrins.'], ['HCV', 'and', 'HIV', 'infections', 'have', 'been', 'implicated', 'in', 'the', 'precipitation', 'of', 'acquired', 'PCT.'], ['There', 'is', 'a', 'hereditary', 'form', 'with', 'AD', 'pattern.'], ['Patients', 'with', 'PCT', 'present', 'with', 'blistering', 'of', 'photoexposed', 'skin,', 'most', 'frequently', 'on', 'the', 'dorsum', 'of', 'the', 'hands', 'and', 'scalp.'], ['In', 'addition', 'to', 'fragility,', 'they', 'may', 'develop', 'hypertrichosis,', 'hyperpigmentation,', 'cicatricial', 'alopecia', 'and', 'sclerodermal', 'induration.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
121_114,"[['QUESTION', 'TYPE:', 'MICROBIOLOGY'], ['CLINICAL', 'CASE:'], ['47-year-old', 'woman.'], ['Native', 'of', 'Cochabamba', '(Bolivia),', 'she', 'has', 'been', 'living', 'in', 'Spain', 'for', '8', 'years.'], ['In', 'mid', '2009', 'she', 'began', 'to', 'experience', 'palpitations,', 'dyspnea', 'and', 'progressive', 'edema', 'in', 'the', 'lower', 'extremities.'], ['She', 'was', 'diagnosed', 'with', 'heart', 'failure', 'secondary', 'to', 'cardiomyopathy', 'due', 'to', 'Chagas', 'disease.'], ['What', 'is', 'the', 'etiological', 'agent', 'of', 'this', 'disease', 'endemic', 'in', 'several', 'Latin', 'American', 'countries?'], ['1-', 'Toxoplasma', 'gondii.'], ['2-', 'Trypanosoma', 'brucei.'], ['3-', 'Lehismania', 'donovani.'], ['4-', 'Giardia', 'lamblia.'], ['5-', 'Trypanosoma', 'cruzi.'], ['CORRECT', 'ANSWER:', '5'], ['The', 'correct', 'answer', 'is', 'the', 'fifth', 'one.'], ['The', 'cause', 'of', 'Chagas', 'disease', 'is', 'Trypanosoma', 'cruzi.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
241_229,"[['QUESTION', 'TYPE:', 'NEUROLOGY'], ['CLINICAL', 'CASE:'], ['A', '29-year-old', 'obese', 'woman,', 'with', 'no', 'past', 'history', 'of', 'interest,', 'consults', 'for', 'a', 'month', 'of', 'intense,', 'bilateral,', 'pulsating', 'headache,', 'accompanied', 'by', 'horizontal', 'diplopia', 'and', 'episodes', 'of', 'monocular', 'amaurosis', 'lasting', 'seconds.'], ['Examination', 'is', 'normal,', 'except', 'for', 'the', 'presence', 'of', 'bilateral', 'papilledema.'], ['Which', 'of', 'these', 'tests', 'do', 'you', 'think', 'will', 'allow', 'you', 'to', 'fully', 'confirm', 'the', 'diagnosis?'], ['1-', 'Ultrasound', 'of', 'supra-aortic', 'trunks.'], ['2-', 'Cranial', 'magnetic', 'resonance', 'imaging.'], ['3-', 'Electroencephalogram.'], ['4-', 'Lumbar', 'puncture.'], ['5-', 'Visual', 'evoked', 'potentials.'], ['CORRECT', 'ANSWER:', '4'], ['Again', 'we', 'are', 'presented', 'with', 'a', 'case', 'to', 'make', 'a', 'diagnosis', 'and', 'then,', 'in', 'this', 'case,', 'perform', 'a', 'confirmatory', 'test.'], ['Now', 'the', 'guiding', 'symptom', 'is', 'bilateral', 'papilledema', 'which', 'is', 'indicative', 'of', 'intracranial', 'hypertension.'], ['Although', 'he', 'does', 'not', 'comment', 'that', 'a', 'space-occupying', 'lesion', 'has', 'been', 'ruled', 'out,', 'given', 'the', 'normal', 'neurological', 'examination', 'and', 'the', 'other', 'symptoms,', 'it', 'is', 'deduced', 'that', 'it', 'is', 'idiopathic', 'intracranial', 'hypertension', 'or', 'pseudotumor', 'cerebri.'], ['Other', 'data', 'suggestive', 'of', 'this', 'entity', 'include:', 'women', 'of', 'reproductive', 'age,', 'obesity,', 'and', 'diplopia', '(due', 'to', 'involvement', 'of', 'the', 'VI', 'cranial', 'nerve).'], ['It', 'is', 'characteristic', 'that', 'the', 'headache', 'and', 'visual', 'blurriness', 'suddenly', 'worsen', 'in', 'the', 'mornings', 'when', 'getting', 'up', 'or', 'changing', 'posture,', 'producing', 'transitory', 'blindness', '(Neurology,', 'Zarranz).'], ['The', 'lumbar', 'puncture', 'invariably', 'shows', 'an', 'increase', 'in', 'cerebrospinal', 'fluid', 'pressure,', 'so', 'the', 'correct', 'answer', 'is', '4.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
576_103,"[['QUESTION', 'TYPE:', 'NEUROLOGY'], ['CLINICAL', 'CASE:'], ['A', '30-year-old', 'male', 'who', 'consults', 'for', 'unilateral', 'periocular', 'headaches', 'that', 'rapidly', 'progress', 'to', 'become', 'very', 'intense.'], ['The', 'pain', 'attacks', 'last', '30-60', 'minutes,', 'occur', '2-3', 'times', 'a', 'day,', 'and', 'are', 'accompanied', 'by', 'tearing', 'in', 'the', 'painful', 'eye', 'and', 'unilateral', 'rhinorrhea.'], ['What', 'is', 'the', 'most', 'appropriate', 'preventive', 'treatment?'], ['1-', 'Oral', 'prednisone', 'with', 'withdrawal', 'in', '2-3', 'months.'], ['2-', 'Oral', 'prednisone', 'with', 'withdrawal', 'in', 'one', 'month,', 'associated', 'with', 'oral', 'verapamil', 'at', 'a', 'dose', 'of', '80-180', 'mg', 'every', '8', 'hours.'], ['3-', 'Carbamazepine', 'at', 'doses', 'of', '600-1200', 'mg', 'per', 'day.'], ['4-', 'Indomethacin', 'at', 'a', 'dose', 'of', '50', 'mg', 'every', '8', 'hours', 'for', 'one', 'month.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '2'], ['They', 'describe', 'a', 'characteristic', 'case', 'of', 'cluster', 'headache.'], ['It', 'is', 'more', 'frequent', 'in', 'males,', 'the', 'pain', 'is', 'characteristically', 'unilateral', 'periocular', 'of', 'great', 'intensity,', 'of', 'variable', 'duration,', 'usually', 'minutes,', 'and', 'it', 'associates', 'trigeminoautonomic', 'signs', 'such', 'as', 'rhinorrhea', 'and', 'unilateral', 'conjunctival', 'injection.'], ['The', 'preventive', 'treatment', 'par', 'excellence', 'is', 'verapamil', 'associated', 'with', 'a', 'descending', 'corticosteroid', 'regimen,', 'as', 'described', 'in', 'answer', '2.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
504_87,"[['QUESTION', 'TYPE:', 'PEDIATRICS'], ['CLINICAL', 'CASE:'], ['Given', 'sudden-onset', 'obsessive-compulsive', 'disorder', '(OCD)', 'in', 'a', '9-year-old', 'boy', 'who', 'also', 'has', 'tics', 'and', 'chorea', 'as', 'neurologic', 'manifestations,', 'an', 'infection', 'by', 'should', 'be', 'ruled', 'out:'], ['1-', 'Streptococcus', 'viridans.'], ['2-', 'Alpha-hemolytic', 'streptococcus.'], ['3-', 'Beta-hemolytic', 'streptococcus,', 'group', 'A.'], ['4-', 'Enterococcus.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['We', 'are', 'presented', 'with', 'a', 'case', 'of', 'PANDAS', 'syndrome,', 'a', 'rare', 'complication', 'of', 'an', 'infection', 'caused', 'by', 'group', 'A', 'beta-hemolytic', 'streptococcus.']]","[['O', 'O', 'O'], ['O', 'O'], ['O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
367_119,"[['QUESTION', 'TYPE:', 'PNEUMOLOGY', 'AND', 'THORACIC', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '38-year-old', 'nonsmoking', 'woman', 'previously', 'diagnosed', 'with', 'atopic', 'rhinitis', 'presents', 'with', 'a', 'two-month', 'history', 'of', 'intermittent', 'cough', 'and', 'wheezing,', 'predominantly', 'at', 'night.'], ['Chest', 'X-ray', 'was', 'normal.'], ['Spirometry', 'within', 'the', 'normal', 'range', 'with', 'negative', 'bronchodilator', 'test.'], ['Which', 'of', 'the', 'following', 'tests', 'would', 'you', 'request', 'next?'], ['1-', 'Paranasal', 'sinus', 'Rx.'], ['2-', 'Thoracic', 'CT.'], ['3-', 'Methacholine', 'test.'], ['4-', 'Prick', 'test.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['A', 'normal', 'spirometry', 'and', 'a', 'negative', 'bronchodilator', 'test', 'does', 'not', 'exclude', 'asthma,', 'and', 'the', ""patient's"", 'clinical', 'picture', 'is', 'highly', 'suggestive', 'of', 'asthma,', 'so', 'a', 'methacholine', 'test', 'would', 'confirm', 'the', 'diagnosis,', 'at', 'least', 'of', 'bronchial', 'hyperresponsiveness.']]","[['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
444_104,,
171_226,"[['QUESTION', 'TYPE:', 'CARDIOLOGY', 'AND', 'CARDIOVASCULAR', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '26-year-old', 'male', 'patient,', 'competitive', 'athlete,', 'is', 'studied', 'because', 'his', 'brother', 'has', 'had', 'a', 'sudden', 'death.'], ['Complementary', 'tests', 'detect', 'the', 'existence', 'of', 'obstructive', 'hypertrophic', 'cardiomyopathy.'], ['Mark', 'the', 'FALSE', 'option', 'regarding', 'this', 'pathology:'], ['1-', 'Treatment', 'with', 'beta-blockers', 'helps', 'to', 'reduce', 'symptoms.'], ['2-', 'Abandonment', 'of', 'competitive', 'sport', 'should', 'be', 'recommended.'], ['3-', 'Digoxin', 'is', 'useful', 'to', 'reduce', 'the', 'subaortic', 'gradient.'], ['4-', 'Diuretics', 'should', 'be', 'avoided', 'or', 'used', 'with', 'great', 'care.'], ['5-', 'Given', 'the', 'hereditary', 'nature', 'of', 'the', 'pathology,', 'a', 'screening', 'study', 'should', 'be', 'performed', 'in', 'the', 'rest', 'of', 'the', 'direct', 'relatives.'], ['CORRECT', 'ANSWER:', '3'], ['Our', 'myocardium', 'is', 'thicker', 'than', 'it', 'should', 'be,', 'predominantly', 'in', 'the', 'septum,', 'and', 'it', 'is', 'so', 'thick', 'that', 'it', 'obstructs', 'the', 'LV', 'outflow,', 'producing', 'a', '""functional""', 'stenosis', 'with', 'a', 'pressure', 'gradient.'], ['Our', 'objective', 'will', 'be,', 'first', 'of', 'all,', 'to', '""relax""', 'the', 'myocardium:', 'for', 'this', 'purpose,', 'a', 'beta-blocker', 'is', 'recommended,', 'whereas', 'digoxin,', 'as', 'a', 'good', 'positive', 'inotrope,', 'increases', 'the', 'gradient', 'and', 'is', 'contraindicated.'], ['Sport', 'is', 'not', 'highly', 'recommended,', 'given', 'the', 'increased', 'risk', 'of', 'sudden', 'death', 'associated', 'with', 'this', 'pathology.'], ['And', 'if', 'we', 'have', 'a', 'fat', 'septum,', 'which', 'protrudes', 'into', 'the', 'LV', 'cavity,', 'it', 'is', 'not', 'advisable', 'to', 'perform', 'volume', 'depletion,', 'since', 'we', 'would', 'also', 'be', 'increasing', 'the', 'gradient.'], ['Regarding', 'number', '5,', 'it', 'is', 'true:', 'it', 'is', 'convenient', 'to', 'perform', 'a', 'careful', 'exploration', 'and', 'an', 'ECG', 'in', 'the', 'relatives', 'of', 'patients', 'with', 'hypertrophy.']]","[['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
555_51,"[['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['55-year-old', 'woman', 'with', 'type', '1', 'diabetes', 'diagnosed', 'at', 'age', '15', 'years', 'who', 'refers', 'nausea', 'and', 'abdominal', 'distention,', 'especially', 'after', 'meals.'], ['Evaluation', 'is', 'consistent', 'with', 'diabetic', 'gastroparesis.'], ['Which', 'of', 'the', 'following', 'medications', 'would', 'be', 'the', 'most', 'appropriate', 'treatment', 'to', 'improve', 'her', 'symptoms:'], ['1-', 'Lansoprazole.'], ['2-', 'Ondansetron.'], ['3-', 'Loperamide.'], ['4-', 'Metoclopramide.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '4'], ['It', 'was', 'approved', 'as', 'a', 'treatment', 'for', 'gastroparesis', 'by', 'the', 'US', 'Food', 'and', 'Drug', 'Administration', '(FDA)', 'in', '1979', 'and', 'remains', 'the', 'first-line', 'drug.'], ['It', 'acts', 'as', 'a', 'prokinetic', 'by', 'its', 'antagonistic', 'effect', 'on', 'dopamine', '2', '(D2)', 'receptors', 'promoting', 'gastric', 'emptying', 'and,', 'in', 'addition,', 'binds', 'to', 'the', '5-hydroxytryptamine', '4', 'receptor', '(serotonin', '5-HT4)', 'to', 'stimulate', 'cholinergic', 'nerve', 'pathways', 'in', 'the', 'stomach.'], ['Physiologically,', 'it', 'accelerates', 'intestinal', 'transit', 'by', 'increasing', 'the', 'tone', 'and', 'amplitude', 'of', 'gastric', 'contractions,', 'increases', 'lower', 'esophageal', 'sphincter', 'pressure', 'and', 'improves', 'antropyloroduodenal', 'coordination.'], ['In', 'addition,', 'this', 'antiemetic', 'agent', 'provides', 'relief', 'through', 'antagonism', 'of', 'central', 'and', 'peripheral', 'dopamine', 'receptors.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
320_142,"[['QUESTION', 'TYPE:', 'RHEUMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '40-year-old', 'man,', 'with', 'no', 'history', 'of', 'interest,', 'presents', 'with', 'acute', 'arthritis', 'of', 'the', 'right', 'knee', 'of', '5', 'days', 'of', 'evolution', 'as', 'well', 'as', 'fever', 'up', 'to', '37.7°C.'], ['He', 'has', 'no', 'history', 'of', 'trauma.'], ['He', 'presented', 'with', 'joint', 'effusion,', 'warmth', 'on', 'palpation', 'and', 'functional', 'limitation', 'due', 'to', 'pain.'], ['Diagnostic', 'arthrocentesis', 'was', 'performed', 'and', 'showed', '30000', 'cels/microliter', 'with', 'predominance', 'of', 'neutrophils.'], ['Polarized', 'light', 'examination', 'revealed', 'rhomboidal', 'and', 'cylindrical', 'crystals', 'with', 'weakly', 'positive', 'birefringence.'], ['On', 'plain', 'radiograph', 'of', 'the', 'knee,', 'radiodense', 'deposits', 'are', 'found', 'in', 'the', 'external', 'meniscus', 'of', 'the', 'knee.'], ['Mark', 'the', 'FALSE', 'answer:'], ['1-', 'Initial', 'treatment', 'will', 'consist', 'of', 'non-steroidal', 'anti-inflammatory', 'drugs,', 'as', 'well', 'as', 'aspiration', 'of', 'synovial', 'fluid.'], ['2-', 'It', 'is', 'advisable', 'to', 'perform', 'a', 'synovial', 'fluid', 'culture', 'to', 'rule', 'out', 'infectious', 'synovitis.'], ['3-', 'Once', 'the', 'acute', 'flare-up', 'has', 'passed,', 'treatment', 'with', 'allopurinol', 'should', 'be', 'started', 'to', 'reduce', 'the', 'incidence', 'of', 'new', 'arthritis', 'flare-ups', 'in', 'the', 'future.'], ['4-', 'The', 'most', 'likely', 'diagnosis', 'is', 'acute', 'arthritis', 'due', 'to', 'calcium', 'pyrophosphate', 'crystal', 'deposition', '(pseudogout).'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['It', 'is', 'a', 'chondrocalcinosis.'], ['There', 'is', 'no', 'treatment', 'for', 'this', 'disease,', 'only', 'treatment', 'for', 'flare-ups', '(colchicine,', 'NSAIDs', 'or', 'corticosteroids),', 'although', 'sometimes', 'if', 'the', 'flare-ups', 'are', 'habitual', 'the', 'colchicine', 'is', 'maintained.'], ['Allopurinol', 'has', 'not', 'shown', 'any', 'efficacy', 'in', 'this', 'microcrystal', 'arthropathy,', 'but', 'it', 'has', 'shown', 'efficacy', 'in', 'gout.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'B-Marker', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
617_119,"[['QUESTION', 'TYPE:', 'TRAUMATOLOGY'], ['CLINICAL', 'CASE:'], ['13-year-old', 'female,', 'with', 'no', 'relevant', 'history,', 'with', 'menarche', '3', 'months', 'ago,', 'followed', 'since', 'the', 'age', 'of', '10', 'years', 'for', 'idiopathic', 'scoliosis', 'that', 'has', 'worsened.'], ['In', 'the', 'physical', 'examination', 'she', 'presents', 'a', 'hump', 'of', '7', 'degrees', 'in', 'the', 'Adams', 'test', 'and', 'in', 'the', 'scoliogram', 'a', 'T4-L1', 'thoracolumbar', 'curve', 'of', '35', 'degrees', 'of', 'Cobb', 'and', 'a', 'Risser', '0:'], ['1-', 'Recommend', 'swimming', 'and', 'revision', 'in', 'three', 'months.'], ['2-', 'Prescribe', 'a', 'brace', 'type', 'orthosis.'], ['3-', 'Refer', 'to', 'physiotherapy', 'for', 'spine', 'elastification.'], ['4-', 'Revise', 'in', '6', 'months', 'with', 'a', 'new', 'X-ray.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '2'], ['We', 'are', 'presented', 'with', 'the', 'case', 'of', 'a', '13', 'year', 'old', 'patient,', 'with', 'menarche', '3', 'months', 'ago,', 'a', 'T4-L1', 'thoracolumbar', 'curve', 'of', '35º', 'and', 'a', 'Risser', '0.'], ['As', 'a', 'general', 'rule', 'we', 'could', 'say', 'that', 'below', '50º', 'the', 'treatment', 'is', 'usually', 'conservative,', 'with', 'two', 'options:', 'observation', 'or', 'use', 'of', 'a', 'brace', 'to', 'slow', 'down', 'the', 'evolution.'], ['In', 'this', 'case,', 'taking', 'into', 'account', 'the', 'remaining', 'growth', '(menarche', '3', 'months', 'ago', 'and', 'Risser', '0)', 'the', 'most', 'indicated', 'would', 'be', 'to', 'use', 'a', 'brace', '(Answer', '2', 'correct).']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim']]"
146_231,"[['QUESTION', 'TYPE:', 'PEDIATRICS'], ['CLINICAL', 'CASE:'], ['A', '7-month-old', 'infant', 'comes', 'to', 'the', 'emergency', 'department', 'referred', 'by', 'his', 'pediatrician', 'for', 'suspected', 'Kawasaki', 'disease.'], ['He', 'reports', 'a', 'fever', 'of', 'up', 'to', '39.5ºC', 'of', '5', 'days', 'evolution', 'that', 'does', 'not', 'subside', 'despite', 'treatment', 'with', 'amoxicillin', 'prescribed', '72', 'hours', 'ago', 'for', 'suspected', 'acute', 'pharyngotonsillitis.'], ['During', 'the', 'last', '24', 'hours', 'he', 'has', 'had', 'erythematous', 'and', 'pruritic', 'exanthema', 'of', 'cephalocaudal', 'evolution', 'and', 'during', 'the', 'last', 'few', 'days', 'his', 'parents', 'have', 'noticed', 'a', 'cough', 'and', 'intense', 'conjunctivitis.'], ['No', 'rhinorrhea', 'was', 'reported.'], ['Clinical', 'examination', 'showed', 'subcrepitant', 'in', 'both', 'lung', 'bases', 'without', 'tachypnea', 'or', 'signs', 'of', 'respiratory', 'distress.'], ['On', 'oropharyngeal', 'examination', 'there', 'are', 'whitish', 'spots', 'in', 'the', 'jugal', 'mucosa.'], ['What', 'is', 'the', 'most', 'probable', 'diagnosis?'], ['1-', 'Kawasaki', 'disease.'], ['2-', 'Scarlet', 'fever.'], ['3-', 'Allergic', 'reaction', 'to', 'amoxicillin.'], ['4-', 'Infectious', 'mononucleosis.'], ['5-', 'Measles.'], ['CORRECT', 'ANSWER:', '5'], ['The', 'correct', 'answer', 'is', '5.'], ['The', 'clue', 'is', 'in', 'the', 'whitish', 'lesions', 'of', 'the', 'jugal', 'mucosa', 'corresponding', 'to', ""Koplik's"", 'spots,', 'which', 'are', 'pathognomonic', 'of', 'measles,', 'although', 'as', 'an', 'observation', 'I', 'would', 'say', 'that', 'they', 'usually', 'appear', 'in', 'the', 'prodromal', 'phase', 'of', 'the', 'disease', 'and', 'are', 'often', 'no', 'longer', 'seen', 'when', 'the', 'exanthema', 'appears.'], ['In', 'this', 'case', 'you', 'are', 'describing', 'measles', 'complicated', 'by', 'pneumonia.'], ['Very', 'timely', 'question', 'at', 'the', 'present', 'time.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O', 'O', 'O', 'O', 'O']]"
467_92,"[['QUESTION', 'TYPE:', 'ORTHOPEDIC', 'SURGERY', 'AND', 'TRAUMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', 'woman', 'presenting', 'with', 'difficulty', 'walking', 'after', 'gynecologic', 'surgery.'], ['She', 'has', 'mild', 'thigh', 'pain', 'and', 'leg', 'failure', 'on', 'support.'], ['On', 'examination', 'she', 'has', 'weakness', 'in', 'hip', 'flexion', 'and', 'knee', 'extension,', 'and', 'dysesthesias', 'in', 'the', 'anterior', 'aspect', 'of', 'the', 'thigh.'], ['What', 'is', 'the', 'most', 'probable', 'diagnosis', 'of', 'suspicion:'], ['1-', 'Femoral', 'nerve', 'neuropathy.'], ['2-', 'Meralgia', 'paresthetica', 'of', 'the', 'femoral', 'cutaneous', 'nerve.'], ['3-', 'Obturator', 'nerve', 'neuropathy.'], ['4-', 'Neuropathy', 'of', 'the', 'sciatic', 'nerve.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '1'], ['The', 'femoral', 'nerve', '(although', 'rare)', 'may', 'be', 'damaged', 'in', 'a', 'cesarean', 'section,', 'hysterectomy', 'or', 'lower', 'abdominal', 'operation.'], ['This', 'nerve', 'injury', 'produces', 'hypoesthesia', 'and', 'weakness', 'along', 'its', 'distribution.'], ['Femoroneuropathy', 'is', 'manifested', 'by', 'paralysis', '(25%', 'of', 'cases)', 'of', 'the', 'quadriceps', 'muscles,', 'abolition', 'of', 'patellar', 'reflexes', 'and', 'hypoesthesia', 'of', 'the', 'anterior', 'and', 'inner', 'thigh.'], ['Therefore,', 'answer', '1', 'is', 'correct.'], ['The', 'femoral', 'cutaneous', 'or', 'lateral', 'femoral', 'cutaneous', 'nerve', '(L2,L3)', 'is', 'only', 'sensitive', 'and', 'is', 'responsible', 'for', 'the', 'sensitivity', 'of', 'the', 'skin', 'of', 'the', 'lateral', 'and', 'anterior', 'aspect', 'of', 'the', 'thigh', 'up', 'to', 'the', 'knee,', 'so', 'it', 'would', 'not', 'explain', 'the', 'motor', 'problem', 'of', 'gait', 'and', '2', 'is', 'false.'], ['The', 'obturator', 'nerve', '(L2-L4)', 'is', 'a', 'mixed', 'nerve.'], ['At', 'the', 'motor', 'level,', 'it', 'invests', 'the', 'obturator', 'externus,', 'pectineus,', 'short', 'approximator,', 'the', 'approximators', '(adductors)', 'and', 'gracilis.'], ['At', 'the', 'sensory', 'level', 'the', 'capsule', 'of', 'the', 'coxofemoral', 'joint,', 'medial', 'aspect', 'of', 'the', 'thigh', 'above', 'the', 'knee.'], ['Therefore', 'neither', 'affects', 'the', 'sensitivity', 'of', 'the', 'anterior', 'aspect', 'of', 'the', 'thigh', 'nor', 'the', 'extension', 'of', 'the', 'knee', 'so', 'that', '3', 'is', 'false.'], ['A', 'lesion', 'of', 'the', 'sciatic', 'nerve', 'at', 'motor', 'level', 'affects', 'to', 'the', 'flexion', 'of', 'the', 'knee', 'not', 'to', 'its', 'extension', 'and', 'at', 'distal', 'level', 'to', 'this', 'one', '(they', 'do', 'not', 'count', 'anything', 'of', 'distal', 'clinic)', 'and', 'at', 'sensitive', 'level', 'also', 'it', 'is', 'distal', 'in', 'the', 'external', 'face', 'of', 'the', 'leg', 'and', 'in', 'the', 'foot', 'reason', 'why', '4', 'also', 'is', 'false.']]","[['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'O', 'B-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
423_89,,
449_151,"[['QUESTION', 'TYPE:', 'NEUROSURGERY'], ['CLINICAL', 'CASE:'], ['A', '13-year-old', 'boy', 'presents', 'with', 'subacute', 'headache', 'and', 'diplopia.'], ['Neurologic', 'examination', 'shows', 'vertical', 'gaze', 'palsy', 'and', 'MRI', 'shows', 'a', 'contrast-enhancing', 'lesion', 'in', 'the', 'pineal', 'region', 'obstructing', 'the', 'aqueduct', 'of', 'Sylvius.'], ['The', 'most', 'likely', 'diagnosis', 'is:'], ['1-', 'Glioblastoma.'], ['2-', 'Medulloblastoma.'], ['3-', 'Germ', 'cell', 'tumor.'], ['4-', 'Meningioma.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['Germinal', 'tumors', 'are', 'the', 'most', 'frequent', 'in', 'children', 'in', 'the', 'pineal', 'region.'], ['They', 'usually', 'capitate', 'homogeneously', 'and', 'cause', 'triventricular', 'hydrocephalus', 'and', 'Parinaud.'], ['Glioblastomas', 'usually', 'occur', 'in', 'adults', 'at', 'the', 'lobar', 'level,', 'medulloblastomas', 'are', 'the', 'most', 'frequent', 'malignant', 'tumors', 'at', 'the', 'posterior', 'fossa', 'level', 'in', 'children', '(vermis', 'and', 'roof', 'of', 'the', 'IV', 'ventricle)', 'but', 'rare', 'at', 'the', 'pineal', 'level', 'and', 'meningiomas', 'are', 'rare', 'in', 'children', 'and', 'also', 'in', 'the', 'pineal', 'region.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
433_118,"[['QUESTION', 'TYPE:', 'INFECTIOUS', 'DISEASES', 'AND', 'MICROBIOLOGY'], ['CLINICAL', 'CASE:'], ['Luis', 'is', 'a', '25-year-old', 'young', 'man', 'who', 'underwent', 'splenectomy', 'after', 'a', 'bicycle', 'accident', '1', 'year', 'ago.'], ['He', 'has', 'a', 'dog', 'that', 'bit', 'him', '24', 'hours', 'ago', 'and', 'has', 'caused', 'a', 'small', 'wound', 'on', 'his', 'right', 'hand.'], ['She', 'comes', 'to', 'her', 'health', 'center', '(located', '3', 'hours', 'from', 'the', 'nearest', 'hospital)', 'with', 'fever', 'of', '39°C,', 'pain', 'in', 'the', 'wound', 'and', 'general', 'malaise.'], ['On', 'examination,', 'BP', '100/60', 'mm', 'Hg,', 'HR', '110', 'beats', 'per', 'minute,', 'slight', 'swelling', 'in', 'the', 'wound', 'without', 'pus.'], ['Which', 'of', 'the', 'following', 'actions', 'is', 'most', 'indicated', 'at', 'this', 'time?'], ['1-', 'Send', 'to', 'hospital', 'for', 'rabies', 'and', 'tetanus', 'vaccination', 'and', 'keep', 'under', 'observation.'], ['2-', 'Clean', 'the', 'wound', 'and', 'administer', 'intramuscular', 'nonspecific', 'gamma', 'globulin.'], ['3-', 'Give', '400', 'mg', 'of', 'oral', 'moxifloxacin', 'and', 'send', 'to', 'hospital.'], ['4-', 'Give', 'clindamycin', '600', 'mg', 'orally', 'every', '8', 'hours', 'and', 'observation.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['This', 'question', 'has', 'been', 'complicated', 'for', 'us.'], ['The', 'question', 'does', 'not', 'have', 'all', 'the', 'necessary', 'information,', 'but', 'using', 'what', 'we', 'have', 'we', 'can', 'try', 'to', 'answer.'], ['The', 'dog', 'is', 'domestic,', 'known', 'and', 'can', 'be', 'monitored,', 'so', 'we', 'would', 'have', 'to', 'wait', 'for', 'the', 'observation', 'period', 'to', 'pass', 'and', 'prophylaxis', 'is', 'not', 'recommended.'], ['At', 'this', 'point', 'we', 'will', 'only', 'have', 'to', 'worry', 'about', 'the', 'possible', 'bacteremia', 'that', 'may', 'be', 'occurring', 'in', 'a', 'patient', 'with', 'the', 'possibility', 'of', 'high', 'risk', 'due', 'to', 'asplenia.'], ['The', 'treatment', 'of', 'choice', 'in', 'dog', 'bite', 'is', 'amoxicillin/clavulanic', 'acid', 'but', 'it', 'is', 'not', 'available,', 'so', 'we', 'can', 'use', 'another', 'treatment', 'such', 'as', 'clindamycin', 'plus', 'cephalosporin', 'or', 'clindamycin', '+', 'moxifloxacin', 'but', 'it', 'is', 'not', 'contemplated', 'among', 'the', 'alternatives.'], ['In', 'a', 'first', 'attempt', 'we', 'answered', '4,', 'but', 'the', 'correct', 'answer', 'is', '3,', 'because', 'of', 'the', 'second', 'part', 'of', 'the', 'question;', 'it', 'is', 'a', 'high', 'risk', 'patient', 'with', 'incipient', 'signs', 'of', 'sepsis', 'so', 'he', 'should', 'be', 'sent', 'to', 'the', 'hospital,', 'here', 'the', 'key', 'more', 'than', 'the', 'antibiotic', 'is', 'in', 'the', 'position', 'to', 'take,', 'in', 'the', 'second', 'part', 'of', 'each', 'answer.'], ['It', 'could', 'be', 'challenged', 'since', 'they', 'do', 'not', 'say', 'in', 'which', 'community', 'the', 'bite', 'occurred', '(if', 'it', 'was', 'in', 'Ceuta', 'or', 'Melilla', 'the', 'protocol', 'may', 'vary).']]","[['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 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'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
337_31,"[['QUESTION', 'TYPE:', 'GYNECOLOGY', 'AND', 'OBSTETRICS'], ['CLINICAL', 'CASE:'], ['20-year-old', 'woman', 'with', 'ovarian', 'tumor', 'of', '15', 'cm,', 'solid-cystic,', 'detected', 'by', 'ultrasound', 'after', 'presenting', 'with', 'unspecific', 'abdominal', 'symptoms.'], ['In', 'the', 'histopathological', 'study', 'of', 'the', 'corresponding', 'specimen,', 'teeth,', 'hairs,', 'areas', 'of', 'intestinal', 'epithelium,', 'areas', 'of', 'squamous', 'epithelium', '(15%)', 'and', 'bronchial', 'epithelium,', 'as', 'well', 'as', 'neuroectodermal', 'and', 'embryonic', 'elements', 'are', 'found', 'in', 'several', 'of', 'the', 'histological', 'preparations.'], ['In', 'reference', 'to', 'this', 'case,', 'point', 'out', 'the', 'correct', 'diagnosis:'], ['1-', 'Teratocarcinoma.'], ['2-', 'Immature', 'teratoma.'], ['3-', 'Mature', 'cystic', 'teratoma.'], ['4-', 'Dysgerminoma.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['The', 'answer', 'is', '3,', 'mature', 'cystic', 'teratoma.'], ['This', 'is', 'due', 'to', 'the', 'characteristics', 'of', 'the', 'tumor:', 'mature', 'teratomas', 'are', 'constituted', 'by', 'adult', 'tissues,', 'coming', 'from', 'the', 'three', 'embryonic', 'leaves,', 'with', 'a', 'clear', 'predominance', 'of', 'ectodermal', 'elements', '(epidermis,', 'pilosebaceous', 'structures', 'and', 'neural', 'tissue).'], ['Mature', 'teratoma', 'is', 'a', 'tumor', 'of', 'ovarian', 'germ', 'cells.']]","[['O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
296_17,"[['QUESTION', 'TYPE:', 'INFECTIOUS', 'DISEASES'], ['CLINICAL', 'CASE:'], ['A', '47-year-old', 'man,', 'active', 'smoker,', 'with', 'a', 'history', 'of', 'drug', 'abuse', 'by', 'parenteral', 'route', 'comes', 'to', 'the', 'ED', 'for', 'a', '2-hour', 'evolution', 'of', 'acute', 'onset', 'pleuritic', 'left', 'costal', 'pain', 'and', 'progressive', 'dyspnea', 'until', 'becoming', 'resting.'], ['In', 'the', 'previous', '2', 'weeks', 'he', 'had', 'presented', 'febrile', 'fever,', 'general', 'malaise', 'and', 'dry', 'cough.'], ['On', 'examination,', 'the', 'patient', 'is', 'tachypneic', 'at', '36', 'rpm,', 'with', 'supraclavicular', 'pull,', 'oxygen', 'saturation', 'by', 'pulse', 'oximetry', 'of', '81%,', 'cyanosis,', 'sweating,', 'tachycardia', 'at', '135', 'beats', 'per', 'minute', 'and', 'BP', 'of', '75/47', 'mm', 'Hg.'], ['The', 'trachea', 'is', 'deviated', 'to', 'the', 'right', 'side', 'and', 'auscultation', 'shows', 'complete', 'absence', 'of', 'vesicular', 'murmur', 'in', 'the', 'left', 'hemithorax.'], ['HIV', 'serology', 'is', 'positive', 'and', 'shows', 'an', 'ADC', 'lymphocyte', 'count', 'of', '176', 'cells/ml.'], ['What', 'is', 'the', 'most', 'likely', 'diagnosis?'], ['1-', 'Subpleural', 'emphysematous', 'bulla', 'rupture.'], ['2-', 'Community-acquired', 'necrotizing', 'bacterial', 'pneumonia.'], ['3-', 'Pulmonary', 'tuberculosis.'], ['4-', 'Pneumocystis', 'jiroveci', 'pneumonia.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '4'], ['Patient', 'with', 'risk', 'factor', 'for', 'HIV', 'acquisition,', 'who', 'comes', 'to', 'the', 'emergency', 'department', 'for', 'a', 'subacute', 'onset', 'of', '2', 'weeks', 'of', 'evolution', '(fever,', 'malaise', 'and', 'dry', 'cough)', 'that', 'worsens', 'abruptly', '(pleuritic', 'pain)', 'and', 'progressively', '(dyspnea).'], ['Physical', 'examination', 'suggests', 'a', 'pneumothorax', '(tachypnea,', 'tugging,', 'low', 'saturation,', 'cyanosis,', 'diaphoresis,', 'tachycardia,', 'deviated', 'trachea', 'and', 'absence', 'of', 'vesicular', 'murmur).'], ['He', 'has', 'a', 'positive', 'HIV', 'serology', 'and', 'a', 'CD4', 'less', 'than', '200', 'cells/mL.'], ['The', 'radiograph', 'shows', 'hyperclarity', 'in', 'the', 'left', 'lung', 'field', 'with', 'absence', 'of', 'vessels', 'between', 'the', 'lung', 'border', 'and', 'the', 'chest', 'wall', 'on', 'the', 'left', 'side,', 'displacement', 'of', 'the', 'mediastinum', 'and', 'trachea', 'to', 'the', 'right', 'side,', 'and', 'a', 'stump', 'in', 'the', 'left', 'pulmonary', 'hilum', 'corresponding', 'to', 'the', 'collapsed', 'lung.'], ['The', 'suspicion', 'of', 'HIV', 'is', 'high', 'and', 'although', 'it', 'is', 'pending', 'confirmation,', 'in', 'the', 'emergency', 'it', 'is', 'valid', 'to', 'assume', 'this', 'option.'], ['That', 'said,', 'I', 'am', 'looking', 'for', 'pathologies', 'that', 'are', 'associated', 'with', 'this', 'picture,', 'the', 'rupture', 'of', 'a', 'bulla', 'although', 'it', 'is', 'related', 'to', 'the', 'appearance', 'of', 'abrupt', 'symptoms', 'does', 'not', 'go', 'hand', 'in', 'hand', 'with', 'the', 'other', 'symptoms', '(you', 'have', 'to', 'look', 'for', 'something', 'that', 'explains', 'everything', 'or', 'almost', 'everything),', 'pneumonia', 'although', 'it', 'is', 'true', 'that', 'it', 'can', 'be', 'related', 'to', 'many', 'of', 'the', 'symptoms', 'does', 'not', 'correlate', 'with', 'the', 'image,', 'Pulmonary', 'TB', 'could', 'be', 'manifested', 'with', 'all', 'of', 'the', 'above', 'and', 'cause', 'a', 'pneumothorax,', 'but', 'here', 'in', 'a', 'patient', 'with', 'a', 'respiratory', 'picture', 'with', 'more', 'than', '7', 'days', 'of', 'evolution', 'that', 'is', 'complicated', 'abruptly,', 'in', 'a', 'patient', 'with', 'a', 'high', 'suspicion', 'of', 'HIV', 'infection', 'the', 'clearest', 'option', 'goes', 'for', 'pneumonia', 'due', 'to', 'P.', 'jirovecii', 'pneumonia.'], ['In', 'patients', 'with', 'Pneumocystis,', '10%,', 'pneumatoceles', 'appear', 'which', 'can', 'sometimes', 'open', 'into', 'the', 'pleural', 'space', 'producing', 'a', 'spontaneous', 'pneumothorax.'], ['As', 'a', 'reminder,', 'the', 'most', 'frequent', 'germs', 'in', 'pulmonary', 'involvement', 'in', 'patients', 'with', 'HIV/AIDS', 'infection', 'are', 'P.', 'jiroveci', '(alone', 'or', 'associated', 'with', 'tuberculosis', 'or', 'other', 'mycobacteria),', 'S.', 'pneumoniae,', 'H.', 'influenzae,', 'S.', 'aureus,', 'cytomegalovirus,', 'Legionella,', 'staphylococci', 'and', 'gram-negative', 'bacilli', '(Pseudomonas).'], ['Patients', 'with', 'P.', 'jirovecii', 'pneumonia', 'have,', 'in', '90%', 'of', 'cases,', 'a', 'CD4', 'count', '<', '250', 'cells/mL.'], ['Other', 'agents', 'that', 'can', 'cause', 'pulmonary', 'involvement', 'less', 'frequently', 'are', 'Rhodococcus', 'equi,', 'Nocardia,', 'Aspergillus,', 'Cryptococcus,', 'Toxoplasma', 'and', 'Leishmania.'], ['Although', 'the', 'frequency', 'of', 'the', 'different', 'opportunistic', 'infections', 'has', 'varied', 'as', 'a', 'consequence', 'of', 'the', 'administration', 'of', 'highly', 'effective', 'antiretroviral', 'treatments,', 'our', 'patient', 'would', 'be', 'in', 'a', 'setting', 'where', 'he', 'has', 'not', 'yet', 'received', 'HAART.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'O', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O']]"
76_87,"[['QUESTION', 'TYPE:', 'ANESTHESIOLOGY,', 'CRITICAL', 'CARE', 'AND', 'EMERGENCIES'], ['CLINICAL', 'CASE:'], ['76-year-old', 'woman', 'with', 'obesity', 'and', 'type', '2', 'diabetes', 'mellitus', 'on', 'metformin.'], ['She', 'comes', 'to', 'the', 'emergency', 'room', 'because', 'for', '3', 'days', 'she', 'presents', 'fever', 'of', '38ºC,', 'polyuria,', 'dysuria,', 'intense', 'thirst', 'and', 'progressive', 'decrease', 'in', 'the', 'level', 'of', 'consciousness.'], ['Physical', 'examination', 'showed', 'signs', 'of', 'dehydration,', 'BP', '95/54', 'mm', 'Hg', 'and', 'no', 'signs', 'of', 'neurological', 'localization.'], ['The', 'CBC', 'shows', 'leukocytosis,', 'creatinine', 'of', '1.8', 'mg/dL', 'and', 'blood', 'glucose', 'of', '855', 'mg/dL.'], ['What', 'is', 'the', 'most', 'likely', 'diagnosis?'], ['1-', 'Hyperglycemic', 'hyperosmolar', 'non-ketotic', 'hyperglycemic', 'coma.'], ['2-', 'Cardiac', 'failure.'], ['3-', 'Subdural', 'hematoma.'], ['4-', 'Obstructive', 'renal', 'failure.'], ['5-', 'Diabetic', 'ketoacidosis', 'with', 'coma.'], ['CORRECT', 'ANSWER:', '1'], ['The', 'question', 'relates', 'the', 'case', 'of', 'a', 'type', '2', 'diabetic', 'patient', 'with', 'hyperglycemia', 'and', 'decreased', 'level', 'of', 'consciousness', 'without', 'neurological', 'focality', 'in', 'the', 'context', 'of', 'a', 'urinary', 'tract', 'infection', 'and', 'who', 'has', 'developed', 'acute', 'renal', 'failure', 'of', 'probable', 'prerenal', 'origin.'], ['Option', '2', 'is', 'immediately', 'ruled', 'out', 'because', 'the', 'clinical', 'picture', 'is', 'not', 'one', 'of', 'heart', 'failure.'], ['Option', '3', 'is', 'also', 'discarded', 'because', 'it', 'does', 'not', 'fit', 'with', 'the', 'clinical', 'picture', 'and', 'in', 'addition', 'HSD', 'would', 'give', 'neurological', 'symptoms', 'with', 'locality.'], ['Option', '4', 'is', 'discarded', 'because', 'obstructive', 'renal', 'failure', 'does', 'not', 'give', 'polyuria,', 'dysuria', 'or', 'the', 'rest', 'of', 'the', 'clinical', 'picture.'], ['Option', '5', 'is', 'less', 'likely', 'because', 'diabetic', 'ketoacidosis', 'is', 'more', 'typical', 'of', 'type', '1', 'DM.'], ['Therefore', 'the', 'correct', 'option', 'is', '1.']]","[['O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
159_111,"[['QUESTION', 'TYPE:', 'UROLOGY'], ['CLINICAL', 'CASE:'], ['A', '45-year-old', 'male', 'patient', 'with', 'a', 'history', 'of', 'uric', 'lithiasis', 'with', 'repeated', 'expulsive', 'nephritic', 'colic', 'for', '25', 'years,', 'comes', 'to', 'the', 'ED', 'referring', 'palpitations', 'and', 'intense', 'right', 'lumbar', 'pain', 'since', '2', 'hours', 'before.'], ['Urinalysis', 'showed', 'a', 'pH', 'of', '5.5', 'and', 'leukocyturia', 'without', 'proteinuria.'], ['The', 'ECG', 'confirms', 'a', 'previously', 'unknown', 'atrial', 'fibrillation.'], ['Blood', 'biochemistry', 'shows', 'a', 'creatinine', 'of', '0.9mg/dl,', 'a', 'calcium', 'of', '11mg/dl', 'and', 'an', 'LDH', 'of', '950', 'U/l.'], ['What', 'is', 'the', 'most', 'useful', 'diagnostic', 'maneuver', 'to', 'perform?'], ['1-', 'Simple', 'abdominal', 'X-ray.'], ['2-', 'IVU.'], ['3-', 'CT', 'with', 'contrast.'], ['4-', 'Abdominal', 'echography.'], ['5-', 'Doppler', 'echocardiography.'], ['CORRECT', 'ANSWER:', '3'], ['In', 'this', 'question', 'I', 'have', 'more', 'doubts', 'as', 'to', 'which', 'is', 'the', 'correct', 'answer,', 'since', 'we', 'must', 'interpret', 'which', 'is', 'the', 'most', 'useful', 'test,', 'with', 'which', 'we', 'can', 'obtain', 'more', 'performance.'], ['However,', 'this', 'situation', 'also', 'depends', 'on', 'the', 'radiology', 'services', 'of', 'each', 'center', 'and', 'their', 'preferences.'], ['I', 'will', 'focus', 'on', 'the', 'urological', 'part,', 'leaving', 'aside', 'the', 'rest', 'of', 'the', 'symptomatology.'], ['-', 'Abdominal', 'X-ray', 'is', 'the', 'first', 'imaging', 'study', 'to', 'be', 'performed', 'because', 'it', 'is', 'fast,', 'simple', 'and', 'practically', 'innocuous', '(except', 'in', 'children', 'and', 'pregnant', 'women).'], ['90%', 'of', 'the', 'stones', 'are', 'radiopaque', 'and', 'therefore', 'visible,', 'but', 'the', 'sensitivity', 'of', 'this', 'test,', 'used', 'in', 'isolation,', 'decreases', 'to', '45-59%.'], ['It', 'is', 'a', 'mandatory', 'test', 'in', 'any', 'suspicion', 'of', 'colic', 'pain.'], ['However,', 'it', 'has', 'a', 'lower', 'yield', 'than', 'the', 'others.'], ['Although', 'the', 'urological', 'history', 'speaks', 'of', 'uric', 'lithiasis', '(radiotransparent),', 'with', 'an', 'acid', 'pH', 'that', 'reaffirms', 'the', 'diagnosis', 'of', 'uric', 'origin,', 'we', 'can', 'never', 'rule', 'out', 'calcium', 'oxalate', 'lithiasis', 'that', 'can', 'appear', 'synchronously.'], ['-', 'IVUS', 'seems', 'to', 'me', 'to', 'be', 'one', 'of', 'the', 'best', 'performing', 'options.'], ['It', 'will', 'give', 'us', 'diagnostic', 'clarity', 'of', 'obstruction,', 'its', 'magnitude', 'and', 'its', 'renal', 'repercussions.'], ['It', 'has', 'long', 'been', 'considered', 'the', 'examination', 'of', 'choice', 'for', 'the', 'study', 'of', 'patients', 'with', 'renal', 'lithiasis.'], ['It', 'is', 'a', 'test', 'with', 'high', 'sensitivity', 'and', 'specificity', '(87-90%', 'and', '94-100%,', 'respectively),', 'relatively', 'innocuous,', 'and', 'available', 'in', 'all', 'hospitals.'], ['It', 'informs', 'us', 'of', 'the', 'number,', 'size,', 'shape', 'and', 'location', 'of', 'the', 'stone,', 'as', 'well', 'as', 'the', 'functional', 'status', 'of', 'the', 'affected', 'kidney.'], ['-', 'Contrast-enhanced', 'CT', 'seems', 'to', 'me', 'to', 'be', 'the', 'most', 'efficient', 'option.'], ['It', 'serves', 'to', 'discover', 'lithiasis', 'that', 'other', 'tests', 'cannot', 'find', 'and', 'gives', 'us', 'a', 'global', 'image', 'of', 'the', 'rest', 'of', 'the', 'structures.'], ['Great', 'performance', 'but', 'also', 'more', 'expensive,', 'more', 'time,', 'more', 'radiation.'], ['It', 'has', 'been', 'confirmed', 'as', 'a', 'high', 'sensitivity', 'and', 'specificity', 'scan,', 'surpassing', 'previous', 'tests', '(94-100%', 'and', '92-100%,', 'respectively,', 'for', 'the', 'detection', 'of', 'ureteral', 'calculi)', 'and', 'with', 'its', 'numerous', 'advantages', 'it', 'has', 'become', 'the', 'reference', 'test', 'and', 'is', 'expected', 'to', 'replace', 'IVUS', 'and', 'ultrasound', 'worldwide.'], ['It', 'performs', 'a', 'helical', 'scan', 'with', '5', 'mm', 'slices', 'allowing', 'the', 'detection', 'of', 'stones', 'up', 'to', '2', 'mm.'], ['With', 'the', 'administration', 'of', 'contrast,', 'it', 'allows', 'the', 'evaluation', 'of', 'renal', 'function.'], ['-', 'Ultrasound', 'is', 'a', 'fast,', 'cheap', 'and', 'innocuous', 'test,', 'but', 'very', 'radiologist-dependent.'], ['It', 'gives', 'great', 'renal', 'information', 'on', 'obstructive', 'repercussions,', 'but', 'less', 'quality', 'in', 'terms', 'of', 'finding', 'a', 'lithiasis.'], ['Ultrasonography', 'only', 'detects', 'calculi', 'larger', 'than', '4', 'mm,', 'located', 'in', 'the', 'pyelo-ureteral', 'junction', 'or', 'the', 'uretero-vesical', 'junction,', 'while', 'the', 'lumbar', 'and', 'pelvic', 'ureter', 'is', 'not', 'very', 'accessible', 'due', 'to', 'the', 'interposition', 'of', 'the', 'intestinal', 'loops.'], ['Therefore,', 'ultrasound', 'performed', 'in', 'isolation', 'is', 'not', 'very', 'sensitive', '(20-45%)', 'for', 'the', 'detection', 'of', 'calculi,', 'but', 'associated', 'with', 'simple', 'abdominal', 'radiography', 'increases', 'its', 'sensitivity', 'and', 'specificity.'], ['-', 'Doppler', 'echocardiography', 'has', 'no', 'use', 'in', 'urological', 'diagnosis.'], ['My', 'answer', 'would', 'be', 'CT', 'with', 'ev', 'contrast', 'and', 'excretory', 'phase', '(answer', '(c)),', 'in', 'terms', 'of', 'performance,', 'sensitivity', 'and', 'specificity.'], ['There', 'are', 'radiology', 'services', 'more', 'skilled', 'or', 'predisposed', 'to', 'one', 'or', 'the', 'other.'], ['Without', 'forgetting', 'that', 'abdominal', 'X-ray', 'should', 'always', 'be', 'done', 'in', 'the', 'suspicion', 'of', 'colic.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 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'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
52_144,"[['QUESTION', 'TYPE:', 'PSYCHIATRY'], ['CLINICAL', 'CASE:'], ['A', '36-year-old', 'patient', 'from', 'another', 'culture', 'who', 'has', 'been', 'living', 'in', 'Spain', 'for', 'the', 'last', '4', 'years', 'presents', 'at', 'a', 'National', 'Health', 'Service', 'office.'], ['He', 'reports', 'presenting', 'with', 'anxious', 'symptoms', 'and', 'depressive', 'mood', 'for', 'the', 'last', '10', 'months.'], ['This', 'condition', 'moderately', 'interferes', 'with', 'her', 'daily', 'activities.'], ['She', 'has', 'no', 'previous', 'psychiatric', 'history.'], ['This', 'situation', 'is', 'the', 'result', 'of', 'the', 'death,', 'in', 'a', 'car', 'accident,', 'of', 'an', 'older', 'brother', 'with', 'whom', 'he', 'was', 'very', 'close.'], ['Indicate', 'which', 'of', 'the', 'following', 'diagnoses', 'is', 'appropriate:'], ['1-', 'Major', 'depression.'], ['2-', 'Bipolar', 'II', 'disorder.'], ['3-', 'Adjustment', 'disorder.'], ['4-', 'Dysthymia.'], ['5-', 'Cyclothymia.'], ['CORRECT', 'ANSWER:', '3'], ['The', 'relative', 'mildness', 'of', 'the', 'symptoms,', 'which', 'do', 'not', 'seriously', 'interfere', 'with', 'daily', 'activities,', 'excludes', 'in', 'principle', 'the', 'diagnosis', 'of', 'major', 'depression.'], ['There', 'is', 'no', 'evidence', 'of', 'hypomanic', 'phases', 'to', 'justify', 'a', 'bipolar', 'II', 'disorder.'], ['Dysthymia', 'requires', 'a', 'duration', 'of', 'at', 'least', 'two', 'years.'], ['Cyclothymia', 'is', 'a', 'very', 'rare', 'diagnosis', 'nowadays', '(because,', 'as', 'Castilla', 'del', 'Pino', 'said', 'in', 'an', 'interview,', 'what', 'used', 'to', 'be', 'cyclothymics', 'are', 'now', 'called', 'bipolar,', 'contributing', 'to', 'one', 'of', 'the', 'multiple', 'psychiatric', 'epidemics', 'of', 'our', 'time),', 'which', 'consists', 'of', 'oscillations', 'between', 'the', 'depressive', 'pole', 'and', 'the', 'manifest,', 'mild.'], ['But', 'there', 'are', 'no', 'data', 'on', 'such', 'oscillations.'], ['The', 'correct', 'answer', 'is,', 'in', 'all', 'probability,', '3.'], ['The', 'adaptive', 'disorder', 'appears', 'within', '3', 'months', 'after', 'the', 'stressful', 'event', 'and', 'does', 'not', 'last', 'more', 'than', '6', 'months', 'if', 'the', 'stressful', 'event', 'or', 'its', 'consequences', 'have', 'ceased', '(which', 'is', 'not', 'the', 'case', 'because', 'the', 'brother', 'of', 'the', 'imaginary', 'patient', 'is', 'still', 'dead).'], ['Mild', 'anxious-depressive', 'symptoms', 'fit', 'such', 'a', 'diagnosis.'], ['One', 'more', 'example', 'of', 'how', 'to', 'conceptualize', 'as', 'illness', 'what', 'are', 'facts', '(albeit', 'painful)', 'of', 'life.'], ['Surely', 'the', 'imaginary', 'patient', 'takes', 'some', 'antidepressant', 'because', 'maybe', 'something', 'helps', '(1).']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 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'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O']]"
297_50,"[['QUESTION', 'TYPE:', 'INFECTIOUS', 'DISEASES'], ['CLINICAL', 'CASE:'], ['A', '58-year-old', 'man', 'reported', 'a', 'weeks-long', 'history', 'of', 'progressive,', 'mildly', 'painful', 'skin', 'lesions', 'on', 'his', 'left', 'arm.'], ['It', 'had', 'started', 'as', 'an', 'erythematous', 'lesion', 'on', 'his', 'left', 'thumb.'], ['He', 'had', 'visible', 'reddish', 'striae', 'as', 'connecting', 'lines', 'between', 'the', 'lesions.'], ['The', 'patient', 'had', 'no', 'fever', 'or', 'other', 'general', 'symptoms.'], ['He', 'had', 'been', 'working', 'in', 'his', 'garden', 'but', 'did', 'not', 'remember', 'any', 'injuries.'], ['The', 'etiologic', 'diagnosis', 'was', 'made', 'by', 'culture', 'of', 'a', 'skin', 'biopsy.'], ['What', 'is', 'the', 'most', 'likely', 'causative', 'agent', 'of', 'this', 'process?'], ['1-', 'Dermatophytosis', 'by', 'Microsporum', 'gypseum.'], ['2-', 'Cutaneous', 'infection', 'by', 'Staphylococcus', 'aureus.'], ['3-', 'Sporotrichosis.'], ['4-', 'Cutaneous', 'infection', 'by', 'Mycobacterium', 'marinum.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['The', 'patient', 'carries', 'out', 'an', 'activity', 'in', 'contact', 'with', 'soil', 'and', 'plants', '(which', 'are', 'not', 'provided', 'free', 'of', 'charge).'], ['The', 'symptoms', 'are', 'chronic,', 'which', 'started', 'distally', '(left', 'thumb)', 'and', 'are', 'affecting', 'the', 'ipsilateral', 'arm', '(reddish', 'striae).'], ['There', 'were', 'no', 'systemic', 'symptoms.'], ['They', 'also', 'comment', 'that', 'the', 'diagnosis', 'was', 'made', 'on', 'the', 'basis', 'of', 'a', 'skin', 'biopsy.'], ['Of', 'the', 'microorganisms', 'discussed,', 'Microsporum', 'gypseum', 'does', 'not', 'usually', 'manifest', 'dissemination', 'of', 'infection', 'of', 'a', 'lymphangitic', 'aspect,', 'in', 'general', 'keratinophilic', 'fungi', '(dermatophytes)', 'do', 'not', 'have', 'any', 'ability', 'to', 'invade', 'deep', 'tissues,', 'so', 'we', 'ruled', 'out', 'this', 'option.'], ['Staphylococcus', 'aureus', 'infection', 'can', 'affect', 'superficial', 'and', 'deep', 'tissue', 'layers,', 'they', 'can', 'spread', 'following', 'a', 'lymphangitic', 'path,', 'but', 'it', 'is', 'not', 'usual', 'such', 'a', 'long', 'evolution,', 'it', 'is', 'usually', 'acute', '(days)', 'and', 'usually', 'accompanied', 'by', 'systemic', 'symptoms,', 'so', 'we', 'discard', 'this', 'option.'], ['Mycobacterium', 'marinum', '(and', 'not', 'Mycobacterum', 'marinum)', 'is', 'a', 'non-tuberculous', 'mycobacterium', 'characterized', 'by', 'being', 'environmental,', 'opportunistic', 'and', 'photochromogenic.'], ['It', 'has', 'a', 'slow', 'growth,', 'from', '2', 'to', '8', 'weeks,', 'at', 'a', 'temperature', 'ranging', 'from', '30', 'to', '37', '°C.'], ['It', 'affects', 'different', 'species', 'of', 'fish', 'in', 'cold,', 'warm,', 'fresh', 'or', 'salt', 'water,', 'especially', 'stagnant', 'waters', 'of', 'fish', 'tanks', 'and', 'pools', 'without', 'chlorine.'], ['Infection', 'in', 'humans', 'occurs', 'by', 'direct', 'contact', 'with', 'fish', 'or', 'contaminated', 'water', 'in', 'the', 'presence', 'of', 'a', 'loss', 'of', 'continuity', 'in', 'the', 'skin', 'of', 'the', 'host.'], ['Our', 'patient', 'has', 'no', 'history', 'of', 'exposure', 'to', 'fish', 'or', 'water', '(they', ""don't"", 'say),', 'so', 'considering', 'that', 'usually', 'the', 'diagnosis', 'is', 'based', 'on', 'a', 'high', 'index', 'of', 'suspicion', 'and', 'specifically', 'asking', 'for', 'this', 'history,', 'our', 'case', 'is', 'far', 'from', 'this', 'possibility.'], ['The', 'Sporothrix', 'schenckii', 'complex', 'is', 'the', 'causative', 'agent', 'of', 'Sporotrichosis,', 'this', 'dimorphic', 'fungus', 'is', 'located', 'in', 'the', 'soil,', 'the', 'complex', 'is', 'formed', 'by', '5', 'species,', 'S.', 'schenckii', 'sensu', 'strictu,', 'S.', 'brasiliensis', 'and', 'S.', 'globosa,', 'capable', 'of', 'causing', 'human', 'and', 'animal', 'disease;', 'the', 'other', 'two', 'are', 'S.', 'mexicana', 'and', 'S.', 'albicana', 'not', 'associated', 'with', 'any', 'disease.'], ['Patients', 'are', 'usually', 'infected', 'by', 'exposure', 'to', 'soil', 'by', 'means', 'of', 'a', 'sharp', 'object', '(thorns,', 'stems,', 'animal', 'claws,', 'etc.)', 'and', 'have', 'a', 'slow', 'evolution,', 'affect', 'deep', 'tissues', 'and', 'their', 'dissemination', 'typically', 'follows', 'a', 'pathway', 'as', 'described', 'in', 'the', 'question.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
74_63,"[['QUESTION', 'TYPE:', 'ANESTHESIOLOGY,', 'CRITICAL', 'CARE', 'AND', 'EMERGENCIES'], ['CLINICAL', 'CASE:'], ['A', '67-year-old', 'woman', 'with', 'a', 'history', 'of', 'congestive', 'heart', 'failure', '(treated', 'with', 'ramipril', 'and', 'furosemide)', 'and', 'type', '2', 'diabetes', '(treated', 'with', 'insulin)', 'comes', 'to', 'the', 'emergency', 'room', 'for', 'dyspnea.'], ['Blood', 'gas', 'analysis', 'performed', 'while', 'breathing', 'room', 'air', 'shows', 'pH', '7.45,', 'paO2', '56,', 'PaCO2', '30', 'mm', 'Hg,', 'HCO3', '26', 'mm', 'Hg.'], ['What', 'gasometric', 'alteration', 'does', 'the', 'patient', 'present?'], ['1-', 'Hypoxemic', 'respiratory', 'failure', 'with', 'compensated', 'respiratory', 'alkalosis.'], ['2-', 'Acute', 'metabolic', 'alkalosis', 'with', 'hypoxemic', 'and', 'hypocapnic', 'respiratory', 'failure.'], ['3-', 'Chronic', 'normocapnic', 'respiratory', 'insufficiency,', 'without', 'alteration', 'of', 'acid-base', 'balance.'], ['4-', 'Chronic', 'hypoxemic', 'respiratory', 'failure', 'with', 'compensated', 'metabolic', 'acidosis.'], ['5-', 'Hypoxemic', 'respiratory', 'failure', 'with', 'compensated', 'mixed', 'alkalosis.'], ['CORRECT', 'ANSWER:', '1'], ['I', 'found', 'this', 'question', 'tricky.'], ['The', 'separate', 'findings', 'are:', 'normal', 'pH', 'but', 'with', 'alkalosis', 'tendency,', 'acute', 'respiratory', 'failure,', 'hypocapnia', 'and', 'normal', 'bicarbonate.'], ['The', 'most', 'appropriate', 'answer', 'seems', 'to', 'me', 'to', 'be', '1,', 'since', 'the', 'patient', 'does', 'not', 'present', 'a', 'metabolic', 'alkalosis', '(bicarbonate', 'would', 'be', 'higher),', 'much', 'less', 'an', 'acidosis', '(bicarbonate', 'would', 'be', 'low).'], ['The', 'alkalosis', 'is', 'not', 'mixed', 'either,', 'but', 'is', 'mainly', 'respiratory.'], ['The', 'patient', 'is', 'probably', 'hyperventilating', 'because', 'of', 'her', 'respiratory', 'failure,', 'and', 'the', 'kidney', 'which', 'always', 'compensates', 'later', 'is', 'starting', 'to', 'retain', 'HCO3', 'to', 'compensate', 'and', 'maintain', 'pH.'], ['Therefore', 'I', 'believe', 'the', 'correct', 'answer', 'is', '1.']]","[['O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['O', 'O', 'O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
288_227,,
460_174,"[['QUESTION', 'TYPE:', 'TRAUMATOLOGY', 'AND', 'ORTHOPEDICS'], ['CLINICAL', 'CASE:'], ['A', '60-year-old,', 'insulin-dependent', 'diabetic', 'woman', 'presents', 'with', 'right-sided,', 'nocturnal-predominant', 'omalgia', 'of', 'several', ""weeks'"", 'duration.'], ['She', 'does', 'not', 'report', 'any', 'trauma.'], ['Physical', 'examination', 'shows', 'active', 'and', 'passive', 'limitation', 'of', 'all', 'the', 'arcs', 'of', 'movement', 'of', 'the', 'shoulder.'], ['Which', 'clinical', 'picture', 'do', 'you', 'suspect', 'as', 'the', 'first', 'diagnostic', 'possibility?'], ['1-', 'A', 'malignant', 'tumor', 'located', 'in', 'the', 'proximal', 'epiphysis', 'of', 'the', 'humerus.'], ['2-', 'Septic', 'arthritis', 'of', 'the', 'shoulder.'], ['3-', 'Adhesive', 'capsulitis.'], ['4-', 'A', 'degenerative', 'acromioclavicular', 'arthrosis', 'process.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['Everything', 'points', 'to', 'adhesive', 'capsulitis,', 'as', 'you', 'say.'], ['The', 'age,', 'the', 'sex,', 'the', 'clinic...', 'the', 'DM....']]","[['O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
333_90,"[['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['A', '35-year-old', 'woman', 'consults', 'for', 'a', 'right', 'thyroid', 'nodule', 'detected', 'incidentally', 'one', 'morning', 'when', 'she', 'observed', 'in', 'the', 'mirror', 'a', 'lump', 'on', 'the', 'anterior', 'aspect', 'of', 'the', 'neck.'], ['After', 'the', 'pertinent', 'studies,', 'it', 'was', 'decided', 'to', 'operate', 'on', 'the', 'patient,', 'performing', 'a', 'total', 'thyroidectomy', 'with', 'emptying', 'of', 'the', 'central', 'lymph', 'node', 'component.'], ['The', ""pathologist's"", 'report', 'was', 'that', 'the', '2.3', 'cm', 'thyroid', 'nodule', 'was', 'entirely', 'occupied', 'by', 'a', 'papillary', 'thyroid', 'carcinoma,', 'tall', 'cell', 'variant,', 'without', 'vascular', 'infiltration', 'but', 'with', 'capsular', 'infiltration.'], ['Thyroglobulin', 'concentrations', '24', 'h', 'after', 'thyroidectomy', 'are', '14', 'ng/mL.'], ['What', 'would', 'be', 'the', 'next', 'step', 'you', 'would', 'take', 'in', 'this', 'patient?'], ['1-', 'Refer', 'patient', 'back', 'to', 'surgeon', 'for', 'right', 'laterocervical', 'lymph', 'node', 'stripping.'], ['2-', 'Initiate', 'treatment', 'with', 'a', 'dose', 'of', 'TSH-suppressing', 'levothyroxine', 'and', 'schedule', 'for', 'review', '6', 'months', 'later', 'with', 'a', 'new', 'analytical', 'determination', 'of', 'thyroglobulin', 'and', 'cervical', 'ultrasound.'], ['3-', 'Request', 'a', 'PET-CT', 'scan', 'for', 'lymph', 'node', 'involvement.'], ['4-', 'Delay', 'initiation', 'of', 'TSH', 'replacement-suppressive', 'treatment', 'with', 'levothyroxine', 'and', 'refer', 'the', 'patient', 'to', 'the', 'Nuclear', 'Medicine', 'service', 'for', 'administration', 'of', 'an', 'ablative', 'dose', 'of', '100', 'mCi', 'of', 'I131.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '4'], ['The', 'verification', 'of', 'the', 'presence', 'of', 'thyroglobulin', 'in', 'blood', 'and', 'the', 'development', 'of', 'techniques', 'by', 'which', 'it', 'can', 'be', 'determined', 'have', 'provided', 'a', 'new', 'procedure', 'for', 'monitoring', 'patients', 'with', 'papillary', 'or', 'follicular', 'thyroid', 'carcinoma.'], ['Thyroglobulin', 'is', 'synthesized', 'in', 'the', 'follicular', 'cells', 'and', 'then', 'secreted', 'into', 'the', 'circulation,', 'therefore,', 'after', 'total', 'thyroidectomy', 'it', 'should', 'disappear,', 'if', 'this', 'does', 'not', 'occur', 'we', 'must', 'think', 'about', 'the', 'existence', 'of', 'remnants', 'of', 'metastatic', 'tissue.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
185_66,"[['QUESTION', 'TYPE:', 'ENDOCRINOLOGY'], ['CLINICAL', 'CASE:'], ['A', '74-year-old', 'patient', 'with', 'bowel', 'resection', 'following', 'mesenteric', 'thrombosis', 'comes', 'to', 'consult', 'for', 'fatigue', 'and', 'bone', 'pain.'], ['He', 'had', 'suffered', 'a', ""Colles'"", 'fracture', 'three', 'months', 'earlier.'], ['Laboratory', 'tests', 'showed', 'anemia', 'of', '9.5', 'g/dl,', 'microcytic,', 'albumin', '3.5', 'g/di,', 'calcium', '7.5', 'mg/dl,', 'phosphate', '2.0', 'mg/dl', 'and', 'alkaline', 'phosphatase', '224', 'IU', '(normal', 'up', 'to', '120', 'IU).'], ['Radiographs', 'of', 'the', 'femur', 'show', 'radiolucent', 'bands', 'perpendicular', 'to', 'the', 'cortex', 'on', 'the', 'inner', 'side', 'of', 'the', 'upper', 'femur.'], ['What', 'is', 'the', 'most', 'likely', 'diagnosis?'], ['1-', 'Osteoporosis.'], ['2-', ""Paget's"", 'disease.'], ['3-', 'Osteitis', 'fibrosa.'], ['4-', 'Prostate', 'cancer', 'metastasis.'], ['5-', 'Osteomalacia.'], ['CORRECT', 'ANSWER:', '5'], ['Although', 'this', 'one', 'had', 'not', 'been', 'assigned', 'to', 'me,', 'I', 'am', 'answering', 'it', 'as', 'well', 'since', 'it', 'deals', 'with', 'an', 'endocrinology', 'topic:', 'vitamin', 'D.'], ['In', 'this', 'case', 'there', 'are', 'important', 'data', 'such', 'as', 'the', 'history', 'of', 'intestinal', 'resection,', 'hypocalcemia', 'and', 'hypophosphoremoia;', 'this', 'should', 'lead', 'us', 'to', 'think', 'in', 'a', 'vitamin', 'D', 'deficit', 'due', 'to', 'malabsorption', 'and', 'therefore,', 'in', 'an', 'osteomalacia.'], ['The', 'rest', 'of', 'the', 'data:', 'previous', 'fracture,', 'pain', 'and', 'the', 'X-ray', 'support', 'the', 'diagnosis.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
107_206,"[['QUESTION', 'TYPE:', 'GENETICS', 'AND', 'IMMUNOLOGY'], ['CLINICAL', 'CASE:'], ['An', '8-year-old', 'girl', '(index', 'case)', 'is', 'clinically', 'diagnosed', 'as', 'having', 'neurofibromatosis', 'type', '1', '(NF1)', 'or', 'Von', ""Recklinghausen's"", 'disease', 'with', 'multiple', 'neurofibromas,', 'café-au-lait', 'spots,', 'and', 'Lisch', 'nodules.'], ['Her', 'father', '(not', 'diagnosed', 'with', 'NF1)', 'died', 'in', 'a', 'traffic', 'accident', 'at', 'the', 'age', 'of', '38', 'years.'], ['On', 'examination,', 'the', 'mother', 'presents', 'two', 'café-au-lait', 'spots', 'and', 'attends', 'the', 'genetic', 'counseling', 'consultation', 'with', 'her', 'new', 'partner', 'where', 'a', 'preimplantation', 'genetic', 'diagnosis', '(PGD)', 'is', 'proposed.'], ['Is', 'PGD', 'indicated', 'in', 'this', 'case?'], ['1-', 'Yes,', 'as', 'the', 'mother', 'has', '2', 'café-au-lait', 'spots,', 'she', 'is', 'a', 'carrier', 'and', 'PGD', 'is', 'indicated', 'with', 'these', 'data.'], ['2-', 'It', 'is', 'indicated', 'after', 'detection', 'of', 'the', 'causative', 'mutation', 'in', 'the', 'index', 'case', 'and', 'eventually', 'in', 'his', 'mother.'], ['3-', 'It', 'is', 'not', 'indicated', 'because', 'NF1', 'responds', 'to', 'mutations', 'in', 'the', 'neurofibromin', 'gene', '(17q11.2),', 'with', 'recessive', 'inheritance.'], ['4-', 'No,', 'two', 'café-au-lait', 'spots', 'are', 'not', 'diagnostic', 'and', 'your', 'new', 'partner', 'is', 'very', 'unlikely', 'to', 'be', 'a', 'carrier', '(NF1', 'is', 'a', 'rare', 'disease).'], ['5-', 'With', 'these', 'data,', 'PGD', 'is', 'indicated,', 'consisting', 'of', 'selecting', 'embryos', 'in', 'vitro,', 'to', 'implant', 'in', 'the', 'maternal', 'uterus', 'those', 'without', 'the', 'mutation.'], ['CORRECT', 'ANSWER:', '2'], ['The', 'first', 'step', 'is', 'to', 'detect', 'the', 'mutation', 'and', 'once', 'detected,', 'if', 'the', 'mother', 'is', 'a', 'carrier,', 'to', 'proceed', 'with', 'PGD.']]","[['O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'B-Diagnostics', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
114_96,"[['QUESTION', 'TYPE:', 'HEMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '43-year-old', 'woman', 'consults', 'her', 'primary', 'care', 'physician', 'for', 'fatigue,', 'gingivorrhea', 'and', 'petechiae.'], ['Laboratory', 'tests', 'showed', 'anemia', 'of', '8', 'g/dL,', 'thrombopenia', 'of', '4000/microliter', 'and', 'leukopenia', 'of', '1200/microliter', 'with', 'absolute', 'neutropenia.'], ['The', 'coagulation', 'study', 'showed', 'APTT', 'elongation', '(43″),', 'decreased', 'prothrombin', 'activity', '(55%),', 'hypofibrinogenemia', '(98', 'mg/dl)', 'and', 'presence', 'of', 'high', 'concentration', 'of', 'D-Dimer', 'and', 'fibrin', 'monomers.'], ['She', 'is', 'referred', 'for', 'urgent', 'hematologic', 'workup', 'and', 'a', 'bone', 'marrow', 'aspirate', 'is', 'performed', 'showing', 'massive', 'infiltration', 'by', 'immature', 'elements', 'with', 'cleaved', 'nuclei', 'and', 'Auer', 'rods', 'in', 'the', 'cytoplasm.'], ['What', 'is', 'the', 'most', 'likely', 'diagnosis', 'in', 'this', 'patient?'], ['1-', 'Chronic', 'myeloid', 'leukemia.'], ['2-', 'Acute', 'promyelocytic', 'leukemia.'], ['3-', 'Acute', 'monoblastic', 'leukemia.'], ['4-', 'Chronic', 'lymphoid', 'leukemia.'], ['5-', 'Acute', 'lymphoid', 'leukemia.'], ['CORRECT', 'ANSWER:', '2'], ['After', 'reading', 'such', 'a', 'long', 'statement,', 'running', 'out', 'of', 'breath,', 'going', 'over', 'it', 'and', 'getting', 'overwhelmed,', 'it', 'is', 'time', 'to', 'take', 'a', 'look', 'at', 'it', 'and', 'grasp', 'at', 'something', 'very', 'characteristic.'], ['A', 'woman', 'with', 'pancytopenia.'], ['A', 'bone', 'marrow', 'showing', 'massive', 'infiltration', 'by', 'immature', 'elements', 'that', 'are', 'proliferating', 'non-stop...with', ""Auer's"", 'canes?'], ['Acute', 'promyelocytic', 'leukemia.'], ['Those', 'rods', 'are', 'the', 'fusion', 'of', 'primary', 'granules', 'of', 'developing', 'myelocytes.'], ['Robin&Cotran', 'say', 'so', 'on', 'page', '696', 'of', 'their', 'book', '""General', 'Pathology""', '[1].'], ['It', 'is', 'also', 'said', 'by', 'Carr', 'and', 'Rodak', 'in', 'their', 'book', '""Atlas', 'of', 'clinical', 'hematology""', 'on', 'page', '157', '[2].']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Disease', 'I-Disease', 'I-Disease'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Disease', 'I-Disease', 'I-Disease'], ['O', 'O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O']]"
61_92,"[['QUESTION', 'TYPE:', 'ANESTHESIOLOGY', 'AND', 'CRITICAL', 'CARE'], ['CLINICAL', 'CASE:'], ['A', '30-year-old', 'man', 'suffers', 'fall', 'from', 'a', 'standing', 'height', 'of', '2', 'meters.'], ['On', 'arrival', 'at', 'the', 'ER,', 'he', 'is', 'cyo,', 'catheterized', 'with', 'clear', 'urine.'], ['He', 'shows', 'swelling', 'of', 'the', 'left', 'heel,', 'as', 'well', 'as', 'mild', 'tingling', 'in', 'the', 'anterior', 'aspect', 'of', 'the', 'right', 'thigh', 'and', 'scrotum,', 'and', 'dysesthesia', 'in', 'both', 'feet.'], ['The', 'patient', 'says', 'goodbye', 'to', 'the', 'stretcher-bearer', 'with', 'a', 'handshake,', 'with', 'a', 'simultaneous', 'pat', 'on', 'the', 'shoulder.'], ['Rotation', 'of', 'the', 'MMII', 'on', 'the', 'stretcher', 'grasped', 'by', 'the', 'ankles', 'is', 'painless', 'and', 'compression', 'of', 'the', 'pelvis', 'is', 'asymptomatic.'], ['Next:'], ['1-', 'We', 'will', 'sit', 'him', 'on', 'the', 'stretcher', 'to', 'be', 'able', 'to', 'explore', 'the', 'cervical', 'spine.'], ['2-', 'We', 'will', 'refer', 'to', 'Rx', 'to', 'perform', 'lower', 'extremities', 'study.'], ['3-', 'Palpate', 'the', 'abdomen', 'and', 'rotate', 'it', 'en', 'bloc', 'to', 'palpate', 'the', 'thoracolumbar', 'spine.'], ['4-', 'Place', 'a', 'cervical', 'collar', 'and', 'refer', 'to', 'radiology', 'for', 'cervical', 'spine', 'and', 'lower', 'extremity', 'imaging.'], ['5-', 'We', 'will', 'request', 'an', 'abdominal', 'echo.'], ['CORRECT', 'ANSWER:', '3'], ['From', 'the', 'symptoms', 'reported,', 'tingling', 'in', 'the', 'anterior', 'thigh,', 'scrotum', 'and', 'dysesthesia', 'in', 'the', 'feet,', 'there', 'seems', 'to', 'be', 'a', 'vertebral', 'involvement', 'at', 'L2-3', 'and', 'sacral', 'roots,', 'so', 'the', 'correct', 'thing', 'to', 'do', 'would', 'be', 'to', 'perform', 'a', 'radiological', 'examination', 'without', 'mobilizing', 'the', 'patient.'], ['But', 'it', 'is', 'necessary', 'to', 'mobilize', 'him', 'to', 'explore', 'him,', 'obviously,', 'en', 'bloc.'], ['The', 'cervical', 'spine', 'seems', 'to', 'be', 'undamaged', 'because', 'the', 'patient', 'mobilizes', 'both', 'arms', 'adequately,', 'without', 'paresthesia.']]","[['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise']]"
231_180,"[['QUESTION', 'TYPE:', 'PEDIATRICS'], ['CLINICAL', 'CASE:'], ['A', '1-month-old', 'infant', 'comes', 'to', 'the', 'hospital', 'emergency', 'department', 'referred', 'by', 'his', 'pediatrician', 'for', 'jaundice.'], ['He', 'reports', 'jaundice', 'for', '10', 'days', 'and', 'it', 'has', 'been', 'increasing.'], ['The', 'blood', 'test', 'showed', 'a', 'total', 'bilirubin', 'of', '7mg/dl', 'with', 'an', 'indirect', 'bilirubin', 'of', '1.5mg/dl.'], ['The', 'most', 'probable', 'cause,', 'among', 'the', 'following,', 'of', 'this', 'jaundice', 'is:'], ['1-', 'Bile', 'duct', 'atresia.'], ['2-', 'Breastfeeding', 'jaundice.'], ['3-', 'Late', 'onset', '0-A', 'isoimmunization.'], ['4-', ""Gilbert's"", 'disease.'], ['5-', 'Hereditary', 'spherocytosis.'], ['CORRECT', 'ANSWER:', '1'], ['The', 'increase', 'in', 'direct', 'bilirubin', 'immediately', 'rules', 'out', 'the', 'rest', 'of', 'the', 'options', 'where', 'the', 'increase', 'in', 'total', 'bilirubin', 'would', 'be', 'at', 'the', 'expense', 'of', 'indirect', 'bilirubin.'], ['Bile', 'duct', 'atresia', 'is', 'the', 'main', 'indication', 'for', 'infant', 'liver', 'transplantation.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
87_54,"[['QUESTION', 'TYPE:', 'CARDIOLOGY', 'AND', 'VASCULAR', 'SURGERY'], ['CLINICAL', 'CASE:'], ['An', '81-year-old', 'patient', 'consults', 'for', 'an', 'episode', 'of', 'syncope.'], ['He', 'reports', 'dyspnea', 'on', 'exertion', 'for', 'a', 'year.'], ['On', 'cardiac', 'auscultation', 'there', 'is', 'a', '3/6', 'systolic', 'murmur', 'on', 'the', 'left', 'sternal', 'border', 'radiating', 'to', 'the', 'carotids', 'and', 'tip.'], ['Which', 'pathology', 'seems', 'most', 'likely?'], ['1-', 'Third-degree', 'atrioventricular', 'block.'], ['2-', 'Degenerative', 'aortic', 'stenosis.'], ['3-', 'Mitral', 'valve', 'insufficiency.'], ['4-', 'Hypertrophic', 'cardiomyopathy.'], ['5-', 'Dilated', 'cardiomyopathy.'], ['CORRECT', 'ANSWER:', '2'], ['Very', 'easy', 'question.'], ['They', 'are', 'describing', 'the', '""portrait""', 'of', 'a', 'degenerative', 'aortic', 'stenosis...'], ['Elderly', 'patient', 'with', 'clinical', 'dyspnea', 'and', 'syncope,', 'and', 'systolic', 'murmur', 'radiating', 'to', 'carotids', 'and', 'tip,', 'all', 'typical', 'of', 'this', 'disease.']]","[['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise']]"
102_87,,
512_153,"[['QUESTION', 'TYPE:', 'DIGESTIVE'], ['CLINICAL', 'CASE:'], ['Patient', 'diagnosed', 'with', 'acute', 'diverticulitis,', 'treated', 'with', 'amoxicillin/clavulanic', 'acid.'], ['After', '5', 'days', 'he', 'starts', 'with', 'fever', 'and', 'diarrhea.'], ['He', 'was', 'diagnosed', 'with', 'Clostridium', 'difficile', 'colitis,', 'amoxicillin/clavulanic', 'acid', 'was', 'discontinued', 'and', 'metronidazole', 'was', 'prescribed.'], ['After', '4', 'days', 'he', 'has', 'not', 'responded', 'to', 'metronidazole,', 'but', 'is', 'clinically', 'stable.'], ['The', 'next', 'step', 'of', 'treatment', 'is:'], ['1-', 'Change', 'metronidazole', 'for', 'oral', 'vancomycin', '(125', 'mg,', 'four', 'times', 'a', 'day', 'for', '10', 'days).'], ['2-', 'Change', 'metronidazole', 'to', 'piperacillin/', 'tazobactam', '(4', 'g', 'piperacillin/0.5', 'g', 'tazobactam', 'every', '8', 'hours).'], ['3-', 'Indicate', 'a', 'subtotal', 'colectomy.'], ['4-', 'Loop', 'ileostomy', 'with', 'antegrade', 'polyethylene', 'glycol', 'lavage.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '1'], ['The', 'treatment', 'of', 'choice', 'for', 'Clostridioides', 'difficile', 'infection', 'is', 'vancomycin', 'orally', '125mg/6h', 'for', '10', 'days.'], ['Metronidazole', 'has', 'been', 'relegated', 'to', 'situations', 'where', 'vancomycin', 'is', 'not', 'available.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
218_123,,
493_107,"[['QUESTION', 'TYPE:', 'HEMATOLOGY'], ['CLINICAL', 'CASE:'], ['An', '18-year-old', 'patient', 'comes', 'to', 'the', 'emergency', 'department', 'with', 'epistaxis', 'of', 'several', ""days'"", 'evolution,', 'with', 'no', 'personal', 'or', 'family', 'history', 'of', 'interest.'], ['On', 'examination', 'he', 'is', 'afebrile,', 'multiple', 'ecchymoses', 'are', 'observed,', 'no', 'splenomegaly', 'is', 'palpable.'], ['Laboratory', 'tests:', 'leukocytes', '7.2', 'x103/μL,', 'Hb', '12.3', 'g/dL,', 'platelets', '6.0', 'x103/μL.'], ['Thrombocytopenia', 'is', 'confirmed', 'in', 'the', 'smear,', 'where', 'platelets', 'of', 'increased', 'size', 'are', 'observed.'], ['Coagulation', 'and', 'biochemistry', 'studies', 'are', 'normal.'], ['What', 'do', 'you', 'consider', 'the', 'most', 'probable', 'diagnosis?'], ['1-', 'Thrombotic', 'thrombocytopenic', 'purpura.'], ['2-', 'Disseminated', 'intravascular', 'coagulation.'], ['3-', 'Thrombocytopenia', 'induced', 'by', 'infection.'], ['4-', 'Primary', 'immune', 'thrombocytopenia.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '4'], ['If', 'they', 'wanted', 'us', 'to', 'answer', 'that', 'it', 'is', 'a', 'TTP', '(answer', '1)', 'they', 'would', 'probably', 'associate', 'anemia', 'and', 'in', 'the', 'smear', 'they', 'would', 'surely', 'tell', 'us', 'about', 'schistocytes.'], ['Not', 'to', 'say', 'that', 'the', ""patient's"", 'symptoms', 'would', 'probably', 'be', 'much', 'more', 'than', 'epistaxis.'], ['The', 'other', 'two', 'answers,', 'you', 'do', 'not', 'have', 'to', 'hesitate', 'with', 'them.'], ['Nothing', 'points', 'to', 'that.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
566_149,"[['QUESTION', 'TYPE:', 'NEPHROLOGY'], ['CLINICAL', 'CASE:'], ['A', '67-year-old', 'woman', 'with', 'chronic', 'kidney', 'disease', 'secondary', 'to', 'diabetic', 'nephropathy.'], ['She', 'currently', 'has', 'a', 'creatinine', 'of', '3.2', 'mg/dL', 'with', 'estimated', 'glomerular', 'filtration', 'rate', '(CKD-EPI)', '14', 'ml/min.'], ['Which', 'of', 'the', 'following', 'is', 'true?'], ['1-', 'He', 'presents', 'stage', '3', 'chronic', 'kidney', 'disease', 'and', 'should', 'initiate', 'phosphorus', 'chelators.'], ['2-', 'He', 'has', 'stage', '5', 'chronic', 'kidney', 'disease', 'and', 'renal', 'replacement', 'therapy', 'should', 'be', 'considered.'], ['3-', 'Good', 'glycemic', 'control', 'can', 'reverse', 'renal', 'failure.'], ['4-', 'It', 'is', 'unlikely', 'to', 'present', 'proteinuria', 'higher', 'than', '500', 'mg/24', 'h.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '2'], ['A', 'glomerular', 'filtration', 'rate', 'of', 'less', 'than', '15', 'ml/min', 'is', 'classified', 'as', 'stage', '5', '(G5),', 'indicating', 'that', 'the', 'renal', 'disease', 'is', 'end-stage', 'and', 'the', 'initiation', 'of', 'replacement', 'therapy', 'should', 'be', 'considered', '(option', '2', 'true,', 'option', '1', 'false).'], ['In', 'this', 'situation,', 'good', 'glycemic', 'control', 'is', 'not', 'expected', 'to', 'reverse', 'renal', 'damage,', 'although', 'it', 'may', 'help', 'to', 'delay', 'progression', '(false', 'choice', '3).'], ['These', 'patients', 'usually', 'present', 'stage', 'A3', 'albuminuria', '(above', '300', 'mg/24', 'h),', 'and', 'may', 'reach', 'the', 'nephrotic', 'range', '(false', 'choice', '4).']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim']]"
254_89,"[['QUESTION', 'TYPE:', 'DIGESTIVE', 'TRACT'], ['CLINICAL', 'CASE:'], ['A', '17-year-old', 'boy,', 'athletic', 'and', 'with', 'no', 'history', 'of', 'interest,', 'comes', 'to', 'the', 'doctor', 'for', 'occasional', 'conjunctival', 'jaundice.'], ['He', 'denies', 'drug', 'intake', 'and', 'abdominal', 'pain.'], ['Laboratory', 'tests', 'show', 'normal', 'ALT,', 'AST,', 'GGT', 'and', 'FA,', 'with', 'total', 'bilirubin', 'of', '3.2', 'mg/dl', 'and', 'direct', 'bilirubin', 'of', '0.4', 'mg/dl.'], ['She', 'has', 'no', 'anemia', 'and', 'the', 'liver', 'is', 'ultrasonographically', 'normal.'], ['What', 'is', 'her', 'diagnosis?'], ['1-', 'Rotor', 'syndrome.'], ['2-', 'Choledocholithiasis.'], ['3-', 'Dubin-Johnson', 'syndrome.'], ['4-', 'Acute', 'hepatitis.'], ['5-', ""Gilbert's"", 'syndrome.'], ['CORRECT', 'ANSWER:', '5'], ['An', 'increase', 'in', 'indirect', 'bilirubin', 'less', 'than', '5', '(intermittently,', 'under', 'stress)', 'in', 'a', 'young', 'healthy', 'boy', 'should', 'make', 'us', 'think', 'of', ""Gilbert's"", 'syndrome.'], ['In', 'Rotor', 'syndrome,', 'Dubin-Johnson', 'syndrome', 'and', 'choledocholithiasis', 'there', 'is', 'an', 'increase', 'in', 'direct', 'bilirubin.'], ['In', 'the', 'case', 'of', 'acute', 'hepatitis', 'there', 'should', 'be', 'an', 'elevation', 'of', 'transaminases.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
597_180,"[['QUESTION', 'TYPE:', 'RHEUMATOLOGY'], ['CLINICAL', 'CASE:'], ['26-year-old', 'woman', 'diagnosed', 'with', 'systemic', 'lupus', 'erythematosus,', 'on', 'treatment', 'with', 'hydroxychloroquine,', 'who', 'consults', 'for', 'a', 'feeling', 'of', 'generalized', 'weakness', 'that', 'has', 'progressively', 'set', 'in', 'over', 'the', 'last', '15', 'days.'], ['The', 'physical', 'examination', 'reveals', 'cutaneous', 'pallor', 'and', 'the', 'CBC', 'shows', 'Hb', '7.4', 'g/dL,', 'Hct', '31%,', 'MCV', '108.'], ['Which', 'of', 'the', 'following', 'determinations', 'will', 'be', 'most', 'useful', 'in', 'deciding', 'the', 'course', 'of', 'action?'], ['1-', 'Haptoglobin.'], ['2-', 'Coombs', 'test.'], ['3-', 'Vitamin', 'B12.'], ['4-', 'Antinuclear', 'antibodies.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '2'], ['In', 'this', 'question,', 'we', 'are', 'presented', 'with', 'a', 'patient', 'with', 'systemic', 'lupus', 'erythematosus', 'presenting', 'with', 'autoimmune', 'hemolytic', 'anemia.'], ['For', 'this,', 'the', 'best', 'option', 'would', 'be', 'to', 'request', 'reticulocytes,', 'however,', 'as', 'it', 'is', 'not', 'among', 'the', 'options,', 'we', 'should', 'request', 'a', ""Coombs'"", 'test,', 'so', 'the', 'correct', 'answer', 'is', '2.'], ['Although', 'they', 'want', 'to', 'confuse', 'us', 'with', 'a', 'MCV', '108,', 'so', 'that', 'we', 'think', 'of', 'a', 'megaloblastic', 'anemia,', 'the', 'MCV', 'is', 'not', 'excessively', 'high,', 'the', 'onset', 'of', 'anemia', 'in', 'our', 'patient', 'has', 'been', 'rapid', 'and', 'would', 'not', 'fit', 'with', 'SLE', 'or', 'the', 'form', 'of', 'presentation.'], ['Antinuclear', 'antibodies', 'are', 'used', 'for', 'diagnosis,', 'but', 'not', 'for', 'monitoring', 'SLE.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
571_170,"[['QUESTION', 'TYPE:', 'NEPHROLOGY'], ['CLINICAL', 'CASE:'], ['A', '75-year-old', 'woman', 'on', 'sertraline', 'treatment', 'who', 'comes', 'to', 'the', 'emergency', 'department', 'with', 'confusional', 'symptoms.'], ['There', 'is', 'no', 'evidence', 'of', 'edema', 'and', 'blood', 'pressure', 'is', '130/70.'], ['The', 'blood', 'test', 'shows', 'Na', '126', 'mEq/l', 'and', 'K', '4', 'mEq/l,', 'natriuria', 'is', '45', 'mEq/l', 'and', 'diuretic', 'intake', 'has', 'been', 'ruled', 'out.'], ['Which', 'of', 'the', 'following', 'is', 'the', 'most', 'correct', 'approach?'], ['1-', 'It', 'is', ""Addison's"", 'disease', 'and', 'corticosteroids', 'should', 'be', 'administered', 'immediately.'], ['2-', 'Administer', 'hypertonic', 'saline', 'to', 'restore', 'natremia', 'as', 'soon', 'as', 'possible.'], ['3-', 'Indicate', 'water', 'restriction', 'and', 'if', 'natremia', 'does', 'not', 'rise,', 'switch', 'to', 'slow', 'infusion', 'of', 'saline.'], ['4-', 'Request', 'brain', 'MRI,', 'since', 'it', 'is', 'probably', 'diabetes', 'insipidus.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['We', 'are', 'presented', 'with', 'a', 'patient', 'with', 'moderate', 'euvolemic', 'hyponatremia,', 'suggesting', 'a', 'syndrome', 'of', 'inadequate', 'antidiuresis', '(SIAD)', 'secondary', 'to', 'sertraline,', 'although', 'it', 'would', 'be', 'necessary', 'to', 'have', 'urinary', 'osmolality', 'to', 'confirm', 'this.'], ['Primary', 'adrenal', 'insufficiency', 'produces', 'hypovolemic', 'hyponatremia', '(incorrect', 'option', '1).'], ['Diabetes', 'insipidus', 'is', 'the', 'opposite', 'of', 'this', 'pathology,', 'usually', 'presenting', 'with', 'hypernatremia', '(option', '4', 'incorrect).'], ['The', 'question', 'remains', 'whether', 'to', 'treat', 'aggressively', 'with', 'hypertonic', 'saline,', 'or', 'to', 'be', 'more', 'conservative', 'by', 'indicating', 'hydric', 'restriction.'], ['With', 'natremia', 'above', '125', 'mmol/l', 'it', 'is', 'not', 'indicated', 'to', 'treat', 'with', 'HSS', 'unless', 'the', 'patient', 'has', 'severe', 'neurological', 'symptoms,', 'which', 'does', 'not', 'seem', 'to', 'be', 'the', 'case', '(they', 'describe', 'a', 'confusional', 'picture', 'that', 'would', 'be', 'a', 'moderate', 'hyponatremic', 'encephalopathy),', 'and', 'it', 'is', 'not', 'indicated', 'to', 'restore', 'natremia', 'as', 'soon', 'as', 'possible', '(due', 'to', 'the', 'risk', 'of', 'osmotic', 'demyelination', 'syndrome).'], ['Therefore,', 'the', 'correct', 'answer', 'would', 'be', '3.'], ['What', 'I', 'do', 'not', 'like', 'about', 'this', 'answer', 'is', 'that', 'the', 'second', 'part', '(""if', 'natraemia', 'does', 'not', 'rise,', 'switch', 'to', 'slow', 'infusion', 'of', 'saline"")', 'is', 'incorrect,', 'since', 'in', 'this', 'case', 'the', 'use', 'of', 'furosemide,', 'tolvaptan', 'or', 'urea', 'should', 'be', 'considered,', 'not', 'saline', '(and', 'it', 'does', 'not', 'indicate', 'tonicity', 'either,', 'since', 'isotonic', 'is', 'not', 'the', 'same', 'as', 'hypertonic).'], ['In', 'any', 'case,', 'I', 'do', 'not', 'see', 'it', 'as', 'very', 'likely', 'to', 'be', 'overridden.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
466_91,"[['QUESTION', 'TYPE:', 'ORTHOPEDIC', 'SURGERY', 'AND', 'TRAUMATOLOGY'], ['CLINICAL', 'CASE:'], ['An', '11-year-old,', '6-month-old,', 'premenarchal', 'girl', 'with', 'known', 'idiopathic', 'scoliosis.'], ['The', 'spine', 'x-ray', 'performed', '6', 'months', 'ago', 'showed', 'a', 'left', 'thoracolumbar', 'curve', 'of', '18º', '(Cobb', 'angle).'], ['The', 'current', 'x-ray', 'shows', 'a', 'Cobb', 'angle', 'of', '28º,', 'with', 'an', 'iliac', 'crest', 'maturation', ""(Risser's"", 'sign)', 'of', '2.'], ['At', 'this', 'stage', 'of', 'evolution,', 'what', 'is', 'the', 'most', 'appropriate', 'treatment', 'to', 'try', 'to', 'stop', 'the', 'progression', 'of', 'the', 'curve?'], ['1-', 'Swimming', 'exercises.'], ['2-', 'Postural', 're-education', 'exercises.'], ['3-', 'Corrective', 'orthopedic', 'brace.'], ['4-', 'Surgical', 'intervention', 'by', 'spinal', 'arthrodesis.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['In', 'the', 'juvenile', 'and', 'adolescent', 'forms,', 'treatment', 'depends', 'on', 'the', 'degree', 'of', 'deformity:', '-', '10', '-', '20°:', 'serial', 'observation.'], ['-', '20-50°:', 'thermoplastic', 'corsets', '(Boston,', 'Cheneau', 'or', 'Milwaukee,', 'according', 'to', 'where', 'the', 'apex', 'of', 'the', 'main', 'curve', 'is', 'located).'], ['-', '40-50°:', 'with', 'Risser', 'less', 'than', '3,', 'surgical', 'arthrodesis', 'would', 'be', 'indicated;', 'with', 'Risser', 'greater', 'than', 'or', 'equal', 'to', '3,', 'the', 'remaining', 'growth', 'potential', 'of', 'the', 'curve', 'is', 'low', 'and', 'observation', 'may', 'be', 'considered', 'in', 'case', 'it', 'tends', 'to', 'progress', 'in', 'adulthood.']]","[['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
175_53,"[['QUESTION', 'TYPE:', 'PULMONOLOGY'], ['CLINICAL', 'CASE:'], ['71-year-old', 'male,', 'retired', 'waiter,', 'non-smoker,', 'who', 'consults', 'for', 'nocturnal', 'snoring.'], ['The', 'patient', 'has', 'a', 'body', 'mass', 'index', 'of', '31.5', 'kg/m2', 'and', 'reports', 'mild', 'postprandial', 'daytime', 'sleepiness', '(Epworth', 'Sleepiness', 'Scale', 'of', '3)', 'with', 'no', 'other', 'relevant', 'symptoms,', 'signs', 'or', 'clinical', 'history.'], ['The', 'apnea-hypopnea', 'index', 'obtained', 'in', 'the', 'polysomnography', 'was', '18.'], ['With', 'these', 'data,', 'what', 'is', 'the', 'most', 'appropriate', 'measure', 'to', 'adopt', 'in', 'this', 'patient?'], ['1-', 'Hygienic-dietary', 'measures', 'and', 'evolution', 'control.'], ['2-', 'Uvulopalatopharyngoplasty.'], ['3-', 'Nasal', 'CPAP', '(Continuous', 'Positive', 'Airway', 'Pressure).'], ['4-', 'Non-invasive', 'mechanical', 'ventilation.'], ['5-', 'Nocturnal', 'oxygen', 'therapy.'], ['CORRECT', 'ANSWER:', '1'], ['With', 'an', 'Apneas-Hypopnea', 'Index', 'of', 'less', 'than', '30,', 'and', 'in', 'the', 'absence', 'of', 'striking', 'symptoms', 'of', 'OSAHS', 'and', 'in', 'the', 'absence', 'of', 'risk', 'professions', 'such', 'as', 'professional', 'drivers,', 'etc.,', 'the', 'correct', 'thing', 'to', 'do', 'is', 'to', 'control', 'weight', 'and', 'the', 'rest', 'of', 'the', 'hygienic-dietary', 'measures,', 'with', 'periodic', 'follow-up.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
91_35,"[['QUESTION', 'TYPE:', 'GENERAL', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '26-year-old', 'woman', 'presenting', 'with', 'fecal', 'incontinence', 'after', 'a', 'prolonged', 'instrumental', 'delivery.'], ['An', 'endoanal', 'ultrasound', 'was', 'performed', 'showing', 'a', 'section', 'of', 'the', 'external', 'anal', 'sphincter', 'of', '30º', 'amplitude.'], ['The', 'electrophysiological', 'study', 'shows', 'normal', 'innervation.'], ['What', 'is', 'the', 'most', 'indicated', 'treatment?'], ['1-', 'Medical', 'treatment', 'with', 'hygienic', 'and', 'dietary', 'norms.'], ['2-', 'Sphincter', 'biofeedback.'], ['3-', 'Surgical', 'sphincteroplasty.'], ['4-', 'Surgical', 'repair', 'of', 'the', 'pelvic', 'floor.'], ['5-', 'Artificial', 'anal', 'sphincter.'], ['CORRECT', 'ANSWER:', '3'], ['The', 'answer', 'is', 'surgical', 'sphincteroplasty', '3.'], ['1', 'is', 'not', 'effective,', '2', 'is', 'not', 'effective', 'for', 'an', 'organic', 'lesion', 'with', 'normal', 'electromyography,', '4', 'is', 'not', 'necessary', 'since', 'the', 'lesion', 'is', 'only', 'of', 'the', 'external', 'sphincter,', '5', 'is', 'not', 'indicated', 'in', 'a', 'lesion', 'that', 'can', 'be', 'repaired', 'with', 'surgery', 'with', 'good', 'results.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
65_218,"[['QUESTION', 'TYPE:', 'PATHOLOGICAL', 'ANATOMY'], ['CLINICAL', 'CASE:'], ['A', '56-year-old', 'man,', 'diabetic', 'and', 'moderately', 'overweight,', 'presents', 'a', 'discrete', 'hepatomegaly.'], ['The', 'patient', 'indicates', 'that', 'he', 'is', 'not', 'a', 'regular', 'drinker,', 'only', 'exceptionally', 'does', 'he', 'drink', 'some', 'wine.'], ['A', 'liver', 'biopsy', 'shows', 'accumulations', 'of', 'clear', 'cytoplasmic', 'vacuoles', 'in', '50%', 'of', 'the', 'hepatocytes.'], ['Multiple', 'inflammatory', 'foci', 'with', 'neutrophils,', ""Mallory's"", 'hyaline', 'degeneration', 'and', 'fibrosis', 'around', 'the', 'terminal', 'hepatic', 'venules.'], ['Point', 'out', 'the', 'correct', 'answer', 'in', 'this', 'case:'], ['1-', 'Biopsy', 'should', 'be', 'repeated', 'to', 'see', 'if', 'the', 'changes', 'are', 'diffuse.'], ['2-', 'Diagnosis', 'is', 'hepatic', 'glycogenosis', 'associated', 'with', 'diabetes.'], ['3-', 'Histological', 'changes', 'are', 'irreversible', 'and', 'will', 'eventually', 'lead', 'to', 'cirrhosis.'], ['4-', 'The', 'injury', 'is', 'clearly', 'caused', 'by', 'alcohol', 'despite', 'the', ""patient's"", 'refusal.'], ['5-', 'It', 'is', 'important', 'to', 'reduce', 'weight', 'and', 'adequately', 'control', 'diabetes', 'to', 'avoid', 'the', 'possible', 'development', 'of', 'cirrhosis.'], ['CORRECT', 'ANSWER:', '5'], ['The', 'changes', 'described', 'in', 'the', 'question', 'statement', 'correspond', 'to', 'an', 'early', 'precirrhotic', 'situation.'], ['Although', 'alcohol', 'is', 'the', 'most', 'frequent', 'toxicant', 'that', 'causes', 'this', 'condition,', 'it', 'is', 'not', 'the', 'exclusive', 'cause.'], ['Diabetes', 'mellitus', 'causes', 'similar', 'hepatic', 'alterations:', 'fat', 'accumulation', 'in', 'hepatocytes,', 'centroacinar', 'fibrosis,', 'inflammatory', 'infiltrate', 'by', 'polymorphonuclear', 'neutrophils', 'and', 'hyaline', 'degeneration', 'of', 'perinuclear', 'mallory.'], ['Taking', 'this', 'into', 'consideration,', 'we', 'can', 'rule', 'out', 'the', 'second', 'question', '(they', 'are', 'intracellular', 'fat', 'accumulations,', 'not', 'glycogen)', 'and', 'the', 'fourth', '(if', 'diabetes', 'also', 'produces', 'this', 'situation,', 'there', 'is', 'no', 'reason', 'to', 'mistrust', 'the', 'patient).'], ['Based', 'on', 'the', 'primum', 'non', 'nocere', 'and', 'not', 'having', 'special', 'relevance', 'for', 'the', 'treatment', 'if', 'it', 'is', 'a', 'focal', 'or', 'generalized', 'disease,', 'it', 'is', 'not', 'necessary', 'to', 'repeat', 'a', 'liver', 'biopsy', 'that', 'would', 'not', 'expand', 'information,', 'discarding', 'the', 'first', 'question.'], ['Fortunately', 'for', 'the', 'hypothetical', 'patient,', 'in', 'the', 'initial', 'phase', 'these', 'changes', 'are', 'reversible', 'when', 'the', 'noxa', 'disappears,', 'so', 'we', 'are', 'left', 'with', 'answer', 'number', '5.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O', 'O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
50_160,"[['QUESTION', 'TYPE:', 'PEDIATRICS'], ['CLINICAL', 'CASE:'], ['A', '5-year-old', 'girl,', 'completely', 'asymptomatic,', 'who', 'comes', 'to', 'the', 'pediatrician', 'for', 'a', 'regular', 'check-up.'], ['She', 'consults', 'because', 'her', 'mother', 'was', 'operated', 'on', 'for', 'a', 'thyroid', 'tumor', 'and', 'a', 'grandmother', 'died', '10', 'years', 'ago', 'from', 'a', 'pheochromocytoma.'], ['The', 'priority', 'therapeutic', 'attitude', 'we', 'will', 'adopt', 'will', 'be:'], ['1-', 'Exhaustive', 'physical', 'examination', 'with', 'blood', 'pressure', 'control', 'to', 'assess', 'whether', 'the', 'child', 'may', 'have', 'a', 'familial', 'disease.'], ['2-', 'Biochemical', 'analysis', 'with', 'calcitonin.', 'If', 'it', 'is', 'normal,', 'no', 'further', 'control', 'is', 'necessary', 'at', 'this', 'age.'], ['3-', 'Annual', 'monitoring', 'of', 'calcitonin', 'levels', 'with', 'pentagastrin', 'stimulation', 'and,', 'if', 'elevated,', 'indication', 'of', 'prophylactic', 'thyroidectomy.'], ['4-', 'Genetic', 'study', 'of', 'the', 'RET', 'c634', 'proto-oncogene', 'mutation,', 'and', 'if', 'positive,', 'prophylactic', 'radical', 'thyroidectomy', 'will', 'be', 'performed', 'at', 'this', 'age.'], ['5-', 'Genetic', 'study', 'of', 'the', 'RET', 'c634', 'proto-oncogene', 'mutation,', 'calcitonin', 'levels', 'and', 'FNA', '(fine', 'needle', 'aspiration)', 'and', 'if', 'positive,', 'radical', 'thyroidectomy', 'will', 'be', 'performed.'], ['CORRECT', 'ANSWER:', '4'], ['The', 'correct', 'answer', 'is', '4.'], ['It', 'seems', 'to', 'me', 'to', 'be', 'more', 'of', 'an', 'endocrine', 'question', 'than', 'a', 'pediatric', 'question.'], ['Proto-oncogene', 'carriers', 'usually', 'have', 'early', 'thyroid', 'tumors', 'so', 'radical', 'thyroidectomy', 'is', 'usually', 'recommended', 'before', 'the', 'age', 'of', '5', 'years.'], ['Obviously', 'I', 'had', 'to', 'look', 'this', 'up...it', 'is', 'not', 'very', 'common', 'in', 'our', 'routine', 'practice.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O']]"
326_173,"[['QUESTION', 'TYPE:', 'CRITICAL,', 'PALLIATIVE', 'AND', 'EMERGENCY', 'CARE'], ['CLINICAL', 'CASE:'], ['A', '35-year-old', 'man', 'suffers', 'a', 'high-voltage', 'electrical', 'burn', '(3000', 'volts)', 'from', 'direct', 'contact', 'with', 'wire', 'with', 'his', 'left', 'hand.'], ['On', 'admission', 'he', 'presents', 'flexion', 'contracture', 'of', 'the', 'hand,', 'pallor', 'of', 'the', 'fingers', 'and', 'absence', 'of', 'radial', 'and', 'ulnar', 'pulse', 'on', 'palpation', 'What', 'is', 'the', 'emergency', 'invasive', 'measure', 'to', 'be', 'performed?'], ['1-', 'Axillary', 'block', 'with', 'catheter.'], ['2-', 'Decompressive', 'scarotomy.'], ['3-', 'Intracompartmental', 'pressure', 'monitoring.'], ['4-', 'Scarectomy.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['3.'], ['In', 'the', 'case', 'of', 'suspected', 'compartment', 'syndrome,', 'the', 'urgent', 'invasive', 'measure', 'to', 'perform', 'would', 'be', 'to', 'measure', 'the', 'intracompartmental', 'pressure', 'and,', 'depending', 'on', 'the', 'result,', 'proceed', 'with', 'treatment.']]","[['O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
354_166,"[['QUESTION', 'TYPE:', 'GYNECOLOGY', 'AND', 'OBSTETRICS'], ['CLINICAL', 'CASE:'], ['A', 'pregnant', 'woman,', '10', 'weeks', 'pregnant,', 'comes', 'to', 'the', 'emergency', 'room', 'with', 'a', 'blood', 'pressure', 'of', '160/105', 'mmHg.'], ['She', 'was', 'in', 'good', 'general', 'condition,', 'with', 'only', 'mild', 'headache,', 'which', 'was', 'the', 'reason', 'for', 'taking', 'her', 'blood', 'pressure.'], ['After', '4', 'hours', 'of', 'rest', 'she', 'presented', 'with', 'a', 'blood', 'pressure', 'of', '150/95mmHg.'], ['A', 'complete', 'blood', 'count', 'is', 'normal', 'and', 'proteinuria', 'is', 'negative.'], ['What', 'type', 'of', 'hypertension', 'is', 'present?'], ['1-', 'Moderate', 'preeclampsia.'], ['2-', 'Pregnancy-induced', 'hypertension.'], ['3-', 'Chronic', 'hypertension.'], ['4-', 'Eclampsia.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['Chronic', 'hypertension', 'is', 'defined', 'as', 'hypertension', 'that', 'is', 'present', 'before', 'pregnancy', 'or', 'that', 'is', 'diagnosed', 'before', 'the', '20th', 'week', 'of', 'gestation.'], ['In', 'this', 'case,', 'the', 'patient', 'is', '10', 'weeks', 'pregnant,', 'so', 'the', 'correct', 'answer', 'is', '3.']]","[['O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
531_58,"[['QUESTION', 'TYPE:', 'ONCOLOGY'], ['CLINICAL', 'CASE:'], ['Faced', 'with', 'a', 'patient', 'presenting', 'with', 'an', 'ulcerovegetating', 'lesion', 'on', 'the', 'mandibular', 'gingiva', 'at', 'the', 'level', 'of', 'the', 'molar', 'region', 'of', '5', 'months', 'of', 'evolution,', 'the', 'appearance', 'of', 'hypoesthesia', 'in', 'the', 'mentonian', 'region', 'requires', 'ruling', 'out:'], ['1-', 'Paraneoplastic', 'neuropathy.'], ['2-', 'Diagnosis', 'of', 'sarcoidosis', 'with', '""on', 'the', 'scale""', 'facial', 'paralysis.'], ['3-', 'Herpes', 'virus', 'infection', 'in', 'immunosuppressed', 'patient.'], ['4-', 'Diagnosis', 'of', 'carcinoma', 'with', 'infiltration', 'of', 'the', 'mandibular', 'canal.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '4'], ['Mentonian', 'paresthesias', ""(Roger's"", 'sign)', 'are', 'associated', 'with', 'bone', 'metastases', '(it', 'is', 'not', 'paraneoplastic', 'but', 'direct', 'infiltration).'], ['In', 'this', 'case', 'what', 'you', 'describe', 'is', 'an', 'oral', 'tumor', 'growing', 'locally', 'and', 'infiltrating', 'the', 'mandibular', 'canal,', 'I', 'believe.']]","[['O', 'O', 'O'], ['O', 'O'], ['O', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'O', 'B-Marker', 'I-Marker'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
93_31,"[['QUESTION', 'TYPE:', 'DERMATOLOGY,', 'VENEREOLOGY', 'AND', 'PLASTIC', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '17-year-old', 'boy', 'with', ""Crohn's"", 'disease', 'with', 'colonic', 'involvement', 'of', '2', 'years', 'of', 'evolution,', 'in', 'maintenance', 'treatment', 'with', 'azathioprine,', 'consults', 'for', 'the', 'appearance', 'for', '5', 'days', 'of', 'subcutaneous', 'purplish', 'red,', 'hot,', 'painful,', 'bilateral,', 'pretibial', 'localization', 'nodules,', 'associated', 'with', 'an', 'increase', 'in', 'the', 'number', 'of', 'stools', 'and', 'abdominal', 'pain.'], ['The', 'most', 'appropriate', 'approach', 'in', 'this', 'case', 'is:'], ['1-', 'Recommend', 'relative', 'rest', 'and', 'warm', 'cloths', 'on', 'both', 'legs', 'and', 'add', 'antidepressant', 'treatment.'], ['2-', 'Biopsy', 'skin', 'areas', 'away', 'from', 'the', 'injured', 'areas', 'and', 'prescribe', 'entry', 'opioid', 'analgesics.'], ['3-', 'Suspect', 'the', 'existence', 'of', 'a', 'malignant', 'intestinal', 'tumor', 'lesion', 'as', 'a', 'trigger', 'of', 'the', 'cutaneous', 'process.'], ['4-', 'Suspect', 'bilateral', 'lower', 'extremity', 'ischemia', 'of', 'drug', 'origin.'], ['5-', 'Adjustment', 'of', 'bowel', 'disease', 'treatment.'], ['CORRECT', 'ANSWER:', '5'], ['2', 'and', '4', 'are', 'discarded', 'alone.'], ['They', 'are', 'explaining', 'erythema', 'nodosum,', 'so', 'we', 'would', 'recommend', 'relative', 'rest', '(but', 'antidepressants', 'do', 'not', 'make', 'any', 'sense,', 'so', 'we', 'also', 'rule', 'out', '(1)).'], ['Although', 'erythema', 'nodosum', 'can', 'be', 'secondary', 'to', 'a', 'malignant', 'process,', 'it', 'is', 'more', 'frequent', 'that', 'it', 'is', 'due', 'to', ""Crohn's"", 'disease', 'itself', '(moreover,', 'in', 'a', '17-year-old', 'boy', 'it', 'would', 'be', 'extremely', 'rare),', 'so', 'if', 'the', 'picture', 'is', 'also', 'accompanied', 'by', 'a', 'flare-up', 'of', 'inflammatory', 'bowel', 'disease,', 'the', 'last', 'option', '(5)', 'seems', 'the', 'most', 'correct.']]","[['O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Marker', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'B-Marker', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
390_188,"[['QUESTION', 'TYPE:', 'PSYCHIATRY'], ['CLINICAL', 'CASE:'], ['An', '80-year-old', 'man', 'is', 'brought', 'to', 'the', 'ER', 'by', 'the', 'police', 'to', 'find', 'him', 'at', 'night,', 'on', 'the', 'street,', 'several', 'blocks', 'from', 'his', 'home,', 'somewhat', 'lost.'], ['He', 'tells', 'the', 'ER', 'doctor', '""I', 'feel', 'fine,', 'I', 'was', 'walking', 'and', 'I', 'got', 'lost"".'], ['The', 'examination,', 'by', 'systems,', 'is', 'anodyne.'], ['When', 'asked', 'about', 'his', 'medication,', 'he', 'does', 'not', 'remember.'], ['His', 'history', 'includes', 'glipizide,', 'atenolol', 'and', 'acenocoumarol.'], ['She', 'has', 'been', 'to', 'the', 'ER', '3', 'times', 'in', 'the', 'last', 'three', 'months', 'for', '""dizziness"",', 'low', 'back', 'pain', 'and', 'an', 'INR', 'of', '5.'], ['She', 'reports', 'independence', 'in', 'basic', 'and', 'instrumental', 'activities', 'of', 'daily', 'living.'], ['There', 'is', 'no', 'evidence', 'of', 'family', 'or', 'close', 'friends.'], ['Several', 'references', 'from', 'the', 'social', 'work', 'in', 'the', 'area', 'indicate', 'that', 'she', 'refuses', 'medical', 'or', 'nursing', 'aids', 'or', 'visits.'], ['In', 'the', 'physical', 'examination,', 'only', 'temperature', 'of', '37.7,', 'BMI', 'of', '16,', 'BP', 'of', '160/90,', 'HR', 'of', '90', 'and', 'SO2', 'of', '99%', 'stand', 'out.'], ['He', 'has', 'global', 'loss', 'of', 'muscle', 'mass.'], ['He', 'is', 'dressed', 'in', 'his', 'robe', 'and', 'smells', 'of', 'urine.'], ['He', 'refuses', 'to', 'answer', ""Minimental's"", 'questions.'], ['Laboratory', 'tests', 'include', '13,000', 'leukocytes,', 'blood', 'glucose', '300,', 'glycosylated', 'hemoglobin', '11%,', 'INR', '0.9,', 'urine', 'over', '50', 'leukocytes/field,', 'nitrites+', 'and', 'urine', 'culture', '>', '100,000', 'Gram', 'negative', 'bacilli.'], ['He', 'is', 'admitted', 'to', 'the', 'hospital,', 'receives', 'antibiotics,', 'insulin', 'and', 'restarts', 'acenocoumarol', 'with', 'good', 'evolution.'], ['He', 'is', 'stable', 'and', 'wants', 'to', 'go', 'home.'], ['The', 'ward', 'nurse', 'says', 'he', 'is', 'unable', 'to', 'self-administer', 'insulin.'], ['Which', 'of', 'the', 'following', 'is', 'the', 'next', 'step', 'in', 'determining', 'the', ""patient's"", 'safety', 'at', 'home?'], ['1-', 'Refer', 'to', 'Primary', 'Care', 'and', 'social', 'work', 'in', 'the', 'area', 'to', 'determine', 'safety', 'at', 'home.'], ['2-', 'Formal', 'evaluation', 'of', 'the', 'capacity', 'to', 'make', 'decisions', 'concerning', 'their', 'health.'], ['3-', 'Evaluation', 'to', 'rule', 'out', 'dementia.'], ['4-', 'Evaluation', 'to', 'rule', 'out', 'depression.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '2'], ['Assessing', 'capacity', 'is', 'not', 'about', 'taking', 'away', 'the', ""patient's"", 'autonomy,', 'but', 'making', 'sure', 'that', 'the', 'patient', 'understands', 'and', 'is', 'aware', 'of', 'the', 'consequences', 'of', 'his', 'decisions.'], ['In', 'fact,', 'it', 'is', 'a', 'protective', 'measure', 'for', 'the', 'most', 'fragile', 'patients', 'to', 'ensure', 'the', 'best', 'care.'], ['This', 'is', 'not', 'done', 'by', 'a', 'psychiatrist,', 'but', 'by', 'the', 'attending', 'physician.'], ['There', 'are', 'several', 'tests', 'or', 'semi-structured', 'interviews', 'to', 'assess', 'the', 'capacity', 'of', 'patients,', 'and', 'all', 'physicians', 'should', 'be', 'familiar', 'with', 'these', 'instruments.'], ['It', 'is', 'important', 'that', 'it', 'is', 'the', 'attending', 'physician', 'who', 'performs', 'this', 'assessment,', 'because', 'he/she', 'is', 'the', 'one', 'who', 'previously', 'informs', 'the', 'patient', '(informed', 'consent)', 'of', 'the', 'therapeutic', 'plan', 'and', 'is', 'the', 'one', 'who', 'is', 'best', 'able', 'to', 'assess', 'whether', 'the', 'patient', 'has', 'understood', 'everything:', 'what', 'the', 'medical', 'problem', 'is,', 'what', 'treatment', 'is', 'proposed,', 'the', 'alternatives', 'if', 'any,', 'whether', 'to', 'accept', 'or', 'reject', 'any', 'of', 'them', 'and', 'why,', 'the', 'consequences', 'of', 'making', 'these', 'decisions', '(also', 'those', 'of', 'not', 'wanting', 'treatment),', 'even', 'assessing', 'psychopathology', 'susceptible', 'to', 'an', 'ICP', 'to', 'Psychiatry.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O']]"
577_105,"[['QUESTION', 'TYPE:', 'NEUROLOGY'], ['CLINICAL', 'CASE:'], ['A', '45-year-old', 'male', 'brought', 'to', 'the', 'consultation', 'by', 'his', 'relatives', 'for', 'a', 'one-year', 'history', 'of', 'memory', 'loss,', 'which', 'has', 'progressed', 'to', 'the', 'point', 'of', 'needing', 'help', 'with', 'some', 'activities', 'of', 'daily', 'living.'], ['He', 'has', 'a', 'history', 'of', 'migraines', 'and', 'some', 'episode', 'of', 'self-limited', 'neurological', 'focality', 'for', 'which', 'he', 'has', 'never', 'consulted.'], ['The', 'neuropsychological', 'examination', 'is', 'compatible', 'with', 'an', 'initial', 'dementia', 'and', 'the', 'brain', 'MRI', 'shows', 'a', 'severe', 'leukoencephalopathy.'], ['Which', 'test', 'should', 'be', 'ordered?'], ['1-', 'Lumbar', 'puncture', 'to', 'analyze', 'amyloid', 'and', 'tau', 'protein', 'in', 'CSF.'], ['2-', 'Genetic', 'study', 'for', 'presenilin', '1', '(PSEN1).'], ['3-', 'Genetic', 'study', 'for', 'NOTCH3.'], ['4-', 'Genetic', 'study', 'for', 'progranulin.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['They', 'describe', 'a', 'characteristic', 'case', 'of', 'CADASIL', '(Cerebral', 'Autosomal', 'Dominant', 'Arteriopathy', 'with', 'Sub-cortical', 'Infarcts', 'and', 'Leukoencephalopathy).'], ['It', 'is', 'a', 'genetic', 'disease', 'of', 'autosomal', 'dominant', 'inheritance', 'by', 'mutation', 'of', 'the', 'NOTCH3', 'gene.'], ['This', 'mutation', 'causes', 'vascular', 'involvement', 'of', 'small', 'vessel', 'that', 'generates', 'severe', 'leukoencephalopathy', 'early,', 'which', 'generates', 'various', 'symptoms.'], ['Migraines,', 'cerebrovascular', 'disease', 'and', 'cognitive', 'impairment', 'at', 'early', 'ages', 'stand', 'out,', 'as', 'shown', 'in', 'the', 'clinical', 'case', 'of', 'the', 'question.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
615_118,"[['QUESTION', 'TYPE:', 'TRAUMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '41-year-old', 'male', 'consults', 'for', 'gonalgia', 'of', 'several', ""days'"", 'evolution.'], ['During', 'the', 'examination,', 'the', 'Thessaly', 'test', 'is', 'performed', '(pain', 'with', 'internal', 'and', 'external', 'rotation', 'movements', 'with', 'the', 'knee', 'flexed),', 'which', 'is', 'positive.'], ['Which', 'of', 'the', 'following', 'lesions', 'is', 'more', 'probable?'], ['1-', 'Meniscal', 'injury.'], ['2-', 'Injury', 'due', 'to', 'rupture', 'of', 'the', 'anterior', 'cruciate', 'ligament.'], ['3-', 'Injury', 'due', 'to', 'rupture', 'of', 'the', 'posterior', 'cruciate', 'ligament.'], ['4-', 'Injury', 'due', 'to', 'degenerative', 'arthropathy.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '1'], ['Answer', '1', 'correct:', 'The', 'Thessaly', 'test', 'is', 'a', 'meniscal', 'exploration', 'maneuver.'], ['The', 'statement', 'focuses', 'exclusively', 'on', 'this', 'part', 'of', 'the', 'examination', 'and', 'also', 'explains', 'that', 'it', 'is', 'indeed', 'positive,', 'which', 'leads', 'to', 'the', 'suspicion', 'of', 'a', 'meniscal', 'lesion.'], ['""The', 'Thessaly', 'test', 'is', 'a', 'dynamic', 'reproduction', 'of', 'load', 'transmission', 'in', 'the', 'knee', 'joint', 'and', 'is', 'performed', 'at', '5°', 'and', '20°', 'of', 'flexion.'], ['The', 'examiner', 'supports', 'the', 'patient', 'by', 'holding', 'his', 'or', 'her', 'outstretched', 'hands', 'while', 'the', 'patient', 'stands', 'flatfooted', 'on', 'the', 'floor.'], ['The', 'patient', 'then', 'rotates', 'his', 'or', 'her', 'knee', 'and', 'body,', 'internally', 'and', 'externally,', 'three', 'times,', 'keeping', 'the', 'knee', 'in', 'slight', 'flexion', '(5°).'], ['Then', 'the', 'same', 'procedure', 'is', 'carried', 'out', 'with', 'the', 'knee', 'flexed', 'at', '20°.'], ['Patients', 'with', 'suspected', 'meniscal', 'tears', 'experience', 'medial', 'or', 'lateral', 'joint-line', 'discomfort', 'and', 'may', 'have', 'a', 'sense', 'of', 'locking', 'or', 'catching.'], ['The', 'theory', 'behind', 'the', 'test', 'is', 'that,', 'with', 'this', 'maneuver,', 'the', 'knee', 'with', 'a', 'meniscal', 'tear', 'is', 'subjected', 'to', 'excessive', 'loading', 'conditions', 'and', 'almost', 'certainly', 'will', 'have', 'the', 'same', 'symptoms', 'that', 'the', 'patient', 'reported.'], ['The', 'test', 'is', 'always', 'performed', 'first', 'on', 'the', 'normal', 'knee', 'so', 'that', 'the', 'patient', 'may', 'be', 'trained,', 'especially', 'with', 'regard', 'to', 'how', 'to', 'keep', 'the', 'knee', 'in', '5°', 'and', 'then', 'in', '20°', 'of', 'flexion', 'and', 'how', 'to', 'recognize,', 'by', 'comparison,', 'a', 'possible', 'positive', 'result', 'in', 'the', 'symptomatic', 'knee.""', 'Answer', '2', 'incorrect:', 'At', 'no', 'time', 'do', 'they', 'describe', 'any', 'exploration', 'maneuvers', 'of', 'the', 'anterior', 'cruciate', 'ligament,', 'nor', 'do', 'they', 'mention', 'any', 'trauma', 'that', 'may', 'have', 'injured', 'it.'], ['Answer', '3', 'incorrect:', 'At', 'no', 'time', 'do', 'they', 'describe', 'any', 'exploration', 'maneuvers', 'of', 'the', 'posterior', 'cruciate', 'ligament,', 'nor', 'do', 'they', 'mention', 'any', 'trauma', 'that', 'could', 'have', 'injured', 'it.'], ['Wrong', 'answer', '4:', 'Although', 'it', 'could', 'occur,', 'it', 'is', 'not', 'to', 'be', 'expected', 'in', 'a', '41', 'year', 'old', 'person', 'with', 'an', 'acutely', 'established', 'clinical', 'condition.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], 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456_200,"[['QUESTION', 'TYPE:', 'OPHTHALMOLOGY'], ['CLINICAL', 'CASE:'], ['A', '67-year-old', 'man,', 'diabetic', 'and', 'asthmatic,', 'with', 'primary', 'open-angle', 'glaucoma', 'in', 'both', 'eyes.'], ['He', 'has', 'an', 'ocular', 'pressure', 'of', '34', 'mmHg', 'in', 'his', 'right', 'eye', 'and', '31', 'mmHg', 'in', 'his', 'left', 'eye.'], ['Which', 'of', 'the', 'following', 'pharmacological', 'groups', 'is', 'the', 'most', 'indicated', 'as', 'first', 'choice', 'as', 'hypotensive', 'treatment?'], ['1-', 'Carbonic', 'anhydrase', 'inhibitors.'], ['2-', 'Beta-blockers.'], ['3-', 'Alpha-2', 'agonists.'], ['4-', 'Prostaglandin', 'derivatives.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '4'], ['We', 'are', 'asked', 'about', 'the', 'first', 'choice', 'treatment', 'for', 'glaucoma.'], ['In', 'the', 'past,', 'beta-blockers', 'were', 'the', 'first', 'choice,', 'but', 'nowadays', 'they', 'have', 'been', 'displaced', 'by', 'the', 'group', 'that', 'lowers', 'intraocular', 'pressure', 'the', 'most:', 'prostaglandins.'], ['Their', 'efficacy', 'and', 'more', 'convenient', 'dosage', '(once', 'a', 'day)', 'generally', 'make', 'them', 'the', 'group', 'of', 'choice.'], ['Beta-blockers', 'would', 'remain', 'as', 'a', 'second', 'choice', 'in', 'cases', 'in', 'which', 'the', 'side', 'effects', 'of', 'prostaglandins', '(change', 'in', 'eye', 'color,', 'increase', 'in', 'eyelash', 'size)', 'make', 'us', 'initially', 'leave', 'them', 'aside.'], ['Since', 'the', 'patient', 'is', 'asthmatic,', 'we', 'should', 'rule', 'out', 'beta-blockers', '(wrong', 'answer', '2).'], ['Also,', 'since', 'we', 'need', 'a', 'significant', 'drop', 'in', 'intraocular', 'pressure', 'because', 'the', 'numbers', 'are', 'high', '(34', 'and', '31),', 'we', 'can', 'also', 'rule', 'out', 'carbonic', 'anhydrase', 'inhibitors', 'and', 'alpha-2', 'agonists', '(options', '1', 'and', '3', 'incorrect).'], ['And', 'opt', 'for', 'the', 'group', 'that', 'can', 'lower', 'intraocular', 'pressure', 'the', 'most.'], ['Answer', '4', 'correct.'], ['And', 'then', 'a', 'couple', 'of', 'nuances', 'of', 'the', 'statement.'], ['It', 'would', 'be', 'more', 'correct', 'to', 'talk', 'about', 'intraocular', 'pressure', 'and', 'not', '""ocular', 'pressure"".'], ['And', 'the', 'wording', 'could', 'be', 'improved', 'so', 'as', 'not', 'to', 'repeat', 'the', 'word', '""as""', 'in', 'the', 'last', 'sentence.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O']]"
484_175,"[['QUESTION', 'TYPE:', 'CRITICAL', 'CARE'], ['CLINICAL', 'CASE:'], ['An', '18-year-old', 'man', 'arrives', 'at', 'the', 'hospital', 'emergency', 'department', 'transported', 'by', 'a', 'basic', 'life', 'support', 'unit.'], ['He', 'has', 'been', 'hit', 'by', 'a', 'car', 'while', 'riding', 'a', 'bicycle.'], ['On', 'arrival', 'he', 'has', 'a', 'heart', 'rate', 'of', '115', 'bpm,', 'a', 'blood', 'pressure', 'of', '110/75', 'mmHg,', 'a', 'palpable', 'radial', 'pulse,', 'a', 'capillary', 'refill', 'of', '2.5', 'seconds', 'and', 'a', 'respiratory', 'rate', 'of', '25', 'rpm.'], ['What', 'do', 'these', 'data', 'tell', 'us:'], ['1-', 'The', 'patient', 'has', 'lost', '15', 'to', '30%', 'of', 'blood', 'volume', 'and', 'requires', 'volume', 'replacement.'], ['2-', 'She', 'has', 'lost', 'more', 'than', '30%', 'of', 'volemia', 'and', 'needs', 'volume', 'and', 'blood', 'replacement.'], ['3-', 'He', 'has', 'lost', 'more', 'than', '40%', 'of', 'blood', 'volume', 'and', 'will', 'require', 'surgical', 'treatment.'], ['4-', 'Has', 'lost', 'more', 'than', '50%', 'of', 'volemia', 'and', 'requires', 'volume', 'and', 'blood', 'replacement.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '1'], ['Technically', 'the', 'patient', 'is', 'in', 'a', 'grade', 'II', 'hemorrhage', 'according', 'to', 'the', 'ATLS', 'classification,', 'in', 'principle', 'this', 'means', 'a', 'loss', 'of', 'between', '750', 'and', '1500mL', 'of', 'blood', 'and', 'the', 'indicated', 'action', 'is', 'resuscitation', 'with', 'crystalloids;', 'however,', 'in', 'the', 'guidelines', 'for', 'the', 'care', 'of', 'severe', 'polytraumatized', 'patients,', 'the', 'early', 'use', 'of', 'blood', 'products', 'is', 'increasingly', 'recommended,', 'especially', 'in', 'borderline', 'cases', 'like', 'this', 'one,', 'and', 'in', 'young', 'patients,', 'who', 'may', 'not', 'be', 'able', 'to', 'translate', 'the', 'severity', 'of', 'the', 'blood', 'loss', 'until', 'it', 'becomes', 'much', 'more', 'significant.'], ['I', 'would', 'therefore', 'hesitate', 'between', 'options', '1', 'and', '2.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"