diff --git "a/en/train_en_ordered.json" "b/en/train_en_ordered.json"
--- "a/en/train_en_ordered.json"
+++ "b/en/train_en_ordered.json"
@@ -1 +1,177856 @@
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"I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim", "I-Claim"]]}, {"id": "86_51", "text": [["QUESTION", "TYPE:", "CARDIOLOGY", "AND", "VASCULAR", "SURGERY"], ["CLINICAL", "CASE:"], ["A", "26-year-old", "man", "with", "no", "history", "of", "interest,", "asymptomatic,", "presents", "on", "examination", "with", "a", "mesosystolic", "murmur", "in", "the", "aortic", "focus", "and", "left", "parasternal", "border", "that", "increases", "with", "the", "Valsalva", "maneuver."], ["BP", "and", "peripheral", "pulses", "are", "normal", "and", "the", "ECG", "shows", "signs", "of", "marked", "left", "ventricular", "enlargement", "and", "very", "deep", "negative", "T", "waves", "in", "V3,", "V4,", "V5", "and", "V6."], ["What", "is", "the", "most", "likely", "diagnosis?"], ["1-", "Functional", "murmur."], ["2-", "Aortic", "stenosis."], ["3-", "Aortic", "insufficiency."], ["4-", "Hypertrophic", "cardiomyopathy."], ["5-", "Ventricular", "septal", "defect."], ["CORRECT", "ANSWER:", "4"], ["A", "young", "male", "patient", "with", "an", "aortic", "systolic", "murmur", "that", "increases", "with", "the", "Valsalva", "maneuver", "and", "signs", "of", "left", "ventricular", "enlargement", "is", "practically", "a", "\"portrait\"", "of", "the", "typical", "findings", "that", "can", "be", "found", "in", "hypertrophic", "cardiomyopathy."], ["Very", "easy", "question."]], "labels": [["O", "O", "O", "O", "O", "O"], ["O", "O"], ["B-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise"], ["B-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "I-Premise", "O", "B-Premise", "I-Premise", "I-Premise", 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"THORACIC", "SURGERY"], ["CLINICAL", "CASE:"], ["A", "patient", "diagnosed", "with", "bronchial", "asthma", "who", "is", "being", "treated", "with", "low-dose", "inhaled", "steroids", "(200", "micrograms", "of", "budesonide", "every", "12", "hours)", "and", "rescue", "medication", "(salbutamol", "on", "demand)", "comes", "for", "periodic", "clinical", "monitoring."], ["The", "patient", "reports", "that", "in", "the", "last", "3", "months", "he", "has", "had", "no", "exacerbations", "and", "that", "he", "uses", "salbutamol", "once", "a", "day."], ["He", "only", "has", "dyspnea", "when", "climbing", "stairs", "and", "some", "nights", "he", "sleeps", "irregularly", "due", "to", "coughing."], ["Which", "of", "the", "following", "therapeutic", "options", "should", "be", "considered", "as", "the", "treatment", "of", "choice?"], ["1-", "Increase", "the", "dose", "of", "inhaled", "corticosteroids", "to", "800", "micrograms/day."], ["2-", "Add", "tiotropium."], ["3-", "Maintain", "the", "same", 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"618_119", "text": [["QUESTION", "TYPE:", "TRAUMATOLOGY"], ["CLINICAL", "CASE:"], ["13-year-old", "female,", "with", "no", "relevant", "history,", "with", "menarche", "3", "months", "ago,", "followed", "since", "the", "age", "of", "10", "years", "for", "idiopathic", "scoliosis", "that", "has", "worsened."], ["In", "the", "physical", "examination", "she", "presents", "a", "hump", "of", "7", "degrees", "in", "the", "Adams", "test", "and", "in", "the", "scoliogram", "a", "T4-L1", "thoracolumbar", "curve", "of", "35", "degrees", "of", "Cobb", "and", "a", "Risser", "0:"], ["1-", "Recommend", "swimming", "and", "review", "in", "three", "months."], ["2-", "Prescribe", "a", "brace-type", "orthosis."], ["3-", "Refer", "to", "physiotherapy", "for", "spine", "elastification."], ["4-", "Check", "in", "6", "months", "with", "a", "new", "X-ray."], ["5-", "nan"], ["CORRECT", "ANSWER:", "2"], ["Treatment", "with", "a", "brace", "in", "Risser", "from", "0", "to", "2", "can", "be", "considered", 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\ No newline at end of file
+[
+    {
+        "id": "402_183",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PRIMARY",
+                "CARE",
+                "AND",
+                "SOCIAL",
+                "NETWORKS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "Juan,",
+                "a",
+                "second",
+                "year",
+                "resident,",
+                "attends",
+                "Sofia,",
+                "a",
+                "15",
+                "year",
+                "old",
+                "girl",
+                "in",
+                "the",
+                "emergency",
+                "room,",
+                "who",
+                "apparently",
+                "fainted",
+                "at",
+                "school",
+                "without",
+                "losing",
+                "consciousness."
+            ],
+            [
+                "The",
+                "patient",
+                "says",
+                "that",
+                "she",
+                "was",
+                "due",
+                "to",
+                "take",
+                "an",
+                "exam,",
+                "which",
+                "caused",
+                "her",
+                "a",
+                "lot",
+                "of",
+                "anxiety."
+            ],
+            [
+                "From",
+                "the",
+                "interrogation,",
+                "it",
+                "appears",
+                "that",
+                "she",
+                "was",
+                "being",
+                "bullied",
+                "by",
+                "her",
+                "classmates",
+                "and",
+                "that",
+                "she",
+                "may",
+                "have",
+                "an",
+                "eating",
+                "disorder."
+            ],
+            [
+                "Vital",
+                "signs",
+                "and",
+                "neurological",
+                "examination",
+                "are",
+                "normal."
+            ],
+            [
+                "Juan",
+                "keeps",
+                "So\ufb01a",
+                "under",
+                "observation",
+                "while",
+                "waiting",
+                "for",
+                "her",
+                "parents",
+                "to",
+                "come",
+                "to",
+                "the",
+                "service,",
+                "periodically",
+                "taking",
+                "a",
+                "look",
+                "at",
+                "how",
+                "the",
+                "patient",
+                "is",
+                "doing."
+            ],
+            [
+                "After",
+                "the",
+                "initial",
+                "scare,",
+                "the",
+                "patient",
+                "seems",
+                "to",
+                "be",
+                "increasingly",
+                "animated",
+                "and",
+                "is",
+                "very",
+                "friendly."
+            ],
+            [
+                "On",
+                "one",
+                "occasion,",
+                "Juan",
+                "finds",
+                "her",
+                "actively",
+                "chatting",
+                "on",
+                "her",
+                "cell",
+                "phone."
+            ],
+            [
+                "Juan",
+                "tells",
+                "her",
+                "that",
+                "it",
+                "would",
+                "be",
+                "better",
+                "for",
+                "her",
+                "to",
+                "put",
+                "the",
+                "cell",
+                "phone",
+                "down",
+                "and",
+                "rest",
+                "and",
+                "to",
+                "reassure",
+                "her,",
+                "he",
+                "tells",
+                "her",
+                "that",
+                "he",
+                "also",
+                "uses",
+                "social",
+                "networks",
+                "a",
+                "lot",
+                "since",
+                "college."
+            ],
+            [
+                "So\ufb01a",
+                "apologizes",
+                "for",
+                "not",
+                "knowing",
+                "that",
+                "she",
+                "should",
+                "have",
+                "her",
+                "cell",
+                "phone",
+                "turned",
+                "off,",
+                "and",
+                "after",
+                "turning",
+                "it",
+                "off,",
+                "asks",
+                "if",
+                "she",
+                "can",
+                "make",
+                "a",
+                "friend",
+                "request",
+                "on",
+                "Facebook."
+            ],
+            [
+                "What",
+                "do",
+                "you",
+                "think",
+                "is",
+                "Juan's",
+                "best",
+                "response?"
+            ],
+            [
+                "1-",
+                "Tell",
+                "him",
+                "to",
+                "make",
+                "the",
+                "friend",
+                "request",
+                "and",
+                "that",
+                "he",
+                "will",
+                "accept",
+                "it,",
+                "as",
+                "he",
+                "is",
+                "sure",
+                "that",
+                "there",
+                "are",
+                "no",
+                "inappropriate",
+                "items",
+                "on",
+                "his",
+                "page",
+                "for",
+                "a",
+                "girl",
+                "of",
+                "So\ufb01a's",
+                "age."
+            ],
+            [
+                "2-",
+                "Because",
+                "you",
+                "consider",
+                "So\ufb01a",
+                "a",
+                "vulnerable",
+                "patient",
+                "and",
+                "are",
+                "concerned",
+                "that",
+                "she",
+                "may",
+                "misinterpret",
+                "a",
+                "rejection,",
+                "agree",
+                "to",
+                "let",
+                "her",
+                "make",
+                "the",
+                "request",
+                "but",
+                "only",
+                "allow",
+                "her",
+                "access",
+                "to",
+                "certain",
+                "content",
+                "on",
+                "your",
+                "page."
+            ],
+            [
+                "3-",
+                "Answer",
+                "that",
+                "it",
+                "is",
+                "important",
+                "to",
+                "maintain",
+                "certain",
+                "professional",
+                "boundaries",
+                "between",
+                "patients",
+                "and",
+                "physicians",
+                "and",
+                "that,",
+                "unfortunately,",
+                "if",
+                "you",
+                "make",
+                "the",
+                "request",
+                "you",
+                "will",
+                "not",
+                "be",
+                "able",
+                "to",
+                "accept",
+                "it,",
+                "so",
+                "it",
+                "is",
+                "better",
+                "not",
+                "to",
+                "do",
+                "so."
+            ],
+            [
+                "4-",
+                "Tell",
+                "him",
+                "to",
+                "make",
+                "the",
+                "request",
+                "but",
+                "without",
+                "any",
+                "intention",
+                "of",
+                "accepting",
+                "it."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "There",
+                "is",
+                "no",
+                "doubt",
+                "that",
+                "the",
+                "doctor-patient",
+                "relationship",
+                "today",
+                "transcends",
+                "the",
+                "physical",
+                "environment",
+                "of",
+                "the",
+                "consultation",
+                "room."
+            ],
+            [
+                "But",
+                "we",
+                "must",
+                "not",
+                "forget",
+                "that",
+                "we",
+                "must",
+                "maintain",
+                "the",
+                "same",
+                "ethical",
+                "and",
+                "professional",
+                "codes",
+                "as",
+                "in",
+                "the",
+                "real",
+                "environment."
+            ],
+            [
+                "The",
+                "code",
+                "of",
+                "ethics",
+                "Article",
+                "26-3."
+            ],
+            [
+                "The",
+                "clinical",
+                "practice",
+                "of",
+                "medicine",
+                "by",
+                "means",
+                "of",
+                "consultations",
+                "exclusively",
+                "by",
+                "letter,",
+                "telephone,",
+                "radio,",
+                "press",
+                "or",
+                "internet,",
+                "is",
+                "contrary",
+                "to",
+                "the",
+                "deontological",
+                "norms."
+            ],
+            [
+                "The",
+                "correct",
+                "action",
+                "implies",
+                "inescapably",
+                "the",
+                "personal",
+                "and",
+                "direct",
+                "contact",
+                "between",
+                "the",
+                "doctor",
+                "and",
+                "the",
+                "patient."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "237_144",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "After",
+                "a",
+                "traffic",
+                "accident",
+                "a",
+                "38-year-old",
+                "patient",
+                "is",
+                "admitted",
+                "to",
+                "the",
+                "ICU",
+                "in",
+                "coma."
+            ],
+            [
+                "After",
+                "several",
+                "days",
+                "the",
+                "patient",
+                "does",
+                "not",
+                "improve",
+                "neurologically",
+                "and",
+                "a",
+                "CT",
+                "scan",
+                "shows",
+                "hemorrhagic",
+                "punctate",
+                "lesions",
+                "in",
+                "the",
+                "corpus",
+                "callosum",
+                "and",
+                "cortico-subcortical",
+                "junction."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Acute",
+                "subdural",
+                "hematoma."
+            ],
+            [
+                "2-",
+                "Trobocytopenic",
+                "purpura."
+            ],
+            [
+                "3-",
+                "Cerebral",
+                "hemorrhagic",
+                "contusion."
+            ],
+            [
+                "4-",
+                "Severe",
+                "diffuse",
+                "axonal",
+                "injury."
+            ],
+            [
+                "5-",
+                "Hypoxic-ischemic",
+                "encephalopathy."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Diffuse",
+                "axonal",
+                "injury",
+                "produces",
+                "an",
+                "early",
+                "and",
+                "sustained",
+                "deterioration",
+                "of",
+                "the",
+                "level",
+                "of",
+                "consciousness",
+                "(as",
+                "mentioned",
+                "in",
+                "the",
+                "case",
+                "statement)",
+                "without",
+                "a",
+                "lesion",
+                "on",
+                "CT",
+                "scan",
+                "to",
+                "justify",
+                "the",
+                "picture."
+            ],
+            [
+                "Sometimes,",
+                "punctate",
+                "hemorrhages",
+                "at",
+                "the",
+                "level",
+                "of",
+                "the",
+                "corpus",
+                "callosum,",
+                "corticosubcortical",
+                "junction",
+                "and",
+                "dorsolateral",
+                "portion",
+                "of",
+                "the",
+                "brainstem",
+                "are",
+                "evidenced",
+                "in",
+                "this",
+                "imaging",
+                "test."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
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+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "620_121",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "396_136",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "253_86",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DIGESTIVE",
+                "TRACT"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "37-year-old",
+                "woman",
+                "with",
+                "extensive",
+                "ulcerative",
+                "colitis",
+                "presents",
+                "a",
+                "severe",
+                "flare-up",
+                "for",
+                "which",
+                "treatment",
+                "with",
+                "prednisone",
+                "at",
+                "a",
+                "dose",
+                "of",
+                "1",
+                "mg/kg",
+                "is",
+                "started."
+            ],
+            [
+                "After",
+                "one",
+                "week",
+                "of",
+                "treatment,",
+                "the",
+                "patient",
+                "shows",
+                "no",
+                "improvement."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "next",
+                "therapeutic",
+                "measure",
+                "to",
+                "be",
+                "taken?"
+            ],
+            [
+                "1-",
+                "Emergency",
+                "subtotal",
+                "colectomy",
+                "and",
+                "in",
+                "a",
+                "second",
+                "time",
+                "prostectomy",
+                "and",
+                "ileoanal",
+                "reservoir."
+            ],
+            [
+                "2-",
+                "Associate",
+                "an",
+                "immunosuppressant",
+                "such",
+                "as",
+                "azathioprine."
+            ],
+            [
+                "3-",
+                "Associate",
+                "mesalazine",
+                "in",
+                "doses",
+                "of",
+                "4g",
+                "per",
+                "day",
+                "orally",
+                "and",
+                "rectal",
+                "triamcinolone",
+                "1",
+                "application",
+                "every",
+                "12",
+                "hours."
+            ],
+            [
+                "4-",
+                "Intravenous",
+                "cyclosporine",
+                "2mg/kg."
+            ],
+            [
+                "5-",
+                "Treatment",
+                "with",
+                "etanercept",
+                "(an",
+                "anti-TNFa",
+                "antibody)",
+                "should",
+                "be",
+                "considered."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "When",
+                "a",
+                "severe",
+                "flare",
+                "does",
+                "not",
+                "respond",
+                "to",
+                "iv",
+                "corticosteroid",
+                "therapy",
+                "at",
+                "full",
+                "doses",
+                "(1mg/kg",
+                "body",
+                "weight),",
+                "it",
+                "is",
+                "necessary",
+                "to",
+                "switch",
+                "to",
+                "cyclosporine",
+                "or",
+                "infliximab."
+            ],
+            [
+                "Etanercept",
+                "is",
+                "not",
+                "approved",
+                "in",
+                "Europe",
+                "for",
+                "inflammatory",
+                "bowel",
+                "disease",
+                "(for",
+                "the",
+                "time",
+                "being)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "224_63",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CARDIOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "52-year-old",
+                "patient",
+                "who",
+                "has",
+                "been",
+                "complaining",
+                "of",
+                "dyspnea",
+                "on",
+                "medium",
+                "exertion",
+                "for",
+                "6",
+                "months."
+            ],
+            [
+                "He",
+                "has",
+                "not",
+                "presented",
+                "angina",
+                "or",
+                "syncope."
+            ],
+            [
+                "Physical",
+                "examination",
+                "and",
+                "diagnostic",
+                "tests",
+                "show",
+                "a",
+                "mean",
+                "aortic",
+                "transvalvular",
+                "gradient",
+                "of",
+                "55",
+                "mmHg",
+                "and",
+                "a",
+                "calculated",
+                "area",
+                "of",
+                "0.7",
+                "cm\u00b2."
+            ],
+            [
+                "Ejection",
+                "fraction",
+                "of",
+                "65%."
+            ],
+            [
+                "The",
+                "treatment",
+                "to",
+                "be",
+                "indicated",
+                "for",
+                "this",
+                "patient",
+                "is:"
+            ],
+            [
+                "1-",
+                "Diuretics",
+                "and",
+                "more",
+                "frequent",
+                "check-ups",
+                "by",
+                "a",
+                "specialist."
+            ],
+            [
+                "2-",
+                "In",
+                "case",
+                "of",
+                "increasing",
+                "dyspnea",
+                "on",
+                "exertion,",
+                "percutaneous",
+                "dilatation",
+                "of",
+                "the",
+                "aortic",
+                "valve",
+                "with",
+                "a",
+                "balloon",
+                "catheter",
+                "should",
+                "be",
+                "performed."
+            ],
+            [
+                "3-",
+                "Replacement",
+                "of",
+                "the",
+                "aortic",
+                "valve",
+                "with",
+                "a",
+                "prosthesis/bioprosthesis."
+            ],
+            [
+                "4-",
+                "Replacement",
+                "of",
+                "the",
+                "aortic",
+                "valve",
+                "with",
+                "a",
+                "homograft."
+            ],
+            [
+                "5-",
+                "Implantation",
+                "of",
+                "a",
+                "percutaneous",
+                "valve."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Something",
+                "aortic."
+            ],
+            [
+                "They",
+                "give",
+                "me",
+                "a",
+                "gradient,",
+                "which",
+                "without",
+                "knowing",
+                "the",
+                "values",
+                "seems",
+                "somewhat",
+                "high",
+                "(55",
+                "mmHg!)",
+                "and",
+                "the",
+                "area,",
+                "which",
+                "looks",
+                "tiny",
+                "to",
+                "the",
+                "naked",
+                "eye:",
+                "this",
+                "is",
+                "going",
+                "to",
+                "be",
+                "aortic",
+                "stenosis..."
+            ],
+            [
+                "And",
+                "he",
+                "has",
+                "dyspnea."
+            ],
+            [
+                "Symptomatic",
+                "aortic",
+                "stenosis,",
+                "will",
+                "the",
+                "examiner",
+                "want",
+                "me",
+                "to",
+                "send",
+                "him",
+                "for",
+                "surgery?"
+            ],
+            [
+                "With",
+                "the",
+                "guidelines",
+                "in",
+                "hand,",
+                "that's",
+                "right:",
+                "this",
+                "is",
+                "a",
+                "severe",
+                "stenosis",
+                "both",
+                "in",
+                "terms",
+                "of",
+                "area",
+                "(<1",
+                "cm\u00b2)",
+                "and",
+                "mean",
+                "gradient",
+                "(>40",
+                "mmHg),",
+                "with",
+                "a",
+                "preserved",
+                "ejection",
+                "fraction,",
+                "and",
+                "symptomatic."
+            ],
+            [
+                "Surgical",
+                "indication."
+            ],
+            [
+                "If",
+                "we",
+                "do",
+                "1",
+                "we",
+                "take",
+                "away",
+                "life",
+                "expectancy,",
+                "because",
+                "we",
+                "allow",
+                "the",
+                "ventricle",
+                "to",
+                "claudicate."
+            ],
+            [
+                "2",
+                "is",
+                "outdated:",
+                "balloon",
+                "valvuloplasty?"
+            ],
+            [
+                "Only",
+                "if",
+                "the",
+                "surgical",
+                "risk",
+                "is",
+                "unaffordable,",
+                "and",
+                "in",
+                "that",
+                "case",
+                "we",
+                "would",
+                "do",
+                "5,",
+                "TAVI",
+                "implantation",
+                "(see",
+                "[1])."
+            ],
+            [
+                "But",
+                "this",
+                "is",
+                "a",
+                "52-year-old",
+                "man,",
+                "who",
+                "we",
+                "assume",
+                "has",
+                "good",
+                "bodywork",
+                "because",
+                "he",
+                "walks",
+                "to",
+                "have",
+                "dyspnea,",
+                "so",
+                "to",
+                "the",
+                "operating",
+                "room."
+            ],
+            [
+                "So",
+                "to",
+                "the",
+                "operating",
+                "room."
+            ],
+            [
+                "A",
+                "homograft?",
+                "That's",
+                "the",
+                "Ross",
+                "technique,",
+                "I",
+                "take",
+                "the",
+                "pulmonary",
+                "and",
+                "put",
+                "it",
+                "where",
+                "the",
+                "aortic."
+            ],
+            [
+                "But",
+                "it's",
+                "rare,",
+                "complex",
+                "and",
+                "only",
+                "done",
+                "in",
+                "pediatrics."
+            ],
+            [
+                "The",
+                "correct",
+                "thing",
+                "to",
+                "do",
+                "is",
+                "3,",
+                "without",
+                "a",
+                "doubt:",
+                "replace",
+                "with",
+                "a",
+                "prosthesis,",
+                "preferably",
+                "mechanical",
+                "unless",
+                "the",
+                "patient",
+                "has",
+                "a",
+                "contraindication",
+                "for",
+                "anticoagulation."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-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"
+            ],
+            [
+                "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",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "430_115",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTIOUS",
+                "DISEASES",
+                "AND",
+                "MICROBIOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "65-year-old",
+                "woman",
+                "who",
+                "underwent",
+                "hematopoietic",
+                "precursor",
+                "transplantation",
+                "30",
+                "days",
+                "ago",
+                "and",
+                "has",
+                "severe",
+                "neutropenia."
+            ],
+            [
+                "She",
+                "starts",
+                "with",
+                "cough",
+                "and",
+                "hemoptotic",
+                "expectoration",
+                "in",
+                "addition",
+                "to",
+                "fever",
+                "and",
+                "moderate",
+                "exertional",
+                "dyspnea",
+                "that",
+                "does",
+                "not",
+                "improve",
+                "despite",
+                "five",
+                "days",
+                "of",
+                "treatment",
+                "with",
+                "amoxicillin-clavulanic",
+                "acid",
+                "(875/125",
+                "mg/8",
+                "h)",
+                "and",
+                "levofloxacin",
+                "(500",
+                "mg/12",
+                "h)."
+            ],
+            [
+                "Chest",
+                "X-ray",
+                "shows",
+                "multiple",
+                "ill-defined",
+                "pulmonary",
+                "nodules,",
+                "some",
+                "of",
+                "them",
+                "cavitated."
+            ],
+            [
+                "Among",
+                "the",
+                "following,",
+                "which",
+                "is",
+                "the",
+                "most",
+                "probable",
+                "diagnosis",
+                "of",
+                "suspicion?"
+            ],
+            [
+                "1-",
+                "Septic",
+                "embolisms."
+            ],
+            [
+                "2-",
+                "Invasive",
+                "pulmonary",
+                "aspergillosis."
+            ],
+            [
+                "3-",
+                "Pneumonia",
+                "due",
+                "to",
+                "Staphylococcus",
+                "aureus."
+            ],
+            [
+                "4-",
+                "Systemic",
+                "candidiasis."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Patient",
+                "on",
+                "her",
+                "30th",
+                "post-transplant",
+                "day",
+                "of",
+                "hematopoietic",
+                "precursor",
+                "transplantation,",
+                "in",
+                "severe",
+                "neutropenia",
+                "who",
+                "presents",
+                "with",
+                "cough",
+                "with",
+                "hemoptotic",
+                "expectoration."
+            ],
+            [
+                "This",
+                "picture",
+                "is",
+                "usually",
+                "seen",
+                "in",
+                "infection",
+                "by",
+                "Aspergillus",
+                "spp."
+            ],
+            [
+                "We",
+                "can",
+                "rule",
+                "out",
+                "infection",
+                "by",
+                "Staphylococcus",
+                "aureus",
+                "because",
+                "of",
+                "previous",
+                "treatment,",
+                "although",
+                "we",
+                "do",
+                "not",
+                "know",
+                "if",
+                "it",
+                "raises",
+                "the",
+                "response",
+                "also",
+                "a",
+                "possible",
+                "MRSA."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "588_63",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "11_74",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "Ten",
+                "days",
+                "after",
+                "performing",
+                "a",
+                "hemithyroidectomy",
+                "on",
+                "a",
+                "patient",
+                "with",
+                "a",
+                "1.5",
+                "cm",
+                "thyroid",
+                "nodule",
+                "you",
+                "receive",
+                "the",
+                "following",
+                "anatomopathologic",
+                "report:",
+                "\"very",
+                "cellular",
+                "follicular",
+                "pattern",
+                "without",
+                "capsular",
+                "invasion",
+                "and",
+                "infiltrating",
+                "adjacent",
+                "blood",
+                "vessels",
+                "and",
+                "nerves\"."
+            ],
+            [
+                "Point",
+                "out",
+                "the",
+                "correct",
+                "answer:"
+            ],
+            [
+                "1-",
+                "As",
+                "there",
+                "is",
+                "no",
+                "capsular",
+                "invasion,",
+                "no",
+                "further",
+                "surgery",
+                "is",
+                "necessary."
+            ],
+            [
+                "2-",
+                "Follicular",
+                "pattern",
+                "is",
+                "an",
+                "indication",
+                "for",
+                "prophylactic",
+                "cervical",
+                "lymph",
+                "node",
+                "emptying."
+            ],
+            [
+                "3-",
+                "This",
+                "is",
+                "a",
+                "follicular",
+                "carcinoma",
+                "and",
+                "requires",
+                "completion",
+                "of",
+                "thyroidectomy."
+            ],
+            [
+                "4-",
+                "The",
+                "report",
+                "allows",
+                "us",
+                "to",
+                "rule",
+                "out",
+                "with",
+                "total",
+                "certainty",
+                "a",
+                "papillary",
+                "carcinoma",
+                "in",
+                "the",
+                "remaining",
+                "thyroid."
+            ],
+            [
+                "5-",
+                "Measurement",
+                "of",
+                "plasma",
+                "calcitonin",
+                "will",
+                "allow",
+                "us",
+                "to",
+                "distinguish",
+                "between",
+                "papillary",
+                "and",
+                "follicular",
+                "carcinoma."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "I",
+                "think",
+                "the",
+                "correct",
+                "answer",
+                "is",
+                "3",
+                "answers",
+                "2,4",
+                "and",
+                "5",
+                "are",
+                "clearly",
+                "false."
+            ],
+            [
+                "The",
+                "doubt",
+                "is",
+                "between",
+                "1",
+                "and",
+                "2."
+            ],
+            [
+                "The",
+                "statement",
+                "of",
+                "1",
+                "is",
+                "correct",
+                "in",
+                "cases",
+                "of",
+                "follicular",
+                "carcinoma",
+                "without",
+                "capsular",
+                "invasion",
+                "a",
+                "total",
+                "thyroidectomy",
+                "can",
+                "be",
+                "performed."
+            ],
+            [
+                "But",
+                "if",
+                "there",
+                "are",
+                "data",
+                "of",
+                "poor",
+                "prognosis",
+                "and",
+                "the",
+                "possibility",
+                "of",
+                "metastases",
+                "-",
+                "as",
+                "in",
+                "this",
+                "case",
+                "-",
+                "it",
+                "is",
+                "best",
+                "to",
+                "complete",
+                "the",
+                "thyroidectomy",
+                "and",
+                "perform",
+                "a",
+                "radioactive",
+                "iodine",
+                "scan",
+                "to",
+                "rule",
+                "out",
+                "metastases",
+                "or",
+                "treat",
+                "them",
+                "if",
+                "they",
+                "are",
+                "present."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "535_121",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "RHEUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "27-year-old",
+                "black",
+                "woman",
+                "consults",
+                "for",
+                "the",
+                "appearance",
+                "of",
+                "edema",
+                "in",
+                "the",
+                "lower",
+                "limbs,",
+                "decreased",
+                "diuresis,",
+                "fever",
+                "and",
+                "a",
+                "malar",
+                "rash",
+                "in",
+                "butterfly",
+                "wings",
+                "of",
+                "20",
+                "days",
+                "of",
+                "evolution."
+            ],
+            [
+                "Laboratory",
+                "tests",
+                "showed",
+                "creatinine",
+                "3",
+                "mg/dl,",
+                "leukopenia,",
+                "hemoglobin",
+                "10.5",
+                "g/dl",
+                "(normochromic",
+                "normocytic),",
+                "CRP",
+                "9",
+                "mg/dl",
+                "and",
+                "ESR",
+                "60",
+                "mm."
+            ],
+            [
+                "Regarding",
+                "the",
+                "pathology",
+                "presented",
+                "by",
+                "this",
+                "patient,",
+                "point",
+                "out",
+                "the",
+                "correct",
+                "answer:"
+            ],
+            [
+                "1-",
+                "The",
+                "anti-Sm",
+                "antibodies",
+                "are",
+                "not",
+                "specific",
+                "for",
+                "this",
+                "pathology."
+            ],
+            [
+                "2-",
+                "Anti-centromere",
+                "antibodies",
+                "are",
+                "detected",
+                "in",
+                "90%",
+                "of",
+                "cases."
+            ],
+            [
+                "3-",
+                "ANA",
+                "(antinuclear",
+                "antibodies)",
+                "are",
+                "detected",
+                "in",
+                "50%",
+                "of",
+                "cases."
+            ],
+            [
+                "4-",
+                "Anti-two-stranded",
+                "or",
+                "native",
+                "anti-DNA",
+                "correlates",
+                "with",
+                "the",
+                "risk",
+                "of",
+                "nephritis."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Another",
+                "question",
+                "about",
+                "SLE",
+                "antibodies."
+            ],
+            [
+                "Clinical",
+                "case",
+                "of",
+                "SLE",
+                "with",
+                "renal",
+                "involvement,",
+                "in",
+                "which",
+                "positive",
+                "double-stranded",
+                "anti-DNA",
+                "increases",
+                "the",
+                "risk",
+                "of",
+                "nephritis."
+            ],
+            [
+                "As",
+                "for",
+                "the",
+                "rest,",
+                "anti-Sm",
+                "are",
+                "specific",
+                "to",
+                "SLE,",
+                "ANA",
+                "are",
+                "detected",
+                "in",
+                "more",
+                "than",
+                "90%",
+                "of",
+                "cases,",
+                "and",
+                "anti-centromere",
+                "are",
+                "typical",
+                "of",
+                "scleroderma."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "452_149",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "In",
+                "a",
+                "woman",
+                "with",
+                "an",
+                "epileptic",
+                "seizure",
+                "presenting",
+                "with",
+                "the",
+                "following",
+                "clinical",
+                "features:",
+                "epigastric",
+                "aura,",
+                "unpleasant",
+                "odor,",
+                "disconnection",
+                "from",
+                "the",
+                "environment,",
+                "motor",
+                "automatisms",
+                "(sucking,",
+                "swallowing,",
+                "opening",
+                "and",
+                "closing",
+                "of",
+                "one",
+                "hand)",
+                "and",
+                "postcritical",
+                "amnesia,",
+                "what",
+                "is",
+                "your",
+                "diagnostic",
+                "suspicion?"
+            ],
+            [
+                "1-",
+                "Generalized",
+                "non-convulsive",
+                "seizure",
+                "or",
+                "typical",
+                "absence."
+            ],
+            [
+                "2-",
+                "Continuous",
+                "partial",
+                "epilepsy."
+            ],
+            [
+                "3-",
+                "Amyotonic",
+                "crisis."
+            ],
+            [
+                "4-",
+                "Complex",
+                "partial",
+                "temporal",
+                "lobe",
+                "seizure."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Clearly",
+                "the",
+                "answer",
+                "is",
+                "4,",
+                "with",
+                "a",
+                "very",
+                "characteristic",
+                "clinic",
+                "of",
+                "temporary",
+                "seizures."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "55_74",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "Ten",
+                "days",
+                "after",
+                "performing",
+                "a",
+                "hemithyroidectomy",
+                "on",
+                "a",
+                "patient",
+                "with",
+                "a",
+                "1.5",
+                "cm",
+                "thyroid",
+                "nodule",
+                "you",
+                "receive",
+                "the",
+                "following",
+                "definitive",
+                "report",
+                "from",
+                "the",
+                "pathologist:",
+                "\"very",
+                "cellular",
+                "follicular",
+                "pattern",
+                "without",
+                "capsular",
+                "invasion",
+                "invading",
+                "adjacent",
+                "blood",
+                "vessels",
+                "and",
+                "nerves\"."
+            ],
+            [
+                "Point",
+                "out",
+                "the",
+                "correct",
+                "answer:"
+            ],
+            [
+                "1-",
+                "As",
+                "there",
+                "is",
+                "no",
+                "capsular",
+                "invasion",
+                "it",
+                "is",
+                "not",
+                "convenient",
+                "to",
+                "perform",
+                "further",
+                "surgery."
+            ],
+            [
+                "2-",
+                "The",
+                "follicular",
+                "pattern",
+                "is",
+                "an",
+                "indication",
+                "for",
+                "prophylactic",
+                "cervical",
+                "lymph",
+                "node",
+                "emptying."
+            ],
+            [
+                "3-",
+                "It",
+                "is",
+                "a",
+                "follicular",
+                "carcinoma",
+                "and",
+                "requires",
+                "completion",
+                "of",
+                "thyroidectomy."
+            ],
+            [
+                "4-",
+                "The",
+                "report",
+                "allows",
+                "to",
+                "rule",
+                "out",
+                "papillary",
+                "carcinoma",
+                "with",
+                "total",
+                "certainty",
+                "in",
+                "the",
+                "remaining",
+                "thyroid."
+            ],
+            [
+                "5-",
+                "Measurement",
+                "of",
+                "plasma",
+                "calcitonin",
+                "will",
+                "allow",
+                "us",
+                "to",
+                "differentiate",
+                "between",
+                "papillary",
+                "and",
+                "follicular",
+                "carcinoma."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "I",
+                "find",
+                "this",
+                "question",
+                "a",
+                "bit",
+                "more",
+                "difficult",
+                "since",
+                "you",
+                "have",
+                "to",
+                "have",
+                "clear",
+                "concepts",
+                "of",
+                "pathologic",
+                "anatomy."
+            ],
+            [
+                "In",
+                "any",
+                "case,",
+                "it",
+                "is",
+                "possible",
+                "to",
+                "exclude",
+                "by",
+                "exclusion",
+                "and",
+                "by",
+                "the",
+                "way",
+                "the",
+                "answers",
+                "are",
+                "expressed:",
+                "Answer",
+                "2:",
+                "prophylactic",
+                "emptying",
+                "is",
+                "indicated",
+                "in",
+                "the",
+                "medullary."
+            ],
+            [
+                "Answer",
+                "4:",
+                "simply",
+                "by",
+                "the",
+                "way",
+                "of",
+                "expressing",
+                "it,",
+                "it",
+                "should",
+                "already",
+                "have",
+                "been",
+                "ruled",
+                "out."
+            ],
+            [
+                "Answer",
+                "5:",
+                "you",
+                "already",
+                "know",
+                "that",
+                "calcitonin",
+                "is",
+                "used",
+                "in",
+                "medullary",
+                "carcinoma",
+                "and",
+                "not",
+                "in",
+                "differentiated",
+                "carcinoma."
+            ],
+            [
+                "Answers",
+                "1",
+                "and",
+                "3",
+                "are",
+                "contrary,",
+                "one",
+                "recommends",
+                "completing",
+                "thyroidectomy",
+                "and",
+                "the",
+                "other",
+                "does",
+                "not."
+            ],
+            [
+                "The",
+                "only",
+                "ones",
+                "in",
+                "which",
+                "complete",
+                "thyroidectomy",
+                "is",
+                "not",
+                "recommended",
+                "are",
+                "microcarcinomas",
+                "measuring",
+                "less",
+                "than",
+                "1",
+                "cm."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "281_33",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PATHOLOGICAL",
+                "ANATOMY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "67-year-old",
+                "woman",
+                "diagnosed",
+                "with",
+                "an",
+                "infiltrating",
+                "ductal",
+                "carcinoma",
+                "of",
+                "the",
+                "breast",
+                "and",
+                "no",
+                "family",
+                "history",
+                "of",
+                "neoplasia."
+            ],
+            [
+                "What",
+                "additional",
+                "studies",
+                "should",
+                "be",
+                "performed",
+                "on",
+                "the",
+                "tumor",
+                "for",
+                "its",
+                "clinical-therapeutic",
+                "implications?"
+            ],
+            [
+                "1-",
+                "Complete",
+                "phenotypic",
+                "study",
+                "by",
+                "flow",
+                "cytometry."
+            ],
+            [
+                "2-",
+                "Study",
+                "of",
+                "hormone",
+                "receptors",
+                "and",
+                "HER2."
+            ],
+            [
+                "3-",
+                "Study",
+                "of",
+                "hormone",
+                "receptors,",
+                "e-cadherin",
+                "and",
+                "study",
+                "of",
+                "first",
+                "degree",
+                "relatives."
+            ],
+            [
+                "4-",
+                "Study",
+                "of",
+                "BRCA",
+                "1-2",
+                "and",
+                "study",
+                "of",
+                "first-degree",
+                "relatives."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "would",
+                "be",
+                "2,",
+                "HORMONE",
+                "AND",
+                "HER2",
+                "RECEPTOR",
+                "STUDY,",
+                "since",
+                "positive",
+                "HER2",
+                "receptors",
+                "imply",
+                "greater",
+                "aggressiveness",
+                "of",
+                "the",
+                "tumor",
+                "but",
+                "treatment",
+                "with",
+                "trastuzumab",
+                "and",
+                "positive",
+                "hormone",
+                "receptors",
+                "would",
+                "imply",
+                "the",
+                "use",
+                "of",
+                "hormone",
+                "therapy."
+            ],
+            [
+                "Answer",
+                "1",
+                "can",
+                "be",
+                "ruled",
+                "out",
+                "visu",
+                "visu,",
+                "while",
+                "answers",
+                "3",
+                "and",
+                "4",
+                "should",
+                "be",
+                "ruled",
+                "out",
+                "since,",
+                "being",
+                "the",
+                "first",
+                "woman",
+                "in",
+                "the",
+                "family",
+                "with",
+                "breast",
+                "carcinoma,",
+                "the",
+                "study",
+                "of",
+                "the",
+                "patient's",
+                "relatives",
+                "would",
+                "not",
+                "be",
+                "obligatory."
+            ],
+            [
+                "Likewise,",
+                "e-cadherin",
+                "is",
+                "important",
+                "for",
+                "the",
+                "differential",
+                "diagnosis",
+                "of",
+                "a",
+                "lobular",
+                "breast",
+                "carcinoma,",
+                "not",
+                "a",
+                "ductal",
+                "one."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "B-Marker",
+                "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",
+                "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",
+                "B-Marker",
+                "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",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "310_216",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "OPHTHALMOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "parent",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "with",
+                "his",
+                "2-year-old",
+                "son",
+                "because",
+                "he",
+                "reports",
+                "that",
+                "he",
+                "has",
+                "hit",
+                "his",
+                "right",
+                "eye",
+                "while",
+                "playing."
+            ],
+            [
+                "Indeed,",
+                "a",
+                "hematoma",
+                "is",
+                "observed",
+                "on",
+                "the",
+                "right",
+                "eyelid,",
+                "apparently",
+                "of",
+                "no",
+                "importance."
+            ],
+            [
+                "The",
+                "fundus",
+                "examination",
+                "showed",
+                "intraretinal",
+                "hemorrhages",
+                "not",
+                "only",
+                "in",
+                "the",
+                "eye",
+                "referred",
+                "by",
+                "the",
+                "parents",
+                "but",
+                "also",
+                "in",
+                "the",
+                "other",
+                "eye."
+            ],
+            [
+                "It",
+                "is",
+                "noteworthy",
+                "that",
+                "the",
+                "child",
+                "appears",
+                "drowsy",
+                "and",
+                "with",
+                "little",
+                "tone."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "statements",
+                "should",
+                "you",
+                "consider",
+                "regarding",
+                "this",
+                "clinical",
+                "picture?"
+            ],
+            [
+                "1-",
+                "It",
+                "is",
+                "a",
+                "highly",
+                "suggestive",
+                "history",
+                "of",
+                "child",
+                "abuse."
+            ],
+            [
+                "2-",
+                "It",
+                "is",
+                "the",
+                "normal",
+                "evolution",
+                "of",
+                "a",
+                "non-perforating",
+                "intraocular",
+                "trauma."
+            ],
+            [
+                "3-",
+                "The",
+                "most",
+                "likely",
+                "diagnosis",
+                "is",
+                "Berlin",
+                "edema."
+            ],
+            [
+                "4-",
+                "It",
+                "is",
+                "the",
+                "characteristic",
+                "picture",
+                "of",
+                "Purstcher's",
+                "traumatic",
+                "retinal",
+                "angiopathy."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Easy",
+                "question",
+                "in",
+                "principle,",
+                "but",
+                "with",
+                "a",
+                "bit",
+                "of",
+                "a",
+                "catch."
+            ],
+            [
+                "If",
+                "you",
+                "have",
+                "the",
+                "right",
+                "intuition",
+                "when",
+                "you",
+                "read",
+                "it",
+                "and",
+                "go",
+                "straight",
+                "to",
+                "what",
+                "you",
+                "think,",
+                "you",
+                "will",
+                "probably",
+                "get",
+                "it",
+                "right."
+            ],
+            [
+                "The",
+                "problem",
+                "is",
+                "option",
+                "4,",
+                "which",
+                "can",
+                "confuse",
+                "us."
+            ],
+            [
+                "Let's",
+                "see:",
+                "we",
+                "have",
+                "a",
+                "blow",
+                "to",
+                "the",
+                "right",
+                "eye",
+                "area,",
+                "with",
+                "a",
+                "hematoma",
+                "on",
+                "the",
+                "eyelid."
+            ],
+            [
+                "So",
+                "far",
+                "so",
+                "normal."
+            ],
+            [
+                "The",
+                "problem",
+                "is",
+                "that",
+                "retinal",
+                "hemorrhages",
+                "appear",
+                "not",
+                "only",
+                "in",
+                "that",
+                "eye",
+                "(which",
+                "in",
+                "itself",
+                "is",
+                "rare,",
+                "because",
+                "an",
+                "external",
+                "blow",
+                "to",
+                "the",
+                "eye",
+                "in",
+                "a",
+                "child",
+                "rarely",
+                "causes",
+                "bleeding",
+                "in",
+                "the",
+                "retina),",
+                "but",
+                "also",
+                "in",
+                "the",
+                "other",
+                "eye."
+            ],
+            [
+                "Therefore,",
+                "something",
+                "other",
+                "than",
+                "the",
+                "blow",
+                "has",
+                "caused",
+                "hemorrhages",
+                "in",
+                "both",
+                "retinas."
+            ],
+            [
+                "Then",
+                "we",
+                "are",
+                "told",
+                "that",
+                "the",
+                "child",
+                "seems",
+                "drowsy",
+                "and",
+                "with",
+                "little",
+                "tone."
+            ],
+            [
+                "Here",
+                "we",
+                "already",
+                "have",
+                "the",
+                "two",
+                "keys;",
+                "we",
+                "have",
+                "to",
+                "suspect",
+                "what",
+                "is",
+                "not",
+                "mentioned",
+                "in",
+                "the",
+                "answers,",
+                "but",
+                "which",
+                "is",
+                "what",
+                "the",
+                "child",
+                "has:",
+                "the",
+                "shaken",
+                "baby",
+                "syndrome",
+                "(shaken",
+                "baby",
+                "syndrome)."
+            ],
+            [
+                "Characteristic",
+                "of",
+                "this",
+                "syndrome",
+                "are",
+                "bilateral",
+                "retinal",
+                "hemorrhages,",
+                "cerebral",
+                "edema",
+                "and",
+                "subdural",
+                "hematoma."
+            ],
+            [
+                "There",
+                "may",
+                "also",
+                "be",
+                "fracture",
+                "of",
+                "long",
+                "bones",
+                "and",
+                "other",
+                "problems."
+            ],
+            [
+                "Numbness",
+                "and",
+                "hypotonia",
+                "allow",
+                "us",
+                "to",
+                "suspect",
+                "intracranial",
+                "complications."
+            ],
+            [
+                "The",
+                "cause",
+                "of",
+                "shaken",
+                "baby",
+                "syndrome",
+                "is",
+                "almost",
+                "always",
+                "abuse,",
+                "so",
+                "the",
+                "answer",
+                "is",
+                "1."
+            ],
+            [
+                "Options",
+                "2",
+                "and",
+                "3",
+                "are",
+                "easy",
+                "to",
+                "rule",
+                "out:",
+                "nothing",
+                "indicates",
+                "perforating",
+                "trauma,",
+                "and",
+                "it",
+                "does",
+                "not",
+                "explain",
+                "the",
+                "hemorrhages",
+                "in",
+                "the",
+                "other",
+                "eye."
+            ],
+            [
+                "And",
+                "the",
+                "berlin",
+                "edema",
+                "is",
+                "an",
+                "edema",
+                "of",
+                "the",
+                "macula",
+                "and",
+                "appears",
+                "as",
+                "a",
+                "whitish",
+                "lesion,",
+                "which",
+                "is",
+                "not",
+                "described",
+                "in",
+                "the",
+                "statement."
+            ],
+            [
+                "The",
+                "catch",
+                "is",
+                "option",
+                "4."
+            ],
+            [
+                "Purstcher's",
+                "retinopathy",
+                "can",
+                "also",
+                "appear",
+                "in",
+                "the",
+                "context",
+                "of",
+                "the",
+                "child",
+                "of",
+                "the",
+                "shaken",
+                "child,",
+                "and",
+                "therefore",
+                "occur",
+                "in",
+                "the",
+                "case",
+                "of",
+                "child",
+                "abuse."
+            ],
+            [
+                "Seeing",
+                "these",
+                "two",
+                "partly",
+                "related",
+                "questions,",
+                "we",
+                "may",
+                "hesitate."
+            ],
+            [
+                "However,",
+                "if",
+                "we",
+                "read",
+                "answer",
+                "4",
+                "carefully,",
+                "it",
+                "does",
+                "not",
+                "tell",
+                "us",
+                "that",
+                "if",
+                "there",
+                "is",
+                "child",
+                "maltreatment",
+                "Purstcher",
+                "can",
+                "occur."
+            ],
+            [
+                "It",
+                "states",
+                "that",
+                "the",
+                "picture",
+                "described",
+                "above",
+                "(intraretinal",
+                "hemorrhages,",
+                "without",
+                "other",
+                "findings)",
+                "is",
+                "characteristic",
+                "of",
+                "Purstcher's",
+                "angiopathy.",
+                "It",
+                "is",
+                "not."
+            ],
+            [
+                "In",
+                "Purstcher's",
+                "there",
+                "are",
+                "hemorrhages,",
+                "but",
+                "also",
+                "cottony",
+                "exudates",
+                "and",
+                "edema."
+            ],
+            [
+                "If",
+                "there",
+                "are",
+                "only",
+                "hemorrhages,",
+                "it's",
+                "not",
+                "Purstcher's."
+            ],
+            [
+                "Here's",
+                "the",
+                "messy",
+                "bit,",
+                "but",
+                "it's",
+                "really",
+                "well",
+                "worded."
+            ],
+            [
+                "If",
+                "he",
+                "had",
+                "a",
+                "Purstcher",
+                "it",
+                "could",
+                "also",
+                "be",
+                "for",
+                "child",
+                "abuse,",
+                "but",
+                "he",
+                "doesn't."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "293_214",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DERMATOLOGY,",
+                "VENEREOLOGY",
+                "AND",
+                "PLASTIC",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "patient",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "with",
+                "erythroderma",
+                "with",
+                "fever",
+                "and",
+                "general",
+                "malaise."
+            ],
+            [
+                "On",
+                "examination,",
+                "the",
+                "nails",
+                "show",
+                "the",
+                "presence",
+                "of",
+                "nail",
+                "pitting",
+                "and",
+                "distal",
+                "yellowish",
+                "areas",
+                "in",
+                "an",
+                "oil",
+                "stain."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "primary",
+                "disease",
+                "that",
+                "caused",
+                "the",
+                "condition?"
+            ],
+            [
+                "1-",
+                "Cutaneous",
+                "lymphoma."
+            ],
+            [
+                "2-",
+                "Atopic",
+                "dermatitis."
+            ],
+            [
+                "3-",
+                "Psoriasis."
+            ],
+            [
+                "4-",
+                "Ichthyosis."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Any",
+                "of",
+                "the",
+                "4",
+                "options",
+                "can",
+                "be",
+                "the",
+                "cause",
+                "of",
+                "erythroderma,",
+                "although",
+                "the",
+                "description",
+                "of",
+                "nail",
+                "lesions",
+                "highly",
+                "suggestive",
+                "of",
+                "psoriasis",
+                "makes",
+                "this",
+                "diagnosis",
+                "the",
+                "most",
+                "likely."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "132_229",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY",
+                "AND",
+                "NEUROSURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "54-year-old",
+                "man,",
+                "with",
+                "a",
+                "personal",
+                "history",
+                "of",
+                "DM,",
+                "hypertension",
+                "and",
+                "mild",
+                "chronic",
+                "renal",
+                "insufficiency,",
+                "presented",
+                "with",
+                "somnolence",
+                "and",
+                "right",
+                "hemiparesis."
+            ],
+            [
+                "Laboratory",
+                "tests:",
+                "creatinine",
+                "2.3",
+                "mg/dl,",
+                "Hb",
+                "10.3",
+                "g/dl",
+                "and",
+                "platelets",
+                "20000",
+                "mm3,",
+                "with",
+                "normal",
+                "coagulation."
+            ],
+            [
+                "Cranial",
+                "CT:",
+                "ischemic",
+                "lesions",
+                "with",
+                "microhemorrhagic",
+                "necrosis."
+            ],
+            [
+                "Subsequently,",
+                "he",
+                "began",
+                "with",
+                "progressive",
+                "deterioration",
+                "of",
+                "the",
+                "level",
+                "of",
+                "consciousness",
+                "and",
+                "increase",
+                "of",
+                "Cr,",
+                "LDH",
+                "and",
+                "unconjugated",
+                "bilirubin."
+            ],
+            [
+                "Direct",
+                "Coombs'",
+                "test",
+                "was",
+                "negative."
+            ],
+            [
+                "Schistocytes",
+                "in",
+                "smear."
+            ],
+            [
+                "In",
+                "view",
+                "of",
+                "the",
+                "diagnostic",
+                "suspicion,",
+                "the",
+                "following",
+                "conduct",
+                "is",
+                "to",
+                "be",
+                "followed:"
+            ],
+            [
+                "1-",
+                "New",
+                "cranial",
+                "CT",
+                "in",
+                "the",
+                "presence",
+                "of",
+                "suspected",
+                "hemorrhagic",
+                "transformation",
+                "of",
+                "ischemic",
+                "stroke."
+            ],
+            [
+                "2-",
+                "Initiate",
+                "urgent",
+                "plasmapheresis."
+            ],
+            [
+                "3-",
+                "Beginning",
+                "of",
+                "treatment",
+                "with",
+                "glucocorticoids",
+                "at",
+                "a",
+                "dose",
+                "of",
+                "1",
+                "mg/kg/day."
+            ],
+            [
+                "4-",
+                "Search",
+                "for",
+                "triggering",
+                "cause",
+                "of",
+                "DIC."
+            ],
+            [
+                "5-",
+                "Suspected",
+                "multiple",
+                "myeloma:",
+                "bone",
+                "marrow",
+                "aspirate."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Let's",
+                "see:",
+                "a",
+                "patient",
+                "with",
+                "certain",
+                "history",
+                "who",
+                "has:",
+                "-",
+                "Schistocytes",
+                "in",
+                "smear:",
+                "indicates",
+                "microangiopathic",
+                "anemia,",
+                "red",
+                "cell",
+                "rupture",
+                "of",
+                "mechanical",
+                "cause,",
+                "which",
+                "can",
+                "be",
+                "seen",
+                "mainly",
+                "in",
+                "PTT,",
+                "autoimmune",
+                "hemolytic",
+                "anemia",
+                "and",
+                "DIC."
+            ],
+            [
+                "-",
+                "Bicytopenia:",
+                "here",
+                "the",
+                "causes",
+                "can",
+                "be",
+                "very,",
+                "very",
+                "varied."
+            ],
+            [
+                "-",
+                "Elevation",
+                "of",
+                "LDH",
+                "and",
+                "Bilirubin,",
+                "which",
+                "indicates",
+                "a",
+                "massive",
+                "rupture",
+                "of",
+                "red",
+                "blood",
+                "cells."
+            ],
+            [
+                "-",
+                "Negative",
+                "direct",
+                "Coombs'",
+                "test:",
+                "essential",
+                "data,",
+                "indicating",
+                "that",
+                "there",
+                "is",
+                "no",
+                "antibody",
+                "that",
+                "sticks",
+                "to",
+                "the",
+                "red",
+                "blood",
+                "cells."
+            ],
+            [
+                "With",
+                "these",
+                "wickers",
+                "we",
+                "are",
+                "going",
+                "to",
+                "weave",
+                "the",
+                "basket:",
+                "Answer",
+                "1:",
+                "it",
+                "cannot",
+                "be",
+                "because",
+                "a",
+                "hemorrhagic",
+                "transformation",
+                "does",
+                "not",
+                "give",
+                "such",
+                "a",
+                "brutal",
+                "elevation",
+                "of",
+                "LDH",
+                "and",
+                "Cr,",
+                "in",
+                "addition",
+                "to",
+                "not",
+                "explaining",
+                "schistocytosis."
+            ],
+            [
+                "Answer",
+                "2:",
+                "urgent",
+                "plasmapheresis...",
+                "in",
+                "case",
+                "of",
+                "thrombotic",
+                "thrombocytopenic",
+                "purpura,",
+                "yes;",
+                "I",
+                "like",
+                "this",
+                "answer",
+                "because",
+                "it",
+                "justifies",
+                "bicytopenia,",
+                "since",
+                "microangiopathic",
+                "hemolytic",
+                "anemia",
+                "is",
+                "produced",
+                "by",
+                "rupture",
+                "of",
+                "red",
+                "blood",
+                "cells",
+                "when",
+                "they",
+                "are",
+                "fragmented",
+                "by",
+                "ultralong",
+                "von",
+                "Willebrand",
+                "factor",
+                "multimers",
+                "in",
+                "case",
+                "of",
+                "deficiency",
+                "of",
+                "the",
+                "ADAMST13",
+                "enzyme,",
+                "resulting",
+                "in",
+                "brutal",
+                "platelet",
+                "aggregates",
+                "and",
+                "the",
+                "flow",
+                "cytometer",
+                "does",
+                "not",
+                "count",
+                "400",
+                "platelets,",
+                "but",
+                "a",
+                "molondron",
+                "of",
+                "platelets",
+                "that",
+                "form",
+                "a",
+                "mass,",
+                "hence",
+                "the",
+                "thrombocytopenia."
+            ],
+            [
+                "It",
+                "also",
+                "explains",
+                "the",
+                "negative",
+                "direct",
+                "Coombs,",
+                "elevated",
+                "LDH",
+                "and",
+                "Cr."
+            ],
+            [
+                "Answer",
+                "3:",
+                "a",
+                "situation",
+                "as",
+                "critical",
+                "as",
+                "that",
+                "patient's",
+                "indicates",
+                "that",
+                "something",
+                "big",
+                "is",
+                "going",
+                "on",
+                "and",
+                "I",
+                "would",
+                "not",
+                "sit",
+                "and",
+                "wait",
+                "for",
+                "glucocorticoids",
+                "to",
+                "take",
+                "effect...and",
+                "I",
+                "do",
+                "not",
+                "know",
+                "right",
+                "now",
+                "what",
+                "pathology",
+                "gives",
+                "that",
+                "symptomatology",
+                "and",
+                "has",
+                "that",
+                "treatment",
+                "as",
+                "standard."
+            ],
+            [
+                "Answer",
+                "4:",
+                "looking",
+                "for",
+                "a",
+                "trigger",
+                "for",
+                "DIC...it",
+                "would",
+                "make",
+                "sense",
+                "if",
+                "it",
+                "were",
+                "not",
+                "for",
+                "the",
+                "fact",
+                "that",
+                "in",
+                "DIC",
+                "it",
+                "is",
+                "VERY",
+                "characteristic",
+                "the",
+                "consumption",
+                "of",
+                "coagulation",
+                "factors,",
+                "which",
+                "is",
+                "not",
+                "present",
+                "in",
+                "this",
+                "case."
+            ],
+            [
+                "Answer",
+                "5:",
+                "a",
+                "myeloma",
+                "does",
+                "not",
+                "give",
+                "schistocytosis",
+                "nor",
+                "does",
+                "it",
+                "have",
+                "this",
+                "symptomatology,",
+                "they",
+                "would",
+                "have",
+                "to",
+                "give",
+                "other",
+                "data",
+                "that",
+                "would",
+                "support",
+                "this",
+                "pathology,",
+                "such",
+                "as",
+                "bone",
+                "pain",
+                "and",
+                "hypercalcemia..."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "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-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-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"
+            ],
+            [
+                "O",
+                "B-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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
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+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "49_159",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "120_192",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PREVENTIVE",
+                "MEDICINE",
+                "AND",
+                "EPIDEMIOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "40-year-old",
+                "orthopedic",
+                "surgeon",
+                "who",
+                "in",
+                "a",
+                "routine",
+                "serology",
+                "was",
+                "found",
+                "to",
+                "have",
+                "anti-HBs",
+                "levels",
+                "of",
+                "30",
+                "IU/l."
+            ],
+            [
+                "He",
+                "refers",
+                "complete",
+                "vaccination",
+                "according",
+                "to",
+                "the",
+                "standard",
+                "hepatitis",
+                "B",
+                "vaccination",
+                "schedule",
+                "4",
+                "years",
+                "ago."
+            ],
+            [
+                "It",
+                "would",
+                "be",
+                "advisable:"
+            ],
+            [
+                "1-",
+                "Restart",
+                "vaccination",
+                "schedule",
+                "(0-1-6",
+                "months)."
+            ],
+            [
+                "2-",
+                "Restart",
+                "vaccination",
+                "schedule",
+                "(0-1-2-12",
+                "months)."
+            ],
+            [
+                "3-",
+                "Do",
+                "not",
+                "revaccinate."
+            ],
+            [
+                "4-",
+                "Give",
+                "a",
+                "booster",
+                "dose."
+            ],
+            [
+                "5-",
+                "Give",
+                "anti-hepatitis",
+                "B",
+                "immunoglobulin",
+                "and",
+                "restart",
+                "vaccination",
+                "schedule",
+                "(0-1-2-12",
+                "months)."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "As",
+                "long",
+                "as",
+                "the",
+                "serological",
+                "levels",
+                "of",
+                "anti-HBs",
+                "are",
+                "above",
+                "10",
+                "IU/l",
+                "it",
+                "is",
+                "not",
+                "necessary",
+                "to",
+                "revaccinate."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "304_174",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEPHROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "87-year-old",
+                "man",
+                "with",
+                "a",
+                "history",
+                "of",
+                "hypertension",
+                "and",
+                "gonarthrosis."
+            ],
+            [
+                "Baseline",
+                "situation",
+                "with",
+                "full",
+                "functional",
+                "and",
+                "cognitive",
+                "autonomy",
+                "that",
+                "allows",
+                "him",
+                "to",
+                "continue",
+                "living",
+                "alone",
+                "in",
+                "the",
+                "community."
+            ],
+            [
+                "He",
+                "is",
+                "receiving",
+                "regular",
+                "treatment",
+                "with",
+                "perindopril",
+                "and",
+                "thiazide",
+                "diuretic",
+                "for",
+                "blood",
+                "pressure",
+                "control",
+                "and",
+                "routinely",
+                "takes",
+                "ibuprofen",
+                "1800",
+                "mg/day",
+                "to",
+                "control",
+                "the",
+                "symptoms",
+                "derived",
+                "from",
+                "his",
+                "gonarthrosis."
+            ],
+            [
+                "After",
+                "routine",
+                "control,",
+                "a",
+                "persistent",
+                "blood",
+                "pressure",
+                "of",
+                "190",
+                "and",
+                "TAD",
+                "80",
+                "mmHg",
+                "was",
+                "observed."
+            ],
+            [
+                "What",
+                "would",
+                "be",
+                "the",
+                "most",
+                "reasonable",
+                "therapeutic",
+                "modification",
+                "to",
+                "achieve",
+                "blood",
+                "pressure",
+                "control?"
+            ],
+            [
+                "1-",
+                "I",
+                "would",
+                "add",
+                "a",
+                "calcium",
+                "channel",
+                "blocker."
+            ],
+            [
+                "2-",
+                "I",
+                "would",
+                "increase",
+                "the",
+                "dose",
+                "of",
+                "hydrochlorothiazide",
+                "to",
+                "25",
+                "mg/day."
+            ],
+            [
+                "3-",
+                "I",
+                "would",
+                "change",
+                "ibuprofen",
+                "for",
+                "paracetamol",
+                "to",
+                "avoid",
+                "the",
+                "possible",
+                "influence",
+                "of",
+                "paracetamol",
+                "on",
+                "the",
+                "effect",
+                "of",
+                "hypotensives."
+            ],
+            [
+                "4-",
+                "I",
+                "would",
+                "add",
+                "an",
+                "alpha",
+                "blocker",
+                "because",
+                "of",
+                "the",
+                "high",
+                "prevalence",
+                "of",
+                "prostatic",
+                "syndrome",
+                "in",
+                "males",
+                "of",
+                "this",
+                "age."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Before",
+                "intensifying",
+                "antihypertensive",
+                "treatment,",
+                "the",
+                "potential",
+                "causes",
+                "should",
+                "be",
+                "resolved."
+            ],
+            [
+                "In",
+                "this",
+                "case",
+                "we",
+                "are",
+                "dealing",
+                "with",
+                "an",
+                "elderly",
+                "patient",
+                "with",
+                "chronic",
+                "treatment",
+                "with",
+                "NSAIDs",
+                "that",
+                "produces",
+                "arterial",
+                "hypertension",
+                "secondary",
+                "to",
+                "renal",
+                "hypoperfusion."
+            ],
+            [
+                "The",
+                "most",
+                "reasonable",
+                "option",
+                "would",
+                "be",
+                "to",
+                "withdraw",
+                "ibuprofen",
+                "and",
+                "replace",
+                "it",
+                "with",
+                "an",
+                "analgesic",
+                "from",
+                "a",
+                "group",
+                "other",
+                "than",
+                "NSAIDs",
+                "(paracetamol,",
+                "opiates),",
+                "subsequently",
+                "monitoring",
+                "the",
+                "evolution",
+                "of",
+                "blood",
+                "pressure."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "214_228",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "RHEUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "19-year-old",
+                "man",
+                "consults",
+                "for",
+                "a",
+                "24-hour",
+                "history",
+                "of",
+                "pain,",
+                "swelling",
+                "and",
+                "functional",
+                "impotence",
+                "of",
+                "the",
+                "right",
+                "knee",
+                "accompanied",
+                "by",
+                "a",
+                "fever",
+                "of",
+                "38\u00b0C."
+            ],
+            [
+                "Physical",
+                "examination",
+                "reveals",
+                "inflammatory",
+                "signs",
+                "and",
+                "joint",
+                "effusion",
+                "in",
+                "the",
+                "right",
+                "knee."
+            ],
+            [
+                "Laboratory",
+                "tests",
+                "showed",
+                "leukocytosis",
+                "with",
+                "neutrophilia",
+                "and",
+                "elevated",
+                "C-reactive",
+                "protein."
+            ],
+            [
+                "The",
+                "syndromic",
+                "diagnosis",
+                "of",
+                "acute",
+                "monoarthritis",
+                "is",
+                "made."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "etiologic",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Arthritis",
+                "due",
+                "to",
+                "microcrystals."
+            ],
+            [
+                "2-",
+                "Reactive",
+                "arthritis."
+            ],
+            [
+                "3-",
+                "Bacterial",
+                "infectious",
+                "arthritis."
+            ],
+            [
+                "4-",
+                "Mycobacterial",
+                "infectious",
+                "arthritis."
+            ],
+            [
+                "5-",
+                "Rheumatoid",
+                "arthritis."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Acute",
+                "monoarthritis",
+                "associated",
+                "with",
+                "fever,",
+                "leukocytosis",
+                "with",
+                "neutrophilia",
+                "and",
+                "increased",
+                "acute",
+                "phase",
+                "reactants",
+                "does",
+                "not",
+                "always",
+                "have",
+                "a",
+                "septic",
+                "origin."
+            ],
+            [
+                "In",
+                "the",
+                "absence",
+                "of",
+                "further",
+                "information",
+                "(more",
+                "complete",
+                "anamnesis",
+                "on",
+                "the",
+                "current",
+                "disease,",
+                "risk",
+                "factors,",
+                "personal",
+                "and",
+                "family",
+                "history,",
+                "extra-articular",
+                "symptoms",
+                "or",
+                "signs,",
+                "etc.)",
+                "it",
+                "can",
+                "be",
+                "said",
+                "that",
+                "also",
+                "1",
+                "and",
+                "2",
+                "(and",
+                "very",
+                "exceptionally",
+                "5)",
+                "could",
+                "debut",
+                "with",
+                "a",
+                "similar",
+                "clinical",
+                "and",
+                "biological",
+                "picture."
+            ],
+            [
+                "With",
+                "the",
+                "data",
+                "provided",
+                "and",
+                "taking",
+                "into",
+                "account",
+                "that",
+                "this",
+                "is",
+                "a",
+                "young",
+                "male,",
+                "the",
+                "most",
+                "likely",
+                "option",
+                "would",
+                "be",
+                "bacterial",
+                "infectious",
+                "arthritis",
+                "(that",
+                "caused",
+                "by",
+                "mycobacteria",
+                "usually",
+                "have",
+                "a",
+                "chronic",
+                "course)."
+            ],
+            [
+                "And",
+                "above",
+                "all,",
+                "because",
+                "of",
+                "its",
+                "implications,",
+                "the",
+                "first",
+                "one",
+                "to",
+                "always",
+                "rule",
+                "out."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "249_120",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTIOUS",
+                "DISEASES"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "53-year-old",
+                "woman",
+                "consults",
+                "for",
+                "a",
+                "fever",
+                "of",
+                "15",
+                "days",
+                "of",
+                "evolution,",
+                "without",
+                "symptoms",
+                "of",
+                "infectious",
+                "focality."
+            ],
+            [
+                "On",
+                "examination,",
+                "a",
+                "painful",
+                "hepatomegaly",
+                "is",
+                "detected",
+                "at",
+                "5",
+                "cm",
+                "from",
+                "the",
+                "costal",
+                "margin",
+                "and",
+                "the",
+                "spleen",
+                "is",
+                "palpated",
+                "at",
+                "14",
+                "cm",
+                "from",
+                "the",
+                "left",
+                "costal",
+                "margin."
+            ],
+            [
+                "The",
+                "blood",
+                "count",
+                "showed",
+                "Hb",
+                "8.5",
+                "g/dL,",
+                "leukocytes",
+                "630/ml",
+                "(lymphocytes",
+                "63%,",
+                "monocytes",
+                "20%,",
+                "neutrophils",
+                "17%)",
+                "and",
+                "platelets",
+                "35,000/ml."
+            ],
+            [
+                "Biochemistry",
+                "shows",
+                "moderate",
+                "elevation",
+                "of",
+                "liver",
+                "biochemistry,",
+                "LDH",
+                "is",
+                "normal",
+                "and",
+                "polyclonal",
+                "hypergammaglobulinemia",
+                "(3.5",
+                "g/dL)",
+                "is",
+                "observed",
+                "in",
+                "the",
+                "proteinogram."
+            ],
+            [
+                "He",
+                "has",
+                "a",
+                "history",
+                "of",
+                "known",
+                "HIV",
+                "infection",
+                "for",
+                "10",
+                "years",
+                "and",
+                "irregular",
+                "adherence",
+                "to",
+                "antiretroviral",
+                "treatment,",
+                "with",
+                "recent",
+                "determinations",
+                "of",
+                "CD4",
+                "lymphocytes",
+                "350",
+                "cells/mL",
+                "and",
+                "HIV",
+                "viral",
+                "load",
+                "of",
+                "154",
+                "copies/mL."
+            ],
+            [
+                "For",
+                "the",
+                "past",
+                "3",
+                "months",
+                "she",
+                "has",
+                "been",
+                "treated",
+                "for",
+                "seronegative",
+                "symmetrical",
+                "polyarthritis",
+                "with",
+                "10-20",
+                "mg/day",
+                "of",
+                "prednisone."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "statements",
+                "is",
+                "correct?"
+            ],
+            [
+                "1-",
+                "I",
+                "would",
+                "perform",
+                "a",
+                "bone",
+                "marrow",
+                "biopsy,",
+                "since",
+                "the",
+                "most",
+                "probable",
+                "diagnosis",
+                "is",
+                "visceral",
+                "leishmaniasis."
+            ],
+            [
+                "2-",
+                "Pancytopenia",
+                "is",
+                "justified",
+                "by",
+                "C",
+                "virus-associated",
+                "cirrhosis",
+                "and",
+                "I",
+                "would",
+                "not",
+                "perform",
+                "further",
+                "testing."
+            ],
+            [
+                "3-",
+                "Probably",
+                "a",
+                "medullary",
+                "toxicity",
+                "due",
+                "to",
+                "prednisone",
+                "that",
+                "would",
+                "be",
+                "treated",
+                "with",
+                "drug",
+                "withdrawal",
+                "and",
+                "filgastrim."
+            ],
+            [
+                "4-",
+                "I",
+                "would",
+                "request",
+                "an",
+                "ANAs",
+                "determination",
+                "to",
+                "rule",
+                "out",
+                "disseminated",
+                "systemic",
+                "lupus."
+            ],
+            [
+                "5-",
+                "I",
+                "would",
+                "intensify",
+                "antiretroviral",
+                "therapy,",
+                "as",
+                "it",
+                "is",
+                "likely",
+                "that",
+                "all",
+                "manifestations",
+                "are",
+                "due",
+                "to",
+                "HIV."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Easy",
+                "and",
+                "quite",
+                "typical",
+                "question."
+            ],
+            [
+                "We",
+                "are",
+                "told",
+                "about",
+                "an",
+                "HIV",
+                "patient",
+                "with",
+                "irregular",
+                "follow-up",
+                "of",
+                "antiretroviral",
+                "treatment,",
+                "presenting",
+                "fever,",
+                "hepatosplenomegaly,",
+                "pancytopenia",
+                "and",
+                "polyclonal",
+                "hypergammaglobulinemia."
+            ],
+            [
+                "All",
+                "these",
+                "data",
+                "are",
+                "suggestive",
+                "of",
+                "visceral",
+                "Leishmaniasis,",
+                "so",
+                "an",
+                "OM",
+                "biopsy",
+                "should",
+                "be",
+                "performed",
+                "to",
+                "look",
+                "for",
+                "amastigotes",
+                "and",
+                "confirm",
+                "the",
+                "diagnosis."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-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"
+            ]
+        ]
+    },
+    {
+        "id": "53_146",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PSYCHIATRY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "31-year-old",
+                "man",
+                "with",
+                "no",
+                "psychiatric",
+                "history",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "room",
+                "complaining...\u00a8",
+                "symptoms",
+                "of",
+                "anxiety."
+            ],
+            [
+                "Two",
+                "days",
+                "ago",
+                "he",
+                "experienced",
+                "another",
+                "episode",
+                "of",
+                "the",
+                "same",
+                "symptoms...",
+                "...."
+            ],
+            [
+                "1",
+                "week",
+                "ago",
+                "he",
+                "broke",
+                "up",
+                "with",
+                "his",
+                "partner...",
+                "ruled",
+                "out",
+                "any",
+                "organic",
+                "pathology....:"
+            ],
+            [
+                "1-",
+                "Post-traumatic",
+                "stress",
+                "reaction."
+            ],
+            [
+                "2-",
+                "Acute\"",
+                "dependent",
+                "personality",
+                "disorder."
+            ],
+            [
+                "3-",
+                "Depressive",
+                "disorder."
+            ],
+            [
+                "4-",
+                "Agoraphobia."
+            ],
+            [
+                "5-",
+                "Anguish",
+                "crisis."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "Here",
+                "it",
+                "is",
+                "good",
+                "that",
+                "they",
+                "tell",
+                "you",
+                "their",
+                "antecedents",
+                "(we",
+                "all",
+                "have",
+                "antecedents",
+                "because",
+                "we",
+                "all",
+                "have",
+                "a",
+                "life)",
+                "and",
+                "that",
+                "they",
+                "rule",
+                "out",
+                "organic",
+                "pathology."
+            ],
+            [
+                "That",
+                "is",
+                "fundamental."
+            ],
+            [
+                "Let",
+                "us",
+                "not",
+                "forget",
+                "that",
+                "also",
+                "the",
+                "hypochondriacs",
+                "have",
+                "body."
+            ],
+            [
+                "We",
+                "first",
+                "eliminate",
+                "the",
+                "most",
+                "striking",
+                "\"acute\"",
+                "personality",
+                "disorder."
+            ],
+            [
+                "Personality",
+                "accompanies",
+                "us",
+                "all",
+                "our",
+                "lives."
+            ],
+            [
+                "There",
+                "are",
+                "no",
+                "\"acute\"",
+                "characteristics",
+                "in",
+                "our",
+                "personality."
+            ],
+            [
+                "Depressive",
+                "disorder?",
+                "There",
+                "is",
+                "a",
+                "time",
+                "criterion",
+                "that",
+                "is",
+                "not",
+                "met,",
+                "it",
+                "may",
+                "be",
+                "sad,",
+                "but",
+                "sad",
+                "is",
+                "not",
+                "depression",
+                "(1)."
+            ],
+            [
+                "agoraphobia?",
+                "if",
+                "it",
+                "was",
+                "something",
+                "like",
+                "that",
+                "we",
+                "would",
+                "have",
+                "been",
+                "told",
+                "the",
+                "context",
+                "post-traumatic",
+                "stress",
+                "reaction?"
+            ],
+            [
+                "That's",
+                "a",
+                "good",
+                "one."
+            ],
+            [
+                "The",
+                "correct",
+                "term",
+                "would",
+                "be",
+                "post-traumatic",
+                "stress",
+                "disorder",
+                "or",
+                "acute",
+                "stress",
+                "reaction,",
+                "and",
+                "according",
+                "to",
+                "ICD",
+                "10:",
+                "\"The",
+                "stressor",
+                "may",
+                "be",
+                "a",
+                "devastating",
+                "traumatic",
+                "experience",
+                "involving",
+                "a",
+                "serious",
+                "threat",
+                "to",
+                "the",
+                "safety",
+                "or",
+                "physical",
+                "integrity",
+                "of",
+                "the",
+                "patient",
+                "or",
+                "loved",
+                "one(s)",
+                "(e.g.,",
+                "natural",
+                "catastrophes,",
+                "accidents,",
+                "battles,",
+                "muggings,",
+                "rapes)",
+                "or",
+                "an",
+                "abrupt",
+                "and",
+                "threatening",
+                "change",
+                "in",
+                "the",
+                "individual's",
+                "rank",
+                "or",
+                "social",
+                "environment",
+                "(e.g.,",
+                "loss",
+                "of",
+                "several",
+                "loved",
+                "ones,",
+                "house",
+                "fire,",
+                "etc.).",
+                ")\"",
+                "or",
+                "more",
+                "briefly:",
+                "\"exceptionally",
+                "threatening",
+                "or",
+                "catastrophic",
+                "nature\"",
+                "Breaking",
+                "up",
+                "with",
+                "a",
+                "partner",
+                "I",
+                "understand",
+                "is",
+                "hard,",
+                "but",
+                "not",
+                "exceptional."
+            ],
+            [
+                "So",
+                "by",
+                "elimination",
+                "5.",
+                "Crisis",
+                "of",
+                "distress."
+            ],
+            [
+                "This",
+                "is",
+                "a",
+                "useful",
+                "question,",
+                "common",
+                "in",
+                "daily",
+                "practice,",
+                "and",
+                "so",
+                "we",
+                "see",
+                "that",
+                "we",
+                "must",
+                "avoid",
+                "giving",
+                "a",
+                "diagnosis",
+                "of",
+                "long",
+                "evolution",
+                "for",
+                "a",
+                "natural",
+                "reaction."
+            ],
+            [
+                "Diagnoses",
+                "1",
+                "to",
+                "4",
+                "would",
+                "be",
+                "like",
+                "calling",
+                "diabetic",
+                "the",
+                "one",
+                "who",
+                "has",
+                "hyperglycemia",
+                "after",
+                "eating",
+                "three",
+                "muffins."
+            ],
+            [
+                "Useful",
+                "and",
+                "realistic",
+                "question."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "48_158",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "10-year-old",
+                "boy",
+                "is",
+                "brought",
+                "to",
+                "the",
+                "Emergency",
+                "Department",
+                "because",
+                "for",
+                "the",
+                "last",
+                "2",
+                "hours",
+                "he",
+                "has",
+                "been",
+                "involuntarily",
+                "turning",
+                "his",
+                "neck",
+                "to",
+                "the",
+                "right",
+                "associated",
+                "with",
+                "marked",
+                "cervical",
+                "pain",
+                "at",
+                "each",
+                "turn."
+            ],
+            [
+                "The",
+                "grandmother",
+                "subsequently",
+                "tells",
+                "us",
+                "that",
+                "he",
+                "has",
+                "been",
+                "vomiting",
+                "since",
+                "yesterday,",
+                "so",
+                "she",
+                "gave",
+                "him",
+                "a",
+                "syrup;",
+                "what",
+                "would",
+                "be",
+                "the",
+                "most",
+                "appropriate",
+                "therapeutic",
+                "approach?"
+            ],
+            [
+                "1-",
+                "Inject",
+                "an",
+                "intravenous",
+                "anticholinergic."
+            ],
+            [
+                "2-",
+                "Do",
+                "not",
+                "treat",
+                "until",
+                "an",
+                "electroencephalogram",
+                "is",
+                "performed",
+                "in",
+                "the",
+                "following",
+                "days."
+            ],
+            [
+                "3-",
+                "Do",
+                "not",
+                "treat",
+                "until",
+                "the",
+                "result",
+                "of",
+                "the",
+                "cerebrospinal",
+                "fluid",
+                "culture",
+                "is",
+                "known",
+                "in",
+                "the",
+                "next",
+                "few",
+                "days."
+            ],
+            [
+                "4-",
+                "Call",
+                "the",
+                "on-call",
+                "psychiatrist."
+            ],
+            [
+                "5-",
+                "Start",
+                "an",
+                "intravenous",
+                "antibiotic",
+                "after",
+                "obtaining",
+                "a",
+                "pharyngeal",
+                "swab."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "1."
+            ],
+            [
+                "The",
+                "anticholinergic",
+                "can",
+                "be",
+                "administered",
+                "intravenously",
+                "and",
+                "also",
+                "intramuscularly",
+                "if",
+                "I",
+                "am",
+                "not",
+                "mistaken."
+            ],
+            [
+                "The",
+                "occurrence",
+                "of",
+                "dystonia",
+                "as",
+                "a",
+                "side",
+                "effect",
+                "is",
+                "common",
+                "in",
+                "children",
+                "and",
+                "is",
+                "one",
+                "of",
+                "the",
+                "main",
+                "reasons",
+                "why",
+                "pediatricians",
+                "do",
+                "not",
+                "usually",
+                "prescribe",
+                "some",
+                "antiemetics",
+                "in",
+                "children."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "490_106",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "HEMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "65-year-old",
+                "woman",
+                "referred",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "for",
+                "fever",
+                "and",
+                "alterations",
+                "in",
+                "the",
+                "laboratory",
+                "tests:",
+                "hemoglobin",
+                "11.4",
+                "g/dL,",
+                "leukocytes",
+                "0.86",
+                "x103/\u03bcL,(neutrophils",
+                "41.9%,",
+                "lymphocytes",
+                "55.8%),platelets",
+                "48.0",
+                "x103/\u03bcL,",
+                "fibrinogen",
+                "118",
+                "mg/dL,D-dimer",
+                "20.2",
+                "\u03bcg/mL."
+            ],
+            [
+                "Bone",
+                "marrow",
+                "examination",
+                "was",
+                "performed",
+                "and",
+                "she",
+                "was",
+                "diagnosed",
+                "with",
+                "acute",
+                "leukemia",
+                "with",
+                "t(15;17)",
+                "in",
+                "60%",
+                "of",
+                "the",
+                "cells."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "answers",
+                "is",
+                "correct?"
+            ],
+            [
+                "1-",
+                "If",
+                "asymptomatic,",
+                "transretinoic",
+                "acid",
+                "(ATRA)",
+                "will",
+                "be",
+                "started",
+                "and",
+                "day",
+                "hospital",
+                "controls",
+                "will",
+                "be",
+                "recommended."
+            ],
+            [
+                "2-",
+                "Start",
+                "treatment",
+                "with",
+                "arsenic",
+                "trioxide,",
+                "ATRA",
+                "and",
+                "supportive",
+                "therapy."
+            ],
+            [
+                "3-",
+                "It",
+                "is",
+                "a",
+                "myeloblastic",
+                "leukemia",
+                "type",
+                "M3,",
+                "so",
+                "chemotherapy",
+                "and",
+                "heparin",
+                "will",
+                "be",
+                "started",
+                "to",
+                "control",
+                "disseminated",
+                "intravascular",
+                "coagulation."
+            ],
+            [
+                "4-",
+                "Antibiotic",
+                "treatment",
+                "should",
+                "be",
+                "started.",
+                "When",
+                "the",
+                "fever",
+                "disappears,",
+                "leukemia",
+                "treatment",
+                "should",
+                "be",
+                "started."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "It",
+                "is",
+                "a",
+                "definitive",
+                "promyelocytic",
+                "leukemia",
+                "with",
+                "t(15;17),",
+                "and",
+                "as",
+                "it",
+                "is",
+                "well",
+                "known",
+                "by",
+                "all",
+                "of",
+                "you",
+                "the",
+                "treatment",
+                "is",
+                "with",
+                "arsenic",
+                "trioxide",
+                "+",
+                "ATRA."
+            ],
+            [
+                "Option",
+                "1",
+                "leaves",
+                "the",
+                "treatment",
+                "incomplete,",
+                "there",
+                "is",
+                "only",
+                "ATRA",
+                "and",
+                "it",
+                "must",
+                "be",
+                "treated",
+                "as",
+                "long",
+                "as",
+                "the",
+                "patient's",
+                "condition",
+                "allows",
+                "it,",
+                "whether",
+                "or",
+                "not",
+                "there",
+                "are",
+                "symptoms."
+            ],
+            [
+                "Option",
+                "3",
+                "3",
+                "years",
+                "ago",
+                "would",
+                "have",
+                "been",
+                "the",
+                "correct",
+                "option",
+                "but",
+                "nowadays",
+                "neither",
+                "chemotherapy",
+                "nor",
+                "heparin",
+                "is",
+                "used."
+            ],
+            [
+                "And",
+                "option",
+                "4",
+                "is",
+                "false",
+                "because",
+                "that",
+                "fever",
+                "is",
+                "due",
+                "to",
+                "the",
+                "leukemia",
+                "itself",
+                "and",
+                "the",
+                "priority",
+                "is",
+                "to",
+                "start",
+                "specific",
+                "treatment",
+                "for",
+                "leukemia."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-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"
+            ]
+        ]
+    },
+    {
+        "id": "416_76",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GENERAL",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "78-year-old",
+                "woman",
+                "with",
+                "dementia",
+                "and",
+                "institutionalized",
+                "is",
+                "brought",
+                "in",
+                "by",
+                "her",
+                "caregivers",
+                "for",
+                "significant",
+                "abdominal",
+                "pain",
+                "with",
+                "deterioration",
+                "of",
+                "general",
+                "condition",
+                "and",
+                "abdominal",
+                "distension."
+            ],
+            [
+                "CBC",
+                "shows",
+                "leukocytosis,",
+                "elevated",
+                "hematocrit,",
+                "renal",
+                "failure",
+                "and",
+                "metabolic",
+                "acidosis."
+            ],
+            [
+                "ECG",
+                "shows",
+                "atrial",
+                "fibrillation."
+            ],
+            [
+                "Abdominal",
+                "tomography",
+                "shows",
+                "edematous",
+                "small",
+                "bowel",
+                "loops,",
+                "with",
+                "intestinal",
+                "and",
+                "portal",
+                "accumulation."
+            ],
+            [
+                "The",
+                "most",
+                "probable",
+                "diagnosis",
+                "is:"
+            ],
+            [
+                "1-",
+                "Perforation",
+                "of",
+                "gastric",
+                "or",
+                "duodenal",
+                "ulcus."
+            ],
+            [
+                "2-",
+                "Biliary",
+                "leak."
+            ],
+            [
+                "3-",
+                "Obstructive",
+                "neoplasm",
+                "of",
+                "the",
+                "sigma",
+                "with",
+                "perforation."
+            ],
+            [
+                "4-",
+                "Mesenteric",
+                "ischemia."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "This",
+                "is",
+                "a",
+                "classic",
+                "picture",
+                "and",
+                "the",
+                "author",
+                "of",
+                "the",
+                "question",
+                "has",
+                "taken",
+                "care",
+                "to",
+                "give",
+                "us",
+                "enough",
+                "clues",
+                "so",
+                "that",
+                "we",
+                "do",
+                "not",
+                "miss",
+                "it."
+            ],
+            [
+                "When",
+                "reading",
+                "this",
+                "statement,",
+                "multiple",
+                "alarms",
+                "go",
+                "off:",
+                "-",
+                "Atrial",
+                "Fibrillation:",
+                "at",
+                "the",
+                "mir",
+                "and",
+                "at",
+                "the",
+                "ED",
+                "door,",
+                "any",
+                "elderly",
+                "person",
+                "with",
+                "AF",
+                "and",
+                "abdominal",
+                "pain",
+                "is",
+                "emboligenic",
+                "mesenteric",
+                "ischemia",
+                "until",
+                "proven",
+                "otherwise."
+            ],
+            [
+                "-",
+                "Acute",
+                "abdominal",
+                "pain,",
+                "SIRS,",
+                "renal",
+                "failure,",
+                "metabolic",
+                "acidosis",
+                "(ischemia!),",
+                "probably",
+                "an",
+                "elevated",
+                "lactic..."
+            ],
+            [
+                "-",
+                "CT:",
+                "The",
+                "finding",
+                "of",
+                "portal",
+                "gas",
+                "is",
+                "also",
+                "highly",
+                "indicative",
+                "of",
+                "mesenteric",
+                "ischemia,",
+                "we",
+                "could",
+                "also",
+                "have",
+                "been",
+                "told",
+                "of",
+                "intestinal",
+                "pneumatosis."
+            ],
+            [
+                "Why",
+                "are",
+                "not",
+                "the",
+                "other",
+                "pictures?"
+            ],
+            [
+                "-",
+                "Perforated",
+                "ulcus:",
+                "We",
+                "would",
+                "have",
+                "been",
+                "told",
+                "of",
+                "a",
+                "history",
+                "of",
+                "NSAID",
+                "use,",
+                "or",
+                "a",
+                "history",
+                "of",
+                "pain",
+                "that",
+                "improves",
+                "with",
+                "ingestion,",
+                "of",
+                "pneumoperitoneum",
+                "on",
+                "chest",
+                "X-ray."
+            ],
+            [
+                "-",
+                "Biliary",
+                "ileus:",
+                "There",
+                "would",
+                "be",
+                "a",
+                "history",
+                "of",
+                "biliary",
+                "colic",
+                "or",
+                "pain",
+                "in",
+                "the",
+                "right",
+                "hypochondrium,",
+                "they",
+                "would",
+                "also",
+                "speak",
+                "of",
+                "aerobilia",
+                "in",
+                "the",
+                "imaging",
+                "test",
+                "and",
+                "dilatation",
+                "of",
+                "the",
+                "small",
+                "loops",
+                "with",
+                "image",
+                "(or",
+                "not)",
+                "of",
+                "biliary",
+                "lithiasis",
+                "in",
+                "the",
+                "terminal",
+                "ileum."
+            ],
+            [
+                "-",
+                "Neo",
+                "sigmoidoscopy:",
+                "In",
+                "the",
+                "myocardial",
+                "imaging",
+                "they",
+                "would",
+                "speak",
+                "of",
+                "weight",
+                "loss,",
+                "change",
+                "of",
+                "stool",
+                "habit,",
+                "pneumoperitoneum",
+                "in",
+                "Rx",
+                "or",
+                "CT",
+                "and",
+                "peritonitic",
+                "abdominal",
+                "exploration",
+                "and",
+                "may",
+                "even",
+                "be",
+                "able",
+                "to",
+                "palpate",
+                "the",
+                "mass."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "B-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"
+            ],
+            [
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Premise",
+                "B-Premise",
+                "I-Premise",
+                "B-Premise",
+                "I-Premise",
+                "B-Claim",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "45_154",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "336_31",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "20-year-old",
+                "woman",
+                "with",
+                "a",
+                "15-cm",
+                "solid-cystic",
+                "ovarian",
+                "tumor",
+                "detected",
+                "by",
+                "ultrasound",
+                "after",
+                "presenting",
+                "with",
+                "nonspecific",
+                "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",
+                "embryonal",
+                "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"
+            ],
+            [
+                "Mature",
+                "cystic",
+                "teratoma",
+                "is",
+                "a",
+                "common",
+                "benign",
+                "tumor",
+                "of",
+                "the",
+                "ovary",
+                "in",
+                "adult",
+                "women."
+            ],
+            [
+                "The",
+                "tissues",
+                "that",
+                "make",
+                "up",
+                "the",
+                "tumor",
+                "are",
+                "well",
+                "differentiated",
+                "(mature",
+                "or",
+                "adult-type);",
+                "apart",
+                "from",
+                "cutaneous",
+                "structures",
+                "many",
+                "other",
+                "tissues",
+                "can",
+                "be",
+                "seen,",
+                "particularly",
+                "in",
+                "a",
+                "thickening",
+                "or",
+                "spur",
+                "that",
+                "eminences",
+                "into",
+                "the",
+                "cavity,",
+                "in",
+                "which",
+                "there",
+                "are",
+                "often",
+                "teeth,",
+                "cartilage",
+                "and",
+                "bone."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "609_115",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "TRAUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "27-year-old",
+                "male,",
+                "a",
+                "regular",
+                "athlete,",
+                "refers",
+                "pain",
+                "in",
+                "the",
+                "right",
+                "leg",
+                "after",
+                "continuous",
+                "running."
+            ],
+            [
+                "He",
+                "has",
+                "visited",
+                "a",
+                "physiotherapist",
+                "on",
+                "several",
+                "occasions",
+                "and",
+                "has",
+                "been",
+                "diagnosed",
+                "with",
+                "calf",
+                "overload."
+            ],
+            [
+                "Several",
+                "months",
+                "have",
+                "passed,",
+                "she",
+                "has",
+                "not",
+                "improved",
+                "and",
+                "refers",
+                "intense",
+                "pain",
+                "after",
+                "physical",
+                "activity",
+                "that",
+                "subsides",
+                "with",
+                "rest",
+                "in",
+                "the",
+                "hours",
+                "following",
+                "exercise."
+            ],
+            [
+                "What",
+                "test",
+                "can",
+                "help",
+                "in",
+                "the",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Positron",
+                "emission",
+                "tomography",
+                "with",
+                "18",
+                "FDG."
+            ],
+            [
+                "2-",
+                "Determination",
+                "of",
+                "posterior",
+                "compartment",
+                "pressure",
+                "immediately",
+                "after",
+                "activity."
+            ],
+            [
+                "3-",
+                "Doppler",
+                "ultrasound",
+                "to",
+                "rule",
+                "out",
+                "a",
+                "circulatory",
+                "disorder",
+                "of",
+                "the",
+                "lower",
+                "extremity."
+            ],
+            [
+                "4-",
+                "Magnetic",
+                "resonance",
+                "spectroscopy."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Exercise-induced",
+                "compartment",
+                "syndrome",
+                "is",
+                "an",
+                "exercise-induced",
+                "condition",
+                "of",
+                "the",
+                "leg."
+            ],
+            [
+                "It",
+                "is",
+                "characterized",
+                "by",
+                "reversible",
+                "ischemia",
+                "of",
+                "the",
+                "muscles",
+                "of",
+                "a",
+                "muscle",
+                "compartment."
+            ],
+            [
+                "Diagnosis",
+                "is",
+                "made",
+                "by",
+                "measuring",
+                "compartment",
+                "pressures",
+                "at",
+                "rest,",
+                "during",
+                "exercise",
+                "and",
+                "after",
+                "exercise",
+                "(answer",
+                "2",
+                "correct)."
+            ],
+            [
+                "Treatment",
+                "usually",
+                "consists",
+                "of",
+                "fasciotomies",
+                "of",
+                "the",
+                "affected",
+                "compartments."
+            ],
+            [
+                "Although",
+                "MRI",
+                "is",
+                "not",
+                "very",
+                "useful",
+                "in",
+                "establishing",
+                "the",
+                "diagnosis,",
+                "it",
+                "can",
+                "help",
+                "in",
+                "the",
+                "differential",
+                "diagnosis."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "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-Diagnostics",
+                "I-Diagnostics",
+                "I-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "389_235",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "201_76",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "patient",
+                "who",
+                "presents",
+                "with",
+                "problems",
+                "in",
+                "understanding",
+                "spoken",
+                "and",
+                "written",
+                "language,",
+                "inability",
+                "to",
+                "name",
+                "objects",
+                "and",
+                "repeat",
+                "words",
+                "that",
+                "are",
+                "said",
+                "to",
+                "him,",
+                "incomprehensible",
+                "fluent",
+                "speech",
+                "with",
+                "semantic",
+                "and",
+                "phonemic",
+                "paraphasias."
+            ],
+            [
+                "This",
+                "is",
+                "a:"
+            ],
+            [
+                "1-",
+                "Global",
+                "aphasia."
+            ],
+            [
+                "2-",
+                "Wernicke's",
+                "aphasia."
+            ],
+            [
+                "3-",
+                "Broca's",
+                "aphasia."
+            ],
+            [
+                "4-",
+                "Sensitive",
+                "transcortical",
+                "aphasia."
+            ],
+            [
+                "5-",
+                "Transcortical",
+                "motor",
+                "aphasia."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Transcortical",
+                "have",
+                "preserved",
+                "repetition."
+            ],
+            [
+                "Broca's",
+                "aphasia",
+                "has",
+                "preserved",
+                "comprehension",
+                "and",
+                "absence",
+                "of",
+                "fluent",
+                "speech."
+            ],
+            [
+                "Wernicke's",
+                "aphasia",
+                "is",
+                "characterized",
+                "by",
+                "fluent",
+                "speech",
+                "(even",
+                "in",
+                "excess)",
+                "with",
+                "paraphasias",
+                "and",
+                "problems",
+                "with",
+                "comprehension,",
+                "nomination",
+                "and",
+                "repetition."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "345_159",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "69-year-old",
+                "woman",
+                "comes",
+                "to",
+                "your",
+                "office",
+                "reporting",
+                "genital",
+                "bleeding",
+                "of",
+                "several",
+                "months'",
+                "evolution."
+            ],
+            [
+                "She",
+                "denies",
+                "hormone",
+                "replacement",
+                "therapy",
+                "and",
+                "anticoagulation."
+            ],
+            [
+                "She",
+                "provides",
+                "normal",
+                "cervicovaginal",
+                "cytology."
+            ],
+            [
+                "General",
+                "and",
+                "genital",
+                "physical",
+                "examination",
+                "without",
+                "findings",
+                "of",
+                "interest."
+            ],
+            [
+                "BMI",
+                "of",
+                "38kg/m2."
+            ],
+            [
+                "Indicate",
+                "the",
+                "most",
+                "correct",
+                "attitude:"
+            ],
+            [
+                "1-",
+                "Prescribe",
+                "cyclic",
+                "progesterone."
+            ],
+            [
+                "2-",
+                "Endometrial",
+                "biopsy."
+            ],
+            [
+                "3-",
+                "Random",
+                "cervical",
+                "biopsies."
+            ],
+            [
+                "4-",
+                "Hormonal",
+                "evaluation",
+                "with",
+                "FSH,",
+                "LH",
+                "and",
+                "estradiol."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "We",
+                "are",
+                "being",
+                "presented",
+                "with",
+                "a",
+                "case",
+                "of",
+                "postmenopausal",
+                "metrorrhagia."
+            ],
+            [
+                "In",
+                "a",
+                "case",
+                "like",
+                "this",
+                "we",
+                "must",
+                "rule",
+                "out",
+                "endometrial",
+                "neoplasia,",
+                "so",
+                "an",
+                "endometrial",
+                "biopsy",
+                "would",
+                "be",
+                "indicated,",
+                "either",
+                "by",
+                "Cornier",
+                "cannula",
+                "if",
+                "possible,",
+                "or",
+                "by",
+                "hysteroscopy."
+            ],
+            [
+                "A",
+                "cervical",
+                "biopsy",
+                "is",
+                "not",
+                "of",
+                "interest",
+                "in",
+                "this",
+                "case",
+                "since",
+                "the",
+                "cytology",
+                "is",
+                "normal",
+                "and",
+                "hormonal",
+                "assessment",
+                "is",
+                "not",
+                "going",
+                "to",
+                "be",
+                "useful",
+                "in",
+                "the",
+                "diagnosis",
+                "of",
+                "endometrial",
+                "neoplasia."
+            ],
+            [
+                "Finally,",
+                "prescribing",
+                "cyclic",
+                "progesterone",
+                "is",
+                "not",
+                "indicated",
+                "in",
+                "a",
+                "postmenopausal",
+                "woman."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "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",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "166_82",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CARDIOLOGY",
+                "AND",
+                "CARDIOVASCULAR",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "45-year-old",
+                "woman",
+                "presents",
+                "arterial",
+                "hypertension",
+                "(190/120",
+                "mmHg)",
+                "accompanied",
+                "by",
+                "K",
+                "2.5",
+                "mEq/l."
+            ],
+            [
+                "An",
+                "abdominal",
+                "ultrasound",
+                "shows",
+                "stenosis",
+                "of",
+                "both",
+                "renal",
+                "arteries."
+            ],
+            [
+                "Indicate",
+                "which",
+                "treatment",
+                "is",
+                "contraindicated:"
+            ],
+            [
+                "1-",
+                "Enalapril."
+            ],
+            [
+                "2-",
+                "Propanolol."
+            ],
+            [
+                "3-",
+                "Amiloride."
+            ],
+            [
+                "4-",
+                "Prazosin."
+            ],
+            [
+                "5-",
+                "Amlodipine."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "If",
+                "the",
+                "renal",
+                "arteries",
+                "are",
+                "stenosed,",
+                "blood",
+                "has",
+                "difficulty",
+                "reaching",
+                "the",
+                "kidneys."
+            ],
+            [
+                "That",
+                "is,",
+                "both",
+                "are",
+                "poorly",
+                "perfused",
+                "and",
+                "can",
+                "only",
+                "create",
+                "the",
+                "pressure",
+                "gradient",
+                "necessary",
+                "for",
+                "filtration",
+                "by",
+                "contraction",
+                "of",
+                "the",
+                "efferent",
+                "arteriole."
+            ],
+            [
+                "If",
+                "we",
+                "administer",
+                "an",
+                "ACEI,",
+                "we",
+                "will",
+                "provoke",
+                "the",
+                "relaxation",
+                "of",
+                "this",
+                "arteriole",
+                "and",
+                "the",
+                "fall",
+                "of",
+                "the",
+                "glomerular",
+                "filtration",
+                "rate."
+            ],
+            [
+                "And",
+                "if",
+                "neither",
+                "kidney",
+                "filters,",
+                "because",
+                "both",
+                "have",
+                "arterial",
+                "stenosis,",
+                "we",
+                "have",
+                "a",
+                "problem...."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "481_171",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "612_116",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "TRAUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "95-year-old",
+                "woman",
+                "living",
+                "in",
+                "a",
+                "nursing",
+                "home,",
+                "independent",
+                "for",
+                "her",
+                "basic",
+                "activities",
+                "of",
+                "daily",
+                "living,",
+                "goes",
+                "out",
+                "to",
+                "the",
+                "garden",
+                "for",
+                "walks."
+            ],
+            [
+                "She",
+                "has",
+                "a",
+                "history",
+                "of",
+                "hypertension,",
+                "dyslipidemia,",
+                "osteoporosis",
+                "and",
+                "mild",
+                "cognitive",
+                "impairment."
+            ],
+            [
+                "She",
+                "suffers",
+                "a",
+                "fall",
+                "when",
+                "getting",
+                "up",
+                "at",
+                "night",
+                "to",
+                "go",
+                "to",
+                "the",
+                "bathroom."
+            ],
+            [
+                "X-ray",
+                "shows",
+                "a",
+                "displaced",
+                "subcapital",
+                "fracture",
+                "of",
+                "the",
+                "right",
+                "hip."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "recommended",
+                "treatment?"
+            ],
+            [
+                "1-",
+                "Hip",
+                "hemiarthroplasty."
+            ],
+            [
+                "2-",
+                "Trochanteric",
+                "nail",
+                "fixation."
+            ],
+            [
+                "3-",
+                "Fixation",
+                "with",
+                "cannulated",
+                "screws."
+            ],
+            [
+                "4-",
+                "Conservative:",
+                "bed-chair",
+                "life."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Correct",
+                "Answer",
+                "1:",
+                "Given",
+                "that",
+                "this",
+                "is",
+                "a",
+                "displaced",
+                "subcapital",
+                "hip",
+                "fracture,",
+                "the",
+                "surgical",
+                "treatment",
+                "we",
+                "should",
+                "consider",
+                "is",
+                "hip",
+                "joint",
+                "replacement,",
+                "given",
+                "that",
+                "the",
+                "injury",
+                "described",
+                "presents",
+                "a",
+                "high",
+                "probability",
+                "of",
+                "necrosis",
+                "of",
+                "the",
+                "femoral",
+                "head."
+            ],
+            [
+                "The",
+                "options",
+                "would",
+                "be",
+                "total",
+                "or",
+                "partial",
+                "arthroplasty:",
+                "in",
+                "elderly",
+                "patients,",
+                "partial",
+                "arthroplasty",
+                "is",
+                "preferred",
+                "because",
+                "it",
+                "is",
+                "a",
+                "shorter",
+                "and",
+                "less",
+                "aggressive",
+                "surgery",
+                "than",
+                "total",
+                "hip",
+                "arthroplasty."
+            ],
+            [
+                "Answer",
+                "2",
+                "incorrect:",
+                "We",
+                "would",
+                "consider",
+                "this",
+                "technique",
+                "in",
+                "basicervical",
+                "fractures",
+                "and",
+                "trochanteric",
+                "mass",
+                "lesions,",
+                "not",
+                "in",
+                "subcapital",
+                "fractures."
+            ],
+            [
+                "Incorrect",
+                "Answer",
+                "3:",
+                "We",
+                "would",
+                "consider",
+                "this",
+                "technique",
+                "in",
+                "nondisplaced",
+                "subcapital",
+                "fractures",
+                "in",
+                "young",
+                "patients."
+            ],
+            [
+                "Incorrect",
+                "answer",
+                "4:",
+                "We",
+                "would",
+                "only",
+                "consider",
+                "non-surgical",
+                "treatment",
+                "in",
+                "a",
+                "patient",
+                "with",
+                "a",
+                "very",
+                "poor",
+                "baseline",
+                "general",
+                "condition:",
+                "bedridden",
+                "patients",
+                "with",
+                "low",
+                "life",
+                "expectancy."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "585_74",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "OBSTETRICS",
+                "AND",
+                "GYNECOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "34-week",
+                "primigravida",
+                "with",
+                "blood",
+                "pressure",
+                "of",
+                "165/95",
+                "and",
+                "headache",
+                "of",
+                "two",
+                "days",
+                "of",
+                "evolution."
+            ],
+            [
+                "Laboratory",
+                "tests:",
+                "hemoglobin",
+                "10.5",
+                "g/dL,",
+                "platelets",
+                "98,000/mm3,",
+                "AST",
+                "356",
+                "IU/L",
+                "(0-31),",
+                "ALT",
+                "234",
+                "IU/L",
+                "(0-31),",
+                "LDH",
+                "878",
+                "IU/L",
+                "(125-243)."
+            ],
+            [
+                "The",
+                "laboratory",
+                "is",
+                "called",
+                "because",
+                "of",
+                "the",
+                "presence",
+                "of",
+                "schistocytes",
+                "in",
+                "the",
+                "peripheral",
+                "blood",
+                "smear."
+            ],
+            [
+                "She",
+                "received",
+                "the",
+                "second",
+                "dose",
+                "of",
+                "corticosteroids",
+                "for",
+                "fetal",
+                "maturation",
+                "24",
+                "hours",
+                "ago."
+            ],
+            [
+                "On",
+                "obstetric",
+                "ultrasound",
+                "the",
+                "estimated",
+                "fetal",
+                "weight",
+                "is",
+                "in",
+                "the",
+                "1st",
+                "percentile",
+                "for",
+                "gestational",
+                "age",
+                "and",
+                "the",
+                "umbilical",
+                "artery",
+                "Doppler",
+                "shows",
+                "absence",
+                "of",
+                "end-diastolic",
+                "flow."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "is",
+                "the",
+                "most",
+                "indicated",
+                "clinical",
+                "approach?"
+            ],
+            [
+                "1-",
+                "Expectant",
+                "management",
+                "with",
+                "antihypertensive",
+                "drugs",
+                "and",
+                "magnesium",
+                "sulfate",
+                "until",
+                "the",
+                "maternal",
+                "platelets",
+                "improve."
+            ],
+            [
+                "2-",
+                "Expectant",
+                "attitude",
+                "with",
+                "antihypertensive",
+                "treatment",
+                "at",
+                "home",
+                "and",
+                "controls",
+                "every",
+                "48",
+                "hours."
+            ],
+            [
+                "3-",
+                "Termination",
+                "of",
+                "gestation",
+                "when",
+                "she",
+                "completes",
+                "fetal",
+                "lung",
+                "maturation."
+            ],
+            [
+                "4-",
+                "Immediate",
+                "termination",
+                "of",
+                "pregnancy."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "They",
+                "are",
+                "describing",
+                "HELLP",
+                "syndrome."
+            ],
+            [
+                "With",
+                "these",
+                "weeks",
+                "of",
+                "gestation",
+                "and",
+                "with",
+                "the",
+                "fetus",
+                "recently",
+                "matured",
+                "(she",
+                "has",
+                "already",
+                "been",
+                "given",
+                "two",
+                "doses",
+                "of",
+                "corticosteroids),",
+                "the",
+                "attitude",
+                "is",
+                "immediate",
+                "termination."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "3_37",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DIGESTIVE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "76-year-old",
+                "woman",
+                "with",
+                "no",
+                "history",
+                "other",
+                "than",
+                "hypertension",
+                "consults",
+                "for",
+                "painless",
+                "jaundice",
+                "and",
+                "pruritus",
+                "with",
+                "anorexia."
+            ],
+            [
+                "Laboratory",
+                "tests",
+                "show",
+                "bilirubin",
+                "of",
+                "12",
+                "mg/dl",
+                "(9.5",
+                "direct)."
+            ],
+            [
+                "Ultrasound",
+                "shows",
+                "intrahepatic",
+                "and",
+                "extrahepatic",
+                "biliary",
+                "dilatation",
+                "together",
+                "with",
+                "a",
+                "single",
+                "hepatic",
+                "nodule",
+                "smaller",
+                "than",
+                "2",
+                "cm",
+                "located",
+                "peripherally",
+                "on",
+                "the",
+                "anterior",
+                "aspect",
+                "of",
+                "the",
+                "left",
+                "lobe."
+            ],
+            [
+                "The",
+                "CT",
+                "scan",
+                "confirms",
+                "these",
+                "findings",
+                "also",
+                "demonstrating",
+                "the",
+                "presence",
+                "of",
+                "a",
+                "pancreatic",
+                "mass",
+                "of",
+                "3.5",
+                "cm.",
+                "In",
+                "the",
+                "pancreatic",
+                "head."
+            ],
+            [
+                "The",
+                "aspiration",
+                "puncture",
+                "of",
+                "the",
+                "hepatic",
+                "nodule",
+                "is",
+                "conclusive",
+                "for",
+                "adenocarcinoma."
+            ],
+            [
+                "Indicate",
+                "the",
+                "best",
+                "therapeutic",
+                "option:"
+            ],
+            [
+                "1-",
+                "Neoadjuvant",
+                "chemo/radiotherapy,",
+                "conditioning",
+                "the",
+                "option",
+                "of",
+                "radical",
+                "surgery",
+                "on",
+                "initial",
+                "response."
+            ],
+            [
+                "2-",
+                "Percutaneous",
+                "external",
+                "biliary",
+                "drainage",
+                "with",
+                "palliative",
+                "character",
+                "with",
+                "eventual",
+                "reconversion",
+                "to",
+                "internal",
+                "drainage",
+                "in",
+                "case",
+                "of",
+                "intolerance",
+                "or",
+                "complications."
+            ],
+            [
+                "3-",
+                "Palliative",
+                "surgical",
+                "biliary",
+                "bypass",
+                "with",
+                "or",
+                "without",
+                "prophylactic",
+                "gastrojejunostomy",
+                "depending",
+                "on",
+                "intraoperative",
+                "findings."
+            ],
+            [
+                "4-",
+                "Metallic",
+                "biliary",
+                "prosthesis",
+                "by",
+                "endoscopic",
+                "retrograde",
+                "cholangiopancreatography",
+                "with",
+                "the",
+                "option",
+                "of",
+                "palliative",
+                "chemotherapy."
+            ],
+            [
+                "5-",
+                "Cephalic",
+                "duodenopancreatectomy,",
+                "with",
+                "percutaneous",
+                "ablation",
+                "by",
+                "radiofrequency",
+                "or",
+                "alcoholization",
+                "of",
+                "the",
+                "hepatic",
+                "lesion."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "This",
+                "case",
+                "does",
+                "not",
+                "seem",
+                "so",
+                "easy",
+                "to",
+                "me."
+            ],
+            [
+                "It",
+                "is",
+                "a",
+                "pancreatic",
+                "adenocarcinoma",
+                "with",
+                "metastasis,",
+                "so",
+                "the",
+                "treatment",
+                "should",
+                "be",
+                "palliative,",
+                "so",
+                "we",
+                "remove",
+                "options",
+                "1",
+                "and",
+                "5."
+            ],
+            [
+                "In",
+                "principle",
+                "she",
+                "is",
+                "a",
+                "patient",
+                "in",
+                "moderately",
+                "good",
+                "general",
+                "condition,",
+                "so",
+                "the",
+                "ideal",
+                "would",
+                "be",
+                "to",
+                "perform",
+                "a",
+                "permanent",
+                "biliary",
+                "diversion",
+                "and",
+                "chemotherapy,",
+                "option",
+                "4",
+                "being",
+                "the",
+                "one",
+                "I",
+                "consider",
+                "most",
+                "correct."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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",
+                "I-Premise",
+                "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",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "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"
+            ],
+            [
+                "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-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"
+            ]
+        ]
+    },
+    {
+        "id": "439_96",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "64-year-old",
+                "woman."
+            ],
+            [
+                "Menopause",
+                "at",
+                "54",
+                "years",
+                "of",
+                "age."
+            ],
+            [
+                "Two",
+                "pregnancies",
+                "and",
+                "eutocic",
+                "deliveries."
+            ],
+            [
+                "She",
+                "does",
+                "not",
+                "take",
+                "any",
+                "medication."
+            ],
+            [
+                "She",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "reporting",
+                "two",
+                "days",
+                "of",
+                "vaginal",
+                "bleeding",
+                "with",
+                "discomfort",
+                "in",
+                "the",
+                "hypogastrium."
+            ],
+            [
+                "The",
+                "clinical",
+                "examination",
+                "performed",
+                "by",
+                "the",
+                "gynecologist",
+                "does",
+                "not",
+                "show",
+                "any",
+                "lesions",
+                "in",
+                "the",
+                "external",
+                "genitalia,",
+                "vagina",
+                "or",
+                "cervix."
+            ],
+            [
+                "Vaginal",
+                "examination",
+                "is",
+                "inconclusive."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "seems",
+                "to",
+                "you",
+                "to",
+                "be",
+                "the",
+                "most",
+                "appropriate",
+                "first",
+                "diagnostic",
+                "approach?"
+            ],
+            [
+                "1-",
+                "Transvaginal",
+                "ultrasound",
+                "and",
+                "measurement",
+                "of",
+                "endometrial",
+                "thickness.",
+                "Depending",
+                "on",
+                "this,",
+                "an",
+                "endometrial",
+                "biopsy",
+                "should",
+                "be",
+                "taken",
+                "or",
+                "not."
+            ],
+            [
+                "2-",
+                "Endometrial",
+                "biopsy",
+                "by",
+                "aspiration",
+                "in",
+                "consultation.",
+                "With",
+                "it",
+                "I",
+                "can",
+                "get",
+                "the",
+                "diagnosis",
+                "very",
+                "reliably",
+                "and",
+                "it",
+                "is",
+                "inexpensive."
+            ],
+            [
+                "3-",
+                "Hysteroscopy",
+                "with",
+                "sedation",
+                "and",
+                "directed",
+                "biopsy",
+                "if",
+                "a",
+                "lesion",
+                "is",
+                "seen."
+            ],
+            [
+                "4-",
+                "I",
+                "would",
+                "perform",
+                "a",
+                "microbleed,",
+                "since",
+                "it",
+                "is",
+                "the",
+                "test",
+                "that",
+                "would",
+                "provide",
+                "me",
+                "with",
+                "the",
+                "definitive",
+                "diagnosis."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Since",
+                "the",
+                "most",
+                "frequent",
+                "cause",
+                "of",
+                "vaginal",
+                "bleeding",
+                "in",
+                "postmenopausal",
+                "women",
+                "is",
+                "urogenital",
+                "atrophy,",
+                "the",
+                "existence",
+                "of",
+                "an",
+                "endometrial",
+                "pathology",
+                "cannot",
+                "be",
+                "ruled",
+                "out."
+            ],
+            [
+                "According",
+                "to",
+                "the",
+                "SEGO:",
+                "\"Abnormal",
+                "genital",
+                "bleeding",
+                "is",
+                "the",
+                "main",
+                "sign",
+                "of",
+                "suspicion",
+                "that",
+                "should",
+                "lead",
+                "us",
+                "to",
+                "rule",
+                "out",
+                "an",
+                "endometrial",
+                "neoplastic",
+                "pathology,",
+                "particularly",
+                "in",
+                "postmenopausal",
+                "patients,",
+                "or",
+                "those",
+                "with",
+                "associated",
+                "risk",
+                "factors",
+                "(...)",
+                "Given",
+                "the",
+                "sign",
+                "of",
+                "suspicion,",
+                "the",
+                "performance",
+                "of",
+                "a",
+                "transvaginal",
+                "ultrasound,",
+                "or",
+                "in",
+                "its",
+                "absence",
+                "transrectal,",
+                "allows",
+                "us",
+                "to:",
+                "rule",
+                "out",
+                "organic",
+                "pathology",
+                "(fibroids,",
+                "polyps);",
+                "measurement",
+                "of",
+                "endometrial",
+                "thickness",
+                "in",
+                "a",
+                "longitudinal",
+                "cut."
+            ],
+            [
+                "It",
+                "is",
+                "recommended",
+                "to",
+                "use",
+                "a",
+                "cut-off",
+                "point",
+                "of",
+                "3mm",
+                "for",
+                "endometrial",
+                "biopsy",
+                "in",
+                "the",
+                "symptomatic",
+                "patient\"."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "192_160",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "The",
+                "parents",
+                "of",
+                "a",
+                "5-month-old",
+                "infant",
+                "come",
+                "because",
+                "their",
+                "child,",
+                "who",
+                "attends",
+                "day",
+                "care,",
+                "has",
+                "been",
+                "presenting",
+                "for",
+                "3",
+                "days,",
+                "coinciding",
+                "with",
+                "an",
+                "upper",
+                "respiratory",
+                "tract",
+                "infection,",
+                "liquid",
+                "stools",
+                "numbering",
+                "4",
+                "per",
+                "day,",
+                "occasional",
+                "alimentary",
+                "vomiting,",
+                "and",
+                "axillary",
+                "temperature",
+                "of",
+                "38.3\u00b0C."
+            ],
+            [
+                "He",
+                "is",
+                "being",
+                "fed",
+                "with",
+                "mixed",
+                "breastfeeding."
+            ],
+            [
+                "On",
+                "examination",
+                "the",
+                "infant",
+                "is",
+                "in",
+                "good",
+                "general",
+                "condition,",
+                "is",
+                "well",
+                "nourished",
+                "and",
+                "hydrated",
+                "and",
+                "his",
+                "breathing",
+                "is",
+                "eupneic;",
+                "his",
+                "weight",
+                "is",
+                "4,730g",
+                "and",
+                "has",
+                "decreased",
+                "by",
+                "70g",
+                "with",
+                "respect",
+                "to",
+                "the",
+                "previous",
+                "week."
+            ],
+            [
+                "The",
+                "abdomen",
+                "is",
+                "soft",
+                "and",
+                "depressible,",
+                "without",
+                "masses",
+                "or",
+                "megaliths,",
+                "and",
+                "the",
+                "fontanel",
+                "is",
+                "normotensive."
+            ],
+            [
+                "Except",
+                "for",
+                "the",
+                "presence",
+                "of",
+                "watery",
+                "rhinorrhea,",
+                "the",
+                "rest",
+                "of",
+                "the",
+                "examination",
+                "by",
+                "organs",
+                "and",
+                "devices",
+                "is",
+                "normal."
+            ],
+            [
+                "Of",
+                "the",
+                "following",
+                "statements,",
+                "indicate",
+                "the",
+                "answer",
+                "that",
+                "you",
+                "consider",
+                "CORRECT:"
+            ],
+            [
+                "1-",
+                "An",
+                "estimation",
+                "of",
+                "losses",
+                "should",
+                "be",
+                "made,",
+                "recommend",
+                "a",
+                "4-hour",
+                "fast",
+                "and",
+                "rehydrate",
+                "during",
+                "this",
+                "time",
+                "with",
+                "oral",
+                "rehydration",
+                "solution."
+            ],
+            [
+                "2-",
+                "It",
+                "is",
+                "advisable",
+                "to",
+                "introduce",
+                "rice",
+                "cereals",
+                "for",
+                "their",
+                "astringent",
+                "effect."
+            ],
+            [
+                "3-",
+                "A",
+                "stool",
+                "culture",
+                "should",
+                "be",
+                "performed",
+                "as",
+                "soon",
+                "as",
+                "possible",
+                "to",
+                "exclude",
+                "a",
+                "bacterial",
+                "origin."
+            ],
+            [
+                "4-",
+                "The",
+                "use",
+                "of",
+                "lactose-free",
+                "formula",
+                "should",
+                "be",
+                "recommended."
+            ],
+            [
+                "5-",
+                "It",
+                "is",
+                "advisable",
+                "to",
+                "replace",
+                "losses",
+                "after",
+                "each",
+                "bowel",
+                "movement",
+                "with",
+                "oral",
+                "rehydration",
+                "solution",
+                "and",
+                "continue",
+                "with",
+                "the",
+                "patient's",
+                "usual",
+                "diet."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "The",
+                "baby",
+                "is",
+                "not",
+                "dehydrated",
+                "and",
+                "is",
+                "in",
+                "good",
+                "general",
+                "condition."
+            ],
+            [
+                "Try",
+                "to",
+                "avoid",
+                "dehydration",
+                "by",
+                "replenishing",
+                "what",
+                "is",
+                "being",
+                "lost,",
+                "avoiding",
+                "drastic",
+                "changes",
+                "in",
+                "feeding",
+                "habits",
+                "as",
+                "much",
+                "as",
+                "possible."
+            ],
+            [
+                "The",
+                "rest",
+                "of",
+                "the",
+                "answers",
+                "touch",
+                "on",
+                "many",
+                "of",
+                "the",
+                "\"myths\"",
+                "and",
+                "customs",
+                "surrounding",
+                "gastroenteritis."
+            ],
+            [
+                "There",
+                "is",
+                "also",
+                "no",
+                "evidence",
+                "of",
+                "lactose",
+                "intolerance",
+                "(perianal",
+                "irritation,",
+                "frothy",
+                "and",
+                "acid",
+                "stools,",
+                "etc.)",
+                "that",
+                "would",
+                "advise",
+                "lactose-free",
+                "milk."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "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-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "261_100",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "289_65",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GENERAL",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "Point",
+                "out",
+                "from",
+                "among",
+                "the",
+                "following",
+                "the",
+                "most",
+                "likely",
+                "complication",
+                "presented",
+                "by",
+                "a",
+                "patient",
+                "operated,",
+                "20",
+                "years",
+                "ago,",
+                "of",
+                "gastric",
+                "ulcer",
+                "by",
+                "antrectomy",
+                "and",
+                "gastrojejunostomy",
+                "(Billroth",
+                "II)",
+                "who",
+                "comes",
+                "to",
+                "your",
+                "office",
+                "referring",
+                "postpradial",
+                "abdominal",
+                "pain,",
+                "abdominal",
+                "distension,",
+                "diarrhea",
+                "and",
+                "analytical",
+                "data",
+                "of",
+                "malabsorption",
+                "of",
+                "fats",
+                "and",
+                "vitamin",
+                "B12:"
+            ],
+            [
+                "1-",
+                "Biliary",
+                "reflux",
+                "gastropathy."
+            ],
+            [
+                "2-",
+                "Gastric",
+                "adenocarcinoma."
+            ],
+            [
+                "3-",
+                "Rapid",
+                "gastric",
+                "emptying",
+                "syndrome",
+                "(dumping)."
+            ],
+            [
+                "4-",
+                "Afferent",
+                "loop",
+                "syndrome",
+                "with",
+                "bacterial",
+                "overgrowth."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "The",
+                "statement",
+                "has",
+                "described",
+                "the",
+                "clinical",
+                "features",
+                "of",
+                "this",
+                "syndrome."
+            ],
+            [
+                "It",
+                "is",
+                "usually",
+                "a",
+                "late",
+                "complication",
+                "(the",
+                "patient",
+                "was",
+                "operated",
+                "20",
+                "years",
+                "ago",
+                "for",
+                "a",
+                "Bilroth",
+                "II,",
+                "remember",
+                "that",
+                "it",
+                "is",
+                "a",
+                "partial",
+                "gastrectomy,",
+                "closure",
+                "of",
+                "the",
+                "gastric",
+                "stump",
+                "and",
+                "anastomosis",
+                "of",
+                "the",
+                "first",
+                "jejunal",
+                "loop",
+                "to",
+                "the",
+                "stump),",
+                "it",
+                "is",
+                "accompanied",
+                "by",
+                "postprandial",
+                "pain,",
+                "abdominal",
+                "distension."
+            ],
+            [
+                "What",
+                "has",
+                "occurred",
+                "is",
+                "a",
+                "stenosis",
+                "of",
+                "the",
+                "afferent",
+                "loop,",
+                "so",
+                "that",
+                "biliary",
+                "and",
+                "pancreatic",
+                "secretions",
+                "do",
+                "not",
+                "mix",
+                "with",
+                "the",
+                "bolus,",
+                "they",
+                "accumulate,",
+                "produce",
+                "pain",
+                "that",
+                "is",
+                "relieved",
+                "by",
+                "vomiting,",
+                "fat",
+                "absorption",
+                "is",
+                "not",
+                "possible",
+                "(lack",
+                "of",
+                "pancreatic",
+                "lipase),",
+                "so",
+                "there",
+                "is",
+                "diarrhea,",
+                "and",
+                "if",
+                "associated",
+                "with",
+                "bacterial",
+                "overgrowth,",
+                "there",
+                "is",
+                "malabsorption",
+                "of",
+                "vitamin",
+                "B12."
+            ],
+            [
+                "If",
+                "it",
+                "were",
+                "gastric",
+                "adenocarcinoma,",
+                "they",
+                "would",
+                "have",
+                "spoken",
+                "of",
+                "constitutional",
+                "syndrome,",
+                "extradigestive",
+                "manifestations",
+                "(sister",
+                "Maria",
+                "Jose",
+                "node,",
+                "Krukenberg",
+                "tumor,",
+                "Virchow",
+                "node)."
+            ],
+            [
+                "It",
+                "is",
+                "not",
+                "dumping",
+                "because",
+                "it",
+                "does",
+                "not",
+                "speak",
+                "of",
+                "vegetative",
+                "symptoms",
+                "(palpitations,",
+                "facial",
+                "flushing,",
+                "etc...)."
+            ],
+            [
+                "Biliary",
+                "reflux",
+                "gastropathy",
+                "is",
+                "an",
+                "endoscopic",
+                "diagnosis,",
+                "moreover",
+                "it",
+                "is",
+                "not",
+                "associated",
+                "with",
+                "diarrhea",
+                "or",
+                "malabsorption."
+            ]
+        ],
+        "labels": [
+            [
+                "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",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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-Marker",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "366_106",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PNEUMOLOGY",
+                "AND",
+                "THORACIC",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "32-year-old",
+                "man",
+                "from",
+                "Cameroon",
+                "consults",
+                "for",
+                "fever",
+                "cough",
+                "and",
+                "left",
+                "hemithorax",
+                "pain",
+                "of",
+                "1",
+                "month",
+                "of",
+                "evolution."
+            ],
+            [
+                "He",
+                "took",
+                "amoxicillin-clavulanic",
+                "acid",
+                "for",
+                "1",
+                "week",
+                "without",
+                "improvement",
+                "of",
+                "symptoms."
+            ],
+            [
+                "A",
+                "blood",
+                "test",
+                "showed",
+                "a",
+                "white",
+                "blood",
+                "cell",
+                "count",
+                "of",
+                "8000/microL",
+                "and",
+                "a",
+                "hemoglobin",
+                "of",
+                "12.8",
+                "g/dL."
+            ],
+            [
+                "Chest",
+                "X-ray",
+                "shows",
+                "a",
+                "loculated",
+                "left",
+                "pleural",
+                "effusion",
+                "occupying",
+                "one",
+                "third",
+                "of",
+                "the",
+                "hemithorax."
+            ],
+            [
+                "A",
+                "thoracentesis",
+                "shows",
+                "a",
+                "yellowish",
+                "fluid",
+                "with",
+                "the",
+                "following",
+                "features:",
+                "red",
+                "blood",
+                "cells",
+                "2000/\u00b5L,",
+                "leukocytes",
+                "2500/\u00b5L",
+                "with",
+                "90%",
+                "lymphocytes,",
+                "protein",
+                "4.9",
+                "g/dL,",
+                "lactate",
+                "dehydrogenase",
+                "550",
+                "VIL,",
+                "glucose",
+                "67",
+                "mg/dL,",
+                "and",
+                "absence",
+                "of",
+                "malignant",
+                "cells",
+                "on",
+                "cytologic",
+                "study."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "tests",
+                "would",
+                "be",
+                "most",
+                "useful",
+                "in",
+                "diagnosing",
+                "the",
+                "cause",
+                "of",
+                "the",
+                "pleural",
+                "effusion?"
+            ],
+            [
+                "1-",
+                "A",
+                "thoracic",
+                "computed",
+                "tomography",
+                "(CT)",
+                "scan."
+            ],
+            [
+                "2-",
+                "Pleural",
+                "fluid",
+                "pH",
+                "measurement."
+            ],
+            [
+                "3-",
+                "Measurement",
+                "of",
+                "pleural",
+                "fluid",
+                "adenosine",
+                "deaminase."
+            ],
+            [
+                "4-",
+                "Tuberculin",
+                "test."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Suspicion",
+                "is",
+                "very",
+                "high",
+                "for",
+                "tuberculous",
+                "pleural",
+                "effusion,",
+                "in",
+                "a",
+                "young",
+                "patient",
+                "from",
+                "an",
+                "area",
+                "with",
+                "a",
+                "high",
+                "rate",
+                "of",
+                "TB,",
+                "a",
+                "lymphocytic",
+                "exudate",
+                "pointing",
+                "to",
+                "TB,",
+                "lymphoma",
+                "or",
+                "tumor."
+            ],
+            [
+                "Tumor",
+                "unlikely",
+                "due",
+                "to",
+                "age,",
+                "negative",
+                "cytology."
+            ],
+            [
+                "Lymphoma",
+                "could",
+                "be",
+                "but",
+                "no",
+                "evidence",
+                "of",
+                "associated",
+                "nodal",
+                "pathology."
+            ],
+            [
+                "High",
+                "adenosine",
+                "deaminase",
+                "in",
+                "LP",
+                "would",
+                "point",
+                "with",
+                "great",
+                "certainty",
+                "to",
+                "a",
+                "pleural",
+                "TB",
+                "although",
+                "it",
+                "would",
+                "be",
+                "advisable",
+                "to",
+                "confirm",
+                "the",
+                "diagnosis",
+                "with",
+                "a",
+                "pleural",
+                "biopsy",
+                "since",
+                "it",
+                "can",
+                "also",
+                "occur",
+                "in",
+                "lymphomas",
+                "and",
+                "empyemas",
+                "of",
+                "other",
+                "origin."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise"
+            ],
+            [
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+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "544_40",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ALLERGOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "16-year-old",
+                "woman",
+                "diagnosed",
+                "with",
+                "allergic",
+                "rhinoconjunctivitis",
+                "due",
+                "to",
+                "sensitization",
+                "to",
+                "grass",
+                "pollens",
+                "since",
+                "she",
+                "was",
+                "10",
+                "years",
+                "old,",
+                "who",
+                "does",
+                "not",
+                "fully",
+                "control",
+                "the",
+                "symptomatology",
+                "during",
+                "the",
+                "pollination",
+                "season",
+                "with",
+                "oral",
+                "antihistamines",
+                "and",
+                "nasal",
+                "topical",
+                "corticosteroids."
+            ],
+            [
+                "Which",
+                "etiologic",
+                "therapeutic",
+                "option",
+                "would",
+                "be",
+                "indicated:"
+            ],
+            [
+                "1-",
+                "Specific",
+                "immunotherapy",
+                "by",
+                "sublingual",
+                "or",
+                "subcutaneous",
+                "route",
+                "for",
+                "a",
+                "minimum",
+                "period",
+                "of",
+                "3",
+                "years."
+            ],
+            [
+                "2-",
+                "Specific",
+                "immunotherapy",
+                "by",
+                "sublingual",
+                "or",
+                "subcutaneous",
+                "route",
+                "for",
+                "a",
+                "maximum",
+                "period",
+                "of",
+                "1",
+                "year."
+            ],
+            [
+                "3-",
+                "Omalizumab",
+                "subcutaneously",
+                "every",
+                "4",
+                "weeks",
+                "for",
+                "up",
+                "to",
+                "1",
+                "year."
+            ],
+            [
+                "4-",
+                "Omalizumab",
+                "subcutaneously",
+                "every",
+                "4",
+                "weeks",
+                "for",
+                "a",
+                "minimum",
+                "period",
+                "of",
+                "6",
+                "months."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Currently",
+                "the",
+                "only",
+                "effective",
+                "treatment",
+                "capable",
+                "of",
+                "modifying",
+                "the",
+                "natural",
+                "course",
+                "of",
+                "respiratory",
+                "allergy",
+                "is",
+                "specific",
+                "allergen",
+                "immunotherapy",
+                "for",
+                "a",
+                "minimum",
+                "of",
+                "3",
+                "consecutive",
+                "years."
+            ],
+            [
+                "In",
+                "this",
+                "patient",
+                "the",
+                "conventional",
+                "treatment",
+                "has",
+                "not",
+                "worked,",
+                "so",
+                "it",
+                "is",
+                "possible",
+                "to",
+                "escalate",
+                "to",
+                "specific",
+                "allergen",
+                "immunotherapy."
+            ],
+            [
+                "It",
+                "is",
+                "true",
+                "that",
+                "it",
+                "is",
+                "not",
+                "necessary",
+                "to",
+                "wait",
+                "10",
+                "years",
+                "to",
+                "start",
+                "it",
+                "since",
+                "it",
+                "is",
+                "indicated",
+                "and",
+                "its",
+                "use",
+                "is",
+                "allowed",
+                "if",
+                "there",
+                "is",
+                "clinical",
+                "relevance",
+                "in",
+                "patients",
+                "older",
+                "than",
+                "5",
+                "years."
+            ],
+            [
+                "Omalizumab",
+                "is",
+                "a",
+                "biological",
+                "treatment",
+                "that",
+                "would",
+                "only",
+                "be",
+                "indicated",
+                "in",
+                "cases",
+                "of",
+                "severe",
+                "moderate",
+                "bronchial",
+                "asthma",
+                "secondary",
+                "to",
+                "respiratory",
+                "allergy."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
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+                "B-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "533_179",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ONCOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "32-year-old",
+                "woman",
+                "with",
+                "multiple",
+                "endocrine",
+                "neoplasia",
+                "syndrome",
+                "type",
+                "2A",
+                "(MEN-2A)",
+                "and",
+                "carrier",
+                "of",
+                "a",
+                "mutation",
+                "in",
+                "RET."
+            ],
+            [
+                "In",
+                "a",
+                "neck",
+                "ultrasound",
+                "a",
+                "6",
+                "mm",
+                "hypoechogenic",
+                "nodule",
+                "with",
+                "calcifications",
+                "inside",
+                "is",
+                "identified."
+            ],
+            [
+                "It",
+                "was",
+                "decided",
+                "to",
+                "perform",
+                "a",
+                "total",
+                "thyroidectomy",
+                "and",
+                "cervical",
+                "lymph",
+                "node",
+                "removal."
+            ],
+            [
+                "In",
+                "the",
+                "macroscopic",
+                "study",
+                "a",
+                "total",
+                "of",
+                "three",
+                "nodules",
+                "were",
+                "identified,",
+                "two",
+                "in",
+                "the",
+                "right",
+                "lobe",
+                "of",
+                "5",
+                "and",
+                "6",
+                "mm,",
+                "and",
+                "one",
+                "in",
+                "the",
+                "left",
+                "lobe",
+                "of",
+                "4",
+                "mm."
+            ],
+            [
+                "In",
+                "the",
+                "microscopic",
+                "study",
+                "the",
+                "three",
+                "lesions",
+                "are",
+                "constituted",
+                "by",
+                "a",
+                "uniform",
+                "proliferation",
+                "of",
+                "rounded",
+                "cells",
+                "arranged",
+                "in",
+                "a",
+                "solid",
+                "pattern",
+                "and",
+                "accompanied",
+                "by",
+                "calcifications",
+                "and",
+                "amyloid",
+                "deposits."
+            ],
+            [
+                "The",
+                "nuclei",
+                "are",
+                "not",
+                "clear,",
+                "nor",
+                "do",
+                "they",
+                "show",
+                "clefts",
+                "or",
+                "pseudoinclusions."
+            ],
+            [
+                "Immunohistochemical",
+                "staining",
+                "for",
+                "synaptophysin",
+                "is",
+                "positive."
+            ],
+            [
+                "In",
+                "the",
+                "cervical",
+                "lymph",
+                "node",
+                "clearance",
+                "metastases",
+                "are",
+                "identified."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "pathologic",
+                "diagnosis",
+                "of",
+                "the",
+                "lesions",
+                "identified",
+                "in",
+                "the",
+                "total",
+                "thyroidectomy?"
+            ],
+            [
+                "1-",
+                "Multifocal",
+                "medullary",
+                "carcinoma."
+            ],
+            [
+                "2-",
+                "Multifocal",
+                "papillary",
+                "carcinoma."
+            ],
+            [
+                "3-",
+                "Follicular",
+                "carcinoma."
+            ],
+            [
+                "4-",
+                "Hyperplasia",
+                "of",
+                "parafollicular",
+                "cells."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Typical",
+                "medullary",
+                "thyroid",
+                "RET",
+                "(C",
+                "cells,",
+                "elevated",
+                "calcitonin,",
+                "inherited",
+                "MEN-2nd,",
+                "typical",
+                "MIR",
+                "question)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "80_37",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DIGESTIVE",
+                "SYSTEM"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "52-year-old",
+                "man",
+                "who",
+                "consults",
+                "for",
+                "a",
+                "second",
+                "opinion",
+                "on",
+                "the",
+                "need",
+                "to",
+                "perform",
+                "a",
+                "liver",
+                "biopsy",
+                "for",
+                "the",
+                "study",
+                "of",
+                "hypertransaminasemia",
+                "detected",
+                "two",
+                "years",
+                "ago",
+                "in",
+                "routine",
+                "company",
+                "analyses."
+            ],
+            [
+                "His",
+                "family",
+                "history",
+                "includes",
+                "the",
+                "death",
+                "of",
+                "his",
+                "father",
+                "of",
+                "an",
+                "unidentified",
+                "etiology",
+                "of",
+                "epatic",
+                "cirrhosis."
+            ],
+            [
+                "Asymptomatic",
+                "and",
+                "performing",
+                "social",
+                "and",
+                "work",
+                "life",
+                "without",
+                "limits."
+            ],
+            [
+                "He",
+                "denies",
+                "alcohol",
+                "consumption."
+            ],
+            [
+                "Physical",
+                "examination",
+                "shows",
+                "metallic",
+                "skin",
+                "pigmentation",
+                "and",
+                "minimal",
+                "non-painful",
+                "hepatomegaly."
+            ],
+            [
+                "The",
+                "rest",
+                "of",
+                "the",
+                "physical",
+                "examination",
+                "was",
+                "normal,",
+                "body",
+                "mass",
+                "index",
+                "23."
+            ],
+            [
+                "Laboratory",
+                "tests",
+                "showed",
+                "the",
+                "following",
+                "results:",
+                "billirubin,",
+                "albumin,",
+                "transaminases",
+                "AST",
+                "and",
+                "ALT,",
+                "normal",
+                "blood",
+                "count",
+                "and",
+                "prothrombin",
+                "time:",
+                "glycemia",
+                "150",
+                "mg/dl;",
+                "serum",
+                "ferritin",
+                "950;",
+                "transferrin",
+                "saturation",
+                ">45%,",
+                "negative",
+                "for",
+                "hepatotropic",
+                "virus."
+            ],
+            [
+                "Normal",
+                "abdominal",
+                "ultrasound."
+            ],
+            [
+                "He",
+                "has",
+                "undergone",
+                "HFE",
+                "genetic",
+                "study",
+                "being",
+                "homozygous",
+                "for",
+                "the",
+                "C282Y",
+                "mutation."
+            ],
+            [
+                "What",
+                "would",
+                "be",
+                "the",
+                "best",
+                "recommendation",
+                "with",
+                "the",
+                "available",
+                "information?"
+            ],
+            [
+                "1-",
+                "Perform",
+                "liver",
+                "biopsy."
+            ],
+            [
+                "2-",
+                "Perform",
+                "hepatic",
+                "MRI."
+            ],
+            [
+                "3-",
+                "Initiate",
+                "treatment",
+                "with",
+                "phlebotomies."
+            ],
+            [
+                "4-",
+                "Start",
+                "treatment",
+                "with",
+                "desferroxamine."
+            ],
+            [
+                "5-",
+                "Start",
+                "treatment",
+                "with",
+                "Vitamin",
+                "E."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "This",
+                "is",
+                "a",
+                "patient",
+                "who",
+                "already",
+                "has",
+                "a",
+                "diagnosis",
+                "of",
+                "hemochromatosis,",
+                "due",
+                "to",
+                "a",
+                "positive",
+                "genetic",
+                "study",
+                "and",
+                "data",
+                "of",
+                "iron",
+                "overload",
+                "(IST",
+                ">45%",
+                "and",
+                "elevated",
+                "ferritin)."
+            ],
+            [
+                "Biopsy",
+                "would",
+                "be",
+                "useful",
+                "if",
+                "the",
+                "diagnosis",
+                "is",
+                "uncertain",
+                "or",
+                "if",
+                "we",
+                "would",
+                "like",
+                "to",
+                "assess",
+                "liver",
+                "involvement",
+                "that",
+                "is",
+                "not",
+                "suspected",
+                "with",
+                "this",
+                "analysis."
+            ],
+            [
+                "The",
+                "treatment",
+                "of",
+                "choice",
+                "is",
+                "phlebotomy."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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"
+            ]
+        ]
+    },
+    {
+        "id": "394_225",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PSYCHIATRY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "Mariano",
+                "is",
+                "a",
+                "53-year-old",
+                "man",
+                "who",
+                "comes",
+                "to",
+                "your",
+                "office",
+                "reporting",
+                "that",
+                "he",
+                "has",
+                "been",
+                "feeling",
+                "very",
+                "unwell",
+                "for",
+                "several",
+                "years."
+            ],
+            [
+                "He",
+                "relates",
+                "his",
+                "discomfort",
+                "to",
+                "a",
+                "behavior",
+                "that",
+                "he",
+                "finds",
+                "absurd",
+                "but",
+                "that",
+                "he",
+                "is",
+                "unable",
+                "to",
+                "avoid."
+            ],
+            [
+                "This",
+                "behavior,",
+                "which",
+                "she",
+                "always",
+                "does",
+                "when",
+                "she",
+                "comes",
+                "home",
+                "from",
+                "work,",
+                "consists",
+                "of",
+                "turning",
+                "the",
+                "doorknob",
+                "of",
+                "the",
+                "bathroom",
+                "on",
+                "the",
+                "upper",
+                "floor",
+                "of",
+                "the",
+                "house",
+                "before",
+                "doing",
+                "anything",
+                "else,",
+                "even",
+                "before",
+                "greeting",
+                "her",
+                "family."
+            ],
+            [
+                "Sometimes",
+                "he",
+                "has",
+                "tried",
+                "to",
+                "resist",
+                "doing",
+                "this",
+                "but",
+                "has",
+                "only",
+                "succeeded",
+                "in",
+                "distressing",
+                "himself",
+                "and",
+                "delaying",
+                "the",
+                "behavior",
+                "for",
+                "a",
+                "few",
+                "minutes."
+            ],
+            [
+                "This",
+                "behavior",
+                "that",
+                "Mariano",
+                "performs",
+                "in",
+                "an",
+                "incoercible",
+                "and",
+                "automatic",
+                "way",
+                "is",
+                "what",
+                "is",
+                "called:"
+            ],
+            [
+                "1-",
+                "Obsessive-compulsive",
+                "disorder."
+            ],
+            [
+                "2-",
+                "Obsession."
+            ],
+            [
+                "3-",
+                "Impulsion."
+            ],
+            [
+                "4-",
+                "Compulsion."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "In",
+                "this",
+                "question",
+                "they",
+                "ask",
+                "for",
+                "the",
+                "name",
+                "of",
+                "the",
+                "symptom,",
+                "not",
+                "the",
+                "disease,",
+                "so",
+                "therefore",
+                "the",
+                "correct",
+                "answer",
+                "is",
+                "compulsion."
+            ],
+            [
+                "According",
+                "to",
+                "the",
+                "DSM-5,",
+                "a",
+                "compulsion",
+                "is",
+                "a",
+                "repetitive",
+                "behavior",
+                "(e.g.,",
+                "washing",
+                "hands,",
+                "tidying",
+                "up,",
+                "checking",
+                "things)",
+                "or",
+                "mental",
+                "act",
+                "(e.g.,",
+                "praying,",
+                "counting,",
+                "repeating",
+                "words",
+                "silently)",
+                "that",
+                "the",
+                "subject",
+                "performs",
+                "in",
+                "response",
+                "to",
+                "an",
+                "obsession",
+                "or",
+                "in",
+                "accordance",
+                "with",
+                "rules",
+                "that",
+                "must",
+                "be",
+                "rigidly",
+                "enforced."
+            ],
+            [
+                "The",
+                "goal",
+                "of",
+                "the",
+                "behaviors",
+                "or",
+                "mental",
+                "acts",
+                "is",
+                "to",
+                "prevent",
+                "or",
+                "decrease",
+                "anxiety",
+                "or",
+                "discomfort,",
+                "or",
+                "to",
+                "avoid",
+                "some",
+                "feared",
+                "event",
+                "or",
+                "situation;",
+                "however,",
+                "these",
+                "behaviors",
+                "or",
+                "mental",
+                "acts",
+                "are",
+                "not",
+                "realistically",
+                "connected",
+                "with",
+                "those",
+                "intended",
+                "to",
+                "neutralize",
+                "or",
+                "prevent",
+                "or",
+                "are",
+                "clearly",
+                "excessive."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "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",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "229_178",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "Previously",
+                "healthy",
+                "10-month-old",
+                "infant",
+                "with",
+                "acute",
+                "gastroenteritis",
+                "of",
+                "one",
+                "day's",
+                "evolution",
+                "and",
+                "signs",
+                "of",
+                "mild",
+                "dehydration,",
+                "without",
+                "blood",
+                "or",
+                "mucus",
+                "in",
+                "the",
+                "stool",
+                "and",
+                "without",
+                "oral",
+                "tolerance."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "initial",
+                "treatment",
+                "of",
+                "choice",
+                "in",
+                "our",
+                "environment?"
+            ],
+            [
+                "1-",
+                "Intravenous",
+                "rehydration,",
+                "absolute",
+                "diet",
+                "8",
+                "hours",
+                "and",
+                "start",
+                "feeding",
+                "with",
+                "astringent",
+                "diet."
+            ],
+            [
+                "2-",
+                "Rehydration",
+                "with",
+                "low",
+                "osmolality",
+                "oral",
+                "rehydration",
+                "solution",
+                "(sodium",
+                "60-75",
+                "mEq/L)",
+                "and",
+                "continue",
+                "with",
+                "his",
+                "usual",
+                "diet."
+            ],
+            [
+                "3-",
+                "Rehydration",
+                "with",
+                "low",
+                "osmolality",
+                "oral",
+                "rehydration",
+                "solution",
+                "(sodium",
+                "60-75",
+                "mEq/L)",
+                "maintain",
+                "usual",
+                "feeding",
+                "and",
+                "oral",
+                "amoxicillin",
+                "10",
+                "days."
+            ],
+            [
+                "4-",
+                "Rehydration",
+                "with",
+                "low",
+                "osmolality",
+                "oral",
+                "rehydration",
+                "solution",
+                "(sodium",
+                "60-75",
+                "mEq/L)",
+                "and",
+                "start",
+                "feeding",
+                "with",
+                "lactose-free",
+                "formulas."
+            ],
+            [
+                "5-",
+                "Rehydration",
+                "with",
+                "low",
+                "osmolality",
+                "oral",
+                "rehydration",
+                "solution",
+                "(sodium",
+                "60-75",
+                "mEq/L)",
+                "maintain",
+                "usual",
+                "feeding",
+                "and",
+                "loperamide",
+                "7",
+                "days."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "The",
+                "infant",
+                "presents",
+                "with",
+                "acute",
+                "GEA",
+                "without",
+                "signs",
+                "of",
+                "alarm",
+                "or",
+                "severe",
+                "dehydration."
+            ],
+            [
+                "The",
+                "first",
+                "step",
+                "would",
+                "be",
+                "to",
+                "try",
+                "oral",
+                "tolerance",
+                "with",
+                "oral",
+                "rehydration",
+                "saline",
+                "and",
+                "continue",
+                "with",
+                "normal",
+                "feeding",
+                "if",
+                "well",
+                "tolerated."
+            ],
+            [
+                "Answer",
+                "1",
+                "may",
+                "give",
+                "rise",
+                "to",
+                "doubts,",
+                "due",
+                "to",
+                "the",
+                "fact",
+                "that",
+                "the",
+                "statement",
+                "says",
+                "that",
+                "the",
+                "patient",
+                "\"does",
+                "not",
+                "tolerate",
+                "the",
+                "oral",
+                "route\"."
+            ],
+            [
+                "In",
+                "this",
+                "case,",
+                "intravenous",
+                "rehydration",
+                "could",
+                "be",
+                "started...",
+                "but",
+                "it",
+                "would",
+                "not",
+                "be",
+                "advisable",
+                "to",
+                "leave",
+                "the",
+                "patient",
+                "on",
+                "an",
+                "absolute",
+                "diet",
+                "for",
+                "8",
+                "hours,",
+                "nor",
+                "a",
+                "subsequent",
+                "astringent",
+                "diet,",
+                "so",
+                "I",
+                "prefer",
+                "answer",
+                "2."
+            ],
+            [
+                "The",
+                "rest",
+                "of",
+                "the",
+                "treatments",
+                "do",
+                "not",
+                "provide",
+                "any",
+                "benefit."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "198_73",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "77-year-old",
+                "man",
+                "with",
+                "a",
+                "history",
+                "of",
+                "type",
+                "2",
+                "Diabetes",
+                "Mellitus",
+                "was",
+                "diagnosed",
+                "2",
+                "years",
+                "ago",
+                "with",
+                "mild",
+                "cognitive",
+                "impairment."
+            ],
+            [
+                "At",
+                "that",
+                "time",
+                "a",
+                "Minimental",
+                "(Folstein)",
+                "28/30,",
+                "abbreviated",
+                "Yesavage",
+                "Test",
+                "14/15,",
+                "a",
+                "CBC",
+                "with",
+                "normal",
+                "TSH",
+                "and",
+                "maturation",
+                "factors",
+                "along",
+                "with",
+                "negative",
+                "LUES",
+                "and",
+                "HIV",
+                "serologies",
+                "and",
+                "a",
+                "magnetic",
+                "resonance",
+                "imaging",
+                "(MRI)",
+                "showing",
+                "diffuse",
+                "cortical",
+                "atrophy",
+                "predominantly",
+                "in",
+                "the",
+                "posterior",
+                "area."
+            ],
+            [
+                "The",
+                "patient",
+                "was",
+                "accompanied",
+                "by",
+                "his",
+                "wife,",
+                "who",
+                "reported",
+                "a",
+                "slow",
+                "progressive",
+                "evolution",
+                "of",
+                "memory",
+                "impairment",
+                "(e.g.,",
+                "sometimes",
+                "confused",
+                "with",
+                "insulin",
+                "doses)."
+            ],
+            [
+                "There",
+                "are",
+                "no",
+                "hallucinations",
+                "or",
+                "behavioral",
+                "disorder."
+            ],
+            [
+                "Current",
+                "Minimental",
+                "is",
+                "24/30",
+                "and",
+                "Yesavage",
+                "test",
+                "14/15,",
+                "there",
+                "is",
+                "no",
+                "neurological",
+                "focality,",
+                "tremor",
+                "or",
+                "tone",
+                "or",
+                "gait",
+                "disorders",
+                "on",
+                "physical",
+                "examination."
+            ],
+            [
+                "Two",
+                "months",
+                "ago",
+                "he",
+                "came",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "after",
+                "a",
+                "mild",
+                "traumatic",
+                "brain",
+                "injury",
+                "due",
+                "to",
+                "an",
+                "accidental",
+                "fall",
+                "(the",
+                "only",
+                "one",
+                "in",
+                "2",
+                "years)",
+                "and",
+                "a",
+                "CT",
+                "scan",
+                "was",
+                "performed",
+                "which",
+                "did",
+                "not",
+                "provide",
+                "new",
+                "information",
+                "compared",
+                "to",
+                "the",
+                "previous",
+                "MRI."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis",
+                "in",
+                "this",
+                "patient?"
+            ],
+            [
+                "1-",
+                "Frontotemporal",
+                "dementia."
+            ],
+            [
+                "2-",
+                "Alzheimer's",
+                "disease."
+            ],
+            [
+                "3-",
+                "Vascular",
+                "dementia."
+            ],
+            [
+                "4-",
+                "Lewy",
+                "body",
+                "disease."
+            ],
+            [
+                "5-",
+                "Creutzfeldt-Jakob",
+                "disease."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "This",
+                "case",
+                "describes",
+                "an",
+                "Alzheimer's",
+                "disease",
+                "with",
+                "insidious",
+                "onset",
+                "of",
+                "short-term",
+                "memory",
+                "problems."
+            ],
+            [
+                "Clinically",
+                "it",
+                "can",
+                "be",
+                "distinguished",
+                "from",
+                "other",
+                "options",
+                "by",
+                "the",
+                "absence",
+                "of",
+                "behavioral",
+                "problems",
+                "(typical",
+                "of",
+                "frontotemporal",
+                "dementia)",
+                "and",
+                "hallucinations",
+                "(early",
+                "in",
+                "Lewy",
+                "body",
+                "disease)."
+            ],
+            [
+                "Vascular",
+                "dementia",
+                "is",
+                "diagnosed",
+                "by",
+                "criteria",
+                "that",
+                "include",
+                "deficits",
+                "in",
+                "memory",
+                "and",
+                "two",
+                "other",
+                "cognitive",
+                "areas",
+                "with",
+                "consequent",
+                "functional",
+                "impairment,",
+                "but",
+                "cerebral",
+                "vascular",
+                "disease",
+                "based",
+                "on",
+                "history,",
+                "examination",
+                "and/or",
+                "neuroimaging",
+                "tests,",
+                "which",
+                "are",
+                "not",
+                "indicated",
+                "in",
+                "the",
+                "case."
+            ],
+            [
+                "Creutzfeldt-Jacob",
+                "disease",
+                "is",
+                "mostly",
+                "rapidly",
+                "progressive",
+                "and",
+                "usually",
+                "presents",
+                "with",
+                "other",
+                "clinical,",
+                "abnormal",
+                "neurological",
+                "examination",
+                "and",
+                "MRI",
+                "alterations."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "351_161",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "27-year-old",
+                "woman",
+                "referred",
+                "to",
+                "a",
+                "gynecology",
+                "office",
+                "for",
+                "evaluation,",
+                "reporting",
+                "dyspareunia",
+                "for",
+                "about",
+                "8",
+                "months,",
+                "along",
+                "with",
+                "dyschezia",
+                "and",
+                "occasional",
+                "rectorrhagia",
+                "coinciding",
+                "with",
+                "menstruation",
+                "for",
+                "3-4",
+                "months."
+            ],
+            [
+                "She",
+                "also",
+                "reports",
+                "dysmenorrhea",
+                "for",
+                "years,",
+                "which",
+                "she",
+                "controls",
+                "well",
+                "with",
+                "ibuprofen."
+            ],
+            [
+                "She",
+                "has",
+                "been",
+                "trying",
+                "to",
+                "get",
+                "pregnant",
+                "for",
+                "16",
+                "months",
+                "without",
+                "success."
+            ],
+            [
+                "In",
+                "the",
+                "gynecological",
+                "examination",
+                "she",
+                "only",
+                "shows",
+                "pain",
+                "when",
+                "pressing",
+                "on",
+                "the",
+                "posterior",
+                "vaginal",
+                "fornix."
+            ],
+            [
+                "Which",
+                "test",
+                "do",
+                "you",
+                "consider",
+                "would",
+                "allow",
+                "you",
+                "to",
+                "reach",
+                "a",
+                "diagnosis",
+                "of",
+                "certainty",
+                "of",
+                "her",
+                "pathology?"
+            ],
+            [
+                "1-",
+                "Transvaginal",
+                "ultrasound."
+            ],
+            [
+                "2-",
+                "Diagnostic",
+                "laparoscopy."
+            ],
+            [
+                "3-",
+                "Magnetic",
+                "resonance",
+                "imaging."
+            ],
+            [
+                "4-",
+                "Colonoscopy."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "The",
+                "clinical",
+                "case",
+                "presented",
+                "is",
+                "a",
+                "woman",
+                "of",
+                "childbearing",
+                "age",
+                "(27",
+                "years)",
+                "presenting",
+                "dyspareunia",
+                "+",
+                "dysmenorrhea",
+                "+",
+                "infertility,",
+                "which",
+                "should",
+                "lead",
+                "us",
+                "to",
+                "think",
+                "of",
+                "endometriosis."
+            ],
+            [
+                "The",
+                "clinical",
+                "history",
+                "and",
+                "ultrasound",
+                "give",
+                "a",
+                "diagnosis",
+                "of",
+                "suspicion,",
+                "but",
+                "the",
+                "diagnosis",
+                "of",
+                "certainty",
+                "is",
+                "given",
+                "by",
+                "direct",
+                "observation",
+                "(with",
+                "or",
+                "without",
+                "associated",
+                "biopsy)",
+                "of",
+                "ectopic",
+                "endometrial",
+                "tissue",
+                "implants,",
+                "either",
+                "by",
+                "laparotomy",
+                "or",
+                "laparoscopy."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "69_124",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ANESTHESIOLOGY,",
+                "CRITICAL",
+                "CARE",
+                "AND",
+                "EMERGENCY",
+                "MEDICINE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "The",
+                "daughter",
+                "of",
+                "an",
+                "82-year-old",
+                "woman",
+                "consults",
+                "us",
+                "because",
+                "she",
+                "has",
+                "found",
+                "her",
+                "mother",
+                "more",
+                "confused",
+                "than",
+                "usual."
+            ],
+            [
+                "The",
+                "patient",
+                "is",
+                "diagnosed",
+                "with",
+                "moderate",
+                "Alzheimer's",
+                "disease."
+            ],
+            [
+                "She",
+                "also",
+                "has",
+                "AF,",
+                "depression",
+                "and",
+                "osteoarthritis."
+            ],
+            [
+                "She",
+                "has",
+                "been",
+                "receiving",
+                "stable",
+                "treatment",
+                "for",
+                "3",
+                "years,",
+                "including",
+                "digoxin,",
+                "acenocoumarol,",
+                "fluoxetine",
+                "for",
+                "the",
+                "last",
+                "4",
+                "months",
+                "and",
+                "ibuprofen",
+                "for",
+                "the",
+                "last",
+                "month",
+                "for",
+                "joint",
+                "pain."
+            ],
+            [
+                "On",
+                "examination,",
+                "her",
+                "blood",
+                "pressure",
+                "is",
+                "130/80,",
+                "heart",
+                "rate",
+                "48",
+                "bpm",
+                "and",
+                "respiratory",
+                "rate",
+                "10",
+                "rpm."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "cause",
+                "of",
+                "the",
+                "increased",
+                "confusion?"
+            ],
+            [
+                "1-",
+                "Progression",
+                "of",
+                "Alzheimer's",
+                "disease."
+            ],
+            [
+                "2-",
+                "Worsening",
+                "depression."
+            ],
+            [
+                "3-",
+                "Digitalis",
+                "intoxication."
+            ],
+            [
+                "4-",
+                "Dementia",
+                "due",
+                "to",
+                "Lewy",
+                "bodies."
+            ],
+            [
+                "5-",
+                "Ibuprofen",
+                "toxicity."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "The",
+                "most",
+                "likely",
+                "cause",
+                "is",
+                "a",
+                "digitalis",
+                "intoxication,",
+                "which",
+                "would",
+                "produce",
+                "this",
+                "slowing",
+                "of",
+                "conduction,",
+                "which",
+                "is",
+                "seen",
+                "in",
+                "the",
+                "heart",
+                "rate."
+            ],
+            [
+                "Probably",
+                "secondary",
+                "to",
+                "renal",
+                "failure",
+                "due",
+                "to",
+                "ibuprofen",
+                "toxicity",
+                "(but",
+                "this",
+                "is",
+                "a",
+                "bit",
+                "of",
+                "a",
+                "stretch)."
+            ]
+        ],
+        "labels": [
+            [
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "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-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"
+            ]
+        ]
+    },
+    {
+        "id": "140_134",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "newborn",
+                "of",
+                "37",
+                "weeks",
+                "gestational",
+                "age,",
+                "with",
+                "no",
+                "pathological",
+                "findings",
+                "in",
+                "the",
+                "prenatal",
+                "ultrasound,",
+                "presents",
+                "in",
+                "the",
+                "examination",
+                "performed",
+                "in",
+                "the",
+                "delivery",
+                "room",
+                "a",
+                "\"stop\"",
+                "to",
+                "the",
+                "passage",
+                "of",
+                "the",
+                "nasogastric",
+                "tube."
+            ],
+            [
+                "Chest",
+                "and",
+                "abdominal",
+                "X-ray",
+                "showed",
+                "an",
+                "atresic",
+                "esophageal",
+                "pouch,",
+                "with",
+                "normal",
+                "gastrointestinal",
+                "pneumatization."
+            ],
+            [
+                "After",
+                "a",
+                "diagnostic",
+                "evaluation",
+                "that",
+                "ruled",
+                "out",
+                "other",
+                "anomalies",
+                "and",
+                "being",
+                "in",
+                "a",
+                "stable",
+                "respiratory",
+                "condition,",
+                "surgical",
+                "intervention",
+                "was",
+                "decided."
+            ],
+            [
+                "On",
+                "what",
+                "basis",
+                "was",
+                "the",
+                "priority",
+                "to",
+                "intervene",
+                "in",
+                "this",
+                "patient",
+                "based?"
+            ],
+            [
+                "1-",
+                "Due",
+                "to",
+                "the",
+                "impossibility",
+                "of",
+                "swallowing",
+                "saliva."
+            ],
+            [
+                "2-",
+                "Because",
+                "of",
+                "frequently",
+                "associated",
+                "cardiac",
+                "malformations."
+            ],
+            [
+                "3-",
+                "Because",
+                "of",
+                "the",
+                "risk",
+                "of",
+                "aspiration",
+                "pneumonitis."
+            ],
+            [
+                "4-",
+                "Due",
+                "to",
+                "the",
+                "impossibility",
+                "of",
+                "enteral",
+                "feeding."
+            ],
+            [
+                "5-",
+                "Associated",
+                "tracheomalacia."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "3."
+            ],
+            [
+                "The",
+                "fact",
+                "that",
+                "there",
+                "is",
+                "intestinal",
+                "aeration",
+                "points",
+                "to",
+                "the",
+                "existence",
+                "of",
+                "a",
+                "fistula",
+                "of",
+                "the",
+                "lower",
+                "esophageal",
+                "segment",
+                "with",
+                "the",
+                "trachea",
+                "or",
+                "with",
+                "a",
+                "bronchus."
+            ],
+            [
+                "In",
+                "this",
+                "case,",
+                "pulmonary",
+                "complications",
+                "are",
+                "frequent",
+                "due",
+                "to",
+                "the",
+                "passage",
+                "of",
+                "gastric",
+                "contents",
+                "into",
+                "the",
+                "airway."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "475_89",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CRITICAL",
+                "CARE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "46-year-old",
+                "man",
+                "with",
+                "bipolar",
+                "disorder",
+                "is",
+                "brought",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "after",
+                "an",
+                "over-ingestion",
+                "of",
+                "lithium",
+                "carbonate."
+            ],
+            [
+                "Examination",
+                "reveals",
+                "severe",
+                "tremor,",
+                "ataxia,",
+                "dysarthria,",
+                "myoclonus",
+                "and",
+                "fasciculations."
+            ],
+            [
+                "Lithemia",
+                "is",
+                "4.1",
+                "mEq/L",
+                "(toxicity",
+                ">",
+                "1.6",
+                "mEq/L)."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "therapeutic",
+                "options",
+                "would",
+                "be",
+                "most",
+                "indicated?"
+            ],
+            [
+                "1-",
+                "Aminophylline",
+                "associated",
+                "with",
+                "a",
+                "cathartic."
+            ],
+            [
+                "2-",
+                "Activated",
+                "charcoal."
+            ],
+            [
+                "3-",
+                "Hemodialysis."
+            ],
+            [
+                "4-",
+                "Forced",
+                "diuresis."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "We",
+                "are",
+                "dealing",
+                "with",
+                "a",
+                "case",
+                "of",
+                "severe",
+                "lithium",
+                "intoxication",
+                "(lithemia",
+                ">",
+                "3.5",
+                "mEq/L",
+                "is",
+                "life",
+                "threatening),",
+                "therefore,",
+                "the",
+                "therapeutic",
+                "option",
+                "of",
+                "choice",
+                "is",
+                "to",
+                "start",
+                "hemodialysis",
+                "urgently."
+            ],
+            [
+                "Remember",
+                "that",
+                "activated",
+                "charcoal",
+                "is",
+                "NOT",
+                "indicated",
+                "in",
+                "lithium",
+                "intoxication."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "85_50",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CARDIOLOGY",
+                "AND",
+                "VASCULAR",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "patient",
+                "with",
+                "a",
+                "history",
+                "of",
+                "febrile",
+                "illness",
+                "and",
+                "chest",
+                "pain",
+                "comes",
+                "to",
+                "the",
+                "hospital",
+                "with",
+                "dyspnea",
+                "and",
+                "tachypnea."
+            ],
+            [
+                "On",
+                "physical",
+                "examination",
+                "his",
+                "blood",
+                "pressure",
+                "is",
+                "low,",
+                "jugular",
+                "venous",
+                "pressure",
+                "is",
+                "elevated",
+                "with",
+                "a",
+                "deep",
+                "descending",
+                "sinus",
+                "\"X\"",
+                "and",
+                "he",
+                "has",
+                "a",
+                "paradoxical",
+                "pulse."
+            ],
+            [
+                "What",
+                "pathology",
+                "should",
+                "you",
+                "suspect?"
+            ],
+            [
+                "1-",
+                "Ischemic",
+                "heart",
+                "disease."
+            ],
+            [
+                "2-",
+                "Dilated",
+                "cardiomyopathy."
+            ],
+            [
+                "3-",
+                "Severe",
+                "aortic",
+                "stenosis."
+            ],
+            [
+                "4-",
+                "Constrictive",
+                "pericarditis."
+            ],
+            [
+                "5-",
+                "Pericardial",
+                "effusion",
+                "with",
+                "cardiac",
+                "tamponade."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "Paradoxical",
+                "pulse",
+                "is",
+                "a",
+                "drop",
+                "in",
+                "blood",
+                "pressure",
+                ">",
+                "10",
+                "mmHg",
+                "during",
+                "inspiration;",
+                "it",
+                "represents",
+                "an",
+                "exaggeration",
+                "of",
+                "the",
+                "physiological",
+                "phenomenon",
+                "consisting",
+                "of",
+                "inspiratory",
+                "lowering",
+                "of",
+                "BP",
+                "(normal",
+                "up",
+                "to",
+                "10",
+                "mmHg)."
+            ],
+            [
+                "In",
+                "cardiac",
+                "tamponade,",
+                "inspiration,",
+                "which",
+                "causes",
+                "an",
+                "increase",
+                "in",
+                "blood",
+                "flow",
+                "to",
+                "the",
+                "right",
+                "chambers,",
+                "increasing",
+                "their",
+                "volume,",
+                "secondarily",
+                "causes",
+                "a",
+                "displacement",
+                "of",
+                "the",
+                "interventricular",
+                "septum",
+                "to",
+                "the",
+                "left,",
+                "so",
+                "that",
+                "the",
+                "left",
+                "heart",
+                "lodges",
+                "and",
+                "expels",
+                "less",
+                "blood",
+                "during",
+                "systole",
+                "and",
+                "the",
+                "pulse,",
+                "therefore,",
+                "decreases."
+            ],
+            [
+                "In",
+                "a",
+                "normal",
+                "heart",
+                "this",
+                "exaggerated",
+                "displacement,",
+                "caused",
+                "by",
+                "the",
+                "pressure",
+                "exerted",
+                "by",
+                "the",
+                "tamponade",
+                "on",
+                "the",
+                "RV",
+                "free",
+                "wall,",
+                "does",
+                "not",
+                "occur."
+            ],
+            [
+                "Sinus",
+                "X",
+                "represents",
+                "the",
+                "systolic",
+                "collapse",
+                "of",
+                "the",
+                "venous",
+                "pulse,",
+                "i.e.,",
+                "the",
+                "pressure",
+                "drop",
+                "due",
+                "to",
+                "atrial",
+                "relaxation",
+                "(also",
+                "partly",
+                "due",
+                "to",
+                "a",
+                "downward",
+                "displacement",
+                "of",
+                "the",
+                "RV",
+                "base",
+                "during",
+                "systole)."
+            ],
+            [
+                "Sinus",
+                "Y",
+                "represents",
+                "the",
+                "diastolic",
+                "collapse",
+                "of",
+                "the",
+                "venous",
+                "pulse,",
+                "i.e.,",
+                "the",
+                "pressure",
+                "drop",
+                "that",
+                "occurs",
+                "from",
+                "the",
+                "moment",
+                "blood",
+                "enters",
+                "the",
+                "tricuspid",
+                "valve",
+                "into",
+                "the",
+                "ventricle."
+            ],
+            [
+                "In",
+                "cardiac",
+                "tamponade,",
+                "the",
+                "deep",
+                "sinus",
+                "X",
+                "is",
+                "characteristic."
+            ],
+            [
+                "In",
+                "constrictive",
+                "pericarditis,",
+                "the",
+                "deep",
+                "Y",
+                "sinus."
+            ],
+            [
+                "For",
+                "all",
+                "these",
+                "reasons,",
+                "the",
+                "correct",
+                "answer",
+                "is",
+                "5."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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"
+            ],
+            [
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "527_31",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEPHROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "patient's",
+                "arterial",
+                "blood",
+                "gas",
+                "result",
+                "is:",
+                "pH:",
+                "7.40,",
+                "PaCO2",
+                "60",
+                "mmHg;",
+                "bicarbonate",
+                "36",
+                "mM/L."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "presenting",
+                "disturbance:"
+            ],
+            [
+                "1-",
+                "None,",
+                "pH",
+                "is",
+                "normal."
+            ],
+            [
+                "2-",
+                "Respiratory",
+                "acidosis."
+            ],
+            [
+                "3-",
+                "Respiratory",
+                "acidosis",
+                "and",
+                "metabolic",
+                "alkalosis."
+            ],
+            [
+                "4-",
+                "Metabolic",
+                "alkalosis."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Blood",
+                "gases",
+                "can",
+                "be",
+                "misleading",
+                "since",
+                "a",
+                "normal",
+                "pH",
+                "may",
+                "suggest",
+                "that",
+                "there",
+                "is",
+                "no",
+                "disturbance",
+                "of",
+                "acid-base",
+                "balance,",
+                "instead",
+                "it",
+                "is",
+                "masking",
+                "a",
+                "double",
+                "disturbance",
+                "in",
+                "opposite",
+                "directions",
+                "as",
+                "in",
+                "this",
+                "case."
+            ],
+            [
+                "The",
+                "patient",
+                "presents",
+                "with",
+                "respiratory",
+                "acidosis",
+                "(PaCO2",
+                "60",
+                "mmHg;",
+                "normal",
+                "to",
+                "50)",
+                "and",
+                "compensatory",
+                "metabolic",
+                "alkalosis",
+                "(bicarbonate",
+                "36",
+                "mmol/l;",
+                "normal",
+                "to",
+                "28)."
+            ],
+            [
+                "This",
+                "is",
+                "the",
+                "typical",
+                "blood",
+                "gas",
+                "of",
+                "the",
+                "patient",
+                "with",
+                "COPD",
+                "and",
+                "compensated",
+                "chronic",
+                "respiratory",
+                "failure."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "407_81",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ONCOLOGY",
+                "(ECTOPIC)"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "30-year-old",
+                "woman",
+                "comes",
+                "to",
+                "the",
+                "clinic",
+                "reporting",
+                "anxiety,",
+                "weight",
+                "loss",
+                "of",
+                "about",
+                "6",
+                "kgs",
+                "and",
+                "a",
+                "feeling",
+                "of",
+                "\"nervousness\"",
+                "in",
+                "the",
+                "last",
+                "three",
+                "months."
+            ],
+            [
+                "Physical",
+                "examination",
+                "showed",
+                "tachycardia,",
+                "hyperreflexia",
+                "and",
+                "absence",
+                "of",
+                "goiter."
+            ],
+            [
+                "TSH",
+                "values",
+                "are",
+                "<",
+                "0.01",
+                "microU/mL,",
+                "T4",
+                "is",
+                "elevated",
+                "and",
+                "thyroglobulin",
+                "levels",
+                "are",
+                "decreased."
+            ],
+            [
+                "A",
+                "scan",
+                "reveals",
+                "an",
+                "absence",
+                "of",
+                "uptake",
+                "in",
+                "the",
+                "thyroid",
+                "region."
+            ],
+            [
+                "What",
+                "seems",
+                "to",
+                "you",
+                "the",
+                "most",
+                "likely",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Factitious",
+                "thyrotoxicosis."
+            ],
+            [
+                "2-",
+                "Hyperthyroidism",
+                "due",
+                "to",
+                "Graves'",
+                "disease."
+            ],
+            [
+                "3-",
+                "Ovarian",
+                "teratoma",
+                "(ovarian",
+                "stromal)."
+            ],
+            [
+                "4-",
+                "Subacute",
+                "thyroiditis."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Patients",
+                "with",
+                "this",
+                "disorder",
+                "voluntarily",
+                "or",
+                "accidentally",
+                "ingest",
+                "excessive",
+                "amounts",
+                "of",
+                "thyroid",
+                "hormone,",
+                "resulting",
+                "in",
+                "hyperthyroidism",
+                "in",
+                "the",
+                "absence",
+                "of",
+                "goiter."
+            ],
+            [
+                "In",
+                "contrast",
+                "to",
+                "all",
+                "other",
+                "causes",
+                "of",
+                "hyperthyroidism,",
+                "serum",
+                "thyroglobulin",
+                "is",
+                "not",
+                "elevated",
+                "and",
+                "is",
+                "almost",
+                "always",
+                "low",
+                "or",
+                "at",
+                "the",
+                "lower",
+                "limit",
+                "of",
+                "normal."
+            ],
+            [
+                "The",
+                "fundamental",
+                "doubt",
+                "we",
+                "had",
+                "with",
+                "ovarian",
+                "teratoma",
+                "(ovarian",
+                "struma)",
+                "which",
+                "is",
+                "a",
+                "rare",
+                "variant",
+                "of",
+                "mature",
+                "monodermal",
+                "teratoma",
+                "composed",
+                "of",
+                "thyroid",
+                "tissue",
+                "described",
+                "at",
+                "the",
+                "beginning",
+                "of",
+                "the",
+                "20th",
+                "century."
+            ],
+            [
+                "It",
+                "is",
+                "so",
+                "named",
+                "when",
+                "the",
+                "teratoma",
+                "is",
+                "predominantly",
+                "composed",
+                "of",
+                "mature",
+                "thyroid",
+                "tissue",
+                "(at",
+                "least",
+                "50%,",
+                "in",
+                "order",
+                "to",
+                "be",
+                "classified",
+                "as",
+                "struma",
+                "ovarii)."
+            ],
+            [
+                "It",
+                "represents",
+                "between",
+                "2.5",
+                "and",
+                "5%",
+                "of",
+                "ovarian",
+                "teratomas."
+            ],
+            [
+                "In",
+                "itself,",
+                "it",
+                "is",
+                "a",
+                "benign",
+                "tumor,",
+                "but",
+                "in",
+                "up",
+                "to",
+                "5%",
+                "of",
+                "cases",
+                "it",
+                "can",
+                "develop",
+                "a",
+                "malignant",
+                "transformation",
+                "of",
+                "its",
+                "elements,",
+                "classically",
+                "referred",
+                "to",
+                "as",
+                "malignant",
+                "struma",
+                "ovarii."
+            ],
+            [
+                "Mostly,",
+                "the",
+                "neoplastic",
+                "tissue",
+                "developed",
+                "is",
+                "a",
+                "papillary",
+                "carcinoma,",
+                "less",
+                "frequently",
+                "it",
+                "corresponds",
+                "to",
+                "follicular",
+                "carcinoma."
+            ],
+            [
+                "This",
+                "malignant",
+                "transformation",
+                "arises",
+                "mostly",
+                "from",
+                "classical",
+                "forms",
+                "of",
+                "struma,",
+                "but",
+                "is",
+                "extremely",
+                "rare",
+                "in",
+                "cases",
+                "of",
+                "mature",
+                "cystic",
+                "teratomas."
+            ],
+            [
+                "Its",
+                "behavior",
+                "is",
+                "similar",
+                "to",
+                "that",
+                "of",
+                "other",
+                "primary",
+                "ovarian",
+                "tumors,",
+                "tending",
+                "to",
+                "metastasize",
+                "to",
+                "the",
+                "peritoneal",
+                "cavity",
+                "and",
+                "hematogenously",
+                "to",
+                "bone,",
+                "liver",
+                "and",
+                "brain."
+            ],
+            [
+                "The",
+                "mean",
+                "age",
+                "of",
+                "presentation",
+                "of",
+                "thyroid",
+                "carcinoma",
+                "on",
+                "struma",
+                "ovarii",
+                "is",
+                "between",
+                "42.9-44",
+                "years",
+                "and",
+                "between",
+                "21",
+                "and",
+                "63",
+                "for",
+                "the",
+                "papillary",
+                "carcinoma",
+                "variant."
+            ],
+            [
+                "Clinically,",
+                "the",
+                "predominant",
+                "form",
+                "of",
+                "presentation",
+                "is",
+                "as",
+                "a",
+                "pelvic",
+                "mass",
+                "or",
+                "abdominal",
+                "pain",
+                "(45%),",
+                "less",
+                "frequently",
+                "hyperthyroidism",
+                "(5-8%)",
+                "or",
+                "ascites",
+                "(17%)."
+            ],
+            [
+                "It",
+                "is",
+                "postulated",
+                "that",
+                "the",
+                "ovarian",
+                "thyroid",
+                "tissue",
+                "in",
+                "the",
+                "struma",
+                "is",
+                "autonomous",
+                "in",
+                "the",
+                "production",
+                "of",
+                "thyroid",
+                "hormones,",
+                "so",
+                "it",
+                "is",
+                "essential",
+                "to",
+                "measure",
+                "serum",
+                "thyroglobulin",
+                "levels",
+                "in",
+                "patients",
+                "affected",
+                "by",
+                "hyperthyroidism,",
+                "as",
+                "they",
+                "point",
+                "to",
+                "the",
+                "extrathyroid",
+                "production",
+                "of",
+                "thyroid",
+                "hormone."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "15_126",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PALLIATIVE",
+                "CARE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "For",
+                "the",
+                "third",
+                "time",
+                "in",
+                "the",
+                "last",
+                "6",
+                "months",
+                "an",
+                "84-year-old",
+                "man",
+                "with",
+                "advanced",
+                "dementia",
+                "is",
+                "admitted",
+                "to",
+                "a",
+                "hospital",
+                "for",
+                "aspiration",
+                "pneumonia."
+            ],
+            [
+                "He",
+                "has",
+                "lost",
+                "9.5",
+                "kg",
+                "in",
+                "the",
+                "last",
+                "10",
+                "months."
+            ],
+            [
+                "He",
+                "has",
+                "a",
+                "pressure",
+                "ulcer",
+                "in",
+                "the",
+                "sacrum."
+            ],
+            [
+                "He",
+                "does",
+                "not",
+                "communicate",
+                "verbally,",
+                "does",
+                "not",
+                "ambulate",
+                "and",
+                "is",
+                "dependent",
+                "for",
+                "all",
+                "activities",
+                "of",
+                "daily",
+                "living."
+            ],
+            [
+                "His",
+                "wife",
+                "cares",
+                "for",
+                "him",
+                "at",
+                "home",
+                "and",
+                "does",
+                "not",
+                "want",
+                "to",
+                "place",
+                "him",
+                "in",
+                "a",
+                "nursing",
+                "home."
+            ],
+            [
+                "A",
+                "swallowing",
+                "study",
+                "indicates",
+                "that",
+                "he",
+                "chokes",
+                "on",
+                "all",
+                "types",
+                "of",
+                "food",
+                "consistencies."
+            ],
+            [
+                "The",
+                "hospital",
+                "physician",
+                "suggests",
+                "tube",
+                "feeding."
+            ],
+            [
+                "The",
+                "patient's",
+                "\"Advance",
+                "Living",
+                "Will\"",
+                "states",
+                "that",
+                "his",
+                "wife",
+                "is",
+                "the",
+                "representative",
+                "decision",
+                "maker",
+                "regarding",
+                "his",
+                "medical",
+                "care",
+                "and",
+                "that",
+                "he",
+                "does",
+                "not",
+                "want",
+                "extraordinary",
+                "measures",
+                "to",
+                "prolong",
+                "his",
+                "life",
+                "including",
+                "artificial",
+                "nutrition."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "is",
+                "the",
+                "most",
+                "appropriate",
+                "recommendation",
+                "for",
+                "this",
+                "patient:"
+            ],
+            [
+                "1-",
+                "Place",
+                "an",
+                "indwelling",
+                "SNG",
+                "and",
+                "discharge",
+                "to",
+                "a",
+                "skilled",
+                "nursing",
+                "home."
+            ],
+            [
+                "2-",
+                "Place",
+                "a",
+                "mid-term",
+                "NGUS",
+                "and",
+                "discharge",
+                "to",
+                "a",
+                "nursing",
+                "home",
+                "with",
+                "specialized",
+                "care",
+                "until",
+                "bedsores",
+                "heal."
+            ],
+            [
+                "3-",
+                "Discharge",
+                "to",
+                "a",
+                "nursing",
+                "home",
+                "with",
+                "specialized",
+                "care",
+                "until",
+                "pressure",
+                "ulcers",
+                "heal."
+            ],
+            [
+                "4-",
+                "Place",
+                "a",
+                "gastrostomy",
+                "tube",
+                "and",
+                "discharge",
+                "home."
+            ],
+            [
+                "5-",
+                "Discharge",
+                "home",
+                "with",
+                "palliative",
+                "care",
+                "from",
+                "the",
+                "health",
+                "area."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "This",
+                "is",
+                "perhaps",
+                "the",
+                "least",
+                "scientific",
+                "of",
+                "this",
+                "year's",
+                "MIR",
+                "questions,",
+                "since",
+                "its",
+                "answer",
+                "is",
+                "based",
+                "on",
+                "the",
+                "interpretation",
+                "of",
+                "a",
+                "law,",
+                "which",
+                "is",
+                "also",
+                "of",
+                "an",
+                "autonomous",
+                "nature."
+            ],
+            [
+                "Probably",
+                "the",
+                "spirit",
+                "of",
+                "the",
+                "examiner",
+                "wants",
+                "to",
+                "reflect",
+                "this",
+                "law,",
+                "in",
+                "an",
+                "extreme",
+                "case."
+            ],
+            [
+                "Let's",
+                "see,",
+                "starting",
+                "from",
+                "article",
+                "11",
+                "of",
+                "Law",
+                "41",
+                "/2002,",
+                "of",
+                "November",
+                "14",
+                "(1),",
+                "basic",
+                "law",
+                "regulating",
+                "patient",
+                "autonomy",
+                "and",
+                "the",
+                "rights",
+                "and",
+                "obligations",
+                "regarding",
+                "information",
+                "and",
+                "clinical",
+                "documentation",
+                "(B.O.E.",
+                "No.",
+                "274,",
+                "of",
+                "November",
+                "15)",
+                "of",
+                "a",
+                "national",
+                "nature,",
+                "in",
+                "Castilla-La",
+                "Mancha",
+                "there",
+                "is",
+                "Law",
+                "6/2005,",
+                "of",
+                "July",
+                "7",
+                "(2),",
+                "of",
+                "Castilla-La",
+                "Mancha,",
+                "on",
+                "the",
+                "Declaration",
+                "of",
+                "Advance",
+                "Directives",
+                "in",
+                "matters",
+                "of",
+                "one's",
+                "own",
+                "health."
+            ],
+            [
+                "(D.O.C.M.",
+                "No.",
+                "141,",
+                "of",
+                "July",
+                "15)",
+                "and",
+                "Decree",
+                "15/2006,",
+                "of",
+                "February",
+                "21",
+                "(3),",
+                "of",
+                "the",
+                "Registry",
+                "of",
+                "Advance",
+                "Directives",
+                "of",
+                "Castilla-La",
+                "Mancha",
+                "(D.O.C.M.",
+                "No.",
+                "42,",
+                "of",
+                "February",
+                "24)."
+            ],
+            [
+                "In",
+                "the",
+                "summary",
+                "published",
+                "by",
+                "the",
+                "JCCM",
+                "(4)",
+                "it",
+                "says:",
+                "\"The",
+                "declaration",
+                "of",
+                "advance",
+                "directives",
+                "(also",
+                "known",
+                "as",
+                "advance",
+                "directives",
+                "or",
+                "living",
+                "will)",
+                "is",
+                "the",
+                "written",
+                "manifestation",
+                "of",
+                "a",
+                "capable",
+                "person",
+                "who,",
+                "acting",
+                "freely,",
+                "expresses",
+                "the",
+                "instructions",
+                "to",
+                "be",
+                "taken",
+                "into",
+                "account",
+                "regarding",
+                "the",
+                "health",
+                "care",
+                "he/she",
+                "wishes",
+                "to",
+                "receive",
+                "in",
+                "situations",
+                "that",
+                "prevent",
+                "him/her",
+                "from",
+                "communicating",
+                "his/her",
+                "will",
+                "personally,",
+                "or",
+                "regarding",
+                "the",
+                "destination",
+                "of",
+                "his/her",
+                "body",
+                "or",
+                "organs",
+                "once",
+                "death",
+                "has",
+                "occurred."
+            ],
+            [
+                "In",
+                "our",
+                "declaration",
+                "of",
+                "advance",
+                "directives,",
+                "we",
+                "can",
+                "refer",
+                "to:",
+                "1.",
+                "The",
+                "expression",
+                "of",
+                "personal",
+                "values,",
+                "in",
+                "order",
+                "to",
+                "help",
+                "in",
+                "the",
+                "interpretation",
+                "of",
+                "the",
+                "document",
+                "itself",
+                "and",
+                "to",
+                "guide",
+                "physicians",
+                "in",
+                "making",
+                "clinical",
+                "decisions."
+            ],
+            [
+                "2."
+            ],
+            [
+                "Instructions",
+                "about",
+                "the",
+                "care",
+                "and",
+                "treatment",
+                "related",
+                "to",
+                "our",
+                "health",
+                "that",
+                "we",
+                "may",
+                "or",
+                "may",
+                "not",
+                "wish",
+                "to",
+                "receive."
+            ],
+            [
+                "3."
+            ],
+            [
+                "We",
+                "may",
+                "appoint",
+                "a",
+                "representative",
+                "to",
+                "act",
+                "as",
+                "an",
+                "interlocutor",
+                "with",
+                "the",
+                "responsible",
+                "physician",
+                "or",
+                "health",
+                "care",
+                "team",
+                "to",
+                "ensure",
+                "that",
+                "the",
+                "instructions",
+                "contained",
+                "in",
+                "the",
+                "declaration",
+                "are",
+                "carried",
+                "out."
+            ],
+            [
+                "4."
+            ],
+            [
+                "We",
+                "may",
+                "also",
+                "include",
+                "our",
+                "decision",
+                "regarding",
+                "organ",
+                "donation."
+            ],
+            [
+                "In",
+                "these",
+                "cases,",
+                "the",
+                "authorization",
+                "of",
+                "the",
+                "family",
+                "will",
+                "not",
+                "be",
+                "required",
+                "for",
+                "the",
+                "removal",
+                "or",
+                "use",
+                "of",
+                "the",
+                "donated",
+                "organs\"."
+            ],
+            [
+                "It",
+                "thus",
+                "seems",
+                "clear",
+                "that",
+                "the",
+                "intended",
+                "response",
+                "is",
+                "5."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "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",
+                "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",
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+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
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+                "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"
+            ],
+            [
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "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"
+            ],
+            [
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+                "O",
+                "O"
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+            [
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+                "O",
+                "O",
+                "O",
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+                "O",
+                "O",
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+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
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+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
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+                "O",
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+                "O",
+                "O",
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+                "O",
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+                "O",
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+                "O",
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+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
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+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
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+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
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+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
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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",
+                "I-Claim"
+            ],
+            [
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "322_85",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "UROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "22-year-old",
+                "boy",
+                "with",
+                "hyposmia",
+                "presents",
+                "lack",
+                "of",
+                "development",
+                "of",
+                "secondary",
+                "sexual",
+                "characteristics",
+                "and",
+                "infertility."
+            ],
+            [
+                "Bilateral",
+                "testicular",
+                "volume",
+                "of",
+                "4",
+                "mL."
+            ],
+            [
+                "Analytically,",
+                "EST-I",
+                "1.2",
+                "U/L",
+                "(vn",
+                "5-15);",
+                "LH",
+                "0.6",
+                "U/L",
+                "(vn",
+                "3-15);",
+                "testosterone",
+                "100",
+                "ng/dL",
+                "(vn",
+                "300-1200),",
+                "prolactin",
+                "normal."
+            ],
+            [
+                "State",
+                "your",
+                "proposed",
+                "treatment",
+                "to",
+                "achieve",
+                "fertility:"
+            ],
+            [
+                "1-",
+                "GnRH",
+                "infusion",
+                "pump."
+            ],
+            [
+                "2-",
+                "Monthly",
+                "intramuscular",
+                "administration",
+                "of",
+                "triptorelin."
+            ],
+            [
+                "3-",
+                "Intramuscular",
+                "administration",
+                "of",
+                "FSH",
+                "and",
+                "LH",
+                "once",
+                "a",
+                "week."
+            ],
+            [
+                "4-",
+                "Treatment",
+                "with",
+                "bromocriptine."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "This",
+                "is",
+                "a",
+                "Kallman",
+                "syndrome",
+                "(hypogonadotropic",
+                "hypogonadism",
+                "+",
+                "olfactory",
+                "disturbance)."
+            ],
+            [
+                "Triptorelin",
+                "is",
+                "a",
+                "GnRH",
+                "agonist,",
+                "which",
+                "by",
+                "continuous",
+                "action",
+                "reduces",
+                "FSH",
+                "and",
+                "LH,",
+                "and",
+                "is",
+                "used",
+                "in",
+                "sex",
+                "hormone-dependent",
+                "cancers,",
+                "as",
+                "well",
+                "as",
+                "precocious",
+                "puberty."
+            ],
+            [
+                "Bromocriptine",
+                "is",
+                "a",
+                "dopaminergic",
+                "agonist",
+                "used",
+                "in",
+                "hyperPRL",
+                "(he",
+                "has",
+                "normal",
+                "PRL),",
+                "pituitary",
+                "tumors..."
+            ],
+            [
+                "We",
+                "stay",
+                "between",
+                "1",
+                "and",
+                "3."
+            ],
+            [
+                "To",
+                "induce",
+                "testicular",
+                "maturation,",
+                "pulsatile",
+                "GnRH",
+                "with",
+                "pump,",
+                "hCG",
+                "or",
+                "FSH+hCG",
+                "can",
+                "be",
+                "used."
+            ],
+            [
+                "LH",
+                "is",
+                "not",
+                "used",
+                "as",
+                "a",
+                "treatment,",
+                "it",
+                "would",
+                "be",
+                "stimulated",
+                "by",
+                "intermittent",
+                "GnRH."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "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",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "610_116",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "391_222",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PSYCHIATRY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "26-year-old",
+                "single",
+                "man",
+                "is",
+                "brought",
+                "in",
+                "by",
+                "his",
+                "family",
+                "because",
+                "he",
+                "has",
+                "been",
+                "refusing",
+                "to",
+                "leave",
+                "his",
+                "home",
+                "for",
+                "3",
+                "months."
+            ],
+            [
+                "The",
+                "reason",
+                "given",
+                "by",
+                "the",
+                "patient",
+                "is",
+                "the",
+                "belief",
+                "that",
+                "he",
+                "has",
+                "an",
+                "asymmetrical",
+                "jaw",
+                "and",
+                "a",
+                "crooked",
+                "face."
+            ],
+            [
+                "According",
+                "to",
+                "the",
+                "patient,",
+                "this",
+                "situation",
+                "is",
+                "progressive",
+                "and",
+                "he",
+                "looks",
+                "more",
+                "and",
+                "more",
+                "deformed",
+                "when",
+                "he",
+                "looks",
+                "in",
+                "the",
+                "mirror."
+            ],
+            [
+                "He",
+                "is",
+                "ashamed",
+                "of",
+                "his",
+                "appearance,",
+                "so",
+                "he",
+                "does",
+                "not",
+                "want",
+                "to",
+                "go",
+                "out,",
+                "he",
+                "gets",
+                "very",
+                "anxious",
+                "when",
+                "he",
+                "sees",
+                "his",
+                "image",
+                "and",
+                "he",
+                "cannot",
+                "stop",
+                "thinking",
+                "about",
+                "his",
+                "deformity",
+                "all",
+                "day",
+                "long."
+            ],
+            [
+                "He",
+                "has",
+                "consulted",
+                "several",
+                "maxillofacial",
+                "surgeons",
+                "but",
+                "they",
+                "tell",
+                "him",
+                "that",
+                "he",
+                "does",
+                "not",
+                "have",
+                "facial",
+                "asymmetry",
+                "and",
+                "refer",
+                "him",
+                "to",
+                "a",
+                "psychiatrist."
+            ],
+            [
+                "The",
+                "patient's",
+                "diagnosis",
+                "is:"
+            ],
+            [
+                "1-",
+                "Major",
+                "depressive",
+                "disorder",
+                "with",
+                "delusional",
+                "ideas",
+                "incongruent",
+                "with",
+                "mood."
+            ],
+            [
+                "2-",
+                "Obsessive-compulsive",
+                "disorder."
+            ],
+            [
+                "3-",
+                "Paranoid",
+                "schizophrenia."
+            ],
+            [
+                "4-",
+                "Body",
+                "dysmorphic",
+                "disorder."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Another",
+                "simple",
+                "question",
+                "with",
+                "an",
+                "immediate",
+                "answer,",
+                "which",
+                "offers",
+                "no",
+                "doubt."
+            ],
+            [
+                "It",
+                "describes",
+                "a",
+                "patient",
+                "worried",
+                "about",
+                "a",
+                "non-existent",
+                "physical",
+                "defect,",
+                "whose",
+                "concern",
+                "distresses",
+                "him",
+                "and",
+                "prevents",
+                "him",
+                "from",
+                "leaving",
+                "the",
+                "house."
+            ],
+            [
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+                "psychiatry",
+                "resident,",
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+                "wish",
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+                "in",
+                "my",
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+                "were",
+                "a",
+                "bit",
+                "more",
+                "thought-provoking",
+                "and",
+                "in-depth,",
+                "although",
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+                "know",
+                "that",
+                "the",
+                "seconds",
+                "you",
+                "will",
+                "have",
+                "saved",
+                "by",
+                "marking",
+                "the",
+                "fourth",
+                "one",
+                "directly",
+                "are",
+                "very",
+                "valuable."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "324_55",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CRITICAL,",
+                "PALLIATIVE",
+                "AND",
+                "EMERGENCY",
+                "CARE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "70-year-old",
+                "female",
+                "patient",
+                "is",
+                "admitted",
+                "to",
+                "the",
+                "ICU",
+                "after",
+                "suffering",
+                "anterior",
+                "AMI",
+                "treated",
+                "by",
+                "coronary",
+                "angioplasty",
+                "and",
+                "stent",
+                "placement",
+                "in",
+                "the",
+                "anterior",
+                "descending",
+                "artery."
+            ],
+            [
+                "Four",
+                "days",
+                "later,",
+                "she",
+                "suddenly",
+                "presents",
+                "hypotension",
+                "that",
+                "requires",
+                "vigorous",
+                "volume",
+                "support,",
+                "initiation",
+                "of",
+                "vasoactive",
+                "drugs,",
+                "orotracheal",
+                "intubation",
+                "and",
+                "connection",
+                "to",
+                "mechanical",
+                "ventilation."
+            ],
+            [
+                "Physical",
+                "examination",
+                "revealed",
+                "a",
+                "murmur",
+                "not",
+                "previously",
+                "present."
+            ],
+            [
+                "Suspecting",
+                "a",
+                "mechanical",
+                "complication",
+                "of",
+                "the",
+                "infarction,",
+                "transthoracic",
+                "echocardiography",
+                "showed",
+                "pericardial",
+                "effusion."
+            ],
+            [
+                "Mark",
+                "the",
+                "CORRECT",
+                "answer:"
+            ],
+            [
+                "1-",
+                "Mortality",
+                "with",
+                "medical",
+                "treatment",
+                "is",
+                "20%."
+            ],
+            [
+                "2-",
+                "In",
+                "case",
+                "of",
+                "free",
+                "wall",
+                "rupture,",
+                "there",
+                "is",
+                "an",
+                "oxymetric",
+                "jump",
+                "in",
+                "the",
+                "right",
+                "ventricle",
+                "in",
+                "the",
+                "Swan-Ganz",
+                "catheterization."
+            ],
+            [
+                "3-",
+                "In",
+                "case",
+                "of",
+                "free",
+                "wall",
+                "rupture,",
+                "there",
+                "is",
+                "no",
+                "palpable",
+                "fr\u00e9mito."
+            ],
+            [
+                "4-",
+                "Mechanical",
+                "complications",
+                "usually",
+                "appear",
+                "on",
+                "the",
+                "first",
+                "post-infarction",
+                "day."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Mortality",
+                "is",
+                "not",
+                "so",
+                "low,",
+                "the",
+                "oximetric",
+                "jump",
+                "occurs",
+                "in",
+                "the",
+                "case",
+                "of",
+                "septum",
+                "rupture,",
+                "as",
+                "well",
+                "as",
+                "fremitus",
+                "(hence",
+                "the",
+                "correct",
+                "answer",
+                "is",
+                "3)",
+                "and",
+                "complications",
+                "can",
+                "occur",
+                "up",
+                "to",
+                "the",
+                "first",
+                "week."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "240_150",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "76-year-old",
+                "man",
+                "consults",
+                "for",
+                "cognitive",
+                "impairment,",
+                "slowness",
+                "and",
+                "clumsiness",
+                "of",
+                "movements,",
+                "of",
+                "eight",
+                "months",
+                "of",
+                "evolution."
+            ],
+            [
+                "The",
+                "family",
+                "reports",
+                "that",
+                "the",
+                "patient",
+                "had",
+                "visual",
+                "hallucinations,",
+                "so",
+                "his",
+                "primary",
+                "care",
+                "physician",
+                "prescribed",
+                "low",
+                "doses",
+                "of",
+                "risperidone,",
+                "with",
+                "a",
+                "significant",
+                "worsening",
+                "of",
+                "motor",
+                "status."
+            ],
+            [
+                "In",
+                "view",
+                "of",
+                "these",
+                "data,",
+                "what",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Alzheimer's",
+                "disease."
+            ],
+            [
+                "2-",
+                "Dementia",
+                "due",
+                "to",
+                "Lewy",
+                "bodies."
+            ],
+            [
+                "3-",
+                "Frontotemporal",
+                "dementia."
+            ],
+            [
+                "4-",
+                "Vascular",
+                "dementia."
+            ],
+            [
+                "5-",
+                "Sporadic",
+                "Creutzfeldt-Jakob",
+                "disease."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "2",
+                "because",
+                "it",
+                "presents",
+                "the",
+                "case",
+                "with",
+                "the",
+                "typical",
+                "symptoms",
+                "of",
+                "dementia",
+                "due",
+                "to",
+                "Lewy",
+                "bodies,",
+                "being",
+                "the",
+                "guiding",
+                "symptom",
+                "visual",
+                "hallucinations."
+            ],
+            [
+                "Progressive",
+                "cognitive",
+                "impairment,",
+                "parkinsonian",
+                "motor",
+                "signs",
+                "(inferred",
+                "from",
+                "clumsiness",
+                "of",
+                "movements)",
+                "and",
+                "hypersensitivity",
+                "to",
+                "neuroleptics",
+                "even",
+                "in",
+                "small",
+                "doses",
+                "are",
+                "also",
+                "mentioned."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "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",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ]
+        ]
+    },
+    {
+        "id": "68_123",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ANESTHESIOLOGY,",
+                "CRITICAL",
+                "CARE",
+                "AND",
+                "EMERGENCY",
+                "MEDICINE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "64-year-old",
+                "man",
+                "with",
+                "a",
+                "history",
+                "of",
+                "hypertension",
+                "and",
+                "ischemic",
+                "heart",
+                "disease",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "for",
+                "oppressive",
+                "chest",
+                "pain",
+                "while",
+                "watching",
+                "television."
+            ],
+            [
+                "In",
+                "the",
+                "ED",
+                "triage",
+                "consultation,",
+                "T.",
+                "art",
+                "values",
+                "of",
+                "155/95",
+                "mmHg",
+                "and",
+                "a",
+                "capillary",
+                "O2",
+                "saturation",
+                "of",
+                "95%",
+                "are",
+                "detected."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "is",
+                "the",
+                "most",
+                "correct",
+                "course",
+                "of",
+                "action?"
+            ],
+            [
+                "1-",
+                "Instruct",
+                "her",
+                "to",
+                "go",
+                "to",
+                "the",
+                "waiting",
+                "room.",
+                "You",
+                "will",
+                "be",
+                "notified",
+                "for",
+                "tests."
+            ],
+            [
+                "2-",
+                "This",
+                "patient",
+                "should",
+                "be",
+                "treated",
+                "in",
+                "the",
+                "vital",
+                "emergency",
+                "room",
+                "(shock",
+                "room)."
+            ],
+            [
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+                "We",
+                "will",
+                "notify",
+                "the",
+                "cardiologist",
+                "on",
+                "duty",
+                "to",
+                "evaluate",
+                "the",
+                "patient."
+            ],
+            [
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+                "the",
+                "patient",
+                "will",
+                "be",
+                "referred",
+                "to",
+                "the",
+                "Coronary",
+                "Unit."
+            ],
+            [
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+                "We",
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+                "do",
+                "an",
+                "ECG",
+                "in",
+                "less",
+                "than",
+                "10",
+                "minutes."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
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+                "the",
+                "ECG",
+                "shows",
+                "ischemic",
+                "changes,",
+                "we",
+                "will",
+                "obviously",
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+                "the",
+                "patient",
+                "in",
+                "the",
+                "emergency",
+                "room",
+                "and",
+                "notify",
+                "the",
+                "cardiologist."
+            ],
+            [
+                "If",
+                "not,",
+                "you",
+                "will",
+                "be",
+                "treated",
+                "as",
+                "if",
+                "it",
+                "were",
+                "angina",
+                "and",
+                "observed,",
+                "with",
+                "serial",
+                "enzymes",
+                "and",
+                "treatment",
+                "in",
+                "the",
+                "observation",
+                "area."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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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+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "206_125",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "UROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "Faced",
+                "with",
+                "a",
+                "49-year-old",
+                "man,",
+                "asymptomatic,",
+                "with",
+                "a",
+                "family",
+                "history",
+                "of",
+                "a",
+                "father",
+                "who",
+                "died",
+                "of",
+                "prostate",
+                "cancer,",
+                "who",
+                "in",
+                "a",
+                "routine",
+                "company",
+                "control",
+                "is",
+                "identified",
+                "a",
+                "PSA",
+                "(Prostate",
+                "Specific",
+                "Antigen)",
+                "of",
+                "5.9",
+                "ng",
+                "/",
+                "ml,",
+                "with",
+                "a",
+                "ratio",
+                "of",
+                "free",
+                "PSA",
+                "/",
+                "total",
+                "PSA",
+                "of",
+                "11%",
+                "and",
+                "that",
+                "a",
+                "rectal",
+                "examination",
+                "shows",
+                "increased",
+                "consistency",
+                "in",
+                "the",
+                "right",
+                "prostatic",
+                "lobe,",
+                "what",
+                "is",
+                "the",
+                "following",
+                "clinical",
+                "indication?"
+            ],
+            [
+                "1-",
+                "Suggest",
+                "to",
+                "the",
+                "patient",
+                "the",
+                "performance",
+                "of",
+                "a",
+                "transrectal",
+                "ultrasound",
+                "and",
+                "prostate",
+                "biopsy."
+            ],
+            [
+                "2-",
+                "Perform",
+                "an",
+                "abdominopelvic",
+                "CT",
+                "scan."
+            ],
+            [
+                "3-",
+                "Initiate",
+                "treatment",
+                "with",
+                "5",
+                "alpha",
+                "Reductase",
+                "Inhibitors",
+                "to",
+                "reduce",
+                "PSA",
+                "levels",
+                "by",
+                "half."
+            ],
+            [
+                "4-",
+                "Initiate",
+                "combined",
+                "treatment",
+                "of",
+                "LHRH",
+                "analogues",
+                "and",
+                "antiandrogens."
+            ],
+            [
+                "5-",
+                "Perform",
+                "a",
+                "bone",
+                "scan."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "The",
+                "patient",
+                "has",
+                "a",
+                "PSA",
+                ">4",
+                "and",
+                "a",
+                "palpation",
+                "with",
+                "increased",
+                "consistency,",
+                "which",
+                "implies",
+                "the",
+                "need",
+                "for",
+                "a",
+                "transrectal",
+                "ultrasound-guided",
+                "biopsy",
+                "to",
+                "diagnose",
+                "whether",
+                "it",
+                "is",
+                "Benign",
+                "Prostatic",
+                "Hyperplasia",
+                "or",
+                "Prostate",
+                "Cancer."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "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-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"
+            ]
+        ]
+    },
+    {
+        "id": "570_153",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEPHROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "19-year-old",
+                "male",
+                "with",
+                "no",
+                "past",
+                "history",
+                "of",
+                "interest",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "because",
+                "after",
+                "a",
+                "respiratory",
+                "infection",
+                "he",
+                "presents",
+                "with",
+                "asthenia,",
+                "malaise,",
+                "oliguria",
+                "and",
+                "headache."
+            ],
+            [
+                "Physical",
+                "examination:",
+                "BP",
+                "210/120",
+                "mmHg,",
+                "fundus",
+                "with",
+                "hypertensive",
+                "retinopathy",
+                "grade",
+                "III."
+            ],
+            [
+                "Laboratory",
+                "tests:",
+                "Hb",
+                "7.4",
+                "g/dl,",
+                "platelets",
+                "85,000/mm3,",
+                "2-3",
+                "schistocytes",
+                "in",
+                "the",
+                "peripheral",
+                "blood",
+                "smear,",
+                "LDH",
+                "950",
+                "IU/ml,",
+                "serum",
+                "creatinine",
+                "8.75",
+                "mg/dl."
+            ],
+            [
+                "Urine",
+                "system:",
+                "proteinuria",
+                "300",
+                "mg/dl,",
+                "sediment",
+                "15",
+                "red",
+                "blood",
+                "cells",
+                "per",
+                "field."
+            ],
+            [
+                "ADAMTS-13",
+                "levels",
+                "are",
+                "normal."
+            ],
+            [
+                "Given",
+                "these",
+                "findings,",
+                "what",
+                "would",
+                "be",
+                "your",
+                "main",
+                "diagnostic",
+                "suspicion?"
+            ],
+            [
+                "1-",
+                "Thrombotic",
+                "thrombocytopenic",
+                "purpura."
+            ],
+            [
+                "2-",
+                "Atypical",
+                "hemolytic",
+                "uremic",
+                "syndrome."
+            ],
+            [
+                "3-",
+                "Disseminated",
+                "intravascular",
+                "coagulation."
+            ],
+            [
+                "4-",
+                "Typical",
+                "hemolytic",
+                "uremic",
+                "syndrome."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Difficult",
+                "question."
+            ],
+            [
+                "The",
+                "patient",
+                "presents",
+                "with",
+                "thrombotic",
+                "microangiopathy",
+                "(TMA)",
+                "with",
+                "acute",
+                "renal",
+                "failure."
+            ],
+            [
+                "This",
+                "points",
+                "to",
+                "HUS,",
+                "TTP,",
+                "drug-induced",
+                "TMA,",
+                "or",
+                "TMA",
+                "mediated",
+                "by",
+                "complement,",
+                "coagulation,",
+                "or",
+                "metabolism."
+            ],
+            [
+                "Normal",
+                "ADAMTS-13",
+                "levels",
+                "rule",
+                "out",
+                "TTP",
+                "(incorrect",
+                "choice",
+                "1)."
+            ],
+            [
+                "The",
+                "absence",
+                "of",
+                "gastrointestinal",
+                "symptoms",
+                "rules",
+                "out",
+                "typical",
+                "Shiga",
+                "toxin",
+                "HUS",
+                "(incorrect",
+                "choice",
+                "4)."
+            ],
+            [
+                "Pneumococcal",
+                "infections",
+                "can",
+                "also",
+                "cause",
+                "HUS,",
+                "although",
+                "it",
+                "is",
+                "rare",
+                "and",
+                "more",
+                "so",
+                "in",
+                "adults."
+            ],
+            [
+                "The",
+                "history",
+                "of",
+                "respiratory",
+                "infection",
+                "(not",
+                "specified,",
+                "it",
+                "could",
+                "be",
+                "pneumococcal",
+                "pneumonia)",
+                "together",
+                "with",
+                "the",
+                "absence",
+                "of",
+                "DIC",
+                "data",
+                "(no",
+                "mention",
+                "of",
+                "bleeding",
+                "or",
+                "altered",
+                "coagulation",
+                "tests)",
+                "makes",
+                "me",
+                "think",
+                "of",
+                "atypical",
+                "HUS",
+                "(option",
+                "2",
+                "correct)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "506_87",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PSYCHIATRY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "Faced",
+                "with",
+                "sudden-onset",
+                "obsessive-compulsive",
+                "disorder",
+                "(OCD)",
+                "in",
+                "a",
+                "9-year-old",
+                "boy",
+                "who",
+                "also",
+                "presents",
+                "with",
+                "tics",
+                "and",
+                "chorea",
+                "as",
+                "neurological",
+                "manifestations,",
+                "infection",
+                "by:"
+            ],
+            [
+                "1-",
+                "Streptococcus",
+                "viridans."
+            ],
+            [
+                "2-",
+                "Alpha-hemolytic",
+                "streptococcus."
+            ],
+            [
+                "3-",
+                "Beta-hemolytic",
+                "streptococcus,",
+                "group",
+                "A."
+            ],
+            [
+                "4-",
+                "Enterococcus."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "There",
+                "is",
+                "a",
+                "large",
+                "literature",
+                "on",
+                "this",
+                "subject."
+            ],
+            [
+                "It",
+                "never",
+                "ceases",
+                "to",
+                "amaze",
+                "us",
+                "the",
+                "strange",
+                "ways",
+                "of",
+                "biology",
+                "and",
+                "that",
+                "the",
+                "axiom",
+                "\"the",
+                "longest",
+                "is",
+                "the",
+                "right",
+                "one\"",
+                "is",
+                "fulfilled",
+                "in",
+                "this",
+                "case."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "619_121",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "161_118",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEPHROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "60-year-old",
+                "woman",
+                "diagnosed",
+                "with",
+                "chronic",
+                "bronchopathy,",
+                "diabetes",
+                "mellitus,",
+                "hypertension",
+                "and",
+                "treated",
+                "for",
+                "4",
+                "months",
+                "with",
+                "Omeprazole,",
+                "Metformin,",
+                "Salbutamol,",
+                "Ipratropium",
+                "Bromide",
+                "and",
+                "Enalapril",
+                "20",
+                "mg",
+                "+",
+                "Hydrochlorothiazide",
+                "25",
+                "mg",
+                "comes",
+                "to",
+                "your",
+                "office",
+                "for",
+                "fatigue,",
+                "decreased",
+                "appetite,",
+                "with",
+                "slight",
+                "dyspnea",
+                "and",
+                "occasional",
+                "cough,",
+                "variable",
+                "stools,",
+                "sometimes",
+                "soft",
+                "and",
+                "without",
+                "urinary",
+                "symptoms."
+            ],
+            [
+                "Blood",
+                "tests",
+                "show",
+                "leukocytes",
+                "10,000/mm\u00b3,",
+                "Ht",
+                "35%,",
+                "MCV",
+                "80,",
+                "Glucose",
+                "150",
+                "mg/dl,",
+                "Urea",
+                "80",
+                "mg/dl,",
+                "Creatinine",
+                "1.6",
+                "mg/dl,",
+                "Sodium",
+                "133",
+                "mEq/l",
+                "and",
+                "Potassium",
+                "2.9",
+                "mEq/l."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "cause",
+                "of",
+                "hypokalemia?"
+            ],
+            [
+                "1-",
+                "Renal",
+                "insufficiency."
+            ],
+            [
+                "2-",
+                "Hyponatremia."
+            ],
+            [
+                "3-",
+                "Potassium",
+                "deficiency."
+            ],
+            [
+                "4-",
+                "Antihypertensive."
+            ],
+            [
+                "5-",
+                "Metformin."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is:",
+                "4."
+            ],
+            [
+                "Antihypertensive."
+            ],
+            [
+                "In",
+                "particular,",
+                "hydrochlorothiazide,",
+                "as",
+                "a",
+                "thiazide,",
+                "is",
+                "primarily",
+                "responsible",
+                "for",
+                "this",
+                "patient's",
+                "hypokalemia."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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-Disease"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "269_141",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "18_138",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DERMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "If",
+                "a",
+                "patient",
+                "reports",
+                "having",
+                "for",
+                "months",
+                "now",
+                "enlargement",
+                "of",
+                "the",
+                "tongue,",
+                "with",
+                "no",
+                "other",
+                "alterations",
+                "of",
+                "the",
+                "tongue",
+                "causing",
+                "constant",
+                "biting,",
+                "which",
+                "disease",
+                "would",
+                "you",
+                "think",
+                "of",
+                "the",
+                "following:"
+            ],
+            [
+                "1-",
+                "Hypoglossal",
+                "paralysis."
+            ],
+            [
+                "2-",
+                "Hyperthyroidism."
+            ],
+            [
+                "3-",
+                "Mastocytosis."
+            ],
+            [
+                "4-",
+                "Amyloidosis."
+            ],
+            [
+                "5-",
+                "Facial",
+                "granuloma."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Question",
+                "shared",
+                "with",
+                "ENT."
+            ],
+            [
+                "Amyloidosis",
+                "is",
+                "a",
+                "localized",
+                "or",
+                "systemic",
+                "deposition",
+                "of",
+                "fibrillar",
+                "proteins."
+            ],
+            [
+                "It",
+                "can",
+                "be",
+                "primary",
+                "or",
+                "secondary."
+            ],
+            [
+                "The",
+                "most",
+                "frequently",
+                "affected",
+                "organs",
+                "are",
+                "the",
+                "kidneys",
+                "and",
+                "the",
+                "heart."
+            ],
+            [
+                "Sometimes",
+                "amyloid",
+                "deposits",
+                "appear",
+                "on",
+                "the",
+                "tongue",
+                "which",
+                "can",
+                "produce",
+                "macroglossia."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "250_78",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DIGESTIVE",
+                "SYSTEM"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "55-year-old",
+                "man,",
+                "father",
+                "of",
+                "a",
+                "celiac",
+                "child,",
+                "with",
+                "iron-deficiency",
+                "anemia",
+                "and",
+                "a",
+                "recent",
+                "increase",
+                "in",
+                "the",
+                "stool",
+                "rhythm,",
+                "has",
+                "been",
+                "tested",
+                "negative",
+                "for",
+                "HLA-DQ2",
+                "and",
+                "HLA-DQ8",
+                "alleles."
+            ],
+            [
+                "Which",
+                "diagnostic",
+                "test",
+                "is",
+                "the",
+                "most",
+                "appropriate",
+                "in",
+                "this",
+                "case?"
+            ],
+            [
+                "1-",
+                "Determination",
+                "of",
+                "anti-transglutaminase",
+                "IgA",
+                "antibodies."
+            ],
+            [
+                "2-",
+                "Upper",
+                "endoscopy",
+                "with",
+                "duodenal",
+                "biopsies."
+            ],
+            [
+                "3-",
+                "D-xylose",
+                "test."
+            ],
+            [
+                "4-",
+                "Evaluate",
+                "response",
+                "to",
+                "gluten-free",
+                "diet."
+            ],
+            [
+                "5-",
+                "Colonoscopy."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "Middle-aged",
+                "male",
+                "with",
+                "iron",
+                "deficiency",
+                "anemia",
+                "and",
+                "increased",
+                "number",
+                "of",
+                "stools,",
+                "a",
+                "colonoscopy",
+                "should",
+                "be",
+                "done",
+                "to",
+                "rule",
+                "out",
+                "colorectal",
+                "cancer!!!"
+            ],
+            [
+                "If",
+                "the",
+                "HLA",
+                "is",
+                "negative",
+                "it",
+                "is",
+                "very",
+                "unlikely",
+                "to",
+                "be",
+                "celiac",
+                "disease",
+                "(high",
+                "negative",
+                "predictive",
+                "value)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-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",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "5_44",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DIGESTIVE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "66-year-old",
+                "man",
+                "reports",
+                "daily",
+                "heartburn",
+                "since",
+                "youth,",
+                "which",
+                "he",
+                "treats",
+                "with",
+                "alkalis."
+            ],
+            [
+                "An",
+                "upper",
+                "endoscopy",
+                "shows",
+                "mild",
+                "erosive",
+                "esophagitis",
+                "and",
+                "displaced",
+                "squamous",
+                "columnar",
+                "junction",
+                "approximately",
+                "7",
+                "cm."
+            ],
+            [
+                "The",
+                "esophageal",
+                "biopsies",
+                "showed",
+                "mild",
+                "erosive",
+                "esophagitis",
+                "and",
+                "a",
+                "columnar",
+                "squamous",
+                "junction",
+                "displaced",
+                "approximately",
+                "7",
+                "cm",
+                "from",
+                "the",
+                "most",
+                "proximal",
+                "portion",
+                "of",
+                "the",
+                "gastric",
+                "folds."
+            ],
+            [
+                "Biopsies",
+                "of",
+                "the",
+                "distal",
+                "esophagus",
+                "reveal",
+                "that",
+                "the",
+                "normal",
+                "squamous",
+                "epithelium",
+                "has",
+                "been",
+                "replaced",
+                "by",
+                "intestinal-type",
+                "columnar",
+                "epithelium",
+                "with",
+                "low-grade",
+                "dysplasia",
+                "What",
+                "is",
+                "the",
+                "most",
+                "appropriate",
+                "management",
+                "option",
+                "for",
+                "this",
+                "patient?"
+            ],
+            [
+                "1-",
+                "Given",
+                "that",
+                "the",
+                "esophagitis",
+                "is",
+                "mild",
+                "and",
+                "the",
+                "dysplasia",
+                "is",
+                "low",
+                "grade,",
+                "it",
+                "is",
+                "advisable",
+                "to",
+                "continue",
+                "treatment",
+                "with",
+                "alkalines."
+            ],
+            [
+                "2-",
+                "Indefinite",
+                "treatment",
+                "with",
+                "high",
+                "doses",
+                "of",
+                "PPI",
+                "since",
+                "it",
+                "has",
+                "been",
+                "demonstrated",
+                "that",
+                "this",
+                "prevents",
+                "the",
+                "progression",
+                "of",
+                "Barrett's",
+                "esophagus",
+                "to",
+                "adenocarcinoma,",
+                "making",
+                "endoscopic",
+                "surveillance",
+                "unnecessary."
+            ],
+            [
+                "3-",
+                "Periodic",
+                "surveillance",
+                "endoscopies",
+                "and",
+                "treatment",
+                "with",
+                "PPIs",
+                "for",
+                "less",
+                "than",
+                "12",
+                "weeks,",
+                "since",
+                "prolonged",
+                "treatment",
+                "is",
+                "associated",
+                "with",
+                "a",
+                "high",
+                "risk",
+                "of",
+                "gastrinoma",
+                "development."
+            ],
+            [
+                "4-",
+                "Periodic",
+                "surveillance",
+                "endoscopies",
+                "and",
+                "indefinite",
+                "treatment",
+                "with",
+                "PPI."
+            ],
+            [
+                "5-",
+                "Esophagectomy."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "This",
+                "patient",
+                "presents",
+                "Barrett's",
+                "esophagus",
+                "with",
+                "low",
+                "grade",
+                "dysplasia."
+            ],
+            [
+                "I",
+                "do",
+                "not",
+                "like",
+                "the",
+                "question,",
+                "since",
+                "not",
+                "being",
+                "with",
+                "acid",
+                "production",
+                "inhibition",
+                "the",
+                "dysplasia",
+                "may",
+                "be",
+                "conditioned",
+                "by",
+                "inflammation",
+                "and",
+                "not",
+                "be",
+                "real."
+            ],
+            [
+                "In",
+                "any",
+                "case,",
+                "Barrett's",
+                "esophagus",
+                "should",
+                "follow",
+                "endoscopic",
+                "surveillance",
+                "and",
+                "lifelong",
+                "PPI",
+                "treatment",
+                "or",
+                "antireflux",
+                "surgery",
+                "to",
+                "prevent",
+                "progression."
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "4."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "359_91",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "HEMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "The",
+                "determination",
+                "in",
+                "a",
+                "70-year-old",
+                "woman",
+                "of",
+                "hematocrit",
+                "32%,",
+                "Hb",
+                "9.6",
+                "g/dL,",
+                "MCV",
+                "85",
+                "fL",
+                "(70-99),",
+                "Fe",
+                "25",
+                "ug/dL",
+                "(37-145)",
+                "and",
+                "ferritin",
+                "350",
+                "ng/mL",
+                "(15-150),",
+                "is",
+                "more",
+                "suggestive",
+                "of:"
+            ],
+            [
+                "1-",
+                "Recent",
+                "blood",
+                "loss",
+                "through",
+                "the",
+                "digestive",
+                "tract."
+            ],
+            [
+                "2-",
+                "Intestinal",
+                "malabsorption."
+            ],
+            [
+                "3-",
+                "Polymyalgia",
+                "rheumatica."
+            ],
+            [
+                "4-",
+                "Thalassemia",
+                "minor."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Polymyalgia",
+                "rheumatica."
+            ],
+            [
+                "Classic",
+                "example",
+                "I",
+                "suppose,",
+                "and",
+                "it",
+                "is",
+                "seen",
+                "in",
+                "the",
+                "clinic",
+                "in",
+                "droves."
+            ],
+            [
+                "Older",
+                "woman",
+                "with",
+                "normocitic",
+                "anemia",
+                "and",
+                "clear",
+                "ferrokinetic",
+                "pattern",
+                "of",
+                "chronic",
+                "disorder",
+                "(hyposideremia",
+                "but",
+                "hyperferritinemia)."
+            ],
+            [
+                "The",
+                "only",
+                "one",
+                "that",
+                "fits,",
+                "and",
+                "it",
+                "fits",
+                "perfectly,",
+                "is",
+                "number",
+                "3;",
+                "they",
+                "only",
+                "needed",
+                "to",
+                "give",
+                "us",
+                "a",
+                "high",
+                "ESR."
+            ],
+            [
+                "1:",
+                "if",
+                "it",
+                "is",
+                "a",
+                "recent",
+                "loss,",
+                "the",
+                "MCV",
+                "could",
+                "remain",
+                "normal,",
+                "but",
+                "the",
+                "ferritin",
+                "should",
+                "be",
+                "affected,",
+                "and",
+                "certainly",
+                "not",
+                "elevated."
+            ],
+            [
+                "2:",
+                "the",
+                "same.",
+                "If",
+                "it",
+                "is",
+                "due",
+                "to",
+                "Fe",
+                "malabsorption,",
+                "ferritin",
+                "should",
+                "be",
+                "low."
+            ],
+            [
+                "And",
+                "if",
+                "it",
+                "were",
+                "due",
+                "to",
+                "B12",
+                "malabsorption,",
+                "the",
+                "MCV",
+                "would",
+                "be",
+                "clearly",
+                "higher."
+            ],
+            [
+                "4:",
+                "70",
+                "tachycardia",
+                "and",
+                "normal",
+                "MCV.",
+                "This",
+                "one",
+                "is",
+                "too",
+                "much."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "108_219",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GENETICS",
+                "AND",
+                "IMMUNOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "man",
+                "has",
+                "a",
+                "partial",
+                "deletion",
+                "in",
+                "the",
+                "dystrophin",
+                "gene",
+                "(chromosome",
+                "Xp21)",
+                "which",
+                "causes",
+                "the",
+                "semiology",
+                "of",
+                "Becker",
+                "muscular",
+                "dystrophy."
+            ],
+            [
+                "He",
+                "goes",
+                "to",
+                "the",
+                "genetic",
+                "consultation",
+                "with",
+                "his",
+                "wife,",
+                "to",
+                "assess",
+                "the",
+                "risks",
+                "of",
+                "transmission",
+                "of",
+                "the",
+                "disease."
+            ],
+            [
+                "What",
+                "correct",
+                "information",
+                "will",
+                "be",
+                "provided",
+                "in",
+                "the",
+                "course",
+                "of",
+                "the",
+                "genetic",
+                "counseling?"
+            ],
+            [
+                "1-",
+                "According",
+                "to",
+                "autosomal",
+                "dominant",
+                "inheritance,",
+                "half",
+                "of",
+                "her",
+                "children",
+                "will",
+                "inherit",
+                "the",
+                "disease",
+                "and",
+                "without",
+                "distinction",
+                "of",
+                "sexes."
+            ],
+            [
+                "2-",
+                "Their",
+                "daughters",
+                "will",
+                "not",
+                "inherit",
+                "the",
+                "disease,",
+                "but",
+                "all",
+                "their",
+                "future",
+                "sons",
+                "will",
+                "be",
+                "carriers",
+                "and",
+                "can",
+                "transmit",
+                "the",
+                "mutation",
+                "to",
+                "50%."
+            ],
+            [
+                "3-",
+                "Their",
+                "sons",
+                "will",
+                "not",
+                "inherit",
+                "the",
+                "disease,",
+                "but",
+                "all",
+                "their",
+                "future",
+                "daughters",
+                "will",
+                "be",
+                "carriers",
+                "and",
+                "can",
+                "transmit",
+                "the",
+                "mutation",
+                "to",
+                "50%."
+            ],
+            [
+                "4-",
+                "There",
+                "is",
+                "no",
+                "risk:",
+                "the",
+                "inheritance",
+                "of",
+                "the",
+                "disease",
+                "is",
+                "of",
+                "the",
+                "mitochondrial",
+                "type,",
+                "never",
+                "transmitted",
+                "by",
+                "males."
+            ],
+            [
+                "5-",
+                "According",
+                "to",
+                "autosomal",
+                "recessive",
+                "inheritance,",
+                "25%",
+                "of",
+                "their",
+                "children",
+                "will",
+                "manifest",
+                "the",
+                "disease",
+                "in",
+                "childhood,",
+                "regardless",
+                "of",
+                "sex."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "It",
+                "is",
+                "the",
+                "male",
+                "who",
+                "presents",
+                "the",
+                "disease,",
+                "which",
+                "we",
+                "are",
+                "told",
+                "is",
+                "X-linked,",
+                "so",
+                "there",
+                "are",
+                "only",
+                "two",
+                "options",
+                "left:",
+                "2",
+                "and",
+                "3."
+            ],
+            [
+                "2",
+                "is",
+                "not",
+                "because",
+                "the",
+                "males",
+                "will",
+                "receive",
+                "the",
+                "Y",
+                "chromosome",
+                "from",
+                "the",
+                "father",
+                "and",
+                "the",
+                "X",
+                "from",
+                "the",
+                "mother,",
+                "who",
+                "is",
+                "healthy,",
+                "so",
+                "the",
+                "daughters",
+                "will",
+                "be",
+                "able",
+                "to",
+                "carry",
+                "the",
+                "disease",
+                "(correct",
+                "option",
+                "3)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "255_94",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DIGESTIVE",
+                "SYSTEM"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "65-year-old",
+                "woman",
+                "with",
+                "a",
+                "history",
+                "of",
+                "joint",
+                "pain",
+                "and",
+                "under",
+                "treatment",
+                "with",
+                "anti-inflammatory",
+                "drugs",
+                "is",
+                "referred",
+                "for",
+                "anemia."
+            ],
+            [
+                "In",
+                "the",
+                "complementary",
+                "studies",
+                "she",
+                "presented",
+                "red",
+                "blood",
+                "cells",
+                "3,164,000,",
+                "Hto.",
+                "32%,",
+                "Hb",
+                "11g/dl,",
+                "MCV",
+                "69",
+                "fl,",
+                "Leukocytes",
+                "7800,",
+                "Platelets",
+                "370,000,",
+                "CRP",
+                "0.29",
+                "mg/dl,",
+                "Fe",
+                "20ng/ml,",
+                "Ferritin",
+                "18",
+                "ng/ml,",
+                "Glucose",
+                "105",
+                "mg/dl,",
+                "GOT,",
+                "GPT,",
+                "GGT,",
+                "Alkaline",
+                "F,",
+                "total",
+                "Bilirubin,",
+                "Cholesterol,",
+                "Creatinine,",
+                "Calcium",
+                "and",
+                "Phosphorus",
+                "normal."
+            ],
+            [
+                "Negative",
+                "antitransglutaminase",
+                "and",
+                "antigliadin",
+                "antibodies."
+            ],
+            [
+                "Gastroscopy:",
+                "hiatus",
+                "hernia",
+                "of",
+                "3",
+                "cm,",
+                "the",
+                "rest",
+                "without",
+                "alterations."
+            ],
+            [
+                "Colonoscopy:",
+                "up",
+                "to",
+                "cecum,",
+                "isolated",
+                "diverticula",
+                "in",
+                "sigma."
+            ],
+            [
+                "Intestinal",
+                "transit",
+                "without",
+                "alterations."
+            ],
+            [
+                "Ultrasound",
+                "of",
+                "the",
+                "abdomen",
+                "without",
+                "alterations."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "examinations",
+                "do",
+                "you",
+                "consider",
+                "most",
+                "appropriate",
+                "to",
+                "complete",
+                "the",
+                "study?"
+            ],
+            [
+                "1-",
+                "Jejunum",
+                "biopsy."
+            ],
+            [
+                "2-",
+                "Arteriography."
+            ],
+            [
+                "3-",
+                "Endoscopic",
+                "capsule."
+            ],
+            [
+                "4-",
+                "Radioisotopes."
+            ],
+            [
+                "5-",
+                "Pelvic",
+                "MRI."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "It",
+                "is",
+                "a",
+                "study",
+                "of",
+                "iron",
+                "deficiency",
+                "anemia",
+                "with",
+                "normal",
+                "gastroscopy",
+                "and",
+                "colonoscopy,",
+                "having",
+                "ruled",
+                "out",
+                "possible",
+                "celiac",
+                "disease."
+            ],
+            [
+                "We",
+                "have",
+                "yet",
+                "to",
+                "see",
+                "jejunum",
+                "and",
+                "ileum,",
+                "so",
+                "we",
+                "will",
+                "have",
+                "to",
+                "perform",
+                "a",
+                "capsule",
+                "endoscopy."
+            ],
+            [
+                "In",
+                "iron",
+                "deficiency",
+                "anemia,",
+                "a",
+                "digestive",
+                "cause",
+                "must",
+                "always",
+                "be",
+                "ruled",
+                "out."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise"
+            ],
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+                "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"
+            ],
+            [
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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"
+            ]
+        ]
+    },
+    {
+        "id": "303_111",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEPHROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "In",
+                "a",
+                "patient",
+                "with",
+                "rheumatoid",
+                "arthritis",
+                "on",
+                "methotrexate,",
+                "prednisone",
+                "and",
+                "indomethacin",
+                "who",
+                "acutely",
+                "presents",
+                "with",
+                "edema",
+                "and",
+                "increased",
+                "plasma",
+                "creatinine",
+                "with",
+                "poorly",
+                "expressive",
+                "urine",
+                "sediment",
+                "and",
+                "proteinuria",
+                "less",
+                "than",
+                "100",
+                "mg/24",
+                "h",
+                "the",
+                "most",
+                "likely",
+                "cause",
+                "is:"
+            ],
+            [
+                "1-",
+                "Renal",
+                "amyloidosis."
+            ],
+            [
+                "2-",
+                "Glomerulonephritis",
+                "secondary",
+                "to",
+                "rheumatoid",
+                "arthritis."
+            ],
+            [
+                "3-",
+                "Renal",
+                "failure",
+                "due",
+                "to",
+                "nonsteroidal",
+                "anti-inflammatory",
+                "drugs."
+            ],
+            [
+                "4-",
+                "Interstitial",
+                "nephritis",
+                "due",
+                "to",
+                "methotrexate."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
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+                "presents",
+                "with",
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+                "usually",
+                "in",
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+                "and",
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+                "chronic",
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+            ],
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+                "has",
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+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Claim",
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+            ],
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+            ],
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+                "I-Claim",
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+            [
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim"
+            ],
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "539_3",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "408_190",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PRIMARY",
+                "CARE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "45-year-old",
+                "woman",
+                "diagnosed",
+                "with",
+                "stage",
+                "IV",
+                "breast",
+                "cancer",
+                "with",
+                "multiple",
+                "bone",
+                "metastases",
+                "on",
+                "hormonal",
+                "treatment",
+                "and",
+                "iv",
+                "bisphosphonates."
+            ],
+            [
+                "She",
+                "comes",
+                "to",
+                "your",
+                "office",
+                "referring",
+                "intense",
+                "bone",
+                "pain",
+                "(VAS=7),",
+                "in",
+                "several",
+                "locations",
+                "without",
+                "associated",
+                "neurological",
+                "symptoms",
+                "and",
+                "exarcerbations",
+                "of",
+                "pain",
+                "(VAS=9)",
+                "several",
+                "times",
+                "a",
+                "day",
+                "that",
+                "force",
+                "her",
+                "to",
+                "remain",
+                "at",
+                "rest."
+            ],
+            [
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+                "the",
+                "treatment",
+                "with",
+                "ibuprofen",
+                "(600",
+                "mg",
+                "every",
+                "8",
+                "h)",
+                "and",
+                "tramadol",
+                "(150",
+                "mg",
+                "per",
+                "day),",
+                "what",
+                "treatment",
+                "would",
+                "you",
+                "consider",
+                "most",
+                "appropriate",
+                "in",
+                "this",
+                "patient",
+                "to",
+                "improve",
+                "the",
+                "pain?"
+            ],
+            [
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+                "Suspend",
+                "ibuprofen",
+                "and",
+                "tramadol",
+                "and",
+                "start",
+                "a",
+                "major",
+                "opioid",
+                "such",
+                "as",
+                "morphine",
+                "or",
+                "oxycodone."
+            ],
+            [
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+                "Suspend",
+                "tramadol,",
+                "maintain",
+                "ibuprofen",
+                "and",
+                "initiate",
+                "a",
+                "major",
+                "opioid",
+                "such",
+                "as",
+                "morphine",
+                "and",
+                "oxycodone."
+            ],
+            [
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+                "Discontinue",
+                "ibuprofen",
+                "and",
+                "tramadol",
+                "and",
+                "start",
+                "a",
+                "major",
+                "opioid",
+                "such",
+                "as",
+                "morphine",
+                "or",
+                "oxycodone",
+                "and",
+                "at",
+                "the",
+                "same",
+                "time",
+                "start",
+                "treatment",
+                "of",
+                "breakthrough",
+                "pain",
+                "with",
+                "sublingual",
+                "fentanyl."
+            ],
+            [
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+                "Suspend",
+                "tramadol,",
+                "maintain",
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+                "and",
+                "initiate",
+                "a",
+                "major",
+                "opioid",
+                "such",
+                "as",
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+                "and",
+                "oxycodone",
+                "and",
+                "at",
+                "the",
+                "same",
+                "time",
+                "treatment",
+                "for",
+                "breakthrough",
+                "pain",
+                "with",
+                "sublingual",
+                "fentanyl."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
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+                "answer",
+                "is",
+                "4",
+                "because",
+                "if",
+                "the",
+                "patient",
+                "has",
+                "bone",
+                "metastases",
+                "and",
+                "may",
+                "suffer",
+                "fractures",
+                "we",
+                "can",
+                "control",
+                "inflammatory",
+                "pain",
+                "with",
+                "ibuprofen",
+                "and",
+                "it",
+                "will",
+                "also",
+                "help",
+                "us",
+                "to",
+                "use",
+                "the",
+                "antalgic",
+                "synergy."
+            ],
+            [
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+                "should",
+                "change",
+                "the",
+                "treatment",
+                "to",
+                "a",
+                "major",
+                "opioid",
+                "and",
+                "treat",
+                "the",
+                "disrruptive",
+                "pain",
+                "vigorously",
+                "since",
+                "she",
+                "is",
+                "at",
+                "almost",
+                "the",
+                "maximum",
+                "pain",
+                "she",
+                "can",
+                "bear."
+            ]
+        ],
+        "labels": [
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+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
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+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
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+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "B-Premise",
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ]
+        ]
+    },
+    {
+        "id": "29_60",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY",
+                "AND",
+                "THORACIC",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
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+                "71-year-old",
+                "patient,",
+                "smoker",
+                "of",
+                "2",
+                "packs",
+                "of",
+                "cigarettes/day",
+                "for",
+                "50",
+                "years,",
+                "with",
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+                "quality",
+                "of",
+                "life",
+                "and",
+                "no",
+                "other",
+                "pathologic",
+                "history",
+                "of",
+                "interest,",
+                "consults",
+                "for",
+                "cough",
+                "and",
+                "hemoptotic",
+                "expectoration."
+            ],
+            [
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+                "examination",
+                "revealed",
+                "no",
+                "significant",
+                "pathological",
+                "findings."
+            ],
+            [
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+                "showed",
+                "a",
+                "mass",
+                "of",
+                "4x3.4",
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+                "lower",
+                "right,",
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+                "finding",
+                "that",
+                "was",
+                "confirmed",
+                "in",
+                "the",
+                "thoracoabdominal",
+                "CT",
+                "scan,",
+                "which",
+                "located",
+                "the",
+                "lesion",
+                "in",
+                "the",
+                "lower",
+                "lobe",
+                "and",
+                "found",
+                "no",
+                "adenopathy",
+                "or",
+                "metastasis."
+            ],
+            [
+                "Bronchoscopy",
+                "showed",
+                "an",
+                "infiltrating",
+                "lesion",
+                "in",
+                "the",
+                "right",
+                "basal",
+                "pyramid,",
+                "biopsied",
+                "as",
+                "a",
+                "well-differentiated",
+                "squamous",
+                "cell",
+                "carcinoma."
+            ],
+            [
+                "As",
+                "for",
+                "respiratory",
+                "function",
+                "tests,",
+                "the",
+                "FVC",
+                "is",
+                "3,300",
+                "cc",
+                "(84%)",
+                "and",
+                "the",
+                "FEV",
+                "1",
+                "is",
+                "2,240",
+                "cc",
+                "(80%)."
+            ],
+            [
+                "What",
+                "should",
+                "be",
+                "the",
+                "next",
+                "step",
+                "to",
+                "follow",
+                "in",
+                "this",
+                "patient?"
+            ],
+            [
+                "1-",
+                "Perform",
+                "mediastinoscopy."
+            ],
+            [
+                "2-",
+                "Surgical",
+                "intervention",
+                "with",
+                "curative",
+                "intent",
+                "should",
+                "be",
+                "contraindicated",
+                "due",
+                "to",
+                "the",
+                "advanced",
+                "age",
+                "of",
+                "the",
+                "patient."
+            ],
+            [
+                "3-",
+                "An",
+                "oxygen",
+                "consumption",
+                "test",
+                "should",
+                "be",
+                "performed,",
+                "given",
+                "the",
+                "respiratory",
+                "limitation",
+                "he",
+                "presents."
+            ],
+            [
+                "4-",
+                "Surgical",
+                "resection",
+                "(lobectomy",
+                "of",
+                "the",
+                "lower",
+                "lobe",
+                "of",
+                "the",
+                "right",
+                "lung)",
+                "should",
+                "be",
+                "indicated",
+                "directly."
+            ],
+            [
+                "5-",
+                "A",
+                "trantoracic",
+                "puncture",
+                "should",
+                "be",
+                "performed."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "1",
+                "and",
+                "5:",
+                "These",
+                "are",
+                "diagnostic",
+                "tests,",
+                "they",
+                "are",
+                "meaningless",
+                "since",
+                "you",
+                "have",
+                "already",
+                "made",
+                "the",
+                "diagnosis."
+            ],
+            [
+                "2:",
+                "Age",
+                "should",
+                "not",
+                "be",
+                "a",
+                "limiting",
+                "factor,",
+                "especially",
+                "considering",
+                "that",
+                "it",
+                "is",
+                "only",
+                "71",
+                "years",
+                "old,",
+                "but",
+                "especially",
+                "because",
+                "the",
+                "patient's",
+                "\"quality",
+                "of",
+                "life\"",
+                "is",
+                "good",
+                "(and",
+                "I",
+                "put",
+                "\"quality",
+                "of",
+                "life\"",
+                "because",
+                "it",
+                "is",
+                "a",
+                "term",
+                "used",
+                "erroneously,",
+                "it",
+                "is",
+                "supposed",
+                "to",
+                "mean",
+                "that",
+                "he",
+                "maintains",
+                "a",
+                "good",
+                "functional",
+                "level)."
+            ],
+            [
+                "3:",
+                "Presents",
+                "a",
+                "very",
+                "mild",
+                "respiratory",
+                "limitation,",
+                "does",
+                "not",
+                "require",
+                "such",
+                "a",
+                "test."
+            ],
+            [
+                "4:",
+                "Is",
+                "the",
+                "correct",
+                "one."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "10_37",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "76-year-old",
+                "woman",
+                "with",
+                "no",
+                "history",
+                "other",
+                "than",
+                "hypertension",
+                "consults",
+                "for",
+                "painless",
+                "jaundice",
+                "and",
+                "pruritus",
+                "with",
+                "anorexia."
+            ],
+            [
+                "Laboratory",
+                "tests",
+                "show",
+                "a",
+                "bilirubin",
+                "level",
+                "of",
+                "12",
+                "mg/dl",
+                "(with",
+                "9.5",
+                "direct",
+                "bilirubin)."
+            ],
+            [
+                "Abdominal",
+                "ultrasound",
+                "shows",
+                "dilatation",
+                "of",
+                "the",
+                "intrahepatic",
+                "and",
+                "extrahepatic",
+                "biliary",
+                "tract,",
+                "together",
+                "with",
+                "a",
+                "single",
+                "2",
+                "cm",
+                "nodule",
+                "located",
+                "peripherally",
+                "in",
+                "the",
+                "anterior",
+                "aspect",
+                "of",
+                "the",
+                "left",
+                "lobe."
+            ],
+            [
+                "CT",
+                "scan",
+                "confirms",
+                "the",
+                "findings,",
+                "also",
+                "demonstrating",
+                "the",
+                "presence",
+                "of",
+                "a",
+                "3.5",
+                "cm",
+                "mass",
+                "in",
+                "the",
+                "head",
+                "of",
+                "the",
+                "pancreas."
+            ],
+            [
+                "Fine",
+                "needle",
+                "aspiration",
+                "confirms",
+                "the",
+                "diagnosis",
+                "of",
+                "adenocarcinoma."
+            ],
+            [
+                "Indicate",
+                "the",
+                "best",
+                "therapeutic",
+                "option:"
+            ],
+            [
+                "1-",
+                "Adjuvant",
+                "chemo/radiotherapy,",
+                "conditioning",
+                "radical",
+                "surgery",
+                "to",
+                "the",
+                "initial",
+                "response."
+            ],
+            [
+                "2-",
+                "Percutaneous",
+                "external",
+                "drainage",
+                "is",
+                "palliative,",
+                "with",
+                "eventual",
+                "conversion",
+                "to",
+                "internal",
+                "drainage",
+                "in",
+                "case",
+                "of",
+                "intolerance",
+                "or",
+                "complications."
+            ],
+            [
+                "3-",
+                "Surgical",
+                "biliary",
+                "bypass,",
+                "with",
+                "or",
+                "without",
+                "prophylactic",
+                "gastrojejunostomy",
+                "depending",
+                "on",
+                "intraoperative",
+                "findings."
+            ],
+            [
+                "4-",
+                "Metallic",
+                "biliary",
+                "prosthesis",
+                "by",
+                "endoscopic",
+                "retrograde",
+                "cholangiography,",
+                "with",
+                "the",
+                "option",
+                "of",
+                "palliative",
+                "chemotherapy."
+            ],
+            [
+                "5-",
+                "Cephalic",
+                "duodenopancreatectomy",
+                "with",
+                "radiofrequency",
+                "ablation",
+                "or",
+                "alcoholization",
+                "of",
+                "the",
+                "liver",
+                "lesion."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "I",
+                "think",
+                "the",
+                "correct",
+                "answer",
+                "is",
+                "4,",
+                "although",
+                "both",
+                "lesions",
+                "are",
+                "resectable,",
+                "pancreatic",
+                "adenocarcinoma",
+                "with",
+                "synchronous",
+                "hepatic",
+                "metastases",
+                "has",
+                "no",
+                "surgical",
+                "indication",
+                "because",
+                "it",
+                "does",
+                "not",
+                "prolong",
+                "survival",
+                "and",
+                "has",
+                "a",
+                "high",
+                "morbidity."
+            ],
+            [
+                "Surgical",
+                "bypass",
+                "has",
+                "more",
+                "complications",
+                "than",
+                "placing",
+                "a",
+                "self-expanding",
+                "metallic",
+                "prosthesis",
+                "that",
+                "has",
+                "a",
+                "median",
+                "patency",
+                "of",
+                "6",
+                "months",
+                "which",
+                "is",
+                "similar",
+                "to",
+                "the",
+                "median",
+                "survival",
+                "of",
+                "a",
+                "patient",
+                "with",
+                "hepatic",
+                "metastases",
+                "of",
+                "pancreatic",
+                "adenocarcinoma."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "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",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "284_57",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "188_230",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "57-year-old",
+                "patient",
+                "had",
+                "an",
+                "acute",
+                "myocardial",
+                "infarction",
+                "and",
+                "has",
+                "a",
+                "blood",
+                "test",
+                "with",
+                "cholesterol",
+                "312",
+                "mg/dl,",
+                "LDL",
+                "241",
+                "mg/dl,",
+                "HDL",
+                "29",
+                "and",
+                "normal",
+                "TG."
+            ],
+            [
+                "He",
+                "smoked",
+                "30",
+                "cig/day,",
+                "was",
+                "not",
+                "obese,",
+                "his",
+                "blood",
+                "pressure",
+                "was",
+                "145/90",
+                "mm",
+                "Hg",
+                "and",
+                "he",
+                "did",
+                "not",
+                "have",
+                "diabetes."
+            ],
+            [
+                "When",
+                "asked",
+                "about",
+                "family",
+                "history,",
+                "he",
+                "mentioned",
+                "that",
+                "an",
+                "uncle",
+                "on",
+                "his",
+                "mother's",
+                "side",
+                "died",
+                "suddenly",
+                "at",
+                "53",
+                "years",
+                "of",
+                "age."
+            ],
+            [
+                "Which",
+                "answer",
+                "do",
+                "you",
+                "agree",
+                "with",
+                "the",
+                "most?"
+            ],
+            [
+                "1-",
+                "Treat",
+                "with",
+                "statins",
+                "until",
+                "cholesterol",
+                "is",
+                "normalized",
+                "and",
+                "recommend",
+                "healthy",
+                "lifestyle",
+                "(diet,",
+                "exercise",
+                "and",
+                "no",
+                "smoking)."
+            ],
+            [
+                "2-",
+                "Rule",
+                "out",
+                "hypothyroidism",
+                "or",
+                "other",
+                "systemic",
+                "disease,",
+                "recommend",
+                "a",
+                "healthy",
+                "lifestyle",
+                "and",
+                "treat",
+                "with",
+                "fibrates",
+                "to",
+                "normalize",
+                "cholesterol."
+            ],
+            [
+                "3-",
+                "It",
+                "is",
+                "not",
+                "necessary",
+                "to",
+                "rule",
+                "out",
+                "secondary",
+                "dyslipidemia",
+                "because",
+                "it",
+                "is",
+                "infrequent.",
+                "A",
+                "family",
+                "lipid",
+                "profile",
+                "should",
+                "be",
+                "performed."
+            ],
+            [
+                "4-",
+                "Rule",
+                "out",
+                "secondary",
+                "dyslipidemia,",
+                "treat",
+                "with",
+                "resins",
+                "(resincholestyramine)",
+                "and",
+                "fibrates",
+                "and",
+                "re-commend",
+                "a",
+                "healthy",
+                "lifestyle.",
+                "Prohibit",
+                "alcohol."
+            ],
+            [
+                "5-",
+                "Rule",
+                "out",
+                "secondary",
+                "dyslipidemia,",
+                "request",
+                "a",
+                "family",
+                "study",
+                "and",
+                "treat",
+                "with",
+                "statins",
+                "to",
+                "maintain",
+                "a",
+                "good",
+                "lipid",
+                "profile.",
+                "Control",
+                "of",
+                "other",
+                "risk",
+                "factors."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "Question",
+                "on",
+                "a",
+                "fashionable",
+                "topic",
+                "in",
+                "recent",
+                "years:",
+                "dyslipidemia;",
+                "I",
+                "would",
+                "answer",
+                "it",
+                "by",
+                "rule",
+                "out."
+            ],
+            [
+                "The",
+                "treatment",
+                "for",
+                "hypercholesterolemia",
+                "is",
+                "statins",
+                "so",
+                "we",
+                "rule",
+                "out",
+                "answers",
+                "2",
+                "and",
+                "4."
+            ],
+            [
+                "The",
+                "statin",
+                "in",
+                "a",
+                "patient",
+                "with",
+                "cardiovascular",
+                "disease",
+                "(such",
+                "as",
+                "an",
+                "AMI)",
+                "is",
+                "a",
+                "lifelong",
+                "treatment",
+                "(we",
+                "discard",
+                "1)",
+                "since",
+                "it",
+                "is",
+                "not",
+                "taken",
+                "until",
+                "LDL",
+                "levels",
+                "are",
+                "normalized."
+            ],
+            [
+                "Between",
+                "3",
+                "and",
+                "5,",
+                "5",
+                "is",
+                "more",
+                "complete",
+                "as",
+                "it",
+                "includes",
+                "treatment",
+                "and",
+                "control",
+                "of",
+                "other",
+                "risk",
+                "factors."
+            ],
+            [
+                "Ruling",
+                "out",
+                "secondary",
+                "dyslipidemia",
+                "is",
+                "easy",
+                "with",
+                "the",
+                "patient's",
+                "clinical",
+                "history",
+                "and",
+                "a",
+                "blood",
+                "test",
+                "with",
+                "thyroid",
+                "function."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "349_160",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "45-year-old",
+                "woman,",
+                "mother",
+                "of",
+                "3",
+                "children,",
+                "attends",
+                "an",
+                "early",
+                "diagnosis",
+                "consultation."
+            ],
+            [
+                "Cervicovaginal",
+                "cytology",
+                "is",
+                "compatible",
+                "with",
+                "a",
+                "high-grade",
+                "squamous",
+                "intraepithelial",
+                "lesion."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "options",
+                "would",
+                "you",
+                "choose?"
+            ],
+            [
+                "1-",
+                "Repeat",
+                "cytology",
+                "in",
+                "1",
+                "month."
+            ],
+            [
+                "2-",
+                "Colposcopy",
+                "with",
+                "possible",
+                "biopsy."
+            ],
+            [
+                "3-",
+                "Hysterectomy",
+                "with",
+                "bilateral",
+                "salpinguectomy",
+                "and",
+                "ovarian",
+                "conservation."
+            ],
+            [
+                "4-",
+                "Fractionated",
+                "uterine",
+                "curettage."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "2."
+            ],
+            [
+                "According",
+                "to",
+                "the",
+                "2014",
+                "SEGO",
+                "Oncoguide",
+                "on",
+                "cervical",
+                "cancer",
+                "prevention,",
+                "when",
+                "a",
+                "cytology",
+                "shows",
+                "a",
+                "high-grade",
+                "squamous",
+                "intraepithelial",
+                "lesion,",
+                "the",
+                "action",
+                "to",
+                "be",
+                "taken",
+                "is",
+                "a",
+                "colposcopy,",
+                "with",
+                "or",
+                "without",
+                "biopsy",
+                "depending",
+                "on",
+                "the",
+                "findings",
+                "(regardless",
+                "of",
+                "the",
+                "patient's",
+                "age",
+                "and",
+                "parity)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "290_50",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DERMATOLOGY,",
+                "VENEREOLOGY",
+                "AND",
+                "PLASTIC",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "58-year-old",
+                "man",
+                "referred",
+                "a",
+                "3-week",
+                "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",
+                "due",
+                "to",
+                "Microsporum",
+                "gypseum."
+            ],
+            [
+                "2-",
+                "Cutaneous",
+                "infection",
+                "by",
+                "Staphylococcus",
+                "aureus."
+            ],
+            [
+                "3-",
+                "Sporotrichosis."
+            ],
+            [
+                "4-",
+                "Cutaneous",
+                "infection",
+                "by",
+                "Mycobacterium",
+                "marinum."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "The",
+                "lesions",
+                "with",
+                "sporotrichoid",
+                "or",
+                "lymphocutaneous",
+                "pattern",
+                "described",
+                "may",
+                "correspond",
+                "to",
+                "sporotrichosis",
+                "or",
+                "aquarium",
+                "granuloma,",
+                "so",
+                "the",
+                "first",
+                "two",
+                "would",
+                "be",
+                "ruled",
+                "out."
+            ],
+            [
+                "The",
+                "history",
+                "of",
+                "having",
+                "been",
+                "working",
+                "in",
+                "the",
+                "garden",
+                "points",
+                "more",
+                "to",
+                "a",
+                "sporotrichosis,",
+                "although",
+                "the",
+                "fact",
+                "that",
+                "the",
+                "question",
+                "asks",
+                "for",
+                "the",
+                "\"causative",
+                "agent\"",
+                "and",
+                "not",
+                "the",
+                "name",
+                "of",
+                "the",
+                "disease",
+                "misleads",
+                "a",
+                "little,",
+                "so",
+                "that",
+                "if",
+                "we",
+                "consider",
+                "sporotrichosis",
+                "in",
+                "reality",
+                "the",
+                "answer",
+                "should",
+                "be",
+                "Sporothrix",
+                "schenckii",
+                "Despite",
+                "this,",
+                "knowing",
+                "that",
+                "this",
+                "question",
+                "will",
+                "be",
+                "correct",
+                "for",
+                "many",
+                "examinees",
+                "although",
+                "it",
+                "is",
+                "poorly",
+                "worded",
+                "-which",
+                "cancels",
+                "it",
+                "directly-",
+                "the",
+                "challenge",
+                "will",
+                "not",
+                "be",
+                "promoted."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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",
+                "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-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "305_174",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEPHROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "87-year-old",
+                "man",
+                "with",
+                "a",
+                "history",
+                "of",
+                "hypertension",
+                "and",
+                "gonarthrosis."
+            ],
+            [
+                "Baseline",
+                "situation",
+                "with",
+                "full",
+                "functional",
+                "and",
+                "cognitive",
+                "autonomy",
+                "that",
+                "allows",
+                "him",
+                "to",
+                "continue",
+                "living",
+                "alone",
+                "in",
+                "the",
+                "community."
+            ],
+            [
+                "He",
+                "is",
+                "receiving",
+                "regular",
+                "treatment",
+                "with",
+                "perindopril",
+                "and",
+                "thiazide",
+                "diuretic",
+                "for",
+                "blood",
+                "pressure",
+                "control",
+                "and",
+                "routinely",
+                "takes",
+                "ibuprofen",
+                "1800",
+                "mg/day",
+                "to",
+                "control",
+                "the",
+                "symptoms",
+                "derived",
+                "from",
+                "his",
+                "gonarthrosis."
+            ],
+            [
+                "After",
+                "routine",
+                "control,",
+                "a",
+                "persistent",
+                "blood",
+                "pressure",
+                "of",
+                "190",
+                "and",
+                "TAD",
+                "80",
+                "mmHg",
+                "was",
+                "observed."
+            ],
+            [
+                "What",
+                "would",
+                "be",
+                "the",
+                "most",
+                "reasonable",
+                "therapeutic",
+                "modification",
+                "to",
+                "achieve",
+                "blood",
+                "pressure",
+                "control?"
+            ],
+            [
+                "1-",
+                "I",
+                "would",
+                "add",
+                "a",
+                "calcium",
+                "channel",
+                "blocker."
+            ],
+            [
+                "2-",
+                "I",
+                "would",
+                "increase",
+                "the",
+                "dose",
+                "of",
+                "hydrochlorothiazide",
+                "to",
+                "25",
+                "mg/day."
+            ],
+            [
+                "3-",
+                "I",
+                "would",
+                "change",
+                "ibuprofen",
+                "to",
+                "paracetamol",
+                "to",
+                "avoid",
+                "the",
+                "possible",
+                "influence",
+                "of",
+                "paracetamol",
+                "on",
+                "the",
+                "effect",
+                "of",
+                "hypotensives."
+            ],
+            [
+                "4-",
+                "I",
+                "would",
+                "add",
+                "an",
+                "alpha-blocker",
+                "because",
+                "of",
+                "the",
+                "high",
+                "prevalence",
+                "of",
+                "prostatic",
+                "syndrome",
+                "in",
+                "males",
+                "of",
+                "this",
+                "age."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "One",
+                "of",
+                "the",
+                "mechanisms",
+                "that",
+                "produce",
+                "the",
+                "hypotensive",
+                "effect",
+                "of",
+                "ACE",
+                "inhibitors",
+                "such",
+                "as",
+                "perindopril",
+                "is",
+                "the",
+                "increased",
+                "action",
+                "of",
+                "vasodilator",
+                "prostaglan-dins",
+                "on",
+                "the",
+                "kidney,",
+                "which",
+                "decreases",
+                "hydrosaline",
+                "retention",
+                "and",
+                "therefore",
+                "increases",
+                "diuresis",
+                "and",
+                "lowers",
+                "blood",
+                "pressure."
+            ],
+            [
+                "NSAIDs",
+                "inhibit",
+                "prostaglandin",
+                "synthesis",
+                "and",
+                "decrease",
+                "renal",
+                "perfusion,",
+                "thus",
+                "antagonizing",
+                "the",
+                "hypotensive",
+                "effect",
+                "of",
+                "many",
+                "antihypertensives,",
+                "including",
+                "ACE",
+                "inhibitors."
+            ],
+            [
+                "Therefore,",
+                "the",
+                "preferable",
+                "thing",
+                "to",
+                "do",
+                "in",
+                "this",
+                "patient,",
+                "before",
+                "increasing",
+                "the",
+                "medication,",
+                "is",
+                "to",
+                "change",
+                "the",
+                "ibuprofen",
+                "for",
+                "paracetamol,",
+                "which",
+                "does",
+                "not",
+                "have",
+                "this",
+                "effect,",
+                "and",
+                "to",
+                "re-evaluate",
+                "it",
+                "later."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "104_91",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "38_232",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "OPHTHALMOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "52-year-old",
+                "woman",
+                "consults",
+                "for",
+                "having",
+                "noticed",
+                "during",
+                "the",
+                "previous",
+                "week",
+                "a",
+                "yellowish",
+                "discoloration",
+                "of",
+                "the",
+                "conjunctivae."
+            ],
+            [
+                "She",
+                "does",
+                "not",
+                "refer",
+                "to",
+                "risky",
+                "sexual",
+                "behavior",
+                "or",
+                "epidemiological",
+                "history",
+                "of",
+                "risk",
+                "of",
+                "viral",
+                "hepatitis."
+            ],
+            [
+                "She",
+                "does",
+                "not",
+                "consume",
+                "alcohol",
+                "or",
+                "hepatotoxic",
+                "drugs."
+            ],
+            [
+                "She",
+                "reports",
+                "a",
+                "one-year",
+                "history",
+                "of",
+                "generalized",
+                "pruritus,",
+                "asthenia,",
+                "dry",
+                "mouth",
+                "and",
+                "absence",
+                "of",
+                "lacrimation",
+                "with",
+                "no",
+                "known",
+                "cause."
+            ],
+            [
+                "Rest",
+                "of",
+                "the",
+                "anamnesis",
+                "without",
+                "pathological",
+                "data."
+            ],
+            [
+                "Physical",
+                "examination",
+                "showed",
+                "scratching",
+                "lesions",
+                "conjunctival",
+                "jaundice",
+                "and",
+                "non-painful",
+                "hepatomegaly."
+            ],
+            [
+                "The",
+                "patient",
+                "brings",
+                "a",
+                "blood",
+                "test",
+                "carried",
+                "out",
+                "in",
+                "his",
+                "company",
+                "with",
+                "the",
+                "following",
+                "pathological",
+                "results:",
+                "total",
+                "bilirubin",
+                "3",
+                "mg/dl",
+                "alkaline",
+                "phosphatase",
+                "400",
+                "UI",
+                "sedimentation",
+                "rate",
+                "40",
+                "mm",
+                "at",
+                "the",
+                "first",
+                "hour."
+            ],
+            [
+                "Indicate",
+                "which",
+                "would",
+                "be",
+                "the",
+                "best",
+                "recommendation",
+                "to",
+                "establish",
+                "the",
+                "etiological",
+                "diagnosis",
+                "of",
+                "the",
+                "patient's",
+                "condition:"
+            ],
+            [
+                "1-",
+                "Anti-mitochondrial",
+                "antibodies."
+            ],
+            [
+                "2-",
+                "Study",
+                "of",
+                "iron",
+                "metabolism."
+            ],
+            [
+                "3-",
+                "Study",
+                "of",
+                "copper",
+                "metabolism."
+            ],
+            [
+                "4-",
+                "Hepatic",
+                "MRI."
+            ],
+            [
+                "5-",
+                "Serology",
+                "of",
+                "virus",
+                "B",
+                "and",
+                "virus",
+                "C."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "A",
+                "middle-aged",
+                "woman",
+                "with",
+                "Sj\u00f6gren's-like",
+                "symptoms",
+                "(absence",
+                "of",
+                "lacrimation,",
+                "dry",
+                "mouth),",
+                "with",
+                "hyperbilirubinemia,",
+                "jaundice",
+                "and",
+                "hepatomegaly,",
+                "makes",
+                "us",
+                "think",
+                "of",
+                "primary",
+                "biliary",
+                "cirrhosis."
+            ],
+            [
+                "To",
+                "diagnose",
+                "it",
+                "we",
+                "will",
+                "use",
+                "antimitochondrial",
+                "antibodies",
+                "(AMA",
+                "IgG)."
+            ],
+            [
+                "Therefore,",
+                "it",
+                "would",
+                "be",
+                "answer",
+                "1."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Diagnostics",
+                "I-Diagnostics"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "376_130",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "39-year-old",
+                "man",
+                "who",
+                "in",
+                "the",
+                "last",
+                "3",
+                "months",
+                "has",
+                "had",
+                "two",
+                "episodes",
+                "of",
+                "wide",
+                "and",
+                "involuntary",
+                "jumping",
+                "movements",
+                "of",
+                "the",
+                "left",
+                "limbs,",
+                "which",
+                "in",
+                "about",
+                "two",
+                "minutes",
+                "lead",
+                "to",
+                "loss",
+                "of",
+                "consciousness."
+            ],
+            [
+                "In",
+                "the",
+                "neuroradiological",
+                "study",
+                "a",
+                "right",
+                "frontal",
+                "expansive",
+                "lesion",
+                "suggestive",
+                "of",
+                "cerebral",
+                "glioma",
+                "was",
+                "found.How",
+                "would",
+                "you",
+                "classify",
+                "this",
+                "patient's",
+                "epilepsy?"
+            ],
+            [
+                "1-",
+                "Generalized",
+                "symptomatic."
+            ],
+            [
+                "2-",
+                "Partially",
+                "symptomatic."
+            ],
+            [
+                "3-",
+                "Partial",
+                "cryptogenic."
+            ],
+            [
+                "4-",
+                "Partial",
+                "secondarily",
+                "generalized",
+                "symptomatic."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "They",
+                "refer",
+                "to",
+                "a",
+                "partial",
+                "seizure",
+                "that",
+                "is",
+                "followed",
+                "by",
+                "loss",
+                "of",
+                "level",
+                "of",
+                "consciousness,",
+                "so",
+                "strictly",
+                "speaking",
+                "it",
+                "would",
+                "be",
+                "a",
+                "symptomatic",
+                "complex",
+                "partial",
+                "seizure,",
+                "not",
+                "a",
+                "secondarily",
+                "generalized",
+                "partial",
+                "seizure",
+                "(which",
+                "occurs",
+                "when",
+                "tonic-clonic",
+                "movements",
+                "extend",
+                "to",
+                "the",
+                "rest",
+                "of",
+                "the",
+                "extremities)."
+            ],
+            [
+                "For",
+                "this",
+                "reason",
+                "the",
+                "most",
+                "correct",
+                "option",
+                "would",
+                "be",
+                "two",
+                "because",
+                "it",
+                "does",
+                "not",
+                "specify",
+                "that",
+                "it",
+                "is",
+                "a",
+                "simple",
+                "symptomatic",
+                "partial",
+                "seizure,",
+                "but",
+                "leaves",
+                "open",
+                "the",
+                "possibility",
+                "that",
+                "it",
+                "is",
+                "a",
+                "simple",
+                "or",
+                "complex",
+                "symptomatic",
+                "partial",
+                "seizure."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "163_122",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEPHROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "66-year-old",
+                "man",
+                "with",
+                "a",
+                "history",
+                "of",
+                "ankylosing",
+                "spondylitis",
+                "of",
+                "long",
+                "evolution."
+            ],
+            [
+                "He",
+                "presents",
+                "proteinuria",
+                "of",
+                "6",
+                "grams",
+                "per",
+                "day",
+                "with",
+                "hypoalbuminemia",
+                "and",
+                "edema."
+            ],
+            [
+                "In",
+                "the",
+                "urinary",
+                "sediment",
+                "no",
+                "hematuria",
+                "is",
+                "detected."
+            ],
+            [
+                "His",
+                "plasma",
+                "creatinine",
+                "is",
+                "1.6",
+                "mg/dL",
+                "and",
+                "his",
+                "glomerular",
+                "filtration",
+                "rate",
+                "is",
+                "45",
+                "mL/min."
+            ],
+            [
+                "Glycemia",
+                "110",
+                "mg/dL."
+            ],
+            [
+                "His",
+                "severe",
+                "spinal",
+                "deformity",
+                "makes",
+                "it",
+                "difficult",
+                "to",
+                "perform",
+                "percutaneous",
+                "renal",
+                "biopsy."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "correct",
+                "initial",
+                "approach?"
+            ],
+            [
+                "1-",
+                "To",
+                "initiate",
+                "corticoids",
+                "for",
+                "suspicion",
+                "of",
+                "minimal",
+                "change",
+                "glomerular",
+                "disease."
+            ],
+            [
+                "2-",
+                "Treat",
+                "with",
+                "cyclophosphamide",
+                "for",
+                "suspected",
+                "membranous",
+                "glomerulopathy."
+            ],
+            [
+                "3-",
+                "Subcutaneous",
+                "fat",
+                "biopsy."
+            ],
+            [
+                "4-",
+                "Initiate",
+                "dialysis."
+            ],
+            [
+                "5-",
+                "Glucose",
+                "overload",
+                "test",
+                "to",
+                "rule",
+                "out",
+                "diabetic",
+                "nephropathy."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is:",
+                "3."
+            ],
+            [
+                "Subcutaneous",
+                "fat",
+                "biopsy."
+            ],
+            [
+                "Lupus",
+                "erythematosus,",
+                "some",
+                "vasculitides,",
+                "Goodpasture's",
+                "disease",
+                "and",
+                "other",
+                "systemic",
+                "diseases",
+                "(ankylosing",
+                "spondylitis",
+                "is",
+                "one",
+                "of",
+                "them)",
+                "affect",
+                "the",
+                "kidney",
+                "and",
+                "condition",
+                "its",
+                "prognosis."
+            ],
+            [
+                "The",
+                "appearance",
+                "of",
+                "urinary",
+                "abnormalities",
+                "or",
+                "renal",
+                "impairment",
+                "of",
+                "parenchymal",
+                "cause",
+                "are",
+                "indications",
+                "for",
+                "renal",
+                "biopsy,",
+                "even",
+                "with",
+                "proteinuria",
+                "ranges",
+                "lower",
+                "than",
+                "those",
+                "accepted",
+                "in",
+                "primary",
+                "nephropathies."
+            ],
+            [
+                "The",
+                "determination",
+                "of",
+                "anti-GBM",
+                "antibodies",
+                "and",
+                "ANCAS",
+                "are",
+                "helpful",
+                "for",
+                "diagnosis,",
+                "but",
+                "they",
+                "do",
+                "not",
+                "replace",
+                "renal",
+                "biopsy,",
+                "since",
+                "they",
+                "lack",
+                "prognostic",
+                "value",
+                "and",
+                "do",
+                "not",
+                "help",
+                "to",
+                "plan",
+                "treatment."
+            ],
+            [
+                "In",
+                "this",
+                "case,",
+                "in",
+                "which",
+                "we",
+                "are",
+                "led",
+                "to",
+                "think",
+                "that",
+                "renal",
+                "biopsy",
+                "is",
+                "not",
+                "possible,",
+                "we",
+                "must",
+                "relate",
+                "AE",
+                "to",
+                "renal",
+                "failure."
+            ],
+            [
+                "In",
+                "most",
+                "cases,",
+                "the",
+                "relationship",
+                "is",
+                "established",
+                "by",
+                "an",
+                "IgA",
+                "nephropathy,",
+                "which",
+                "presents",
+                "with",
+                "hematuria,",
+                "a",
+                "symptom",
+                "that",
+                "claims",
+                "not",
+                "to",
+                "exist",
+                "in",
+                "this",
+                "case."
+            ],
+            [
+                "A",
+                "non-negligible",
+                "number",
+                "of",
+                "patients",
+                "with",
+                "evolved",
+                "AD",
+                "is",
+                "amyloidosis,",
+                "which",
+                "also",
+                "matches",
+                "the",
+                "patient's",
+                "symptomatology."
+            ],
+            [
+                "Therefore,",
+                "and",
+                "given",
+                "that",
+                "amyloidosis",
+                "can",
+                "be",
+                "diagnosed",
+                "with",
+                "a",
+                "subcutaneous",
+                "fat",
+                "biopsy,",
+                "it",
+                "is",
+                "answer",
+                "3",
+                "that",
+                "should",
+                "be",
+                "considered",
+                "valid."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "148_158",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PSYCHIATRY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "23-year-old",
+                "woman",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "because",
+                "she",
+                "is",
+                "very",
+                "nervous",
+                "after",
+                "an",
+                "argument",
+                "with",
+                "her",
+                "partner."
+            ],
+            [
+                "Her",
+                "medical",
+                "history",
+                "shows",
+                "several",
+                "similar",
+                "complaints",
+                "in",
+                "the",
+                "previous",
+                "year,",
+                "two",
+                "of",
+                "them",
+                "after",
+                "a",
+                "self-injurious",
+                "gesture."
+            ],
+            [
+                "Frequent",
+                "conflicts",
+                "in",
+                "the",
+                "couple's",
+                "relationship,",
+                "job",
+                "changes",
+                "and",
+                "family",
+                "arguments",
+                "are",
+                "also",
+                "noted."
+            ],
+            [
+                "She",
+                "says",
+                "she",
+                "feels",
+                "misunderstood",
+                "by",
+                "everyone,",
+                "including",
+                "the",
+                "psychiatrists",
+                "attending",
+                "her."
+            ],
+            [
+                "The",
+                "diagnosis",
+                "is:"
+            ],
+            [
+                "1-",
+                "Borderline",
+                "personality",
+                "disorder."
+            ],
+            [
+                "2-",
+                "Histrionic",
+                "personality",
+                "disorder."
+            ],
+            [
+                "3-",
+                "Dysthymia."
+            ],
+            [
+                "4-",
+                "Dissociative",
+                "disorder."
+            ],
+            [
+                "5-",
+                "Depersonalization",
+                "disorder."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "The",
+                "woman",
+                "is",
+                "23",
+                "years",
+                "old",
+                "and",
+                "is",
+                "pissed",
+                "off."
+            ],
+            [
+                "She",
+                "needs",
+                "support",
+                "and",
+                "a",
+                "lot",
+                "of",
+                "emotional",
+                "education",
+                "to",
+                "curb",
+                "her",
+                "impulsivity...",
+                "she",
+                "feels",
+                "misunderstood...",
+                "maybe",
+                "she",
+                "is",
+                "right..."
+            ],
+            [
+                "The",
+                "issue",
+                "is",
+                "that",
+                "she",
+                "cannot",
+                "stand",
+                "rejection",
+                "and",
+                "has",
+                "self-injurious",
+                "gestures."
+            ],
+            [
+                "The",
+                "diagnosis",
+                "is",
+                "1."
+            ],
+            [
+                "3,",
+                "4",
+                "and",
+                "5",
+                "are",
+                "not",
+                "even",
+                "close,",
+                "there",
+                "is",
+                "no",
+                "clinical",
+                "picture",
+                "described",
+                "in",
+                "the",
+                "question."
+            ],
+            [
+                "Then",
+                "in",
+                "real",
+                "life",
+                "exploring",
+                "well",
+                "almost",
+                "certainly",
+                "there",
+                "would",
+                "be",
+                "dissociative",
+                "and",
+                "depersonalization",
+                "symptoms,",
+                "as",
+                "well",
+                "as",
+                "depressive",
+                "symptoms...",
+                "but",
+                "symptom",
+                "is",
+                "not",
+                "disorder."
+            ],
+            [
+                "Why",
+                "not",
+                "2?"
+            ],
+            [
+                "It",
+                "could",
+                "also",
+                "be",
+                "very",
+                "punctilious",
+                "and",
+                "spinning",
+                "very",
+                "fine...",
+                "here",
+                "the",
+                "discussion",
+                "is",
+                "served."
+            ],
+            [
+                "I",
+                "put",
+                "the",
+                "criteria",
+                "of",
+                "each",
+                "one",
+                "and",
+                "we",
+                "talk",
+                "about",
+                "it,...",
+                "but",
+                "the",
+                "intention",
+                "of",
+                "the",
+                "examiner",
+                "was",
+                "the",
+                "1",
+                "and",
+                "I",
+                "see",
+                "it",
+                "well",
+                "defended."
+            ],
+            [
+                "It",
+                "cannot",
+                "be",
+                "challenged."
+            ],
+            [
+                "-",
+                "The",
+                "limit:",
+                "A",
+                "general",
+                "pattern",
+                "of",
+                "instability",
+                "in",
+                "interpersonal",
+                "relationships,",
+                "self-image",
+                "and",
+                "self-efficacy,",
+                "and",
+                "notable",
+                "impulsivity,",
+                "beginning",
+                "in",
+                "early",
+                "adulthood",
+                "and",
+                "occurring",
+                "in",
+                "a",
+                "variety",
+                "of",
+                "contexts,",
+                "as",
+                "indicated",
+                "by",
+                "five",
+                "(or",
+                "more)",
+                "of",
+                "the",
+                "following",
+                "items:",
+                "1."
+            ],
+            [
+                "Frantic",
+                "efforts",
+                "to",
+                "avoid",
+                "real",
+                "or",
+                "imagined",
+                "abandonment."
+            ],
+            [
+                "Note:",
+                "Do",
+                "not",
+                "include",
+                "suicidal",
+                "or",
+                "self-mutilating",
+                "behaviors",
+                "covered",
+                "in",
+                "Criterion",
+                "5."
+            ],
+            [
+                "2."
+            ],
+            [
+                "A",
+                "pattern",
+                "of",
+                "unstable",
+                "and",
+                "intense",
+                "interpersonal",
+                "relationships",
+                "characterized",
+                "by",
+                "alternating",
+                "between",
+                "extremes",
+                "of",
+                "idealization",
+                "and",
+                "devaluation."
+            ],
+            [
+                "3."
+            ],
+            [
+                "Identity",
+                "disturbance:",
+                "marked",
+                "and",
+                "persistently",
+                "unstable",
+                "self-image",
+                "or",
+                "sense",
+                "of",
+                "self."
+            ],
+            [
+                "Impulsivity",
+                "in",
+                "at",
+                "least",
+                "two",
+                "areas,",
+                "which",
+                "is",
+                "potentially",
+                "self-harming",
+                "(e.g.,",
+                "spending,",
+                "sex,",
+                "substance",
+                "abuse,",
+                "reckless",
+                "driving,",
+                "binge",
+                "eating)."
+            ],
+            [
+                "Note:",
+                "Do",
+                "not",
+                "include",
+                "suicidal",
+                "or",
+                "self-mutilating",
+                "behaviors",
+                "listed",
+                "in",
+                "Criterion",
+                "5."
+            ],
+            [
+                "5."
+            ],
+            [
+                "Recurrent",
+                "suicidal",
+                "behaviors,",
+                "attempts",
+                "or",
+                "threats,",
+                "or",
+                "self-mutilating",
+                "behavior."
+            ],
+            [
+                "Affective",
+                "instability",
+                "due",
+                "to",
+                "marked",
+                "mood",
+                "reactivity",
+                "(e.g.,",
+                "episodes",
+                "of",
+                "intense",
+                "dysphoria,",
+                "irritability,",
+                "or",
+                "anxiety,",
+                "usually",
+                "lasting",
+                "a",
+                "few",
+                "hours",
+                "and",
+                "rarely",
+                "a",
+                "few",
+                "days)."
+            ],
+            [
+                "7."
+            ],
+            [
+                "Chronic",
+                "feelings",
+                "of",
+                "emptiness."
+            ],
+            [
+                "8."
+            ],
+            [
+                "Inappropriate",
+                "and",
+                "intense",
+                "anger",
+                "or",
+                "difficulties",
+                "in",
+                "controlling",
+                "anger",
+                "(e.g.,",
+                "frequent",
+                "displays",
+                "of",
+                "temper,",
+                "constant",
+                "anger,",
+                "recurrent",
+                "physical",
+                "fights)."
+            ],
+            [
+                "9."
+            ],
+            [
+                "Transient",
+                "stress-related",
+                "paranoid",
+                "ideation",
+                "or",
+                "severe",
+                "dissociative",
+                "symptoms."
+            ],
+            [
+                "-",
+                "The",
+                "histrionic:",
+                "A",
+                "general",
+                "pattern",
+                "of",
+                "excessive",
+                "emotionality",
+                "and",
+                "attention-seeking,",
+                "beginning",
+                "in",
+                "early",
+                "adulthood",
+                "and",
+                "occurring",
+                "in",
+                "a",
+                "variety",
+                "of",
+                "contexts,",
+                "as",
+                "indicated",
+                "by",
+                "five",
+                "(or",
+                "more)",
+                "of",
+                "the",
+                "following",
+                "items:",
+                "1."
+            ],
+            [
+                "Not",
+                "comfortable",
+                "in",
+                "situations",
+                "where",
+                "he/she",
+                "is",
+                "not",
+                "the",
+                "center",
+                "of",
+                "attention."
+            ],
+            [
+                "Interaction",
+                "with",
+                "others",
+                "is",
+                "often",
+                "characterized",
+                "by",
+                "sexually",
+                "seductive",
+                "or",
+                "provocative",
+                "behavior."
+            ],
+            [
+                "3."
+            ],
+            [
+                "3."
+            ],
+            [
+                "Displays",
+                "a",
+                "superficial",
+                "and",
+                "rapidly",
+                "changing",
+                "emotional",
+                "expression."
+            ],
+            [
+                "4."
+            ],
+            [
+                "Constantly",
+                "uses",
+                "physical",
+                "appearance",
+                "to",
+                "draw",
+                "attention",
+                "to",
+                "him/herself."
+            ],
+            [
+                "5."
+            ],
+            [
+                "Has",
+                "a",
+                "way",
+                "of",
+                "speaking",
+                "that",
+                "is",
+                "excessively",
+                "subjective",
+                "and",
+                "lacking",
+                "in",
+                "nuance."
+            ],
+            [
+                "6."
+            ],
+            [
+                "Shows",
+                "self-dramatization,",
+                "theatricality",
+                "and",
+                "exaggerated",
+                "emotional",
+                "expression."
+            ],
+            [
+                "7."
+            ],
+            [
+                "Is",
+                "suggestible,",
+                "e.g.,",
+                "easily",
+                "influenced",
+                "by",
+                "others",
+                "or",
+                "by",
+                "circumstances."
+            ],
+            [
+                "8.",
+                "considers",
+                "his",
+                "relationships",
+                "more",
+                "intimate",
+                "than",
+                "they",
+                "really",
+                "are."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+            ],
+            [
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+            ],
+            [
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+                "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"
+            ],
+            [
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+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ]
+        ]
+    },
+    {
+        "id": "178_94",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "HEMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "18-month-old",
+                "boy,",
+                "with",
+                "complete",
+                "vaccination",
+                "schedule",
+                "to",
+                "date,",
+                "who",
+                "consults",
+                "the",
+                "Emergency",
+                "Department",
+                "for",
+                "swelling",
+                "of",
+                "the",
+                "right",
+                "knee",
+                "after",
+                "playing",
+                "in",
+                "the",
+                "park,",
+                "without",
+                "obvious",
+                "trauma."
+            ],
+            [
+                "In",
+                "the",
+                "directed",
+                "anamnesis,",
+                "the",
+                "mother",
+                "refers",
+                "that",
+                "an",
+                "uncle",
+                "of",
+                "hers",
+                "had",
+                "similar",
+                "problems."
+            ],
+            [
+                "The",
+                "ultrasound",
+                "examination",
+                "is",
+                "compatible",
+                "with",
+                "hemarthrosis",
+                "and",
+                "in",
+                "the",
+                "analysis",
+                "performed",
+                "only",
+                "an",
+                "APTT",
+                "lengthening",
+                "of",
+                "52\u2033",
+                "(normal",
+                "25-35\u2033)",
+                "stands",
+                "out."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnostic",
+                "hypothesis?"
+            ],
+            [
+                "1-",
+                "Marfan",
+                "syndrome."
+            ],
+            [
+                "2-",
+                "Von",
+                "Willebrand's",
+                "disease."
+            ],
+            [
+                "3-",
+                "Ehlers-Danlos",
+                "disease."
+            ],
+            [
+                "4-",
+                "Hemophilia",
+                "A."
+            ],
+            [
+                "5-",
+                "Bemard-Soulier",
+                "disease."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "In",
+                "this",
+                "question",
+                "they",
+                "also",
+                "do",
+                "not",
+                "stop",
+                "dropping",
+                "clues",
+                "to",
+                "throw",
+                "us",
+                "headlong",
+                "into",
+                "the",
+                "correct",
+                "diagnosis."
+            ],
+            [
+                "Let's",
+                "review:",
+                "a",
+                "small",
+                "child",
+                "who",
+                "suffers",
+                "a",
+                "hemarthrosis",
+                "without",
+                "clear",
+                "trauma."
+            ],
+            [
+                "An",
+                "uncle",
+                "of",
+                "his",
+                "had",
+                "similar",
+                "problems,",
+                "so",
+                "we",
+                "suspect",
+                "hereditary",
+                "disease."
+            ],
+            [
+                "The",
+                "APTT,",
+                "which",
+                "evaluates",
+                "the",
+                "intrinsic",
+                "coagulation",
+                "pathway",
+                "(involving",
+                "factors",
+                "V,",
+                "VIII,",
+                "IX,",
+                "X,",
+                "XI",
+                "and",
+                "XII)",
+                "is",
+                "elongated."
+            ],
+            [
+                "Hereditary",
+                "coagulation",
+                "problem."
+            ],
+            [
+                "We",
+                "thus",
+                "discard",
+                "answers",
+                "1,",
+                "2",
+                "and",
+                "5."
+            ],
+            [
+                "We",
+                "are",
+                "left",
+                "with",
+                "von",
+                "Willebrand's",
+                "disease",
+                "and",
+                "hemophilia",
+                "A."
+            ],
+            [
+                "I",
+                "consider",
+                "that",
+                "the",
+                "correct",
+                "answer",
+                "is",
+                "4,",
+                "hemophilia",
+                "A,",
+                "since",
+                "the",
+                "inheritance",
+                "pattern",
+                "is",
+                "X-linked",
+                "and",
+                "its",
+                "main",
+                "clinical",
+                "manifestation",
+                "is",
+                "soft",
+                "tissue",
+                "bruising",
+                "and",
+                "spontaneous",
+                "hemarthrosis,",
+                "without",
+                "apparent",
+                "trauma,",
+                "while",
+                "von",
+                "Willebrand",
+                "disease",
+                "is",
+                "characterized",
+                "by",
+                "bleeding",
+                "after",
+                "surgery",
+                "or",
+                "trauma",
+                "and",
+                "a",
+                "prolonged",
+                "bleeding",
+                "time",
+                "with",
+                "a",
+                "normal",
+                "platelet",
+                "count",
+                "is",
+                "characteristic",
+                "(data",
+                "not",
+                "mentioned",
+                "in",
+                "the",
+                "statement)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
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+                "B-Claim",
+                "I-Claim"
+            ],
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+                "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-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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "100_85",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "24-year-old",
+                "man",
+                "reports",
+                "progressive",
+                "asthenia",
+                "for",
+                "at",
+                "least",
+                "6",
+                "months,",
+                "hoarse",
+                "voice,",
+                "slow",
+                "speech,",
+                "drowsiness",
+                "and",
+                "swelling",
+                "of",
+                "the",
+                "hands,",
+                "feet",
+                "and",
+                "face."
+            ],
+            [
+                "Examination:",
+                "pulse",
+                "at",
+                "52",
+                "beats",
+                "per",
+                "minute,",
+                "abotarada",
+                "face",
+                "and",
+                "dry",
+                "and",
+                "pale",
+                "skin."
+            ],
+            [
+                "CBC:",
+                "mild",
+                "anemia,",
+                "cholesterol",
+                "385",
+                "mg/dL",
+                "(normal",
+                "<220),",
+                "creatinine",
+                "1.3",
+                "mg/dL",
+                "(normal:",
+                "0.5-1.1),",
+                "negative",
+                "proteinuria,",
+                "TSH",
+                "187\u03bcIU/mL",
+                "(normal",
+                "0.35-5.5)",
+                "and",
+                "Free",
+                "T4",
+                "0.2",
+                "ng/dL",
+                "(normal",
+                "0.85-1.86)."
+            ],
+            [
+                "What",
+                "strategy",
+                "do",
+                "you",
+                "think",
+                "is",
+                "most",
+                "appropriate?"
+            ],
+            [
+                "1-",
+                "Perform",
+                "a",
+                "thyroid",
+                "ultrasound",
+                "before",
+                "starting",
+                "treatment."
+            ],
+            [
+                "2-",
+                "Determine",
+                "free",
+                "T3",
+                "and",
+                "perform",
+                "a",
+                "pituitary",
+                "MRI."
+            ],
+            [
+                "3-",
+                "Treat",
+                "with",
+                "L-triiodothyronine",
+                "and",
+                "a",
+                "statin."
+            ],
+            [
+                "4-",
+                "Treat",
+                "with",
+                "L-Tyroxine",
+                "and",
+                "determine",
+                "antithyroid",
+                "antibodies."
+            ],
+            [
+                "5-",
+                "Perform",
+                "thyroid",
+                "cytology",
+                "prior",
+                "to",
+                "treatment."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "This",
+                "is",
+                "severe",
+                "primary",
+                "hypothyroidism."
+            ],
+            [
+                "Treatment",
+                "is",
+                "with",
+                "thyroxine."
+            ],
+            [
+                "If",
+                "there",
+                "is",
+                "no",
+                "nodule,",
+                "neither",
+                "echo",
+                "nor",
+                "FNA",
+                "is",
+                "indicated."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "398_140",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "TRAUMATOLOGY",
+                "AND",
+                "ORTHOPEDICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "You",
+                "evaluate",
+                "a",
+                "66-year-old",
+                "patient",
+                "with",
+                "groin",
+                "pain",
+                "accentuated",
+                "by",
+                "prolonged",
+                "standing",
+                "a",
+                "few",
+                "days",
+                "a",
+                "month."
+            ],
+            [
+                "A",
+                "plain",
+                "radiograph",
+                "of",
+                "the",
+                "hips",
+                "shows",
+                "narrowing",
+                "of",
+                "the",
+                "femoroacetabular",
+                "joint",
+                "space,",
+                "sclerosis",
+                "and",
+                "osteophytes."
+            ],
+            [
+                "What",
+                "is",
+                "your",
+                "approach?"
+            ],
+            [
+                "1-",
+                "I",
+                "make",
+                "the",
+                "diagnosis",
+                "of",
+                "coxarthrosis",
+                "and",
+                "send",
+                "to",
+                "the",
+                "traumatologist",
+                "to",
+                "place",
+                "a",
+                "hip",
+                "prosthesis."
+            ],
+            [
+                "2-",
+                "Start",
+                "treatment",
+                "with",
+                "weak",
+                "opioids",
+                "that",
+                "have",
+                "shown",
+                "evidence",
+                "in",
+                "stopping",
+                "the",
+                "progression",
+                "of",
+                "the",
+                "disease."
+            ],
+            [
+                "3-",
+                "I",
+                "insist",
+                "treatment",
+                "with",
+                "paracetamol,",
+                "explain",
+                "that",
+                "the",
+                "evolution",
+                "is",
+                "very",
+                "variable",
+                "and",
+                "the",
+                "surgical",
+                "indication",
+                "depends",
+                "on",
+                "the",
+                "functionality",
+                "and",
+                "pain",
+                "control."
+            ],
+            [
+                "4-",
+                "Because",
+                "of",
+                "the",
+                "radiological",
+                "features",
+                "described,",
+                "I",
+                "need",
+                "a",
+                "hip",
+                "MRI",
+                "before",
+                "making",
+                "a",
+                "therapeutic",
+                "decision."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "We",
+                "are",
+                "talking",
+                "about",
+                "a",
+                "66-year-old",
+                "patient",
+                "with",
+                "pain",
+                "on",
+                "some",
+                "days,",
+                "pain",
+                "of",
+                "an",
+                "occasional",
+                "nature."
+            ],
+            [
+                "Although",
+                "the",
+                "diagnosis",
+                "is",
+                "clearly",
+                "osteoarthritis,",
+                "it",
+                "does",
+                "not",
+                "lead",
+                "directly",
+                "to",
+                "a",
+                "surgical",
+                "indication."
+            ],
+            [
+                "The",
+                "first",
+                "step",
+                "is",
+                "to",
+                "try",
+                "conservative",
+                "treatment",
+                "(we",
+                "ruled",
+                "out",
+                "the",
+                "first",
+                "option)."
+            ],
+            [
+                "Osteoarthritis",
+                "is",
+                "a",
+                "degenerative",
+                "process",
+                "that",
+                "opioids",
+                "certainly",
+                "do",
+                "not",
+                "stop,",
+                "so",
+                "we",
+                "rule",
+                "out",
+                "option",
+                "two."
+            ],
+            [
+                "Option",
+                "four",
+                "can",
+                "also",
+                "be",
+                "quickly",
+                "discarded:",
+                "the",
+                "statement",
+                "makes",
+                "the",
+                "diagnosis",
+                "and",
+                "treatment",
+                "to",
+                "follow",
+                "clear:",
+                "in",
+                "this",
+                "case",
+                "the",
+                "MRI",
+                "will",
+                "not",
+                "provide",
+                "us",
+                "with",
+                "any",
+                "information",
+                "of",
+                "interest."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "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",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "28_58",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "587_76",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "554_50",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "58-year-old",
+                "man",
+                "comes",
+                "for",
+                "a",
+                "scheduled",
+                "check-up",
+                "for",
+                "type",
+                "2",
+                "diabetes",
+                "mellitus",
+                "diagnosed",
+                "6",
+                "years",
+                "ago."
+            ],
+            [
+                "He",
+                "has",
+                "a",
+                "personal",
+                "history",
+                "of",
+                "hypertension,",
+                "dyslipidemia,",
+                "ischemic",
+                "heart",
+                "disease",
+                "and",
+                "pancreatitis",
+                "of",
+                "biliary",
+                "origin."
+            ],
+            [
+                "His",
+                "medication",
+                "includes",
+                "lisinopril,",
+                "metoprolol,",
+                "metformin,",
+                "ASA",
+                "and",
+                "atorvastatin."
+            ],
+            [
+                "Physical",
+                "examination",
+                "showed",
+                "blood",
+                "pressure",
+                "151/93",
+                "mmHg,",
+                "BMI",
+                "27.1",
+                "kg/m2."
+            ],
+            [
+                "Glycated",
+                "hemoglobin",
+                "is",
+                "8.3%."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "is",
+                "the",
+                "most",
+                "appropriate",
+                "treatment",
+                "for",
+                "this",
+                "patient?"
+            ],
+            [
+                "1-",
+                "Empaglifozin."
+            ],
+            [
+                "2-",
+                "Glipizide."
+            ],
+            [
+                "3-",
+                "Acarbose."
+            ],
+            [
+                "4-",
+                "Sitagliptin."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Patient",
+                "with",
+                "obesity,",
+                "hypertension",
+                "and",
+                "increased",
+                "HbA1C."
+            ],
+            [
+                "In",
+                "recent",
+                "studies,",
+                "Empaglifozin,",
+                "a",
+                "highly",
+                "selective",
+                "inhibitor",
+                "of",
+                "SGLT210,",
+                "significantly",
+                "reduces",
+                "AT,",
+                "HbA1C",
+                "and",
+                "BMI."
+            ],
+            [
+                "Glipizide",
+                "is",
+                "of",
+                "the",
+                "sulfonylurea",
+                "group."
+            ],
+            [
+                "Its",
+                "use",
+                "should",
+                "be",
+                "avoided",
+                "in",
+                "patients",
+                "with",
+                "heart",
+                "disease."
+            ],
+            [
+                "Acarbose",
+                "can",
+                "interact",
+                "with",
+                "beta-blockers,",
+                "such",
+                "as",
+                "those",
+                "taken",
+                "by",
+                "our",
+                "patient."
+            ],
+            [
+                "Sitagliptin",
+                "has",
+                "been",
+                "shown",
+                "to",
+                "decrease",
+                "HbA1C",
+                "but",
+                "not",
+                "HT",
+                "or",
+                "BMI."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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-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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "251_81",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DIGESTIVE",
+                "SYSTEM"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "50-year-old",
+                "woman",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "with",
+                "asthenia,",
+                "anorexia,",
+                "weight",
+                "loss,",
+                "jaundice,",
+                "fever",
+                "and",
+                "abdominal",
+                "pain."
+            ],
+            [
+                "She",
+                "has",
+                "no",
+                "recent",
+                "history",
+                "of",
+                "blood",
+                "transfusion,",
+                "risky",
+                "sexual",
+                "contacts",
+                "or",
+                "addiction",
+                "to",
+                "parenteral",
+                "drugs."
+            ],
+            [
+                "Habitual",
+                "consumption",
+                "of",
+                "60",
+                "grams",
+                "of",
+                "alcohol",
+                "per",
+                "day",
+                "during",
+                "the",
+                "last",
+                "five",
+                "years,",
+                "consumption",
+                "that",
+                "has",
+                "increased",
+                "during",
+                "the",
+                "previous",
+                "month",
+                "due",
+                "to",
+                "family",
+                "problems."
+            ],
+            [
+                "Temperature",
+                "38.5\u00baC,",
+                "blood",
+                "pressure",
+                "100/60",
+                "mmHg."
+            ],
+            [
+                "Physical",
+                "examination",
+                "showed",
+                "temporal",
+                "and",
+                "spatial",
+                "disorientation,",
+                "malnutrition,",
+                "asterixis,",
+                "jaundice",
+                "and",
+                "painful",
+                "hepatomegaly."
+            ],
+            [
+                "No",
+                "ascites",
+                "or",
+                "evidence",
+                "of",
+                "peritoneal",
+                "irritation."
+            ],
+            [
+                "Laboratory",
+                "tests",
+                "include",
+                "leukocytes",
+                "15,000/microliter",
+                "with",
+                "90%",
+                "polymorphonuclear,",
+                "red",
+                "blood",
+                "cells",
+                "3",
+                "million/mm3,",
+                "hemoglobin",
+                "10g/dl,",
+                "mean",
+                "corpuscular",
+                "volume",
+                "115",
+                "fl,",
+                "bilirubin",
+                "15",
+                "mg/dl",
+                "direct",
+                "predominance,",
+                "AST",
+                "(GOT)",
+                "300",
+                "IU/L,",
+                "ALT",
+                "(GPT)",
+                "120",
+                "IU/L,",
+                "GGT",
+                "635",
+                "IU/L,",
+                "prothrombin",
+                "time",
+                "prolongation",
+                "greater",
+                "than",
+                "50%."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis",
+                "of",
+                "the",
+                "patient's",
+                "condition?"
+            ],
+            [
+                "1-",
+                "Hepatic",
+                "abscess."
+            ],
+            [
+                "2-",
+                "Acute",
+                "cholecystitis."
+            ],
+            [
+                "3-",
+                "Acute",
+                "cholangitis."
+            ],
+            [
+                "4-",
+                "Alcoholic",
+                "hepatitis."
+            ],
+            [
+                "5-",
+                "Acute",
+                "pancreatitis."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Patient",
+                "with",
+                "harmful",
+                "alcohol",
+                "consumption",
+                "(60g",
+                "and",
+                "female),",
+                "high",
+                "fever,",
+                "hepatic",
+                "encephalopathy",
+                "(disorientation,",
+                "asterixis),",
+                "very",
+                "high",
+                "direct",
+                "bilirubin,",
+                "jaundice,",
+                "painful",
+                "hepatomegaly,",
+                "coagulopathy",
+                "(elevated",
+                "prothrombin",
+                "time)",
+                "and",
+                "mild",
+                "elevation",
+                "of",
+                "transaminases",
+                "(less",
+                "than",
+                "5",
+                "times",
+                "the",
+                "upper",
+                "limit",
+                "of",
+                "normal)",
+                "suggest",
+                "acute",
+                "alcohol",
+                "hepatitis."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Premise",
+                "I-Premise",
+                "B-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",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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"
+            ]
+        ]
+    },
+    {
+        "id": "128_79",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY",
+                "AND",
+                "NEUROSURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "42-year-old",
+                "married",
+                "woman",
+                "with",
+                "2",
+                "school-age",
+                "children",
+                "consults",
+                "her",
+                "family",
+                "physician",
+                "for",
+                "a",
+                "severe",
+                "headache",
+                "of",
+                "about",
+                "7",
+                "days'",
+                "evolution."
+            ],
+            [
+                "Although",
+                "she",
+                "has",
+                "been",
+                "having",
+                "similar",
+                "episodes",
+                "for",
+                "more",
+                "than",
+                "a",
+                "year,",
+                "in",
+                "the",
+                "last",
+                "2",
+                "months",
+                "they",
+                "have",
+                "worsened",
+                "considerably."
+            ],
+            [
+                "The",
+                "pain",
+                "is",
+                "like",
+                "a",
+                "weight",
+                "that",
+                "starts",
+                "in",
+                "the",
+                "occipital",
+                "area,",
+                "spreads",
+                "to",
+                "both",
+                "temporal",
+                "regions",
+                "and",
+                "is",
+                "barely",
+                "relieved",
+                "by",
+                "taking",
+                "650",
+                "mg",
+                "paracetamol",
+                "tablets,",
+                "so",
+                "she",
+                "requests",
+                "a",
+                "CT",
+                "scan",
+                "(she",
+                "is",
+                "convinced",
+                "that",
+                "\"something",
+                "must",
+                "be",
+                "wrong",
+                "with",
+                "her",
+                "head\")."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "is",
+                "the",
+                "most",
+                "plausible",
+                "cause",
+                "of",
+                "her",
+                "headache?"
+            ],
+            [
+                "1-",
+                "Migraine."
+            ],
+            [
+                "2-",
+                "Vascular",
+                "disorders."
+            ],
+            [
+                "3-",
+                "Temporal",
+                "artery",
+                "arteritis."
+            ],
+            [
+                "4-",
+                "Tension."
+            ],
+            [
+                "5-",
+                "Oncologic."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Just",
+                "as",
+                "last",
+                "year",
+                "they",
+                "wanted",
+                "to",
+                "paint",
+                "a",
+                "nurse",
+                "as",
+                "bad",
+                "for",
+                "waking",
+                "us",
+                "up",
+                "for",
+                "a",
+                "patient",
+                "with",
+                "myasthenia,",
+                "this",
+                "year",
+                "they",
+                "entertain",
+                "us",
+                "by",
+                "presenting",
+                "a",
+                "patient",
+                "asking",
+                "for",
+                "a",
+                "CT",
+                "scan."
+            ],
+            [
+                "I",
+                "interpret",
+                "that",
+                "they",
+                "show",
+                "a",
+                "patient",
+                "stressed",
+                "by",
+                "her",
+                "children",
+                "with",
+                "recurrent",
+                "headaches",
+                "of",
+                "occipital",
+                "location",
+                "that",
+                "she",
+                "previously",
+                "relieved",
+                "with",
+                "a",
+                "low",
+                "dose",
+                "of",
+                "paracetamol",
+                "and",
+                "now",
+                "she",
+                "does",
+                "not."
+            ],
+            [
+                "Both",
+                "the",
+                "initially",
+                "occipital",
+                "location,",
+                "the",
+                "2-year",
+                "evolution",
+                "time,",
+                "and",
+                "the",
+                "sensation",
+                "of",
+                "weight",
+                "lead",
+                "to",
+                "answer",
+                "4,",
+                "a",
+                "tension",
+                "headache."
+            ],
+            [
+                "Migraine",
+                "and",
+                "vascular",
+                "disorders,",
+                "accompanied",
+                "by",
+                "other",
+                "neurological",
+                "symptoms",
+                "or",
+                "nausea,",
+                "photophobia,",
+                "etc.,",
+                "are",
+                "quickly",
+                "ruled",
+                "out,",
+                "as",
+                "well",
+                "as",
+                "the",
+                "rare",
+                "temporal",
+                "arteritis",
+                "before",
+                "the",
+                "age",
+                "of",
+                "50",
+                "years."
+            ],
+            [
+                "Tumor",
+                "headache",
+                "is",
+                "usually",
+                "\"in",
+                "crescendo\",",
+                "not",
+                "recurrent",
+                "as",
+                "the",
+                "case",
+                "suggests,",
+                "and",
+                "is",
+                "accompanied",
+                "by",
+                "other",
+                "neurological",
+                "symptoms",
+                "or",
+                "intracranial",
+                "hypertension."
+            ]
+        ],
+        "labels": [
+            [
+                "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",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-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",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
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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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "0_34",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DIGESTIVE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "27-year-old",
+                "woman",
+                "under",
+                "study",
+                "in",
+                "the",
+                "dermatology",
+                "department",
+                "for",
+                "recurrent",
+                "episodes",
+                "of",
+                "oral",
+                "aphthous",
+                "ulcers."
+            ],
+            [
+                "She",
+                "was",
+                "referred",
+                "to",
+                "the",
+                "gastrointestinal",
+                "department",
+                "for",
+                "a",
+                "blood",
+                "test",
+                "showing",
+                "Hb",
+                "11.5",
+                "gr/dl",
+                "Fe",
+                "38",
+                "AST",
+                "52",
+                "ALT",
+                "64",
+                "Ac",
+                "antitrasglutaminase",
+                "IgA",
+                "177."
+            ],
+            [
+                "The",
+                "patient",
+                "reported",
+                "only",
+                "occasional",
+                "diffuse",
+                "abdominal",
+                "discomfort."
+            ],
+            [
+                "She",
+                "reports",
+                "no",
+                "signs",
+                "of",
+                "hemorrhage",
+                "or",
+                "jaundice."
+            ],
+            [
+                "The",
+                "physical",
+                "examination",
+                "is",
+                "normal."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "tests",
+                "do",
+                "you",
+                "consider",
+                "to",
+                "be",
+                "the",
+                "most",
+                "appropriate",
+                "to",
+                "make",
+                "the",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Capsule",
+                "endoscopy."
+            ],
+            [
+                "2-",
+                "Colonoscopy."
+            ],
+            [
+                "3-",
+                "Serology",
+                "for",
+                "hepatitis",
+                "b",
+                "and",
+                "c",
+                "virus."
+            ],
+            [
+                "4-",
+                "Intestinal",
+                "biopsy."
+            ],
+            [
+                "5-",
+                "Abdominal",
+                "ultrasound."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "In",
+                "this",
+                "question,",
+                "they",
+                "give",
+                "an",
+                "important",
+                "piece",
+                "of",
+                "information",
+                "when",
+                "it",
+                "comes",
+                "to",
+                "suspecting",
+                "a",
+                "diagnosis,",
+                "which",
+                "is",
+                "the",
+                "antitransglutaminase",
+                "antibodies",
+                "that",
+                "must",
+                "lead",
+                "you",
+                "to",
+                "suspect",
+                "celiac",
+                "disease."
+            ],
+            [
+                "The",
+                "rest",
+                "of",
+                "the",
+                "symptoms",
+                "fall",
+                "perfectly",
+                "within",
+                "the",
+                "picture",
+                "and",
+                "although",
+                "probably",
+                "several",
+                "of",
+                "the",
+                "tests",
+                "that",
+                "it",
+                "says",
+                "will",
+                "be",
+                "done,",
+                "the",
+                "answer",
+                "that",
+                "will",
+                "give",
+                "us",
+                "the",
+                "diagnosis",
+                "is",
+                "4",
+                "(intestinal",
+                "biopsy)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "256_162",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DIGESTIVE",
+                "SYSTEM"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "80-year-old",
+                "woman",
+                "consults",
+                "for",
+                "presenting,",
+                "since",
+                "1",
+                "month",
+                "ago,",
+                "a",
+                "progressive",
+                "increase",
+                "in",
+                "abdominal",
+                "perimeter."
+            ],
+            [
+                "During",
+                "the",
+                "previous",
+                "4-5",
+                "months",
+                "she",
+                "noted",
+                "asthenia,",
+                "anorexia",
+                "and",
+                "unspecified",
+                "weight",
+                "loss."
+            ],
+            [
+                "Physical",
+                "examination",
+                "revealed",
+                "tension",
+                "ascites",
+                "and",
+                "malleolar",
+                "edema,",
+                "with",
+                "no",
+                "other",
+                "relevant",
+                "signs."
+            ],
+            [
+                "An",
+                "ultrasound",
+                "and",
+                "CT",
+                "scan",
+                "of",
+                "the",
+                "abdomen",
+                "showed",
+                "the",
+                "presence",
+                "of",
+                "ascites,",
+                "of",
+                "homogeneous",
+                "density,",
+                "without",
+                "peritoneal",
+                "implants",
+                "or",
+                "abdominal",
+                "or",
+                "pelvic",
+                "masses."
+            ],
+            [
+                "Liver,",
+                "pancreas,",
+                "adrenal,",
+                "spleen",
+                "and",
+                "kidneys",
+                "without",
+                "significant",
+                "findings."
+            ],
+            [
+                "Paracentesis",
+                "is",
+                "performed",
+                "through",
+                "a",
+                "thick",
+                "needle,",
+                "obtaining",
+                "with",
+                "difficulty",
+                "a",
+                "somewhat",
+                "yellowish,",
+                "dense",
+                "and",
+                "gelatinous",
+                "fluid."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "probable",
+                "etiology?"
+            ],
+            [
+                "1-",
+                "Hydropic",
+                "decompensation",
+                "secondary",
+                "to",
+                "liver",
+                "cirrhosis."
+            ],
+            [
+                "2-",
+                "Chylous",
+                "ascites",
+                "due",
+                "to",
+                "non-Hodgkin's",
+                "lymphoma."
+            ],
+            [
+                "3-",
+                "Peritoneal",
+                "tuberculosis."
+            ],
+            [
+                "4-",
+                "Peritoneal",
+                "metastasis",
+                "of",
+                "adenocarcinoma."
+            ],
+            [
+                "5-",
+                "Ascites",
+                "secondary",
+                "to",
+                "constrictive",
+                "pericarditis."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "The",
+                "characteristics",
+                "of",
+                "the",
+                "fluid",
+                "described",
+                "are",
+                "milky,",
+                "i.e.,",
+                "chylous",
+                "ascitic",
+                "fluid."
+            ],
+            [
+                "Taking",
+                "into",
+                "account",
+                "the",
+                "age",
+                "of",
+                "the",
+                "patient",
+                "and",
+                "the",
+                "constitutional",
+                "syndrome",
+                "described,",
+                "it",
+                "is",
+                "most",
+                "likely",
+                "to",
+                "be",
+                "a",
+                "non-Hodgkin's",
+                "lymphoma",
+                "and",
+                "not",
+                "tuberculosis,",
+                "which",
+                "also",
+                "presents",
+                "with",
+                "chylous",
+                "ascitic",
+                "fluid,",
+                "since",
+                "there",
+                "is",
+                "no",
+                "mention",
+                "of",
+                "infectious",
+                "symptoms."
+            ],
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+                "of",
+                "the",
+                "entities",
+                "offered",
+                "do",
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+                "present",
+                "with",
+                "chylous",
+                "ascitic",
+                "fluid."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-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",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "604_113",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "TRAUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "35-year-old",
+                "man,",
+                "a",
+                "letter",
+                "carrier,",
+                "with",
+                "no",
+                "history",
+                "of",
+                "interest,",
+                "who",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "for",
+                "acute",
+                "cervical",
+                "pain",
+                "of",
+                "24",
+                "hours",
+                "of",
+                "evolution,",
+                "without",
+                "previous",
+                "trauma,",
+                "which",
+                "radiates",
+                "to",
+                "the",
+                "left",
+                "arm",
+                "up",
+                "to",
+                "the",
+                "hand",
+                "and",
+                "is",
+                "accompanied",
+                "by",
+                "paresthesia",
+                "in",
+                "the",
+                "radial",
+                "border",
+                "of",
+                "the",
+                "forearm."
+            ],
+            [
+                "She",
+                "presents",
+                "no",
+                "objectifiable",
+                "loss",
+                "of",
+                "strength,",
+                "preserves",
+                "neck",
+                "mobility",
+                "although",
+                "it",
+                "is",
+                "painful",
+                "and",
+                "contracture",
+                "of",
+                "the",
+                "paravertebral",
+                "musculature",
+                "is",
+                "appreciated."
+            ],
+            [
+                "The",
+                "first",
+                "attitude",
+                "will",
+                "be:"
+            ],
+            [
+                "1-",
+                "Conservative",
+                "treatment",
+                "with",
+                "nonsteroidal",
+                "anti-inflammatory",
+                "drugs,",
+                "local",
+                "heat",
+                "and",
+                "relative",
+                "rest."
+            ],
+            [
+                "2-",
+                "Urgent",
+                "call",
+                "to",
+                "the",
+                "neurosurgeon",
+                "for",
+                "surgical",
+                "evaluation."
+            ],
+            [
+                "3-",
+                "Preferential",
+                "request",
+                "for",
+                "MRI",
+                "and",
+                "electromyogram."
+            ],
+            [
+                "4-",
+                "Preferential",
+                "referral",
+                "to",
+                "outpatient",
+                "traumatology",
+                "consultations."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Cervicalgia",
+                "without",
+                "alarm",
+                "signs."
+            ],
+            [
+                "Conservative",
+                "treatment",
+                "with",
+                "a",
+                "success",
+                "rate",
+                "of",
+                "75%-90%."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "362_96",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "410_195",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PRIMARY",
+                "CARE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "75",
+                "a",
+                "man",
+                "is",
+                "admitted",
+                "to",
+                "the",
+                "hospital",
+                "because",
+                "he",
+                "refuses",
+                "to",
+                "eat",
+                "and",
+                "has",
+                "lost",
+                "30%",
+                "of",
+                "his",
+                "weight."
+            ],
+            [
+                "He",
+                "has",
+                "a",
+                "history",
+                "of",
+                "multiple",
+                "sclerosis",
+                "which",
+                "has",
+                "worsened",
+                "in",
+                "recent",
+                "months."
+            ],
+            [
+                "His",
+                "only",
+                "family",
+                "member",
+                "who",
+                "was",
+                "his",
+                "sister",
+                "died",
+                "3",
+                "months",
+                "ago",
+                "and",
+                "since",
+                "then",
+                "he",
+                "has",
+                "deteriorated."
+            ],
+            [
+                "He",
+                "has",
+                "become",
+                "incontinent,",
+                "has",
+                "stopped",
+                "eating",
+                "and",
+                "participating",
+                "in",
+                "social",
+                "events."
+            ],
+            [
+                "He",
+                "is",
+                "suffering",
+                "from",
+                "psychotic",
+                "depression."
+            ],
+            [
+                "He",
+                "is",
+                "physically",
+                "able",
+                "to",
+                "eat."
+            ],
+            [
+                "Psychotropic",
+                "medication",
+                "is",
+                "started",
+                "and",
+                "discontinued",
+                "due",
+                "to",
+                "adverse",
+                "events."
+            ],
+            [
+                "If",
+                "his",
+                "nutritional",
+                "status",
+                "improves",
+                "it",
+                "is",
+                "possible",
+                "to",
+                "resume",
+                "his",
+                "medications."
+            ],
+            [
+                "He",
+                "refuses",
+                "intravenous",
+                "fluids",
+                "and",
+                "then",
+                "accepts",
+                "them",
+                "but",
+                "the",
+                "IV",
+                "is",
+                "started",
+                "a",
+                "few",
+                "hours",
+                "later."
+            ],
+            [
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+                "is",
+                "to",
+                "perform",
+                "a",
+                "percutaneous",
+                "endoscopic",
+                "gastrostomy",
+                "(PEG)",
+                "and",
+                "discharge",
+                "him",
+                "to",
+                "his",
+                "residence."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "is",
+                "the",
+                "most",
+                "appropriate",
+                "course",
+                "of",
+                "action",
+                "for",
+                "this",
+                "patient?"
+            ],
+            [
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+                "Ask",
+                "the",
+                "hospital",
+                "ethics",
+                "committee",
+                "to",
+                "help",
+                "determine",
+                "the",
+                "decision",
+                "that",
+                "is",
+                "in",
+                "the",
+                "best",
+                "interest",
+                "of",
+                "the",
+                "patient."
+            ],
+            [
+                "2-",
+                "Assess",
+                "whether",
+                "the",
+                "residence",
+                "will",
+                "take",
+                "the",
+                "patient",
+                "if",
+                "PEG",
+                "is",
+                "not",
+                "performed."
+            ],
+            [
+                "3-",
+                "Seek",
+                "a",
+                "court",
+                "order",
+                "to",
+                "perform",
+                "PEG."
+            ],
+            [
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+                "Enrolling",
+                "the",
+                "patient",
+                "in",
+                "terminal",
+                "palliative",
+                "care."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
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+                "correct",
+                "answer",
+                "is",
+                "1",
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+                "the",
+                "patient",
+                "is",
+                "in",
+                "a",
+                "situation",
+                "of",
+                "psychotic",
+                "depression",
+                "and",
+                "is",
+                "not",
+                "able",
+                "to",
+                "decide",
+                "for",
+                "his",
+                "life",
+                "and",
+                "it",
+                "does",
+                "not",
+                "seem",
+                "that",
+                "the",
+                "patient",
+                "has",
+                "filled",
+                "in",
+                "the",
+                "last",
+                "will",
+                "and",
+                "testament,",
+                "the",
+                "most",
+                "convenient",
+                "thing",
+                "to",
+                "do",
+                "is",
+                "to",
+                "present",
+                "the",
+                "case",
+                "to",
+                "the",
+                "ethics",
+                "committee",
+                "of",
+                "the",
+                "center",
+                "to",
+                "make",
+                "a",
+                "decision",
+                "on",
+                "the",
+                "matter",
+                "in",
+                "accordance",
+                "with",
+                "the",
+                "law."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "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",
+                "B-Marker",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "361_94",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "HEMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "51-year-old",
+                "man",
+                "is",
+                "admitted",
+                "from",
+                "the",
+                "emergency",
+                "department",
+                "for",
+                "macrocytic",
+                "anemia",
+                "(Hb",
+                "6.3",
+                "g/dL,",
+                "MCV",
+                "120",
+                "fL)."
+            ],
+            [
+                "Studies",
+                "ruled",
+                "out",
+                "a",
+                "deficiency",
+                "origin."
+            ],
+            [
+                "Reticulocytes",
+                "were",
+                "24000/microL."
+            ],
+            [
+                "The",
+                "bone",
+                "marrow",
+                "study",
+                "is",
+                "compatible",
+                "with",
+                "myelodysplastic",
+                "syndrome",
+                "(MDS)."
+            ],
+            [
+                "Cytogenetics",
+                "shows",
+                "a",
+                "5q",
+                "deletion."
+            ],
+            [
+                "Which",
+                "is",
+                "the",
+                "correct",
+                "statement",
+                "regarding",
+                "this",
+                "patient?"
+            ],
+            [
+                "1-",
+                "This",
+                "deletion",
+                "(5q-)",
+                "is",
+                "an",
+                "alteration",
+                "of",
+                "good",
+                "prognosis",
+                "and",
+                "has",
+                "a",
+                "specific",
+                "treatment",
+                "(lenalidomide)."
+            ],
+            [
+                "2-",
+                "It",
+                "would",
+                "be",
+                "advisable",
+                "in",
+                "this",
+                "patient",
+                "to",
+                "perform",
+                "HLA",
+                "typing",
+                "in",
+                "order",
+                "to",
+                "organize",
+                "an",
+                "allogeneic",
+                "transplant."
+            ],
+            [
+                "3-",
+                "This",
+                "is",
+                "a",
+                "patient",
+                "with",
+                "a",
+                "high",
+                "International",
+                "Prognostic",
+                "Index",
+                "(IPSS)."
+            ],
+            [
+                "4-",
+                "Treatment",
+                "in",
+                "this",
+                "case",
+                "would",
+                "be",
+                "transfusion",
+                "only."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "This",
+                "is",
+                "a",
+                "young",
+                "patient",
+                "with",
+                "no",
+                "comorbidities",
+                "and",
+                "is",
+                "therefore",
+                "a",
+                "candidate",
+                "for",
+                "treatment",
+                "with",
+                "curative",
+                "intent,",
+                "so",
+                "option",
+                "4",
+                "is",
+                "ruled",
+                "out."
+            ],
+            [
+                "Option",
+                "3",
+                "is",
+                "also",
+                "incorrect",
+                "since",
+                "we",
+                "cannot",
+                "know",
+                "the",
+                "patient's",
+                "IPSS",
+                "since",
+                "we",
+                "do",
+                "not",
+                "know",
+                "the",
+                "number",
+                "of",
+                "blasts",
+                "and",
+                "the",
+                "number",
+                "of",
+                "leukocytes",
+                "and",
+                "platelets",
+                "to",
+                "calculate",
+                "the",
+                "risk."
+            ],
+            [
+                "Option",
+                "2",
+                "is",
+                "also",
+                "incorrect",
+                "since",
+                "the",
+                "indication",
+                "for",
+                "a",
+                "bone",
+                "marrow",
+                "transplant",
+                "in",
+                "MDS",
+                "is",
+                "those",
+                "patients",
+                "with",
+                "high",
+                "or",
+                "intermediate-2",
+                "IPSS,",
+                "and",
+                "in",
+                "this",
+                "case",
+                "we",
+                "do",
+                "not",
+                "know",
+                "the",
+                "risk,",
+                "the",
+                "only",
+                "thing",
+                "we",
+                "know",
+                "about",
+                "the",
+                "risk",
+                "is",
+                "the",
+                "cytogenetics",
+                "which",
+                "is",
+                "of",
+                "good",
+                "prognosis",
+                "that",
+                "would",
+                "give",
+                "us",
+                "0",
+                "points."
+            ],
+            [
+                "Therefore",
+                "the",
+                "correct",
+                "one",
+                "is",
+                "1",
+                "since",
+                "it",
+                "is",
+                "true",
+                "that",
+                "it",
+                "has",
+                "a",
+                "favorable",
+                "cytogenetics",
+                "(5q-)",
+                "and",
+                "has",
+                "a",
+                "specific",
+                "treatment",
+                "lenalidomide,",
+                "also",
+                "used",
+                "in",
+                "other",
+                "pathologies",
+                "such",
+                "as",
+                "multiple",
+                "myeloma."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "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",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "172_50",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PNEUMOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "patient",
+                "with",
+                "severe",
+                "COPD",
+                "comes",
+                "to",
+                "the",
+                "ED",
+                "with",
+                "an",
+                "acute",
+                "onset",
+                "and",
+                "presents",
+                "an",
+                "arterial",
+                "blood",
+                "gas",
+                "drawn",
+                "with",
+                "Fi02",
+                "of",
+                "31%",
+                "at",
+                "sea",
+                "level",
+                "with",
+                "a",
+                "Pa02",
+                "of",
+                "86",
+                "mm",
+                "Hg,",
+                "PaC02",
+                "65",
+                "mm",
+                "Hg,",
+                "pH",
+                "7.13",
+                "and",
+                "Bicarbonate",
+                "27",
+                "mmol/liter."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "statements",
+                "is",
+                "FALSE?"
+            ],
+            [
+                "1-",
+                "The",
+                "patient",
+                "is",
+                "hyperventilating."
+            ],
+            [
+                "2-",
+                "The",
+                "alveolar",
+                "arterial",
+                "oxygen",
+                "gradient",
+                "is",
+                "elevated."
+            ],
+            [
+                "3-",
+                "The",
+                "patient",
+                "is",
+                "in",
+                "respiratory",
+                "acidosis."
+            ],
+            [
+                "4-",
+                "Bicarbonate",
+                "level",
+                "is",
+                "normal."
+            ],
+            [
+                "5-",
+                "Initiation",
+                "of",
+                "mechanical",
+                "ventilation",
+                "should",
+                "be",
+                "considered."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Blood",
+                "gas",
+                "analysis",
+                "shows",
+                "an",
+                "acute",
+                "respiratory",
+                "acidosis,",
+                "due",
+                "to",
+                "an",
+                "increase",
+                "in",
+                "PCO2",
+                "of",
+                "short",
+                "evolution",
+                "time",
+                "because",
+                "the",
+                "kidney",
+                "has",
+                "not",
+                "yet",
+                "had",
+                "time",
+                "to",
+                "retain",
+                "bicarbonates",
+                "(bicarbonate",
+                "level",
+                "at",
+                "the",
+                "high",
+                "limit",
+                "of",
+                "normality)."
+            ],
+            [
+                "The",
+                "patient",
+                "is",
+                "not",
+                "hyperventilating",
+                "but",
+                "hypoventilating",
+                "because",
+                "PCO2",
+                "is",
+                "elevated."
+            ],
+            [
+                "The",
+                "alveolar",
+                "arterial",
+                "oxygen",
+                "gradient",
+                "is",
+                "altered",
+                "since",
+                "the",
+                "patient",
+                "has",
+                "a",
+                "normal",
+                "PaO2,",
+                "but",
+                "because",
+                "he",
+                "has",
+                "a",
+                "high",
+                "FiO2."
+            ],
+            [
+                "If",
+                "he",
+                "were",
+                "without",
+                "oxygen,",
+                "he",
+                "would",
+                "be",
+                "hypoxemic."
+            ],
+            [
+                "Respiratory",
+                "acidosis",
+                "below",
+                "7.20",
+                "is",
+                "a",
+                "reason",
+                "to",
+                "consider",
+                "noninvasive",
+                "mechanical",
+                "ventilation",
+                "acutely",
+                "and",
+                "in",
+                "principle",
+                "temporarily",
+                "in",
+                "a",
+                "patient",
+                "with",
+                "severe",
+                "COPD."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "83_48",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CARDIOLOGY",
+                "AND",
+                "VASCULAR",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "What",
+                "therapeutic",
+                "intervention",
+                "would",
+                "you",
+                "consider",
+                "in",
+                "a",
+                "67-year-old",
+                "patient",
+                "with",
+                "idiopathic",
+                "dilated",
+                "cardiomyopathy,",
+                "left",
+                "bundle",
+                "branch",
+                "block,",
+                "left",
+                "ventricular",
+                "ejection",
+                "fraction",
+                "of",
+                "26%,",
+                "mitral",
+                "insufficiency",
+                "grade",
+                "II-III/IV,",
+                "undergoing",
+                "treatment",
+                "with",
+                "furosemide,",
+                "spironolactone,",
+                "enalapril",
+                "and",
+                "bisoprolol",
+                "and",
+                "who",
+                "remains",
+                "in",
+                "NYHA",
+                "functional",
+                "class",
+                "III?"
+            ],
+            [
+                "1-",
+                "Surgical",
+                "coronary",
+                "revascularization."
+            ],
+            [
+                "2-",
+                "Mitral",
+                "valve",
+                "replacement."
+            ],
+            [
+                "3-",
+                "Implantation",
+                "of",
+                "an",
+                "aortic",
+                "balloon",
+                "pump."
+            ],
+            [
+                "4-",
+                "Implantation",
+                "of",
+                "a",
+                "ventricular",
+                "assist",
+                "device."
+            ],
+            [
+                "5-",
+                "Implantation",
+                "of",
+                "a",
+                "cardiac",
+                "resynchronization",
+                "system."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "We",
+                "are",
+                "talking",
+                "about",
+                "a",
+                "patient",
+                "with",
+                "heart",
+                "failure",
+                "with",
+                "severe",
+                "LV",
+                "dysfunction",
+                "(EF",
+                "<",
+                "35%),",
+                "LBBB",
+                "(wide",
+                "QRS),",
+                "who",
+                "is",
+                "following",
+                "optimal",
+                "medical",
+                "treatment",
+                "and",
+                "who",
+                "remains",
+                "in",
+                "advanced",
+                "functional",
+                "class",
+                "despite",
+                "this."
+            ],
+            [
+                "Coronary",
+                "revascularization",
+                "does",
+                "not",
+                "appear",
+                "to",
+                "be",
+                "of",
+                "much",
+                "benefit",
+                "in",
+                "this",
+                "patient",
+                "at",
+                "this",
+                "time."
+            ],
+            [
+                "Nor",
+                "does",
+                "mitral",
+                "valve",
+                "replacement,",
+                "firstly",
+                "because",
+                "mitral",
+                "regurgitation",
+                "is",
+                "most",
+                "likely",
+                "the",
+                "result",
+                "of",
+                "mitral",
+                "annular",
+                "dilatation,",
+                "and",
+                "secondly",
+                "because",
+                "we",
+                "would",
+                "need",
+                "an",
+                "echocardiographic",
+                "assessment",
+                "of",
+                "the",
+                "mitral",
+                "valve",
+                "to",
+                "determine",
+                "whether",
+                "there",
+                "is",
+                "any",
+                "alteration."
+            ],
+            [
+                "Intra-aortic",
+                "balloon",
+                "counterpulsation",
+                "implantation",
+                "would",
+                "not",
+                "be",
+                "indicated",
+                "in",
+                "this",
+                "patient",
+                "(it",
+                "is",
+                "used",
+                "in",
+                "situations",
+                "of",
+                "cardiogenic",
+                "shock,",
+                "in",
+                "post-AMI",
+                "mechanical",
+                "complications,",
+                "as",
+                "a",
+                "bridge",
+                "to",
+                "cardiac",
+                "Tx...)."
+            ],
+            [
+                "The",
+                "ventricular",
+                "assist",
+                "device",
+                "would",
+                "also",
+                "not",
+                "be",
+                "indicated",
+                "in",
+                "this",
+                "patient."
+            ],
+            [
+                "What",
+                "would",
+                "really",
+                "benefit",
+                "him",
+                "of",
+                "all",
+                "the",
+                "answers",
+                "is",
+                "number",
+                "5,",
+                "the",
+                "resynchronization",
+                "device."
+            ],
+            [
+                "By",
+                "achieving",
+                "simultaneous",
+                "stimulation",
+                "of",
+                "both",
+                "ventricles,",
+                "a",
+                "mechanical",
+                "synergy",
+                "is",
+                "achieved",
+                "that",
+                "improves",
+                "cardiac",
+                "function."
+            ],
+            [
+                "The",
+                "indications",
+                "for",
+                "the",
+                "application",
+                "of",
+                "CRT",
+                "(cardiac",
+                "resynchronization",
+                "therapy)",
+                "are",
+                "precisely",
+                "those",
+                "mentioned",
+                "at",
+                "the",
+                "beginning:",
+                "severe",
+                "ventricular",
+                "dysfunction,",
+                "asynchrony",
+                "demonstrated",
+                "by",
+                "the",
+                "presence",
+                "of",
+                "wide",
+                "QRS",
+                "in",
+                "the",
+                "ECG",
+                "(usually",
+                "due",
+                "to",
+                "LBBB)",
+                "and",
+                "advanced",
+                "functional",
+                "class",
+                "(III-IV)",
+                "despite",
+                "optimal",
+                "medical",
+                "treatment."
+            ]
+        ],
+        "labels": [
+            [
+                "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",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "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",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ]
+        ]
+    },
+    {
+        "id": "141_135",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "2-year-old",
+                "boy,",
+                "his",
+                "personal",
+                "history",
+                "includes:",
+                "3",
+                "episodes",
+                "of",
+                "acute",
+                "otitis",
+                "media,",
+                "1",
+                "meningococcal",
+                "meningitis",
+                "and",
+                "2",
+                "pneumonias",
+                "(one",
+                "middle",
+                "lobe",
+                "and",
+                "one",
+                "left",
+                "upper",
+                "lobe)."
+            ],
+            [
+                "She",
+                "has",
+                "been",
+                "admitted",
+                "on",
+                "3",
+                "occasions",
+                "for",
+                "thrombopenic",
+                "purpura",
+                "(on",
+                "three",
+                "occasions",
+                "antiplatelet",
+                "antibodies",
+                "were",
+                "negative",
+                "and",
+                "bone",
+                "marrow",
+                "showed",
+                "normal",
+                "megakaryocytes)."
+            ],
+            [
+                "Several",
+                "males",
+                "of",
+                "the",
+                "maternal",
+                "family",
+                "had",
+                "died",
+                "in",
+                "childhood",
+                "due",
+                "to",
+                "infectious",
+                "processes."
+            ],
+            [
+                "The",
+                "examination",
+                "showed",
+                "typical",
+                "lesions",
+                "of",
+                "atopic",
+                "dermatitis."
+            ],
+            [
+                "The",
+                "immunological",
+                "study",
+                "showed",
+                "a",
+                "slight",
+                "decrease",
+                "in",
+                "T",
+                "lymphocyte",
+                "subpopulations;",
+                "elevated",
+                "IgA",
+                "and",
+                "IgE;",
+                "decreased",
+                "IgM",
+                "and",
+                "IgG",
+                "at",
+                "the",
+                "lower",
+                "limit",
+                "of",
+                "normal."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Wiskott-Aldrich",
+                "syndrome."
+            ],
+            [
+                "2-",
+                "Hyper",
+                "IgE",
+                "syndrome."
+            ],
+            [
+                "3-",
+                "Transient",
+                "hypogammaglobulinemia",
+                "of",
+                "infancy."
+            ],
+            [
+                "4-",
+                "Severe",
+                "X-associated",
+                "combined",
+                "immunodeficiency."
+            ],
+            [
+                "5-",
+                "Common",
+                "variable",
+                "immunodeficiency."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "1."
+            ],
+            [
+                "Wiskott-Aldrich",
+                "syndrome",
+                "associates",
+                "immunodeficiency,",
+                "thrombopenia",
+                "and",
+                "atopic",
+                "dermatitis",
+                "with",
+                "the",
+                "immunological",
+                "study",
+                "described",
+                "in",
+                "the",
+                "statement."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Disease",
+                "I-Disease",
+                "I-Disease"
+            ],
+            [
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "317_139",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "RHEUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "70-year-old",
+                "woman",
+                "with",
+                "a",
+                "history",
+                "of",
+                "anorexia,",
+                "weight",
+                "loss,",
+                "muscle",
+                "and",
+                "proximal",
+                "joint",
+                "discomfort",
+                "and",
+                "pain",
+                "in",
+                "the",
+                "temporomandibular",
+                "region",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "for",
+                "unilateral",
+                "vision",
+                "loss",
+                "(hand",
+                "movement),",
+                "sudden",
+                "and",
+                "painless",
+                "onset",
+                "(afferent",
+                "pupillary",
+                "defect)."
+            ],
+            [
+                "What",
+                "test",
+                "would",
+                "you",
+                "order",
+                "first",
+                "for",
+                "diagnostic",
+                "purposes?"
+            ],
+            [
+                "1-",
+                "Lumbar",
+                "puncture."
+            ],
+            [
+                "2-",
+                "C",
+                "Reactive",
+                "Protein."
+            ],
+            [
+                "3-",
+                "Magnetic",
+                "resonance",
+                "angiography."
+            ],
+            [
+                "4-",
+                "Carotid",
+                "ultrasound."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "It",
+                "is",
+                "possibly",
+                "a",
+                "temporal",
+                "arteritis,",
+                "the",
+                "clinical",
+                "picture",
+                "and",
+                "a",
+                "CBC",
+                "with",
+                "increased",
+                "reactants",
+                "are",
+                "enough",
+                "to",
+                "confirm",
+                "the",
+                "suspicion."
+            ],
+            [
+                "Then",
+                "an",
+                "ocular",
+                "evaluation",
+                "should",
+                "be",
+                "done",
+                "to",
+                "rule",
+                "out",
+                "AIN,",
+                "urgent",
+                "treatment",
+                "should",
+                "be",
+                "instituted",
+                "(if",
+                "there",
+                "is",
+                "AIN,",
+                "3",
+                "boluses",
+                "of",
+                "methylprednisolone",
+                "1",
+                "g,",
+                "if",
+                "there",
+                "is",
+                "not,",
+                "prednisone",
+                "mg/kg)",
+                "and",
+                "biopsy",
+                "should",
+                "be",
+                "evaluated."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "550_129",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "110_152",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "Patient",
+                "76",
+                "years",
+                "old,",
+                "parity",
+                "3-0-3-1,",
+                "with",
+                "menopause",
+                "at",
+                "age",
+                "52."
+            ],
+            [
+                "She",
+                "reports",
+                "that",
+                "for",
+                "at",
+                "least",
+                "4-5",
+                "years",
+                "she",
+                "has",
+                "had",
+                "vulvar",
+                "pruritus",
+                "of",
+                "variable",
+                "intensity",
+                "which",
+                "has",
+                "been",
+                "treated",
+                "sometimes",
+                "with",
+                "self-medication",
+                "and",
+                "other",
+                "times",
+                "on",
+                "the",
+                "advice",
+                "of",
+                "her",
+                "general",
+                "practitioner",
+                "with",
+                "topical",
+                "preparations",
+                "(creams",
+                "and",
+                "washes)."
+            ],
+            [
+                "The",
+                "pruritus",
+                "has",
+                "evolved",
+                "intermittently,",
+                "but",
+                "for",
+                "the",
+                "last",
+                "3-4",
+                "months",
+                "she",
+                "has",
+                "also",
+                "noticed",
+                "a",
+                "small",
+                "lump",
+                "on",
+                "the",
+                "left",
+                "labium",
+                "majus",
+                "of",
+                "the",
+                "vulva,",
+                "which",
+                "has",
+                "been",
+                "leaking",
+                "serohaematically",
+                "on",
+                "rubbing",
+                "for",
+                "a",
+                "few",
+                "days;",
+                "she",
+                "therefore",
+                "consulted",
+                "a",
+                "gynecologist."
+            ],
+            [
+                "On",
+                "questioning,",
+                "she",
+                "reports",
+                "occasional",
+                "dysuria",
+                "and",
+                "her",
+                "general",
+                "condition",
+                "is",
+                "good."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis",
+                "in",
+                "this",
+                "patient?"
+            ],
+            [
+                "1-",
+                "Genital",
+                "herpes."
+            ],
+            [
+                "2-",
+                "Paget's",
+                "disease",
+                "of",
+                "the",
+                "vulva."
+            ],
+            [
+                "3-",
+                "Urethral",
+                "caruncle."
+            ],
+            [
+                "4-",
+                "Chronic",
+                "granuloma",
+                "of",
+                "the",
+                "vulva."
+            ],
+            [
+                "5-",
+                "Vulvar",
+                "squamous",
+                "cell",
+                "carcinoma."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "5."
+            ],
+            [
+                "Vulvar",
+                "carcinoma",
+                "is",
+                "characterized",
+                "by",
+                "chronic",
+                "vulvar",
+                "itching",
+                "resistant",
+                "to",
+                "multiple",
+                "treatments,",
+                "appearance",
+                "of",
+                "lumpiness",
+                "or",
+                "ulceration,",
+                "dysuria",
+                "and",
+                "urinary",
+                "urgency,",
+                "and",
+                "late",
+                "pain",
+                "and",
+                "bleeding."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "419_77",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GENERAL",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "80-year-old",
+                "woman",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "with",
+                "abdominal",
+                "pain",
+                "starting",
+                "in",
+                "the",
+                "epigastrium",
+                "and",
+                "radiating",
+                "later",
+                "to",
+                "the",
+                "left",
+                "iliac",
+                "fossa."
+            ],
+            [
+                "An",
+                "abdominal",
+                "CT",
+                "scan",
+                "is",
+                "performed,",
+                "showing",
+                "inflammation",
+                "of",
+                "the",
+                "sigmoid",
+                "walls",
+                "and",
+                "a",
+                "2",
+                "cm",
+                "mesenteric",
+                "abscess."
+            ],
+            [
+                "The",
+                "treatment",
+                "of",
+                "choice",
+                "is:"
+            ],
+            [
+                "1-",
+                "Admission",
+                "to",
+                "the",
+                "ward",
+                "with",
+                "absolute",
+                "diet",
+                "and",
+                "broad-spectrum",
+                "antibiotic",
+                "treatment."
+            ],
+            [
+                "2-",
+                "Discharge",
+                "colostomy."
+            ],
+            [
+                "3-",
+                "Drainage",
+                "by",
+                "laparoscopic",
+                "surgery."
+            ],
+            [
+                "4-",
+                "Urgent",
+                "surgery",
+                "with",
+                "sigmoidectomy",
+                "and",
+                "colorectal",
+                "anastomosis."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "In",
+                "this",
+                "question",
+                "we",
+                "are",
+                "presented",
+                "with",
+                "a",
+                "clinical",
+                "picture",
+                "whose",
+                "manifestations",
+                "are",
+                "compatible",
+                "with",
+                "acute",
+                "diverticulitis,",
+                "already",
+                "asked",
+                "on",
+                "numerous",
+                "occasions",
+                "previously."
+            ],
+            [
+                "A",
+                "case",
+                "of",
+                "acute",
+                "diverticulitis",
+                "complicated",
+                "with",
+                "small",
+                "mesenteric",
+                "abscess",
+                "(<",
+                "2-3",
+                "cm)",
+                "is",
+                "presented."
+            ],
+            [
+                "Abscesses",
+                "should",
+                "be",
+                "drained",
+                "by",
+                "CT-guided",
+                "percutaneous",
+                "puncture,",
+                "since",
+                "the",
+                "intra-abdominal",
+                "approach",
+                "can",
+                "spread",
+                "the",
+                "contents",
+                "into",
+                "the",
+                "abdominal",
+                "cavity."
+            ],
+            [
+                "However,",
+                "in",
+                "small",
+                "abscesses",
+                "with",
+                "Hinchey",
+                "grade",
+                "I",
+                "divertciulitis,",
+                "in",
+                "patients",
+                "without",
+                "great",
+                "deterioration",
+                "of",
+                "the",
+                "general",
+                "condition",
+                "as",
+                "in",
+                "the",
+                "proposed",
+                "case,",
+                "they",
+                "can",
+                "be",
+                "managed",
+                "by",
+                "conservative",
+                "treatment",
+                "with",
+                "intravenous",
+                "antiobiotic",
+                "therapy",
+                "and",
+                "absolute",
+                "diet,",
+                "therefore",
+                "the",
+                "correct",
+                "option",
+                "is",
+                "1."
+            ],
+            [
+                "The",
+                "urgent",
+                "surgical",
+                "approach",
+                "should",
+                "be",
+                "reserved",
+                "for",
+                "cases",
+                "that",
+                "present",
+                "peritonitis",
+                "(grade",
+                "III,",
+                "IV)",
+                "by",
+                "resection",
+                "of",
+                "the",
+                "affected",
+                "segment",
+                "and",
+                "primary",
+                "anastomosis",
+                "in",
+                "stable",
+                "patients",
+                "or",
+                "carry",
+                "out",
+                "the",
+                "Hartamn",
+                "intervention",
+                "that",
+                "includes",
+                "resection",
+                "with",
+                "terminal",
+                "colostomy",
+                "and",
+                "closure",
+                "of",
+                "the",
+                "distal",
+                "rectal",
+                "stump",
+                "performing",
+                "anastomosis",
+                "in",
+                "a",
+                "second",
+                "surgical",
+                "time."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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",
+                "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",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "37_227",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "OPHTHALMOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "78-year-old",
+                "woman",
+                "consults",
+                "for",
+                "acute",
+                "vision",
+                "loss",
+                "of",
+                "the",
+                "left",
+                "eye."
+            ],
+            [
+                "In",
+                "the",
+                "last",
+                "3",
+                "weeks",
+                "she",
+                "has",
+                "presented",
+                "with",
+                "fever,",
+                "pain",
+                "in",
+                "the",
+                "shoulders,",
+                "neck",
+                "and",
+                "hips,",
+                "and",
+                "moderate",
+                "headache."
+            ],
+            [
+                "Funduscopy",
+                "shows",
+                "a",
+                "pale",
+                "and",
+                "edematous",
+                "optic",
+                "disc."
+            ],
+            [
+                "Mobilization",
+                "of",
+                "the",
+                "shoulders",
+                "and",
+                "hips",
+                "produces",
+                "pain."
+            ],
+            [
+                "There",
+                "are",
+                "no",
+                "alterations",
+                "on",
+                "palpation",
+                "of",
+                "the",
+                "temporal",
+                "arteries."
+            ],
+            [
+                "Laboratory",
+                "data:",
+                "hemoglobin",
+                "9.7",
+                "g/dL",
+                "ferritin",
+                "450",
+                "ng/mL",
+                "erythrocyte",
+                "sedimentation",
+                "rate",
+                "115",
+                "mm/h."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "appropriate",
+                "immediate",
+                "action",
+                "in",
+                "this",
+                "patient?"
+            ],
+            [
+                "1-",
+                "Request",
+                "a",
+                "Doppler",
+                "ultrasound",
+                "of",
+                "temporal",
+                "arteries."
+            ],
+            [
+                "2-",
+                "Start",
+                "treatment",
+                "with",
+                "prednisone",
+                "60mg",
+                "per",
+                "day",
+                "and",
+                "aspirin",
+                "100",
+                "mg",
+                "per",
+                "day."
+            ],
+            [
+                "3-",
+                "Start",
+                "treatment",
+                "with",
+                "prednisone",
+                "10",
+                "mg",
+                "per",
+                "day."
+            ],
+            [
+                "4-",
+                "Request",
+                "a",
+                "temporal",
+                "artery",
+                "biopsy."
+            ],
+            [
+                "5-",
+                "Request",
+                "a",
+                "brain",
+                "magnetic",
+                "resonance",
+                "imaging."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "The",
+                "clinical",
+                "presentation",
+                "is",
+                "strongly",
+                "suggestive",
+                "of",
+                "giant",
+                "cell",
+                "arteritis",
+                "(GCA),",
+                "with",
+                "febrile",
+                "fever,",
+                "shoulder",
+                "girdle",
+                "and",
+                "pelvic",
+                "pain,",
+                "and",
+                "headache."
+            ],
+            [
+                "Age",
+                "and",
+                "sex",
+                "also",
+                "point",
+                "to",
+                "this",
+                "possibility."
+            ],
+            [
+                "Abrupt",
+                "unilateral",
+                "visual",
+                "loss",
+                "with",
+                "pale",
+                "papillary",
+                "edema",
+                "is",
+                "highly",
+                "indicative",
+                "of",
+                "arteritic",
+                "ischemic",
+                "optic",
+                "neuropathy",
+                "due",
+                "to",
+                "GCA."
+            ],
+            [
+                "The",
+                "ESR",
+                "is",
+                "elevated,",
+                "which",
+                "further",
+                "clarifies",
+                "the",
+                "diagnosis."
+            ],
+            [
+                "We",
+                "have",
+                "to",
+                "quickly",
+                "start",
+                "corticosteroid",
+                "treatment."
+            ],
+            [
+                "We",
+                "can",
+                "already",
+                "rule",
+                "out",
+                "1",
+                "and",
+                "5",
+                "because",
+                "they",
+                "do",
+                "not",
+                "contribute",
+                "anything."
+            ],
+            [
+                "4",
+                "could",
+                "make",
+                "us",
+                "doubt,",
+                "and",
+                "it",
+                "is",
+                "true",
+                "that",
+                "we",
+                "will",
+                "have",
+                "to",
+                "ask",
+                "for",
+                "a",
+                "temporal",
+                "artery",
+                "biopsy,",
+                "but",
+                "that",
+                "is",
+                "not",
+                "immediate:",
+                "the",
+                "statement",
+                "makes",
+                "it",
+                "very",
+                "clear",
+                "that",
+                "we",
+                "have",
+                "to",
+                "act",
+                "immediately."
+            ],
+            [
+                "The",
+                "current",
+                "trend",
+                "is",
+                "to",
+                "use",
+                "megadoses",
+                "of",
+                "intravenous",
+                "corticosteroids,",
+                "and",
+                "although",
+                "aspirin",
+                "has",
+                "traditionally",
+                "been",
+                "proposed",
+                "to",
+                "reduce",
+                "ischemic",
+                "events,",
+                "the",
+                "evidence",
+                "currently",
+                "indicates",
+                "that",
+                "antiplatelet",
+                "agents",
+                "do",
+                "not",
+                "contribute",
+                "much."
+            ],
+            [
+                "An",
+                "oral",
+                "corticosteroid",
+                "dose",
+                "of",
+                "around",
+                "1mg/kg",
+                "would",
+                "also",
+                "be",
+                "acceptable."
+            ],
+            [
+                "Therefore,",
+                "if",
+                "we",
+                "rule",
+                "out",
+                "3",
+                "because",
+                "the",
+                "dose",
+                "is",
+                "too",
+                "low,",
+                "we",
+                "would",
+                "have",
+                "to",
+                "stay",
+                "with",
+                "2."
+            ],
+            [
+                "With",
+                "reservations,",
+                "since",
+                "aspirin",
+                "has",
+                "a",
+                "rather",
+                "dubious",
+                "role,",
+                "and",
+                "the",
+                "corticosteroid",
+                "dose",
+                "remains",
+                "ambiguous",
+                "(we",
+                "do",
+                "not",
+                "know",
+                "how",
+                "much",
+                "the",
+                "patient",
+                "weighs)."
+            ],
+            [
+                "Of",
+                "all",
+                "the",
+                "ophthalmology",
+                "questions,",
+                "this",
+                "is",
+                "perhaps",
+                "the",
+                "one",
+                "most",
+                "likely",
+                "to",
+                "be",
+                "contested."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Premise",
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+                "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",
+                "I-Claim"
+            ],
+            [
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+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "O",
+                "B-Premise",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "532_67",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "272_69",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DIGESTIVE",
+                "SYSTEM"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "60-year-old",
+                "man",
+                "with",
+                "extensive",
+                "ulcerative",
+                "colitis",
+                "of",
+                "15",
+                "years",
+                "of",
+                "evolution",
+                "and",
+                "in",
+                "clinical",
+                "remission",
+                "for",
+                "the",
+                "last",
+                "3",
+                "years,",
+                "comes",
+                "to",
+                "our",
+                "office",
+                "to",
+                "be",
+                "informed",
+                "about",
+                "the",
+                "risk",
+                "of",
+                "colorectal",
+                "cancer",
+                "and",
+                "about",
+                "the",
+                "possibility",
+                "of",
+                "participating",
+                "in",
+                "prevention",
+                "programs."
+            ],
+            [
+                "It",
+                "is",
+                "correct",
+                "to",
+                "inform",
+                "him",
+                "that:"
+            ],
+            [
+                "1-",
+                "Ulcerative",
+                "colitis",
+                "is",
+                "only",
+                "associated",
+                "with",
+                "an",
+                "increased",
+                "risk",
+                "of",
+                "colorectal",
+                "cancer",
+                "in",
+                "smokers."
+            ],
+            [
+                "2-",
+                "In",
+                "her",
+                "case,",
+                "given",
+                "that",
+                "she",
+                "is",
+                "in",
+                "long-term",
+                "remission,",
+                "the",
+                "screening",
+                "advised",
+                "to",
+                "the",
+                "general",
+                "population",
+                "is",
+                "considered",
+                "appropriate."
+            ],
+            [
+                "3-",
+                "In",
+                "cases",
+                "such",
+                "as",
+                "yours,",
+                "it",
+                "is",
+                "considered",
+                "appropriate",
+                "to",
+                "undergo",
+                "periodic",
+                "colonoscopies",
+                "with",
+                "multiple",
+                "biopsies",
+                "staggered",
+                "along",
+                "the",
+                "entire",
+                "colon."
+            ],
+            [
+                "4-",
+                "In",
+                "cases",
+                "such",
+                "as",
+                "yours,",
+                "screening",
+                "with",
+                "periodic",
+                "fecal",
+                "occult",
+                "blood",
+                "tests",
+                "is",
+                "considered",
+                "appropriate,",
+                "but",
+                "with",
+                "a",
+                "higher",
+                "frequency",
+                "than",
+                "that",
+                "used",
+                "in",
+                "screening",
+                "the",
+                "general",
+                "population."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Patients",
+                "with",
+                "inflammatory",
+                "bowel",
+                "disease",
+                "(IBD)",
+                "have",
+                "an",
+                "increased",
+                "risk",
+                "of",
+                "colorectal",
+                "cancer,",
+                "whether",
+                "or",
+                "not",
+                "they",
+                "are",
+                "smokers."
+            ],
+            [
+                "It",
+                "is",
+                "recommended",
+                "to",
+                "start",
+                "screening",
+                "8-10",
+                "years",
+                "after",
+                "diagnosis",
+                "of",
+                "IBD",
+                "(or",
+                "earlier",
+                "if",
+                "primary",
+                "sclerosing",
+                "cholangitis",
+                "or",
+                "other",
+                "events",
+                "occur",
+                "during",
+                "this",
+                "interval)."
+            ],
+            [
+                "The",
+                "recommended",
+                "techniques",
+                "are",
+                "colonoscopy",
+                "with",
+                "random",
+                "biopsies",
+                "(answer",
+                "3)",
+                "and",
+                "pancolonic",
+                "chromoendoscopy",
+                "with",
+                "staining,",
+                "which",
+                "is",
+                "currently",
+                "the",
+                "gold",
+                "standard",
+                "because",
+                "it",
+                "detects",
+                "dysplasia",
+                "better,",
+                "although",
+                "it",
+                "requires",
+                "more",
+                "technical",
+                "experience."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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"
+            ]
+        ]
+    },
+    {
+        "id": "428_61",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTIOUS",
+                "DISEASES",
+                "AND",
+                "MICROBIOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "62-year-old",
+                "man",
+                "comes",
+                "to",
+                "the",
+                "hospital",
+                "emergency",
+                "department",
+                "with",
+                "a",
+                "fever",
+                "of",
+                "38.3\u2033C",
+                "and",
+                "chills."
+            ],
+            [
+                "He",
+                "is",
+                "tachycardic",
+                "and",
+                "tachypneic."
+            ],
+            [
+                "Blood",
+                "tests:",
+                "leukocytosis",
+                "with",
+                "left",
+                "shift."
+            ],
+            [
+                "Blood",
+                "pressure",
+                "is",
+                "90/60",
+                "mmHg."
+            ],
+            [
+                "No",
+                "murmurs",
+                "are",
+                "heard",
+                "on",
+                "cardiac",
+                "auscultation",
+                "and",
+                "chest",
+                "X-ray",
+                "rules",
+                "out",
+                "pneumonia."
+            ],
+            [
+                "As",
+                "history",
+                "of",
+                "interest",
+                "she",
+                "refers",
+                "repeated",
+                "urinary",
+                "tract",
+                "infections."
+            ],
+            [
+                "A",
+                "week",
+                "ago",
+                "the",
+                "primary",
+                "care",
+                "physician",
+                "prescribed",
+                "cefuroxime,",
+                "a",
+                "drug",
+                "he",
+                "is",
+                "currently",
+                "taking."
+            ],
+            [
+                "Two",
+                "blood",
+                "cultures",
+                "were",
+                "taken",
+                "and",
+                "urine",
+                "was",
+                "sent",
+                "for",
+                "sediment",
+                "examination",
+                "and",
+                "microbiological",
+                "culture."
+            ],
+            [
+                "The",
+                "sediment",
+                "was",
+                "pathological,",
+                "with",
+                "intense",
+                "pyuria,",
+                "but",
+                "negative",
+                "nitrites."
+            ],
+            [
+                "After",
+                "24",
+                "hours,",
+                "the",
+                "microbiology",
+                "laboratory",
+                "reported",
+                "that",
+                "both",
+                "the",
+                "urine",
+                "and",
+                "the",
+                "blood",
+                "cultures",
+                "were",
+                "positive,",
+                "and",
+                "the",
+                "results",
+                "showed",
+                "gram-positive",
+                "cocci",
+                "grouped",
+                "in",
+                "chains,",
+                "pending",
+                "identification",
+                "and",
+                "antibiogram."
+            ],
+            [
+                "Pending",
+                "the",
+                "definitive",
+                "result,",
+                "what",
+                "would",
+                "you",
+                "recommend?"
+            ],
+            [
+                "1-",
+                "Continue",
+                "with",
+                "cefuroxime",
+                "while",
+                "awaiting",
+                "the",
+                "definitive",
+                "result,",
+                "since",
+                "the",
+                "patient",
+                "has",
+                "undergone",
+                "multiple",
+                "treatments",
+                "and",
+                "we",
+                "should",
+                "not",
+                "make",
+                "a",
+                "mistake",
+                "in",
+                "his",
+                "current",
+                "treatment."
+            ],
+            [
+                "2-",
+                "Change",
+                "to",
+                "ertapenem,",
+                "considering",
+                "the",
+                "possibility",
+                "of",
+                "multiresistant",
+                "microorganisms."
+            ],
+            [
+                "3-",
+                "Switch",
+                "to",
+                "a",
+                "broad-spectrum",
+                "antimicrobial",
+                "treatment",
+                "that",
+                "covers",
+                "Enterococcus",
+                "spp."
+            ],
+            [
+                "4-",
+                "Switch",
+                "to",
+                "broad-spectrum",
+                "antimicrobial",
+                "therapy",
+                "containing",
+                "imipenem,",
+                "considering",
+                "the",
+                "possibility",
+                "of",
+                "Staphylococcus",
+                "aureus,",
+                "since",
+                "our",
+                "hospital",
+                "has",
+                "a",
+                "high",
+                "incidence",
+                "of",
+                "methicillin-resistant",
+                "S.",
+                "aureus",
+                "(MRSA)."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "With",
+                "the",
+                "urine",
+                "nitrite",
+                "test",
+                "we",
+                "detect",
+                "the",
+                "presence",
+                "of",
+                "nitrites",
+                "in",
+                "the",
+                "urine."
+            ],
+            [
+                "These",
+                "appear",
+                "due",
+                "to",
+                "the",
+                "presence",
+                "in",
+                "the",
+                "urine",
+                "of",
+                "a",
+                "high",
+                "concentration",
+                "of",
+                "bacteria",
+                "possessing",
+                "the",
+                "enzyme",
+                "nitrate",
+                "reductase,",
+                "which",
+                "is",
+                "capable",
+                "of",
+                "reducing",
+                "the",
+                "nitrates",
+                "present",
+                "in",
+                "the",
+                "urine",
+                "to",
+                "nitrites."
+            ],
+            [
+                "This",
+                "enzyme",
+                "is",
+                "active",
+                "in",
+                "most",
+                "of",
+                "the",
+                "bacteria",
+                "that",
+                "most",
+                "frequently",
+                "cause",
+                "urinary",
+                "tract",
+                "infection,",
+                "such",
+                "as",
+                "many",
+                "Gram-negative",
+                "bacilli."
+            ],
+            [
+                "Other",
+                "microorganisms,",
+                "relatively",
+                "frequent",
+                "causes",
+                "of",
+                "urinary",
+                "tract",
+                "infection,",
+                "do",
+                "not",
+                "possess",
+                "this",
+                "enzyme",
+                "and",
+                "do",
+                "not",
+                "reduce",
+                "nitrates,",
+                "such",
+                "as",
+                "enterococci,",
+                "staphylococci",
+                "and",
+                "yeasts."
+            ],
+            [
+                "As",
+                "the",
+                "Gram",
+                "stain",
+                "indicates",
+                "that",
+                "the",
+                "bacteria",
+                "are",
+                "grouped",
+                "in",
+                "chains,",
+                "as",
+                "this",
+                "is",
+                "typical",
+                "of",
+                "enterococcus,",
+                "we",
+                "suggest",
+                "the",
+                "need",
+                "to",
+                "cover",
+                "this",
+                "group",
+                "of",
+                "bacteria",
+                "with",
+                "antibiotic",
+                "treatment."
+            ],
+            [
+                "Staphylococci",
+                "are",
+                "typically",
+                "seen",
+                "on",
+                "Gram",
+                "stain",
+                "as",
+                "Gram-positive",
+                "cocci",
+                "forming",
+                "clusters",
+                "and",
+                "yeasts,",
+                "although",
+                "with",
+                "the",
+                "same",
+                "staining,",
+                "have",
+                "a",
+                "different",
+                "typical",
+                "morphology",
+                "than",
+                "Gram-positive",
+                "cocci."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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-Premise",
+                "I-Premise",
+                "I-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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "393_224",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PSYCHIATRY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "patient",
+                "presents",
+                "with",
+                "a",
+                "long",
+                "history",
+                "of",
+                "multiple",
+                "physical",
+                "symptoms:",
+                "memory",
+                "loss,",
+                "headache,",
+                "dizziness,",
+                "vomiting,",
+                "genital",
+                "pain,",
+                "limb",
+                "pain,",
+                "abdominal",
+                "distention,",
+                "and",
+                "menstrual",
+                "irregularities."
+            ],
+            [
+                "The",
+                "various",
+                "medical",
+                "examinations",
+                "have",
+                "ruled",
+                "out",
+                "any",
+                "medical",
+                "illness."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "is",
+                "most",
+                "likely",
+                "to",
+                "be",
+                "the",
+                "case?"
+            ],
+            [
+                "1-",
+                "Conversive",
+                "disorder."
+            ],
+            [
+                "2-",
+                "Hypochondriac",
+                "disorder."
+            ],
+            [
+                "3-",
+                "Somatization",
+                "disorder."
+            ],
+            [
+                "4-",
+                "Dissociative",
+                "disorder."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "According",
+                "to",
+                "ICD-10",
+                "the",
+                "criteria",
+                "for",
+                "diagnosing",
+                "Somatization",
+                "Disorder",
+                "(F45.0)",
+                "are:",
+                "A."
+            ],
+            [
+                "History",
+                "of",
+                "multiple",
+                "physical",
+                "symptoms,",
+                "which",
+                "begins",
+                "before",
+                "age",
+                "30,",
+                "persists",
+                "for",
+                "several",
+                "years,",
+                "and",
+                "compels",
+                "seeking",
+                "medical",
+                "attention",
+                "or",
+                "causes",
+                "significant",
+                "impairment",
+                "socially,",
+                "occupationally,",
+                "or",
+                "in",
+                "other",
+                "important",
+                "areas",
+                "of",
+                "the",
+                "individual's",
+                "activity."
+            ],
+            [
+                "B."
+            ],
+            [
+                "All",
+                "of",
+                "the",
+                "following",
+                "criteria",
+                "must",
+                "be",
+                "met,",
+                "and",
+                "each",
+                "symptom",
+                "can",
+                "occur",
+                "at",
+                "any",
+                "time",
+                "during",
+                "the",
+                "disturbance:",
+                "1."
+            ],
+            [
+                "Four",
+                "painful",
+                "symptoms:",
+                "history",
+                "of",
+                "pain",
+                "related",
+                "to",
+                "at",
+                "least",
+                "four",
+                "areas",
+                "of",
+                "the",
+                "body",
+                "or",
+                "four",
+                "functions",
+                "(e.g.,",
+                "head,",
+                "abdomen,",
+                "back,",
+                "joints,",
+                "extremities,",
+                "chest,",
+                "rectum;",
+                "during",
+                "menstruation,",
+                "sexual",
+                "intercourse,",
+                "or",
+                "urination)."
+            ],
+            [
+                "Two",
+                "gastrointestinal",
+                "symptoms:",
+                "history",
+                "of",
+                "at",
+                "least",
+                "two",
+                "gastrointestinal",
+                "symptoms",
+                "other",
+                "than",
+                "pain",
+                "(e.g.,",
+                "nausea,",
+                "bloating,",
+                "vomiting",
+                "[not",
+                "during",
+                "pregnancy],",
+                "diarrhea,",
+                "or",
+                "intolerance",
+                "to",
+                "different",
+                "foods)."
+            ],
+            [
+                "3."
+            ],
+            [
+                "A",
+                "sexual",
+                "symptom:",
+                "history",
+                "of",
+                "at",
+                "least",
+                "one",
+                "sexual",
+                "or",
+                "reproductive",
+                "symptom",
+                "other",
+                "than",
+                "pain",
+                "(e.g.,",
+                "sexual",
+                "indifference,",
+                "erectile",
+                "or",
+                "ejaculatory",
+                "dysfunction,",
+                "irregular",
+                "menses,",
+                "excessive",
+                "menstrual",
+                "leakage,",
+                "vomiting",
+                "during",
+                "pregnancy)."
+            ],
+            [
+                "4."
+            ],
+            [
+                "A",
+                "pseudoneurological",
+                "symptom:",
+                "History",
+                "of",
+                "at",
+                "least",
+                "one",
+                "symptom",
+                "or",
+                "deficit",
+                "suggestive",
+                "of",
+                "a",
+                "neurological",
+                "disorder",
+                "not",
+                "limited",
+                "to",
+                "pain",
+                "(conversion",
+                "symptoms",
+                "of",
+                "the",
+                "type",
+                "of",
+                "impaired",
+                "psychomotor",
+                "coordination",
+                "or",
+                "balance,",
+                "localized",
+                "muscle",
+                "paralysis",
+                "or",
+                "weakness,",
+                "difficulty",
+                "swallowing,",
+                "lump-in-throat",
+                "sensation,",
+                "aphonia,",
+                "urinary",
+                "retention,",
+                "hallucinations,",
+                "loss",
+                "of",
+                "tactile",
+                "and",
+                "painful",
+                "sensation,",
+                "diplopia,",
+                "blindness,",
+                "deafness,",
+                "seizures;",
+                "dissociative",
+                "symptoms",
+                "such",
+                "as",
+                "amnesia;",
+                "or",
+                "loss",
+                "of",
+                "consciousness",
+                "other",
+                "than",
+                "fainting)."
+            ],
+            [
+                "C."
+            ],
+            [
+                "Either",
+                "of",
+                "the",
+                "following",
+                "two",
+                "characteristics:",
+                "1."
+            ],
+            [
+                "Upon",
+                "adequate",
+                "examination,",
+                "none",
+                "of",
+                "the",
+                "symptoms",
+                "in",
+                "Criterion",
+                "B",
+                "can",
+                "be",
+                "explained",
+                "by",
+                "the",
+                "presence",
+                "of",
+                "a",
+                "known",
+                "medical",
+                "illness",
+                "or",
+                "by",
+                "the",
+                "direct",
+                "effects",
+                "of",
+                "a",
+                "substance",
+                "(e.g.,",
+                "drugs",
+                "or",
+                "medication)."
+            ],
+            [
+                "2."
+            ],
+            [
+                "If",
+                "a",
+                "medical",
+                "illness",
+                "is",
+                "present,",
+                "the",
+                "physical",
+                "symptoms",
+                "or",
+                "social",
+                "or",
+                "occupational",
+                "impairment",
+                "are",
+                "excessive",
+                "compared",
+                "to",
+                "what",
+                "would",
+                "be",
+                "expected",
+                "from",
+                "the",
+                "history,",
+                "physical",
+                "examination,",
+                "or",
+                "laboratory",
+                "findings."
+            ],
+            [
+                "D."
+            ],
+            [
+                "The",
+                "symptoms",
+                "are",
+                "not",
+                "intentionally",
+                "produced",
+                "and",
+                "are",
+                "not",
+                "simulated",
+                "(unlike",
+                "in",
+                "factitious",
+                "disorder",
+                "and",
+                "simulation)."
+            ],
+            [
+                "Everything",
+                "fits",
+                "with",
+                "what",
+                "is",
+                "described",
+                "in",
+                "the",
+                "statement."
+            ],
+            [
+                "Conversive",
+                "or",
+                "dissociative",
+                "disorder",
+                "is",
+                "ruled",
+                "out",
+                "because",
+                "these",
+                "are",
+                "usually",
+                "related",
+                "to",
+                "psychological",
+                "factors,",
+                "associated",
+                "with",
+                "the",
+                "symptom",
+                "or",
+                "deficit",
+                "(not",
+                "deliberate)."
+            ],
+            [
+                "The",
+                "onset",
+                "or",
+                "exacerbation",
+                "of",
+                "the",
+                "condition",
+                "is",
+                "preceded",
+                "by",
+                "conflicts",
+                "or",
+                "other",
+                "triggers,",
+                "which",
+                "is",
+                "not",
+                "mentioned",
+                "in",
+                "the",
+                "statement."
+            ],
+            [
+                "Neither",
+                "would",
+                "it",
+                "be",
+                "a",
+                "hypochondriacal",
+                "disorder",
+                "because",
+                "this",
+                "implies",
+                "a",
+                "preoccupation",
+                "and",
+                "fear",
+                "of",
+                "having,",
+                "or",
+                "the",
+                "conviction",
+                "of",
+                "having,",
+                "a",
+                "serious",
+                "illness",
+                "based",
+                "on",
+                "the",
+                "personal",
+                "interpretation",
+                "of",
+                "somatic",
+                "symptoms."
+            ],
+            [
+                "But",
+                "it",
+                "does",
+                "not",
+                "involve",
+                "physical",
+                "signs",
+                "or",
+                "symptoms."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "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-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "124_46",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEPHROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "58-year-old",
+                "woman",
+                "comes",
+                "for",
+                "a",
+                "follow-up",
+                "visit",
+                "for",
+                "diabetes",
+                "mellitus",
+                "and",
+                "hypertension."
+            ],
+            [
+                "She",
+                "feels",
+                "well",
+                "but",
+                "states",
+                "that",
+                "she",
+                "has",
+                "stopped",
+                "taking",
+                "verapamil",
+                "because",
+                "of",
+                "constipation."
+            ],
+            [
+                "She",
+                "presents",
+                "with",
+                "intolerance",
+                "to",
+                "ACE",
+                "inhibitors",
+                "due",
+                "to",
+                "coughing."
+            ],
+            [
+                "On",
+                "examination,",
+                "blood",
+                "pressure",
+                "is",
+                "156/92",
+                "mm",
+                "Hg."
+            ],
+            [
+                "CBC",
+                "includes",
+                "a",
+                "creatinine",
+                "of",
+                "1.6",
+                "mg/dL,",
+                "24-hour",
+                "urine",
+                "protein",
+                "excretion",
+                "of",
+                "1.5",
+                "g/day,",
+                "and",
+                "a",
+                "creatinine",
+                "clearance",
+                "of",
+                "45",
+                "ml/min."
+            ],
+            [
+                "On",
+                "this",
+                "basis,",
+                "what",
+                "is",
+                "the",
+                "most",
+                "effective",
+                "treatment",
+                "to",
+                "slow",
+                "the",
+                "progression",
+                "of",
+                "the",
+                "patient's",
+                "type",
+                "2",
+                "diabetic",
+                "nephropathy?"
+            ],
+            [
+                "1-",
+                "Angiotensin",
+                "converting",
+                "enzyme",
+                "inhibitor."
+            ],
+            [
+                "2-",
+                "Angiotensin",
+                "receptor",
+                "blocker."
+            ],
+            [
+                "3-",
+                "Calcium",
+                "antagonist."
+            ],
+            [
+                "4-",
+                "Alpha-blocker."
+            ],
+            [
+                "5-",
+                "Beta-blocker."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "This",
+                "question",
+                "is",
+                "typical",
+                "and",
+                "quite",
+                "easy."
+            ],
+            [
+                "The",
+                "antihypertensive",
+                "drugs",
+                "that",
+                "have",
+                "been",
+                "shown",
+                "to",
+                "slow",
+                "the",
+                "progression",
+                "of",
+                "diabetic",
+                "nephropathy",
+                "are",
+                "the",
+                "ACE",
+                "inhibitors",
+                "and",
+                "ARAIIs."
+            ],
+            [
+                "Specifically,",
+                "angiotensin",
+                "II",
+                "receptor",
+                "blockers",
+                "have",
+                "demonstrated",
+                "their",
+                "efficacy",
+                "in",
+                "this",
+                "field",
+                "for",
+                "type",
+                "2",
+                "DM,",
+                "which",
+                "together",
+                "with",
+                "the",
+                "side",
+                "effects",
+                "that",
+                "IECAS",
+                "produce",
+                "in",
+                "the",
+                "patient",
+                "makes",
+                "an",
+                "ARAII",
+                "the",
+                "drug",
+                "of",
+                "choice."
+            ],
+            [
+                "This",
+                "does",
+                "not",
+                "seem",
+                "to",
+                "me",
+                "to",
+                "be",
+                "an",
+                "open",
+                "question",
+                "(without",
+                "going",
+                "into",
+                "pharmacoeconomic",
+                "issues,",
+                "of",
+                "course...)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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",
+                "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-Disease",
+                "I-Disease",
+                "I-Disease",
+                "I-Disease"
+            ],
+            [
+                "O",
+                "B-Treatment",
+                "I-Treatment",
+                "I-Treatment",
+                "I-Treatment"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "405_31",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ONCOLOGY",
+                "(ECTOPIC)"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "20-year-old",
+                "woman",
+                "with",
+                "a",
+                "15-cm",
+                "solid-cystic",
+                "ovarian",
+                "tumor",
+                "detected",
+                "by",
+                "ultrasound",
+                "after",
+                "presenting",
+                "with",
+                "nonspecific",
+                "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:",
+                "2"
+            ],
+            [
+                "Teratoma",
+                "is",
+                "the",
+                "most",
+                "frequent",
+                "germinal",
+                "tumor."
+            ],
+            [
+                "It",
+                "presents",
+                "differentiation",
+                "in",
+                "elements",
+                "of",
+                "the",
+                "three",
+                "embryonic",
+                "layers:",
+                "endoderm,",
+                "mesoderm",
+                "and",
+                "ectoderm."
+            ],
+            [
+                "Macroscopically",
+                "they",
+                "can",
+                "be",
+                "cystic",
+                "or",
+                "solid,",
+                "and",
+                "histologically",
+                "the",
+                "tissues",
+                "composing",
+                "the",
+                "tumor",
+                "can",
+                "be",
+                "mature",
+                "(well",
+                "differentiated,",
+                "like",
+                "adult",
+                "tissues)",
+                "or",
+                "immature",
+                "(like",
+                "embryonic",
+                "tissues).Mature",
+                "cystic",
+                "teratoma",
+                "is",
+                "the",
+                "most",
+                "frequent:",
+                "they",
+                "represent",
+                "on",
+                "average",
+                "10%",
+                "of",
+                "ovarian",
+                "tumors",
+                "(5-25%",
+                "depending",
+                "on",
+                "the",
+                "casuistry)."
+            ],
+            [
+                "They",
+                "occur",
+                "at",
+                "any",
+                "age."
+            ],
+            [
+                "They",
+                "predominate",
+                "in",
+                "ectodermal",
+                "tissues,",
+                "such",
+                "as",
+                "skin,",
+                "lining",
+                "a",
+                "cavity",
+                "of",
+                "keratinous",
+                "content."
+            ],
+            [
+                "In",
+                "the",
+                "cavity",
+                "a",
+                "spur",
+                "is",
+                "recognized",
+                "from",
+                "which",
+                "hair",
+                "or",
+                "tooth",
+                "structures",
+                "often",
+                "arise."
+            ],
+            [
+                "Frequent",
+                "tissues",
+                "include:",
+                "nervous",
+                "tissue,",
+                "usually",
+                "glial",
+                "and",
+                "ependymal",
+                "epithelium,",
+                "respiratory",
+                "and",
+                "digestive",
+                "epithelia",
+                "and",
+                "various",
+                "mesodermal",
+                "structures."
+            ],
+            [
+                "They",
+                "are",
+                "bilateral",
+                "in",
+                "about",
+                "10%",
+                "of",
+                "cases."
+            ],
+            [
+                "The",
+                "mature",
+                "cystic",
+                "teratoma",
+                "is",
+                "benign,",
+                "but",
+                "in",
+                "2%",
+                "of",
+                "them",
+                "a",
+                "malignant",
+                "tumor",
+                "may",
+                "develop",
+                "from",
+                "one",
+                "of",
+                "the",
+                "tissue",
+                "components",
+                "(spinocellular",
+                "carcinoma,",
+                "carcinoid,",
+                "adenocarcinoma,",
+                "thyroid",
+                "tissue",
+                "carcinoma,",
+                "sarcoma)."
+            ],
+            [
+                "In",
+                "this",
+                "case",
+                "at",
+                "first",
+                "we",
+                "thought",
+                "that",
+                "the",
+                "option",
+                "was",
+                "mature",
+                "cystic",
+                "teratoma",
+                "but",
+                "thanks",
+                "to",
+                "Ram\u00f3n,",
+                "when",
+                "we",
+                "read",
+                "it",
+                "more",
+                "carefully,",
+                "we",
+                "found",
+                "that",
+                "it",
+                "had",
+                "neuroectodermal",
+                "and",
+                "embryonal",
+                "elements",
+                "in",
+                "several",
+                "of",
+                "the",
+                "histological",
+                "preparations,",
+                "so",
+                "we",
+                "consider",
+                "that",
+                "the",
+                "correct",
+                "answer",
+                "is",
+                "2."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "497_127",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "MEDICAL",
+                "ONCOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "60-year-old",
+                "man,",
+                "smoker",
+                "of",
+                "40",
+                "packs/year,",
+                "who",
+                "consults",
+                "for",
+                "pain",
+                "in",
+                "the",
+                "ulnar",
+                "border",
+                "of",
+                "the",
+                "left",
+                "arm",
+                "and",
+                "left",
+                "palpebral",
+                "ptosis",
+                "since",
+                "one",
+                "month",
+                "ago."
+            ],
+            [
+                "Chest",
+                "X-ray",
+                "shows",
+                "a",
+                "mass",
+                "in",
+                "the",
+                "left",
+                "upper",
+                "lobe",
+                "and",
+                "CT",
+                "scan",
+                "confirms",
+                "the",
+                "lesion",
+                "with",
+                "invasion",
+                "of",
+                "the",
+                "second",
+                "rib."
+            ],
+            [
+                "In",
+                "relation",
+                "to",
+                "the",
+                "suspected",
+                "diagnosis,",
+                "the",
+                "most",
+                "appropriate",
+                "treatment",
+                "is:"
+            ],
+            [
+                "1-",
+                "Neoadjuvant",
+                "chemotherapy",
+                "with",
+                "combined",
+                "chemoradiotherapy,",
+                "followed",
+                "by",
+                "surgery."
+            ],
+            [
+                "2-",
+                "Neoadjuvant",
+                "chemotherapy",
+                "without",
+                "surgery,",
+                "followed",
+                "by",
+                "radiotherapy."
+            ],
+            [
+                "3-",
+                "Surgery",
+                "followed",
+                "by",
+                "combined",
+                "chemoradiotherapy."
+            ],
+            [
+                "4-",
+                "Radiotherapy",
+                "without",
+                "chemotherapy,",
+                "followed",
+                "by",
+                "surgery."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Typical",
+                "smoker's",
+                "pancoast,",
+                "probably",
+                "an",
+                "epidermoid,",
+                "with",
+                "Horner's",
+                "sdr."
+            ],
+            [
+                "Best",
+                "would",
+                "be",
+                "chemoradio",
+                "followed",
+                "by",
+                "surgical",
+                "salvage."
+            ],
+            [
+                "In",
+                "the",
+                "old",
+                "days",
+                "it",
+                "was",
+                "just",
+                "RT",
+                "and",
+                "surgery."
+            ],
+            [
+                "Maybe",
+                "not",
+                "far",
+                "off",
+                "enter",
+                "immunotherapy",
+                "in",
+                "first",
+                "line."
+            ],
+            [
+                "There",
+                "are",
+                "more",
+                "and",
+                "more",
+                "new",
+                "things."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "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",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "307_207",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "OPHTHALMOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "34-year-old",
+                "patient",
+                "playing",
+                "tennis",
+                "is",
+                "hit",
+                "by",
+                "a",
+                "ball",
+                "at",
+                "the",
+                "level",
+                "of",
+                "the",
+                "left",
+                "orbit."
+            ],
+            [
+                "On",
+                "examination",
+                "he",
+                "presents",
+                "significant",
+                "palpebral",
+                "hematoma,",
+                "hyposphagmia,",
+                "diplopia",
+                "to",
+                "superior",
+                "vision",
+                "with",
+                "limitation",
+                "of",
+                "the",
+                "upper",
+                "version",
+                "of",
+                "the",
+                "eyeball."
+            ],
+            [
+                "What",
+                "would",
+                "you",
+                "suspect?"
+            ],
+            [
+                "1-",
+                "Fracture",
+                "of",
+                "the",
+                "inferior",
+                "wall",
+                "of",
+                "the",
+                "floor",
+                "of",
+                "the",
+                "orbit",
+                "with",
+                "trapping",
+                "of",
+                "the",
+                "inferior",
+                "rectus",
+                "muscle."
+            ],
+            [
+                "2-",
+                "Zygomatic",
+                "arch",
+                "fracture."
+            ],
+            [
+                "3-",
+                "Fracture",
+                "of",
+                "the",
+                "superior",
+                "wall",
+                "of",
+                "the",
+                "orbit",
+                "with",
+                "entrapment",
+                "of",
+                "the",
+                "superior",
+                "rectus",
+                "muscle."
+            ],
+            [
+                "4-",
+                "Dentoalveolar",
+                "fracture."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "This",
+                "question",
+                "has",
+                "a",
+                "small",
+                "typo",
+                "(one",
+                "would",
+                "say",
+                "\"tennis\"),",
+                "but",
+                "personally",
+                "I",
+                "am",
+                "a",
+                "little",
+                "more",
+                "bothered",
+                "by",
+                "the",
+                "error",
+                "in",
+                "the",
+                "description",
+                "of",
+                "the",
+                "scan."
+            ],
+            [
+                "Specifically",
+                "when",
+                "they",
+                "say",
+                "\"diplopia",
+                "to",
+                "superior",
+                "vision",
+                "with",
+                "limitation",
+                "of",
+                "the",
+                "superior",
+                "version",
+                "of",
+                "the",
+                "eyeball\"."
+            ],
+            [
+                "Versions",
+                "are",
+                "bilateral",
+                "conjugated",
+                "movements",
+                "of",
+                "both",
+                "eyes."
+            ],
+            [
+                "That",
+                "is,",
+                "a",
+                "version",
+                "is",
+                "composed",
+                "of",
+                "the",
+                "sum",
+                "of",
+                "two",
+                "ductions,",
+                "since",
+                "duction",
+                "is",
+                "the",
+                "movement",
+                "of",
+                "only",
+                "one",
+                "eye."
+            ],
+            [
+                "When",
+                "you",
+                "explore",
+                "the",
+                "versions,",
+                "specifically",
+                "the",
+                "superior",
+                "version",
+                "or",
+                "supraversion,",
+                "both",
+                "eyes",
+                "rotate",
+                "upward."
+            ],
+            [
+                "At",
+                "that",
+                "time,",
+                "you",
+                "may",
+                "encounter",
+                "a",
+                "limitation",
+                "of",
+                "the",
+                "movement",
+                "of",
+                "one",
+                "eye."
+            ],
+            [
+                "In",
+                "this",
+                "case,",
+                "when",
+                "you",
+                "scan",
+                "the",
+                "supraversion,",
+                "you",
+                "suspect",
+                "or",
+                "you",
+                "detect",
+                "a",
+                "limitation",
+                "in",
+                "the",
+                "movement",
+                "of",
+                "the",
+                "left",
+                "eye."
+            ],
+            [
+                "And",
+                "we",
+                "would",
+                "call",
+                "this",
+                "a",
+                "limitation",
+                "to",
+                "the",
+                "supraversion",
+                "of",
+                "that",
+                "eye."
+            ],
+            [
+                "It",
+                "doesn't",
+                "make",
+                "sense",
+                "to",
+                "talk",
+                "about",
+                "limitation",
+                "to",
+                "the",
+                "version",
+                "of",
+                "the",
+                "eyeball,",
+                "because",
+                "the",
+                "version",
+                "is",
+                "always",
+                "of",
+                "both",
+                "eyeballs."
+            ],
+            [
+                "Okay,",
+                "it",
+                "is",
+                "understood,",
+                "but",
+                "it",
+                "is",
+                "an",
+                "important",
+                "misconception",
+                "that",
+                "should",
+                "not",
+                "be",
+                "made",
+                "by",
+                "the",
+                "person",
+                "writing",
+                "the",
+                "question",
+                "(who",
+                "is",
+                "supposed",
+                "to",
+                "be",
+                "an",
+                "expert",
+                "on",
+                "the",
+                "subject),",
+                "but",
+                "well,",
+                "as",
+                "I",
+                "do",
+                "not",
+                "think",
+                "it",
+                "is",
+                "a",
+                "reason",
+                "to",
+                "challenge",
+                "the",
+                "question,",
+                "let's",
+                "go",
+                "on."
+            ],
+            [
+                "It",
+                "is",
+                "about",
+                "a",
+                "patient",
+                "who",
+                "has",
+                "received",
+                "a",
+                "blow."
+            ],
+            [
+                "All",
+                "four",
+                "answers",
+                "are",
+                "fractures,",
+                "so",
+                "we",
+                "have",
+                "a",
+                "pretty",
+                "definite",
+                "picture."
+            ],
+            [
+                "The",
+                "palpebral",
+                "hematoma",
+                "and",
+                "hyposphagma",
+                "(subconjunctival",
+                "hemorrhage)",
+                "does",
+                "not",
+                "give",
+                "us",
+                "the",
+                "key",
+                "data."
+            ],
+            [
+                "What",
+                "is",
+                "important",
+                "is",
+                "that",
+                "the",
+                "eye",
+                "that",
+                "has",
+                "received",
+                "the",
+                "blow",
+                "does",
+                "not",
+                "go",
+                "up,",
+                "and",
+                "therefore",
+                "there",
+                "is",
+                "double",
+                "vision",
+                "in",
+                "the",
+                "superior",
+                "gaze."
+            ],
+            [
+                "It",
+                "might",
+                "be",
+                "tempting",
+                "to",
+                "answer",
+                "3,",
+                "thinking",
+                "that",
+                "because",
+                "the",
+                "superior",
+                "rectus",
+                "is",
+                "trapped,",
+                "it",
+                "does",
+                "not",
+                "work",
+                "and",
+                "therefore",
+                "the",
+                "eye",
+                "cannot",
+                "go",
+                "up."
+            ],
+            [
+                "However,",
+                "muscles",
+                "trapped",
+                "in",
+                "a",
+                "fracture",
+                "do",
+                "not",
+                "automatically",
+                "lose",
+                "their",
+                "muscular",
+                "action."
+            ],
+            [
+                "What",
+                "happens",
+                "is",
+                "that",
+                "they",
+                "become",
+                "trapped,",
+                "they",
+                "are",
+                "\"hooked\",",
+                "and",
+                "cannot",
+                "stretch."
+            ],
+            [
+                "The",
+                "problem",
+                "is",
+                "that",
+                "the",
+                "inferior",
+                "wall",
+                "has",
+                "been",
+                "broken,",
+                "the",
+                "inferior",
+                "rectus",
+                "has",
+                "been",
+                "trapped,",
+                "and",
+                "when",
+                "the",
+                "eye",
+                "must",
+                "look",
+                "up,",
+                "this",
+                "inferior",
+                "rectus",
+                "cannot",
+                "stretch",
+                "as",
+                "it",
+                "should."
+            ],
+            [
+                "It",
+                "is",
+                "not",
+                "paralysis,",
+                "but",
+                "a",
+                "restrictive",
+                "problem."
+            ],
+            [
+                "This",
+                "question",
+                "could",
+                "also",
+                "be",
+                "answered",
+                "by",
+                "discarding."
+            ],
+            [
+                "Options",
+                "2",
+                "and",
+                "4",
+                "can",
+                "be",
+                "ignored",
+                "because",
+                "they",
+                "are",
+                "too",
+                "far",
+                "away",
+                "from",
+                "the",
+                "extraocular",
+                "muscles",
+                "to",
+                "produce",
+                "diplopia."
+            ],
+            [
+                "And",
+                "as",
+                "for",
+                "the",
+                "walls",
+                "of",
+                "the",
+                "orbit,",
+                "the",
+                "ones",
+                "that",
+                "break",
+                "most",
+                "frequently",
+                "are",
+                "the",
+                "inferior",
+                "and",
+                "medial",
+                "wall."
+            ],
+            [
+                "The",
+                "superior",
+                "wall",
+                "ruptures",
+                "very",
+                "rarely."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "589_63",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "350_160",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "45-year-old",
+                "woman,",
+                "mother",
+                "of",
+                "3",
+                "children,",
+                "attends",
+                "an",
+                "early",
+                "diagnosis",
+                "consultation."
+            ],
+            [
+                "Cervicovaginal",
+                "cytology",
+                "is",
+                "compatible",
+                "with",
+                "a",
+                "high-grade",
+                "squamous",
+                "intraepithelial",
+                "lesion."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "options",
+                "would",
+                "you",
+                "choose?"
+            ],
+            [
+                "1-",
+                "Repeat",
+                "cytology",
+                "in",
+                "1",
+                "month."
+            ],
+            [
+                "2-",
+                "Colposcopy",
+                "with",
+                "possible",
+                "biopsy."
+            ],
+            [
+                "3-",
+                "Hysterectomy",
+                "with",
+                "bilateral",
+                "salpinguectomy",
+                "and",
+                "ovarian",
+                "conservation."
+            ],
+            [
+                "4-",
+                "Fractionated",
+                "uterine",
+                "curettage."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Colposcopy",
+                "with",
+                "possible",
+                "biopsy."
+            ],
+            [
+                "H-SIL",
+                "(High-grade",
+                "squamous",
+                "intraepithelial",
+                "lesion)*:",
+                "includes",
+                "changes",
+                "suggestive",
+                "of",
+                "CIN2",
+                "and",
+                "CIN3/CIS."
+            ],
+            [
+                "The",
+                "cytologic",
+                "diagnosis",
+                "must",
+                "be",
+                "confirmed",
+                "by",
+                "biopsy,",
+                "for",
+                "which",
+                "it",
+                "is",
+                "necessary",
+                "to",
+                "perform",
+                "a",
+                "directed",
+                "biopsy",
+                "by",
+                "colposcopy."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "25_116",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTIOUS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "40-year-old",
+                "woman",
+                "is",
+                "admitted",
+                "to",
+                "the",
+                "Emergency",
+                "Department",
+                "with",
+                "a",
+                "fever",
+                "of",
+                "38\u00baC",
+                "and",
+                "right",
+                "lumbar",
+                "pain."
+            ],
+            [
+                "The",
+                "CBC",
+                "shows",
+                "25000",
+                "leukocytes/mm3",
+                "with",
+                "left",
+                "deviation",
+                "and",
+                "an",
+                "abdominal",
+                "ultrasound",
+                "shows",
+                "a",
+                "coralliform",
+                "lithiasis."
+            ],
+            [
+                "What",
+                "microorganism",
+                "do",
+                "we",
+                "expect",
+                "to",
+                "find?"
+            ],
+            [
+                "1-",
+                "Escherichia",
+                "coli."
+            ],
+            [
+                "2-",
+                "Enterococcus",
+                "faecalis."
+            ],
+            [
+                "3-",
+                "Salmonella",
+                "typhi."
+            ],
+            [
+                "4-",
+                "Candida",
+                "albicans."
+            ],
+            [
+                "5-",
+                "Proteus",
+                "mirabilis."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "Epidemiology",
+                "question",
+                "shared",
+                "with",
+                "URO."
+            ],
+            [
+                "Coraliform",
+                "lithiasis",
+                "are",
+                "associated",
+                "with",
+                "urea-folding",
+                "germs:",
+                "Proteus",
+                "in",
+                "the",
+                "first",
+                "place,",
+                "Pseudomonas,",
+                "Klebsiella",
+                "and",
+                "some",
+                "staphylococci."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "103_89",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "22_112",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTIOUS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "patient",
+                "comes",
+                "to",
+                "the",
+                "Emergency",
+                "Department",
+                "with",
+                "fever",
+                "without",
+                "focus",
+                "of",
+                "24",
+                "h",
+                "of",
+                "evolution,",
+                "hypothyroidism",
+                "and",
+                "impression",
+                "of",
+                "severity."
+            ],
+            [
+                "She",
+                "underwent",
+                "a",
+                "splenectomy",
+                "2",
+                "years",
+                "ago",
+                "for",
+                "staging",
+                "of",
+                "Hosgkin's",
+                "disease."
+            ],
+            [
+                "Which",
+                "microorganism",
+                "is",
+                "most",
+                "frequently",
+                "implicated?"
+            ],
+            [
+                "1-",
+                "Streptococcus",
+                "pneumoniae."
+            ],
+            [
+                "2-",
+                "Pseudomonas",
+                "aeruginosa."
+            ],
+            [
+                "3-",
+                "Salmonella",
+                "no",
+                "typhi."
+            ],
+            [
+                "4-",
+                "Pneumocystis",
+                "jirovecii."
+            ],
+            [
+                "5-",
+                "Streptococcus",
+                "viridans."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Another",
+                "one",
+                "on",
+                "epidemiology."
+            ],
+            [
+                "In",
+                "splenectomized",
+                "patients,",
+                "the",
+                "risk",
+                "of",
+                "acquiring",
+                "serious",
+                "infections",
+                "by",
+                "encapsulated",
+                "germs",
+                "is",
+                "increased,",
+                "again",
+                "Pneumococcus",
+                "being",
+                "the",
+                "most",
+                "frequent."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-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",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "488_105",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "HEMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "67-year-old",
+                "patient",
+                "who",
+                "in",
+                "the",
+                "last",
+                "6",
+                "months,",
+                "in",
+                "two",
+                "routine",
+                "analyses,",
+                "presents",
+                "progressive",
+                "lymphocytosis."
+            ],
+            [
+                "In",
+                "the",
+                "last",
+                "one,",
+                "hemoglobin",
+                "15.4",
+                "g/dL;",
+                "leukocytes",
+                "18.5",
+                "x103/\u03bcL",
+                "with",
+                "82%",
+                "of",
+                "mature",
+                "lymphocytes",
+                "that",
+                "by",
+                "flow",
+                "cytometry",
+                "express",
+                "CD5/CD19/CD23",
+                "antigens",
+                "and",
+                "platelets",
+                "240",
+                "x103/\u03bcL."
+            ],
+            [
+                "What",
+                "attitude",
+                "do",
+                "you",
+                "think",
+                "is",
+                "correct?"
+            ],
+            [
+                "1-",
+                "Study",
+                "of",
+                "TP53",
+                "mutations",
+                "to",
+                "establish",
+                "prognosis."
+            ],
+            [
+                "2-",
+                "Bone",
+                "aspirate/biopsy",
+                "to",
+                "confirm",
+                "the",
+                "diagnosis."
+            ],
+            [
+                "3-",
+                "PET/CT",
+                "to",
+                "establish",
+                "the",
+                "therapeutic",
+                "attitude."
+            ],
+            [
+                "4-",
+                "New",
+                "clinical",
+                "and",
+                "analytical",
+                "control",
+                "in",
+                "6",
+                "months."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "A",
+                "question",
+                "that",
+                "I",
+                "think",
+                "can",
+                "be",
+                "complicated",
+                "for",
+                "a",
+                "MIR",
+                "examiner."
+            ],
+            [
+                "We",
+                "are",
+                "told",
+                "of",
+                "a",
+                "leukocytosis",
+                "at",
+                "the",
+                "expense",
+                "of",
+                "lymphocytes",
+                "with",
+                "a",
+                "B-CLL",
+                "phenotype."
+            ],
+            [
+                "It",
+                "seems",
+                "that",
+                "there",
+                "are",
+                "no",
+                "other",
+                "alarming",
+                "data."
+            ],
+            [
+                "No",
+                "clinical",
+                "data",
+                "are",
+                "given",
+                "(so",
+                "we",
+                "assume",
+                "that",
+                "the",
+                "patient",
+                "is",
+                "asymptomatic)."
+            ],
+            [
+                "No",
+                "cytopenias..."
+            ],
+            [
+                "Conclusion:",
+                "FOLLOW",
+                "UP."
+            ],
+            [
+                "The",
+                "main",
+                "hesitation",
+                "with",
+                "the",
+                "answer",
+                "should",
+                "be",
+                "with",
+                "option",
+                "1."
+            ],
+            [
+                "Why",
+                "do",
+                "I",
+                "consider",
+                "it",
+                "incorrect?"
+            ],
+            [
+                "Because",
+                "the",
+                "TP53",
+                "mutation,",
+                "although",
+                "it",
+                "establishes",
+                "prognosis,",
+                "is",
+                "not",
+                "indicated",
+                "at",
+                "diagnosis,",
+                "but",
+                "when",
+                "treatment",
+                "is",
+                "going",
+                "to",
+                "be",
+                "initiated",
+                "(first",
+                "line",
+                "and",
+                "prior",
+                "to",
+                "successive",
+                "lines",
+                "in",
+                "case",
+                "they",
+                "are",
+                "needed)."
+            ],
+            [
+                "It",
+                "would",
+                "be",
+                "possible",
+                "to",
+                "go",
+                "too",
+                "far",
+                "in",
+                "this",
+                "question",
+                "in",
+                "which",
+                "the",
+                "percentage",
+                "given",
+                "does",
+                "not",
+                "refer",
+                "directly",
+                "to",
+                "clonal",
+                "lymphocytes,",
+                "so",
+                "that",
+                "it",
+                "could",
+                "even",
+                "be",
+                "a",
+                "monoclonal",
+                "B",
+                "lymphocytosis."
+            ],
+            [
+                "But",
+                "this",
+                "is",
+                "going",
+                "too",
+                "far."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-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",
+                "I-Claim"
+            ],
+            [
+                "B-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "111_153",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "59-year-old",
+                "woman",
+                "consults",
+                "a",
+                "gynecologist",
+                "for",
+                "a",
+                "spontaneous,",
+                "spontaneous,",
+                "uniorificial",
+                "discharge",
+                "from",
+                "the",
+                "right",
+                "nipple",
+                "(unilateral)",
+                "without",
+                "palpable",
+                "nodularity."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Given",
+                "the",
+                "hematic",
+                "nature",
+                "of",
+                "the",
+                "discharge,",
+                "the",
+                "most",
+                "likely",
+                "diagnosis",
+                "is",
+                "infiltrating",
+                "ductal",
+                "carcinoma."
+            ],
+            [
+                "2-",
+                "Intraductal",
+                "papilloma."
+            ],
+            [
+                "3-",
+                "Paget's",
+                "disease",
+                "of",
+                "the",
+                "nipple."
+            ],
+            [
+                "4-",
+                "Tumor",
+                "hyperprolactinemia."
+            ],
+            [
+                "5-",
+                "Mammography",
+                "will",
+                "indicate",
+                "the",
+                "diagnosis."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "2."
+            ],
+            [
+                "In",
+                "the",
+                "presence",
+                "of",
+                "unilateral",
+                "and",
+                "uniorificial",
+                "hematic",
+                "telorrhea,",
+                "the",
+                "most",
+                "frequent",
+                "cause",
+                "is",
+                "intraductal",
+                "papilloma",
+                "(50%),",
+                "followed",
+                "by",
+                "ductal",
+                "ectasia",
+                "and",
+                "carcinoma."
+            ],
+            [
+                "When",
+                "associated",
+                "with",
+                "palpable",
+                "mass,",
+                "60%",
+                "correspond",
+                "to",
+                "carcinoma."
+            ],
+            [
+                "Paget's",
+                "disease",
+                "is",
+                "of",
+                "the",
+                "eczematous",
+                "type."
+            ],
+            [
+                "In",
+                "hyperprolactinemia,",
+                "telorrhea",
+                "is",
+                "bilateral",
+                "and",
+                "pluriorificial."
+            ],
+            [
+                "Mammography",
+                "often",
+                "does",
+                "not",
+                "show",
+                "papillomas,",
+                "being",
+                "more",
+                "useful",
+                "ultrasound",
+                "and",
+                "galactography."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-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"
+            ],
+            [
+                "O",
+                "B-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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "119_119",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "17-year-old",
+                "woman",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "with",
+                "a",
+                "high",
+                "fever,",
+                "pharyngeal",
+                "pain",
+                "and",
+                "cervical",
+                "lymphadenopathy."
+            ],
+            [
+                "She",
+                "had",
+                "previously",
+                "been",
+                "diagnosed",
+                "with",
+                "acute",
+                "pharyngitis",
+                "and",
+                "was",
+                "treated",
+                "with",
+                "amoxicillin,",
+                "and",
+                "later",
+                "presented",
+                "with",
+                "a",
+                "generalized",
+                "macular",
+                "skin",
+                "rash."
+            ],
+            [
+                "Laboratory",
+                "tests",
+                "showed",
+                "slight",
+                "leukocytosis",
+                "with",
+                "lymphocytosis",
+                "and",
+                "presence",
+                "of",
+                "activated",
+                "lymphocytes,",
+                "slight",
+                "thrombopenia",
+                "and",
+                "slightly",
+                "increased",
+                "transaminases."
+            ],
+            [
+                "What",
+                "would",
+                "be",
+                "the",
+                "most",
+                "likely",
+                "diagnosis",
+                "of",
+                "this",
+                "clinical",
+                "picture?"
+            ],
+            [
+                "1-",
+                "It",
+                "is",
+                "a",
+                "typical",
+                "picture",
+                "of",
+                "infectious",
+                "mononucleosis."
+            ],
+            [
+                "2-",
+                "Varicella",
+                "zoster",
+                "virus",
+                "infection."
+            ],
+            [
+                "3-",
+                "Acute",
+                "toxoplasmosis."
+            ],
+            [
+                "4-",
+                "Lyme",
+                "disease."
+            ],
+            [
+                "5-",
+                "Infection",
+                "by",
+                "herpes",
+                "virus",
+                "8."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Of",
+                "course",
+                "it",
+                "is",
+                "a",
+                "typical",
+                "picture",
+                "(EBV,",
+                "CMV,",
+                "VH6,",
+                "Toxoplasma),",
+                "of",
+                "which",
+                "you",
+                "will",
+                "not",
+                "see",
+                "so",
+                "clearly",
+                "at",
+                "the",
+                "emergency",
+                "room",
+                "door",
+                "when",
+                "you",
+                "are",
+                "on",
+                "call."
+            ],
+            [
+                "Be",
+                "careful",
+                "with",
+                "the",
+                "bad",
+                "blood",
+                "in",
+                "answer",
+                "3,",
+                "because",
+                "an",
+                "acute",
+                "toxoplasmosis",
+                "can",
+                "behave",
+                "like",
+                "this",
+                "and",
+                "also",
+                "give",
+                "a",
+                "macular",
+                "exanthema,",
+                "although",
+                "the",
+                "one",
+                "of",
+                "this",
+                "girl",
+                "is",
+                "related",
+                "to",
+                "the",
+                "intake",
+                "of",
+                "amoxicillin."
+            ],
+            [
+                "By",
+                "the",
+                "way,",
+                "I",
+                "add",
+                "a",
+                "note,",
+                "if",
+                "instead",
+                "of",
+                "a",
+                "girl",
+                "of",
+                "17",
+                "years",
+                "so",
+                "clear",
+                "it",
+                "were",
+                "a",
+                "young",
+                "man/girl",
+                "with",
+                "risky",
+                "sexual",
+                "relations,",
+                "do",
+                "not",
+                "forget",
+                "the",
+                "HIV",
+                "primoinfection",
+                "as",
+                "a",
+                "cause",
+                "of",
+                "mononucleosis",
+                "syndrome."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-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"
+            ],
+            [
+                "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",
+                "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"
+            ],
+            [
+                "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-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "562_183",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "HEMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "45-year-old",
+                "woman",
+                "with",
+                "no",
+                "history",
+                "of",
+                "interest",
+                "consults",
+                "for",
+                "dyspneic",
+                "sensation",
+                "of",
+                "about",
+                "4",
+                "days",
+                "of",
+                "evolution."
+            ],
+            [
+                "Examination",
+                "shows",
+                "rhythmic",
+                "tachycardia,",
+                "without",
+                "murmurs,",
+                "and",
+                "pulmonary",
+                "auscultation",
+                "is",
+                "normal."
+            ],
+            [
+                "Arterial",
+                "blood",
+                "gases",
+                "showed",
+                "a",
+                "pO2",
+                "of",
+                "70",
+                "mmHg",
+                "and",
+                "a",
+                "pCO2",
+                "of",
+                "32",
+                "mmHg."
+            ],
+            [
+                "Hemogram,",
+                "renal",
+                "and",
+                "hepatic",
+                "function",
+                "are",
+                "normal."
+            ],
+            [
+                "Prothrombin",
+                "time",
+                "90%,",
+                "activated",
+                "partial",
+                "thromboplastin",
+                "time",
+                "(APTT)",
+                "ratio",
+                "of",
+                "2",
+                "to",
+                "control",
+                "(N",
+                "<1.2)."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "diagnoses",
+                "is",
+                "the",
+                "most",
+                "likely:"
+            ],
+            [
+                "1-",
+                "Antiphospholipid",
+                "syndrome."
+            ],
+            [
+                "2-",
+                "Factor",
+                "V",
+                "of",
+                "Leiden."
+            ],
+            [
+                "3-",
+                "Hemophilia."
+            ],
+            [
+                "4-",
+                "Acute",
+                "pericarditis."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "In",
+                "this",
+                "question",
+                "what",
+                "they",
+                "assume",
+                "is",
+                "that",
+                "this",
+                "is",
+                "a",
+                "45-year-old",
+                "woman",
+                "who",
+                "is",
+                "diagnosed",
+                "with",
+                "pulmonary",
+                "thromboembolism",
+                "(PTE)."
+            ],
+            [
+                "With",
+                "this",
+                "diagnosis,",
+                "options",
+                "3",
+                "and",
+                "4",
+                "are",
+                "directly",
+                "excluded",
+                "(also,",
+                "she",
+                "is",
+                "female,",
+                "so",
+                "we",
+                "would",
+                "not",
+                "have",
+                "to",
+                "think",
+                "about",
+                "hemophilia)",
+                "As",
+                "an",
+                "analytical",
+                "data,",
+                "it",
+                "says",
+                "that",
+                "there",
+                "is",
+                "a",
+                "lengthening",
+                "of",
+                "the",
+                "aPTT."
+            ],
+            [
+                "So,",
+                "they",
+                "want",
+                "you",
+                "to",
+                "know,",
+                "she",
+                "has",
+                "positive",
+                "lupus",
+                "ac",
+                "and",
+                "link",
+                "it",
+                "directly",
+                "to",
+                "antiphospholipid",
+                "syndrome",
+                "(APS)."
+            ],
+            [
+                "A",
+                "Leiden's",
+                "does",
+                "not",
+                "alter",
+                "coagulation,",
+                "so",
+                "it",
+                "is",
+                "ruled",
+                "out",
+                "as",
+                "well."
+            ],
+            [
+                "Anyway,",
+                "although",
+                "it",
+                "is",
+                "not",
+                "within",
+                "the",
+                "possible",
+                "answers,",
+                "lupus",
+                "positivity",
+                "can",
+                "be",
+                "related",
+                "to",
+                "a",
+                "myriad",
+                "of",
+                "clinical",
+                "situations,",
+                "syndromes",
+                "and",
+                "pathologies."
+            ],
+            [
+                "Assuming",
+                "that",
+                "a",
+                "PTE",
+                "+",
+                "lupus",
+                "is",
+                "a",
+                "PFS",
+                "seems",
+                "to",
+                "me",
+                "to",
+                "be",
+                "a",
+                "bit",
+                "of",
+                "a",
+                "stretch,",
+                "but",
+                "it",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "with",
+                "the",
+                "data",
+                "provided."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-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",
+                "B-Premise",
+                "I-Premise",
+                "I-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "514_97",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CRITICAL",
+                "AND",
+                "EMERGENCY",
+                "CARE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "After",
+                "a",
+                "traffic",
+                "accident",
+                "you",
+                "attend",
+                "to",
+                "an",
+                "injured",
+                "person."
+            ],
+            [
+                "The",
+                "patient",
+                "opens",
+                "his",
+                "eyes",
+                "at",
+                "your",
+                "call,",
+                "but",
+                "only",
+                "utters",
+                "words",
+                "that",
+                "are",
+                "inappropriate."
+            ],
+            [
+                "On",
+                "motor",
+                "examination,",
+                "the",
+                "pain",
+                "is",
+                "localized",
+                "in",
+                "the",
+                "right",
+                "extremities,",
+                "but",
+                "spreads",
+                "on",
+                "stimulation",
+                "of",
+                "the",
+                "left",
+                "extremities."
+            ],
+            [
+                "How",
+                "would",
+                "you",
+                "describe",
+                "his",
+                "condition",
+                "according",
+                "to",
+                "the",
+                "Glasgow",
+                "Coma",
+                "Scale?"
+            ],
+            [
+                "1-",
+                "E3V2M4."
+            ],
+            [
+                "2-",
+                "E3V3M5."
+            ],
+            [
+                "3-",
+                "E2V3M4."
+            ],
+            [
+                "4-",
+                "E2V4M5."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "The",
+                "first",
+                "thing",
+                "we",
+                "should",
+                "know",
+                "when",
+                "applying",
+                "the",
+                "Glasgow",
+                "Coma",
+                "Scale",
+                "to",
+                "a",
+                "patient",
+                "is",
+                "that",
+                "we",
+                "should",
+                "always",
+                "keep",
+                "the",
+                "best",
+                "value",
+                "in",
+                "each",
+                "sphere",
+                "(ocular",
+                "response,",
+                "motor",
+                "response",
+                "and",
+                "verbal",
+                "response)."
+            ],
+            [
+                "In",
+                "this",
+                "case,",
+                "we",
+                "have",
+                "a",
+                "patient",
+                "who",
+                "has",
+                "an",
+                "ocular",
+                "opening",
+                "to",
+                "the",
+                "call",
+                "(ocular",
+                "response",
+                "3",
+                "out",
+                "of",
+                "4),",
+                "emits",
+                "inappropriate",
+                "words",
+                "(verbal",
+                "response",
+                "3",
+                "out",
+                "of",
+                "5)",
+                "and",
+                "localizes",
+                "pain",
+                "with",
+                "right",
+                "extremities",
+                "(motor",
+                "response",
+                "5",
+                "out",
+                "of",
+                "6)."
+            ],
+            [
+                "The",
+                "Glasgow",
+                "Coma",
+                "Scale",
+                "score",
+                "would",
+                "be",
+                "11",
+                "(out",
+                "of",
+                "15)."
+            ],
+            [
+                "The",
+                "best",
+                "value",
+                "of",
+                "the",
+                "examination",
+                "is",
+                "taken",
+                "because",
+                "in",
+                "many",
+                "cases",
+                "(assessment",
+                "of",
+                "a",
+                "polytraumatized",
+                "patient,",
+                "ischemic",
+                "stroke",
+                "or",
+                "spontaneous",
+                "acute",
+                "cerebral",
+                "bleeding),",
+                "the",
+                "motor",
+                "examination",
+                "may",
+                "be",
+                "artifacted",
+                "by",
+                "other",
+                "elements."
+            ],
+            [
+                "For",
+                "example:",
+                "in",
+                "a",
+                "polytraumatized",
+                "patient",
+                "(such",
+                "as",
+                "the",
+                "one",
+                "in",
+                "question),",
+                "the",
+                "response",
+                "presented",
+                "with",
+                "left",
+                "extremities",
+                "may",
+                "be",
+                "due",
+                "to",
+                "localized",
+                "trauma",
+                "in",
+                "that",
+                "area,",
+                "and",
+                "not",
+                "strictly",
+                "speaking",
+                "to",
+                "an",
+                "underlying",
+                "traumatic",
+                "brain",
+                "injury."
+            ],
+            [
+                "Likewise,",
+                "sometimes",
+                "the",
+                "verbal",
+                "response",
+                "may",
+                "be",
+                "underestimated",
+                "in",
+                "the",
+                "polytraumatized",
+                "patient",
+                "due",
+                "to",
+                "airway",
+                "obstruction",
+                "(e.g.,",
+                "due",
+                "to",
+                "the",
+                "tongue",
+                "retreating",
+                "into",
+                "the",
+                "oropharynx)."
+            ],
+            [
+                "By",
+                "always",
+                "assessing",
+                "the",
+                "best",
+                "response,",
+                "we",
+                "will",
+                "have",
+                "a",
+                "truer",
+                "picture",
+                "of",
+                "the",
+                "patient's",
+                "condition."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-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",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "101_86",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "55-year-old",
+                "woman",
+                "consults",
+                "for",
+                "fatigue",
+                "and",
+                "polyuria",
+                "of",
+                "two",
+                "years'",
+                "evolution."
+            ],
+            [
+                "Laboratory",
+                "tests",
+                "reveal",
+                "hypercalcemia,",
+                "increased",
+                "PTH",
+                "and",
+                "increased",
+                "bone",
+                "turnover",
+                "markers."
+            ],
+            [
+                "The",
+                "radiographic",
+                "study",
+                "shows",
+                "subperiosteal",
+                "resorption",
+                "and",
+                "osteoporosis."
+            ],
+            [
+                "Sestamibi",
+                "scintigraphy",
+                "revealed",
+                "a",
+                "parathyroid",
+                "adenoma."
+            ],
+            [
+                "Parathyroidectomy",
+                "was",
+                "performed",
+                "with",
+                "minimally",
+                "invasive",
+                "surgery."
+            ],
+            [
+                "Postoperatively,",
+                "the",
+                "patient",
+                "developed",
+                "severe",
+                "hypocalcemia",
+                "and",
+                "tetany,",
+                "with",
+                "PTH",
+                "below",
+                "5",
+                "ng/l."
+            ],
+            [
+                "The",
+                "patient",
+                "responds",
+                "well",
+                "to",
+                "initial",
+                "treatment",
+                "with",
+                "intravenous",
+                "calcium",
+                "and",
+                "later",
+                "with",
+                "oral",
+                "calcium",
+                "and",
+                "vitamin",
+                "D."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Permanent",
+                "surgical",
+                "hypoparathyroidism."
+            ],
+            [
+                "2-",
+                "Transfusion",
+                "of",
+                "citrated",
+                "blood."
+            ],
+            [
+                "3-",
+                "Vitamin",
+                "D",
+                "insufficiency."
+            ],
+            [
+                "4-",
+                "Hungry",
+                "bone",
+                "syndrome."
+            ],
+            [
+                "5-",
+                "Osteomalacia."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Question",
+                "of",
+                "very",
+                "high",
+                "difficulty,",
+                "I",
+                "would",
+                "not",
+                "worry",
+                "about",
+                "having",
+                "failed",
+                "it."
+            ],
+            [
+                "It",
+                "is",
+                "easy",
+                "to",
+                "get",
+                "confused",
+                "with",
+                "the",
+                "hypoparathyroidism",
+                "answer."
+            ],
+            [
+                "Permanent",
+                "post-surgical",
+                "hypoparathyroidism",
+                "after",
+                "parathyroidectomy",
+                "of",
+                "an",
+                "adenoma",
+                "with",
+                "minimally",
+                "invasive",
+                "surgery",
+                "is",
+                "rare."
+            ],
+            [
+                "I",
+                "write",
+                "a",
+                "brief",
+                "summary",
+                "of",
+                "the",
+                "hungry",
+                "bone",
+                "syndrome",
+                "that",
+                "I",
+                "have",
+                "found",
+                "in",
+                "a",
+                "clinical",
+                "case",
+                "in",
+                "the",
+                "Annals",
+                "of",
+                "Internal",
+                "Medicine",
+                "[1]:",
+                "\"The",
+                "pathophysiology",
+                "of",
+                "the",
+                "hungry",
+                "bone",
+                "syndrome",
+                "(HBS)",
+                "is",
+                "related",
+                "to",
+                "an",
+                "imbalance",
+                "between",
+                "bone",
+                "formation",
+                "and",
+                "bone",
+                "resorption,",
+                "which",
+                "is",
+                "associated",
+                "with",
+                "hypocalcemia,",
+                "hypophosphatemia",
+                "and",
+                "hypomagnesemia",
+                "(1)."
+            ],
+            [
+                "This",
+                "syndrome",
+                "can",
+                "be",
+                "observed",
+                "after",
+                "surgery",
+                "in",
+                "patients",
+                "with",
+                "primary",
+                "hyperparathyroidism",
+                "(HPT),",
+                "as",
+                "well",
+                "as",
+                "in",
+                "tertiary",
+                "HPT",
+                "of",
+                "chronic",
+                "renal",
+                "failure,",
+                "and",
+                "to",
+                "a",
+                "lesser",
+                "extent",
+                "after",
+                "treatment",
+                "of",
+                "processes",
+                "with",
+                "excess",
+                "of",
+                "circulating",
+                "thyroid",
+                "hormones",
+                "(2)."
+            ],
+            [
+                "In",
+                "PTH,",
+                "there",
+                "is",
+                "an",
+                "excess",
+                "of",
+                "parathyroid",
+                "hormone",
+                "(PTH)",
+                "which",
+                "stimulates",
+                "osteoclastic",
+                "activity",
+                "causing",
+                "demineralization",
+                "of",
+                "the",
+                "bone",
+                "matrix",
+                "and",
+                "releasing",
+                "calcium",
+                "into",
+                "the",
+                "bloodstream."
+            ],
+            [
+                "After",
+                "parathyroidectomy,",
+                "serum",
+                "PTH",
+                "levels",
+                "drop",
+                "dramatically,",
+                "thus,",
+                "PTH-induced",
+                "bone",
+                "resorption",
+                "ceases,",
+                "while",
+                "osteoblastic",
+                "activity",
+                "continues",
+                "resulting",
+                "in",
+                "increased",
+                "bone",
+                "uptake",
+                "of",
+                "calcium,",
+                "phosphate",
+                "and",
+                "magnesium,",
+                "thus",
+                "SHH",
+                "appears",
+                "(3).\""
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "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",
+                "B-Disease",
+                "I-Disease",
+                "I-Disease",
+                "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",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "230_179",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "4-year-old",
+                "boy",
+                "comes",
+                "to",
+                "the",
+                "health",
+                "center",
+                "who,",
+                "5",
+                "minutes",
+                "before,",
+                "starts",
+                "with",
+                "angioedema",
+                "in",
+                "the",
+                "face,",
+                "conjunctivitis,",
+                "nasal",
+                "congestion",
+                "and",
+                "hoarseness,",
+                "coinciding",
+                "with",
+                "the",
+                "ingestion",
+                "of",
+                "a",
+                "spoonful",
+                "of",
+                "yogurt",
+                "given",
+                "to",
+                "him",
+                "by",
+                "mistake",
+                "at",
+                "school."
+            ],
+            [
+                "Among",
+                "the",
+                "antecedents,",
+                "he",
+                "was",
+                "diagnosed",
+                "with",
+                "cow's",
+                "milk",
+                "protein",
+                "allergy."
+            ],
+            [
+                "Examination",
+                "revealed",
+                "mild",
+                "hypotension,",
+                "heart",
+                "rate",
+                "110",
+                "bpm,",
+                "O2",
+                "Sat",
+                "93%,",
+                "pale",
+                "and",
+                "slightly",
+                "sweaty,",
+                "with",
+                "scattered",
+                "wheezing."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "first",
+                "treatment",
+                "of",
+                "choice?"
+            ],
+            [
+                "1-",
+                "Provoke",
+                "vomiting."
+            ],
+            [
+                "2-",
+                "Adrenaline",
+                "1/1000",
+                "subcutaneous."
+            ],
+            [
+                "3-",
+                "Intramuscular",
+                "adrenaline",
+                "1/1000."
+            ],
+            [
+                "4-",
+                "Intramuscular",
+                "methylprednisolone."
+            ],
+            [
+                "5-",
+                "Nebulized",
+                "salbutamol."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "We",
+                "are",
+                "facing",
+                "a",
+                "case",
+                "of",
+                "Anaphylaxis",
+                "so",
+                "the",
+                "first",
+                "measure",
+                "is",
+                "to",
+                "administer",
+                "Adrenaline",
+                "1/1000",
+                "intramuscular",
+                "(0.01mg/kg)."
+            ],
+            [
+                "Subsequently,",
+                "systemic",
+                "corticosteroids",
+                "such",
+                "as",
+                "methylprednisolone",
+                "will",
+                "be",
+                "given,",
+                "which",
+                "will",
+                "take",
+                "a",
+                "few",
+                "hours",
+                "to",
+                "take",
+                "effect."
+            ],
+            [
+                "So",
+                "adrenaline",
+                "first,",
+                "as",
+                "it",
+                "is",
+                "faster",
+                "acting,",
+                "then",
+                "the",
+                "rest",
+                "(Question",
+                "very",
+                "similar",
+                "to",
+                "one",
+                "last",
+                "year,",
+                "instead",
+                "of",
+                "yogurt,",
+                "it",
+                "was",
+                "omelet)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "479_164",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CRITICAL",
+                "CARE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "72-year-old",
+                "man",
+                "presenting",
+                "since",
+                "48",
+                "hours",
+                "with",
+                "fever",
+                "of",
+                "38.7\u00b0C,",
+                "cough,",
+                "purulent",
+                "expectoration",
+                "and",
+                "dyspnea."
+            ],
+            [
+                "Constants:",
+                "BP",
+                "85/60",
+                "mmHg,",
+                "heart",
+                "rate",
+                "100",
+                "bpm,",
+                "respiratory",
+                "rate",
+                "35",
+                "rpm,",
+                "SatO2",
+                "80%."
+            ],
+            [
+                "Of",
+                "note",
+                "was",
+                "the",
+                "presence",
+                "of",
+                "confusion",
+                "and",
+                "crackles",
+                "in",
+                "the",
+                "left",
+                "lower",
+                "lung",
+                "field."
+            ],
+            [
+                "Chest",
+                "X-ray",
+                "confirms",
+                "the",
+                "existence",
+                "of",
+                "pneumonia",
+                "of",
+                "the",
+                "lingula",
+                "and",
+                "left",
+                "lower",
+                "lobe."
+            ],
+            [
+                "What",
+                "would",
+                "be",
+                "the",
+                "appropriate",
+                "place",
+                "of",
+                "care?"
+            ],
+            [
+                "1-",
+                "Outpatient",
+                "treatment",
+                "at",
+                "home."
+            ],
+            [
+                "2-",
+                "Admission",
+                "to",
+                "an",
+                "emergency",
+                "observation",
+                "unit."
+            ],
+            [
+                "3-",
+                "Hospital",
+                "admission",
+                "to",
+                "the",
+                "ward."
+            ],
+            [
+                "4-",
+                "Admission",
+                "to",
+                "the",
+                "Intensive",
+                "Care",
+                "Unit."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Applying",
+                "the",
+                "CURB-65",
+                "severity",
+                "scale",
+                "(one",
+                "of",
+                "the",
+                "most",
+                "commonly",
+                "used",
+                "in",
+                "the",
+                "ED",
+                "for",
+                "stratifying",
+                "the",
+                "severity",
+                "of",
+                "pneumonia,",
+                "although",
+                "in",
+                "this",
+                "case",
+                "simply",
+                "applying",
+                "common",
+                "sense,",
+                "the",
+                "patient",
+                "should",
+                "be",
+                "admitted",
+                "to",
+                "the",
+                "ICU),",
+                "we",
+                "would",
+                "have",
+                "a",
+                "score",
+                "of",
+                "at",
+                "least",
+                "4",
+                "points",
+                "(we",
+                "would",
+                "be",
+                "missing",
+                "the",
+                "serum",
+                "urea",
+                "data),",
+                "which",
+                "gives",
+                "us",
+                "severity",
+                "criteria."
+            ],
+            [
+                "Since",
+                "there",
+                "are",
+                "no",
+                "criteria",
+                "that",
+                "contraindicate",
+                "admission",
+                "to",
+                "the",
+                "ICU,",
+                "admission",
+                "to",
+                "the",
+                "unit",
+                "would",
+                "be",
+                "indicated."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "515_101",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CRITICAL",
+                "AND",
+                "EMERGENCY",
+                "CARE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "15-year-old",
+                "male,",
+                "admitted",
+                "after",
+                "being",
+                "run",
+                "over",
+                "on",
+                "the",
+                "public",
+                "road,",
+                "resulting",
+                "in",
+                "being",
+                "ejected."
+            ],
+            [
+                "He",
+                "was",
+                "admitted",
+                "conscious",
+                "and",
+                "oriented,",
+                "with",
+                "intense",
+                "pain",
+                "in",
+                "the",
+                "left",
+                "hemithorax",
+                "and",
+                "dyspnea."
+            ],
+            [
+                "Physical",
+                "examination",
+                "showed",
+                "blood",
+                "pressure",
+                "90/60",
+                "mmHg,",
+                "heart",
+                "rate",
+                "130",
+                "bpm,",
+                "basal",
+                "oxygen",
+                "saturation",
+                "90%,",
+                "respiratory",
+                "rate",
+                "35",
+                "rpm."
+            ],
+            [
+                "There",
+                "is",
+                "complete",
+                "hypophonesis",
+                "in",
+                "the",
+                "left",
+                "hemithorax",
+                "and",
+                "dullness",
+                "to",
+                "percussion."
+            ],
+            [
+                "Chest",
+                "X-ray",
+                "shows",
+                "multiple",
+                "left",
+                "costal",
+                "fractures",
+                "and",
+                "massive",
+                "ipsilateral",
+                "pleural",
+                "effusion."
+            ],
+            [
+                "Placement",
+                "of",
+                "a",
+                "pleural",
+                "drain",
+                "is",
+                "indicated,",
+                "with",
+                "1700",
+                "cc",
+                "of",
+                "hematic",
+                "fluid",
+                "coming",
+                "out."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "decision",
+                "to",
+                "be",
+                "made:"
+            ],
+            [
+                "1-",
+                "Institute",
+                "noninvasive",
+                "mechanical",
+                "ventilation",
+                "and",
+                "request",
+                "blood",
+                "transfusion."
+            ],
+            [
+                "2-",
+                "Analgesia,",
+                "oxygen",
+                "therapy,",
+                "request",
+                "blood",
+                "transfusion",
+                "and",
+                "indicate",
+                "urgent",
+                "surgery."
+            ],
+            [
+                "3-",
+                "Orotracheal",
+                "intubation,",
+                "request",
+                "blood",
+                "transfusion",
+                "and",
+                "observation",
+                "for,",
+                "in",
+                "case",
+                "of",
+                "worsening,",
+                "indicate",
+                "surgical",
+                "intervention."
+            ],
+            [
+                "4-",
+                "Orotracheal",
+                "intubation",
+                "and",
+                "urgent",
+                "CT",
+                "scan",
+                "for",
+                "accurate",
+                "assessment",
+                "of",
+                "lesions."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "There",
+                "are",
+                "two",
+                "answers",
+                "that",
+                "we",
+                "can",
+                "immediately",
+                "rule",
+                "out",
+                "if",
+                "we",
+                "stick",
+                "to",
+                "the",
+                "initial",
+                "management",
+                "of",
+                "severe",
+                "chest",
+                "trauma:",
+                "1",
+                "(noninvasive",
+                "ventilation",
+                "is",
+                "not",
+                "indicated",
+                "because",
+                "it",
+                "does",
+                "not",
+                "secure",
+                "the",
+                "airway)",
+                "and",
+                "3",
+                "(observation",
+                "in",
+                "these",
+                "cases,",
+                "waiting",
+                "for",
+                "worsening,",
+                "only",
+                "leads",
+                "to",
+                "increased",
+                "morbidity",
+                "and",
+                "mortality)."
+            ],
+            [
+                "Between",
+                "options",
+                "2",
+                "and",
+                "4",
+                "there",
+                "could",
+                "be",
+                "controversy",
+                "between",
+                "the",
+                "literature",
+                "and",
+                "the",
+                "usual",
+                "clinical",
+                "practice,",
+                "in",
+                "which",
+                "we",
+                "usually",
+                "have",
+                "to",
+                "face",
+                "in",
+                "a",
+                "delicate",
+                "balance",
+                "the",
+                "clinical",
+                "stability",
+                "of",
+                "the",
+                "patient",
+                "(and",
+                "what",
+                "we",
+                "can",
+                "\"make",
+                "up\"",
+                "this",
+                "stability",
+                "with",
+                "our",
+                "life",
+                "support",
+                "therapies)",
+                "and",
+                "the",
+                "actions",
+                "that",
+                "result",
+                "in",
+                "better",
+                "patient",
+                "care",
+                "for",
+                "the",
+                "definitive",
+                "treatment",
+                "of",
+                "the",
+                "lesions."
+            ],
+            [
+                "We",
+                "are",
+                "dealing",
+                "with",
+                "a",
+                "severe",
+                "polytraumatized",
+                "patient."
+            ],
+            [
+                "With",
+                "the",
+                "data",
+                "provided",
+                "by",
+                "the",
+                "question,",
+                "a",
+                "patient",
+                "who",
+                "seems",
+                "to",
+                "be",
+                "in",
+                "shock",
+                "(tachycardia,",
+                "hypoxemia,",
+                "tachypnea...",
+                "although",
+                "we",
+                "do",
+                "not",
+                "receive",
+                "data,",
+                "for",
+                "example,",
+                "on",
+                "lactacidemia),",
+                "and",
+                "in",
+                "whom",
+                "we",
+                "have",
+                "to",
+                "our",
+                "knowledge",
+                "a",
+                "left",
+                "thoracic",
+                "trauma,",
+                "which",
+                "not",
+                "only",
+                "implies",
+                "bone",
+                "injury,",
+                "but",
+                "may",
+                "mask",
+                "other",
+                "injuries",
+                "of",
+                "high",
+                "severity",
+                "and",
+                "which",
+                "are",
+                "not",
+                "diagnosed",
+                "with",
+                "a",
+                "chest",
+                "X-ray:",
+                "myocardial",
+                "contusion,",
+                "pericardial",
+                "effusion,",
+                "splenic",
+                "injury,",
+                "diaphragmatic",
+                "injury..."
+            ],
+            [
+                "We",
+                "place",
+                "a",
+                "left",
+                "pleural",
+                "drain",
+                "on",
+                "the",
+                "patient",
+                "and",
+                "obtain",
+                "a",
+                "debit",
+                "of",
+                "1700cc",
+                "of",
+                "hematic",
+                "fluid."
+            ],
+            [
+                "If",
+                "we",
+                "follow",
+                "the",
+                "ATLS",
+                "(ATLS-Advanced",
+                "Trauma",
+                "Life",
+                "Support",
+                "10th",
+                "edition)",
+                "guidelines",
+                "for",
+                "the",
+                "care",
+                "of",
+                "severely",
+                "polytraumatized",
+                "patients,",
+                "they",
+                "tell",
+                "us",
+                "that",
+                "an",
+                "immediate",
+                "bleeding",
+                "of",
+                "more",
+                "than",
+                "1500cc",
+                "of",
+                "blood",
+                "is",
+                "an",
+                "indication",
+                "for",
+                "urgent",
+                "thoracotomy,",
+                "and",
+                "that",
+                "even",
+                "in",
+                "patients",
+                "with",
+                "a",
+                "bleeding",
+                "of",
+                "less",
+                "than",
+                "1500cc,",
+                "if",
+                "the",
+                "debit",
+                "persists",
+                "at",
+                "a",
+                "rate",
+                "of",
+                "200mL/h",
+                "for",
+                "2",
+                "to",
+                "4h,",
+                "this",
+                "indication",
+                "would",
+                "also",
+                "exist."
+            ],
+            [
+                "Therefore,",
+                "the",
+                "person",
+                "who",
+                "asked",
+                "the",
+                "MIR",
+                "question",
+                "wants",
+                "us",
+                "to",
+                "answer",
+                "option",
+                "2."
+            ],
+            [
+                "However,",
+                "in",
+                "real",
+                "life,",
+                "the",
+                "course",
+                "of",
+                "action",
+                "will",
+                "depend",
+                "on",
+                "the",
+                "stability",
+                "of",
+                "the",
+                "patient",
+                "when",
+                "we",
+                "have",
+                "applied",
+                "the",
+                "treatments",
+                "indicated",
+                "in",
+                "option",
+                "2:",
+                "adequate",
+                "analgesia,",
+                "oxygen",
+                "therapy",
+                "and",
+                "initiation",
+                "of",
+                "blood",
+                "transfusion."
+            ],
+            [
+                "If",
+                "by",
+                "optimizing",
+                "the",
+                "patient",
+                "we",
+                "manage",
+                "to",
+                "stabilize",
+                "him",
+                "and",
+                "assess",
+                "that",
+                "it",
+                "is",
+                "safe",
+                "to",
+                "transfer",
+                "him,",
+                "the",
+                "performance",
+                "of",
+                "a",
+                "body",
+                "CT",
+                "scan",
+                "will",
+                "define",
+                "in",
+                "much",
+                "greater",
+                "detail",
+                "the",
+                "lesions",
+                "he",
+                "has,",
+                "and",
+                "will",
+                "help",
+                "to",
+                "ensure",
+                "that",
+                "the",
+                "surgery",
+                "he",
+                "will",
+                "probably",
+                "end",
+                "up",
+                "undergoing",
+                "will",
+                "be",
+                "a",
+                "definitive",
+                "surgery",
+                "and",
+                "not",
+                "just",
+                "damage",
+                "control",
+                "surgery."
+            ],
+            [
+                "In",
+                "this",
+                "case,",
+                "the",
+                "doubt",
+                "would",
+                "arise",
+                "with",
+                "option",
+                "4,",
+                "although,",
+                "as",
+                "I",
+                "say,",
+                "everything",
+                "will",
+                "depend",
+                "on",
+                "the",
+                "clinical",
+                "stability",
+                "of",
+                "the",
+                "patient",
+                "and",
+                "the",
+                "time",
+                "we",
+                "have",
+                "before",
+                "achieving",
+                "definitive",
+                "control",
+                "of",
+                "the",
+                "hemorrhagic",
+                "focus",
+                "(which",
+                "is,",
+                "after",
+                "all,",
+                "what",
+                "we",
+                "are",
+                "after",
+                "in",
+                "this",
+                "situation)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
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+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
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+                "I-Premise",
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+            ],
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+            ],
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+                "B-Premise",
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "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",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
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+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
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+                "I-Premise",
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+            ],
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
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+            ],
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+            ],
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+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+            ]
+        ]
+    },
+    {
+        "id": "234_105",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "HEMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "72-year-old",
+                "man",
+                "comes",
+                "to",
+                "the",
+                "Emergency",
+                "Department",
+                "with",
+                "a",
+                "pathological",
+                "fracture",
+                "of",
+                "the",
+                "left",
+                "femur."
+            ],
+            [
+                "After",
+                "surgery,",
+                "a",
+                "diagnostic",
+                "study",
+                "is",
+                "performed",
+                "to",
+                "determine",
+                "the",
+                "underlying",
+                "pathology",
+                "with",
+                "the",
+                "following",
+                "findings:",
+                "hemoglobin",
+                "9.5",
+                "g/dl,",
+                "total",
+                "proteins",
+                "11",
+                "g/dl,",
+                "(VN:",
+                "6-8",
+                "g/dl),",
+                "serum",
+                "albumin",
+                "2",
+                "g/dl,",
+                "(VN",
+                "3.5-5.0",
+                "g/dl),",
+                "beta",
+                "2",
+                "microglobulin",
+                "6",
+                "mg/l",
+                "(VN",
+                "1.1-2.4",
+                "mg/l),",
+                "serum",
+                "creatinine",
+                "1.8",
+                "mg/dl",
+                "(VN:",
+                "0.1-1.4",
+                "mg/dl)."
+            ],
+            [
+                "Indicate",
+                "which",
+                "diagnostic",
+                "tests",
+                "would",
+                "be",
+                "necessary",
+                "to",
+                "confirm",
+                "the",
+                "most",
+                "likely",
+                "diagnosis:"
+            ],
+            [
+                "1-",
+                "Radiological",
+                "bone",
+                "series",
+                "and",
+                "bone",
+                "marrow",
+                "aspirate."
+            ],
+            [
+                "2-",
+                "Serum",
+                "and",
+                "urine",
+                "electrophoresis",
+                "and",
+                "renal",
+                "function",
+                "tests."
+            ],
+            [
+                "3-",
+                "Bone",
+                "marrow",
+                "aspirate",
+                "and",
+                "serum",
+                "calcium",
+                "concentration."
+            ],
+            [
+                "4-",
+                "Bone",
+                "marrow",
+                "aspirate",
+                "and",
+                "serum",
+                "and",
+                "urine",
+                "electrophoresis."
+            ],
+            [
+                "5-",
+                "Biopsy",
+                "of",
+                "the",
+                "pathological",
+                "fracture",
+                "and",
+                "radiological",
+                "bone",
+                "series."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "She",
+                "is",
+                "going",
+                "to",
+                "have",
+                "myeloma."
+            ],
+            [
+                "For",
+                "diagnosis,",
+                "a",
+                "sample",
+                "(bone",
+                "marrow)",
+                "and",
+                "electrophoresis",
+                "to",
+                "determine",
+                "the",
+                "type",
+                "of",
+                "monoclonal",
+                "peak."
+            ],
+            [
+                "Then,",
+                "for",
+                "extension,",
+                "prognostic",
+                "value",
+                "and",
+                "to",
+                "decide",
+                "treatments,",
+                "the",
+                "rest,",
+                "but",
+                "once",
+                "diagnosed."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "174_52",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PNEUMOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "67-year-old",
+                "man",
+                "consults",
+                "for",
+                "moderate",
+                "exertional",
+                "dyspnea",
+                "of",
+                "progressive",
+                "onset",
+                "in",
+                "recent",
+                "years."
+            ],
+            [
+                "He",
+                "has",
+                "daily",
+                "whitish",
+                "expectoration",
+                "and",
+                "sometimes",
+                "breath",
+                "sounds,",
+                "especially",
+                "in",
+                "winter",
+                "with",
+                "respiratory",
+                "infections."
+            ],
+            [
+                "He",
+                "has",
+                "been",
+                "a",
+                "smoker",
+                "of",
+                "about",
+                "20",
+                "cigarettes",
+                "a",
+                "day",
+                "for",
+                "the",
+                "last",
+                "45",
+                "years."
+            ],
+            [
+                "On",
+                "examination",
+                "he",
+                "is",
+                "eupneic,",
+                "normocolored,",
+                "with",
+                "an",
+                "oxygen",
+                "saturation",
+                "of",
+                "94%,",
+                "and",
+                "has",
+                "generalized",
+                "decreased",
+                "vesicular",
+                "murmur",
+                "on",
+                "chest",
+                "auscultation",
+                "as",
+                "the",
+                "only",
+                "findings",
+                "of",
+                "interest."
+            ],
+            [
+                "Chest",
+                "X-ray",
+                "shows",
+                "an",
+                "elongated",
+                "cardiac",
+                "silhouette,",
+                "with",
+                "signs",
+                "of",
+                "hyperinflation",
+                "or",
+                "pulmonary",
+                "air",
+                "trapping,",
+                "without",
+                "other",
+                "alterations."
+            ],
+            [
+                "Spirometry",
+                "was",
+                "performed",
+                "with",
+                "the",
+                "following",
+                "result:",
+                "FVC",
+                "84%,",
+                "FEV1",
+                "58%,",
+                "FEV1/FVC",
+                "61%,",
+                "unchanged",
+                "after",
+                "bronchodilator."
+            ],
+            [
+                "Among",
+                "those",
+                "indicated,",
+                "indicate",
+                "the",
+                "most",
+                "appropriate",
+                "treatment",
+                "for",
+                "this",
+                "patient:"
+            ],
+            [
+                "1-",
+                "Daily",
+                "inhaled",
+                "corticosteroid."
+            ],
+            [
+                "2-",
+                "Home",
+                "oxygen",
+                "therapy",
+                "with",
+                "portable",
+                "oxygen",
+                "source",
+                "for",
+                "ambulation."
+            ],
+            [
+                "3-",
+                "Oral",
+                "leukotriene",
+                "antagonist."
+            ],
+            [
+                "4-",
+                "Oral",
+                "corticosteroid",
+                "for",
+                "three",
+                "months."
+            ],
+            [
+                "5-",
+                "Inhaled",
+                "tiotropium."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "In",
+                "a",
+                "patient",
+                "with",
+                "a",
+                "low",
+                "symptomatic",
+                "COPD",
+                "that",
+                "could",
+                "probably",
+                "be",
+                "classified",
+                "as",
+                "GOLD",
+                "2,",
+                "the",
+                "starting",
+                "treatment",
+                "can",
+                "be",
+                "either",
+                "with",
+                "inhaled",
+                "tiotropium",
+                "or",
+                "with",
+                "a",
+                "long-acting",
+                "beta",
+                "two."
+            ],
+            [
+                "Therefore",
+                "there",
+                "is",
+                "no",
+                "doubt",
+                "in",
+                "the",
+                "correct",
+                "answer."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "143_141",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "Given",
+                "a",
+                "7-month-old",
+                "child",
+                "with",
+                "fever",
+                "and",
+                "irritability,",
+                "bulging",
+                "fontanel",
+                "and",
+                "a",
+                "cerebrospinal",
+                "fluid",
+                "study",
+                "with",
+                "110",
+                "cells/mm3",
+                "(75%",
+                "lymphocytes),",
+                "protein",
+                "120",
+                "mg/dl",
+                "and",
+                "glucose",
+                "28",
+                "mg/dl",
+                "(serum",
+                "glycemia",
+                "89",
+                "mg/dl),",
+                "what",
+                "is",
+                "the",
+                "most",
+                "reasonable",
+                "diagnostic",
+                "suspicion?"
+            ],
+            [
+                "1-",
+                "Viral",
+                "meningitis."
+            ],
+            [
+                "2-",
+                "Bacterial",
+                "meningitis."
+            ],
+            [
+                "3-",
+                "Tuberculous",
+                "meningitis."
+            ],
+            [
+                "4-",
+                "Mononucleosis",
+                "syndrome."
+            ],
+            [
+                "5-",
+                "Guillain-Barre",
+                "syndrome."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "3."
+            ],
+            [
+                "It",
+                "defines",
+                "a",
+                "typical",
+                "cerebrospinal",
+                "fluid",
+                "of",
+                "tuberculosis."
+            ],
+            [
+                "In",
+                "clinical",
+                "practice",
+                "things",
+                "might",
+                "not",
+                "be",
+                "so",
+                "simple......"
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "9_36",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "87-year-old",
+                "patient",
+                "with",
+                "a",
+                "history",
+                "of",
+                "chronic",
+                "bronchitis",
+                "and",
+                "heart",
+                "failure,",
+                "has",
+                "been",
+                "diagnosed",
+                "with",
+                "acute",
+                "calculous",
+                "cholecystitis",
+                "."
+            ],
+            [
+                "After",
+                "four",
+                "days",
+                "of",
+                "treatment",
+                "with",
+                "absolute",
+                "diet,",
+                "serum",
+                "therapy",
+                "and",
+                "piperacillin/tazobactam,",
+                "the",
+                "patient",
+                "continues",
+                "with",
+                "fever,",
+                "persistent",
+                "abdominal",
+                "pain",
+                "and",
+                "leukocytosis."
+            ],
+            [
+                "The",
+                "most",
+                "appropriate",
+                "attitude",
+                "at",
+                "this",
+                "time",
+                "would",
+                "be:"
+            ],
+            [
+                "1-",
+                "Surgical",
+                "treatment",
+                "(urgent",
+                "cholecystectomy)."
+            ],
+            [
+                "2-",
+                "Biliary",
+                "drainage",
+                "by",
+                "percutaneous",
+                "cholecystostomy."
+            ],
+            [
+                "3-",
+                "Substitute",
+                "metronidazole",
+                "+",
+                "cefotaxime",
+                "for",
+                "piperacillin/tazobactam."
+            ],
+            [
+                "4-",
+                "Replace",
+                "piperacillin/tazobactam",
+                "with",
+                "amikacin+clindamycin."
+            ],
+            [
+                "5-",
+                "Add",
+                "gentamicin."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "I",
+                "think",
+                "the",
+                "correct",
+                "answer",
+                "is",
+                "2",
+                "although",
+                "the",
+                "treatment",
+                "for",
+                "acute",
+                "cholecystitis",
+                "is",
+                "cholecystectomy,",
+                "for",
+                "this",
+                "it",
+                "is",
+                "necessary",
+                "that",
+                "the",
+                "patient",
+                "is",
+                "a",
+                "surgical",
+                "candidate,",
+                "in",
+                "this",
+                "case",
+                "it",
+                "is",
+                "an",
+                "elderly",
+                "patient,",
+                "with",
+                "previous",
+                "diseases",
+                "that",
+                "increase",
+                "the",
+                "surgical",
+                "risk",
+                "and",
+                "would",
+                "be",
+                "an",
+                "ASA",
+                "IV",
+                "for",
+                "an",
+                "urgent",
+                "intervention."
+            ],
+            [
+                "In",
+                "these",
+                "cases",
+                "cholecystostomy",
+                "can",
+                "cure",
+                "cholecystitis;",
+                "and",
+                "after",
+                "recovery,",
+                "assess",
+                "scheduled",
+                "surgery",
+                "according",
+                "to",
+                "the",
+                "patient's",
+                "situation."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "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"
+            ],
+            [
+                "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",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "601_112",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "TRAUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "61-year-old",
+                "woman,",
+                "administrative,",
+                "with",
+                "a",
+                "history",
+                "of",
+                "overweight,",
+                "hypertension,",
+                "dyslipidemia",
+                "and",
+                "metabolic",
+                "syndrome,",
+                "who",
+                "consults",
+                "for",
+                "pain",
+                "in",
+                "both",
+                "buttocks,",
+                "left",
+                "trochanteric",
+                "region,",
+                "lateral",
+                "aspect",
+                "of",
+                "the",
+                "left",
+                "thigh",
+                "up",
+                "to",
+                "the",
+                "knee",
+                "and",
+                "left",
+                "leg",
+                "up",
+                "to",
+                "the",
+                "middle",
+                "third."
+            ],
+            [
+                "The",
+                "pain",
+                "appears",
+                "when",
+                "the",
+                "lower",
+                "limb",
+                "is",
+                "lifted",
+                "with",
+                "the",
+                "knee",
+                "extended,",
+                "but",
+                "is",
+                "relieved",
+                "when",
+                "the",
+                "knee",
+                "is",
+                "flexed."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "first",
+                "clinical",
+                "suspicion?"
+            ],
+            [
+                "1-",
+                "Gouty",
+                "arthritis",
+                "of",
+                "the",
+                "left",
+                "hip."
+            ],
+            [
+                "2-",
+                "Left",
+                "coxofemoral",
+                "arthrosis."
+            ],
+            [
+                "3-",
+                "Radiated",
+                "low",
+                "back",
+                "pain",
+                "/",
+                "lumbosciatica."
+            ],
+            [
+                "4-",
+                "Claudication",
+                "due",
+                "to",
+                "canal",
+                "stenosis."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Positive",
+                "Lasegue's",
+                "sign,",
+                "reappearance",
+                "of",
+                "the",
+                "symptoms",
+                "when",
+                "performing",
+                "the",
+                "extension",
+                "maneuver",
+                "of",
+                "the",
+                "affected",
+                "limb,",
+                "compatible",
+                "with",
+                "involvement",
+                "of",
+                "nerve",
+                "roots",
+                "at",
+                "the",
+                "lumbosacral",
+                "spine",
+                "level."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "202_44",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GENERAL",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "Patient",
+                "with",
+                "acute",
+                "pancreatitis."
+            ],
+            [
+                "Computerized",
+                "Axial",
+                "Tomography",
+                "(CAT)",
+                "performed",
+                "72",
+                "hours",
+                "after",
+                "admission",
+                "showed",
+                "necrosis",
+                "of",
+                "50%",
+                "of",
+                "the",
+                "pancreas."
+            ],
+            [
+                "At",
+                "the",
+                "3rd",
+                "week",
+                "of",
+                "admission",
+                "the",
+                "patient",
+                "began",
+                "with",
+                "high",
+                "fever",
+                "and",
+                "leukocytosis."
+            ],
+            [
+                "Urgent",
+                "chest",
+                "X-ray",
+                "and",
+                "urinary",
+                "sediment",
+                "are",
+                "requested,",
+                "both",
+                "being",
+                "normal."
+            ],
+            [
+                "Indicate",
+                "the",
+                "next",
+                "step",
+                "to",
+                "follow:"
+            ],
+            [
+                "1-",
+                "Fine",
+                "needle",
+                "aspiration",
+                "of",
+                "pancreatic",
+                "necrosis",
+                "guided",
+                "by",
+                "ultrasound",
+                "or",
+                "CT."
+            ],
+            [
+                "2-",
+                "Bronchoalveolar",
+                "aspirate,",
+                "urine",
+                "culture",
+                "and",
+                "blood",
+                "cultures."
+            ],
+            [
+                "3-",
+                "Abdominal",
+                "MRI."
+            ],
+            [
+                "4-",
+                "Urgent",
+                "cholecystectomy."
+            ],
+            [
+                "5-",
+                "Echoendoscopy",
+                "with",
+                "puncture",
+                "of",
+                "the",
+                "necrosis."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Although",
+                "the",
+                "latest",
+                "recommendations",
+                "on",
+                "the",
+                "management",
+                "of",
+                "severe",
+                "acute",
+                "pancreatitis",
+                "advise",
+                "against",
+                "FNA",
+                "because",
+                "of",
+                "the",
+                "risk",
+                "of",
+                "infection",
+                "of",
+                "sterile",
+                "necrosis."
+            ],
+            [
+                "Current",
+                "management",
+                "is",
+                "governed",
+                "by",
+                "stepwise",
+                "treatment."
+            ],
+            [
+                "In",
+                "the",
+                "situation",
+                "described",
+                "in",
+                "the",
+                "question",
+                "the",
+                "current",
+                "treatment",
+                "is",
+                "to",
+                "start",
+                "antibiotics",
+                "and",
+                "assess",
+                "response."
+            ]
+        ],
+        "labels": [
+            [
+                "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",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "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",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "259_97",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "54-year-old",
+                "man",
+                "who",
+                "goes",
+                "for",
+                "a",
+                "check-up",
+                "at",
+                "his",
+                "company."
+            ],
+            [
+                "A",
+                "body",
+                "mass",
+                "index",
+                "of",
+                "32.8",
+                "kg/m2",
+                "and",
+                "fasting",
+                "blood",
+                "glucose",
+                "of",
+                "138",
+                "mg/l",
+                "were",
+                "detected."
+            ],
+            [
+                "One",
+                "month",
+                "later,",
+                "glycemia",
+                "13",
+                "mg/dl."
+            ],
+            [
+                "Which",
+                "therapeutic",
+                "recommendation",
+                "would",
+                "you",
+                "make",
+                "first?"
+            ],
+            [
+                "1-",
+                "Administer",
+                "metformin."
+            ],
+            [
+                "2-",
+                "Prescribe",
+                "a",
+                "sulfonylurea."
+            ],
+            [
+                "3-",
+                "Behavioral",
+                "changes.",
+                "Diet",
+                "and",
+                "physical",
+                "exercise."
+            ],
+            [
+                "4-",
+                "Insulin",
+                "before",
+                "each",
+                "meal."
+            ],
+            [
+                "5-",
+                "Take",
+                "acarbose",
+                "at",
+                "night,",
+                "before",
+                "going",
+                "to",
+                "bed."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Behavioral",
+                "changes:",
+                "diet",
+                "and",
+                "physical",
+                "exercise."
+            ],
+            [
+                "This",
+                "is",
+                "the",
+                "first",
+                "thing",
+                "we",
+                "do",
+                "when",
+                "diagnosed",
+                "with",
+                "type",
+                "2",
+                "diabetes."
+            ],
+            [
+                "This",
+                "is",
+                "a",
+                "good",
+                "question",
+                "to",
+                "remember",
+                "that",
+                "before",
+                "any",
+                "drug,",
+                "we",
+                "must",
+                "insist",
+                "on",
+                "changing",
+                "habits."
+            ],
+            [
+                "Then",
+                "we",
+                "would",
+                "prescribe",
+                "Metformin."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-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",
+                "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",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "204_220",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GENETICS",
+                "AND",
+                "IMMUNOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "43-year-old",
+                "man",
+                "consults",
+                "for",
+                "diarrheal",
+                "syndrome,",
+                "and",
+                "refers",
+                "among",
+                "his",
+                "history",
+                "3",
+                "pneumonias",
+                "in",
+                "adulthood."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "immunological",
+                "studies",
+                "should",
+                "we",
+                "request:"
+            ],
+            [
+                "1-",
+                "Serum",
+                "immunoglobulin",
+                "count",
+                "and",
+                "antibody",
+                "production",
+                "capacity",
+                "test."
+            ],
+            [
+                "2-",
+                "Phagocytosis",
+                "test",
+                "and",
+                "oxidative",
+                "metabolism",
+                "of",
+                "neutrophils."
+            ],
+            [
+                "3-",
+                "Apoptosis",
+                "test",
+                "(programmed",
+                "cell",
+                "death)",
+                "in",
+                "the",
+                "patient's",
+                "circulating",
+                "lymphocytes."
+            ],
+            [
+                "4-",
+                "Study",
+                "of",
+                "the",
+                "repertoire",
+                "and",
+                "clonality",
+                "of",
+                "T",
+                "lymphocytes",
+                "(alpha/beta)."
+            ],
+            [
+                "5-",
+                "In",
+                "this",
+                "patient",
+                "it",
+                "would",
+                "not",
+                "be",
+                "appropriate",
+                "to",
+                "request",
+                "any",
+                "immunological",
+                "study."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "More",
+                "than",
+                "2",
+                "lobar",
+                "pneumonias",
+                "make",
+                "it",
+                "necessary",
+                "to",
+                "rule",
+                "out",
+                "an",
+                "immunologic",
+                "deficit."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "4_40",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DIGESTIVE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "man",
+                "presents",
+                "abruptly",
+                "with",
+                "asthenia",
+                "and",
+                "jaundice",
+                "with",
+                "transaminases",
+                "above",
+                "2000",
+                "IU/L."
+            ],
+            [
+                "Serological",
+                "markers",
+                "show",
+                "the",
+                "following",
+                "pattern:",
+                "anti-HAV",
+                "IgM",
+                "negative,",
+                "HBsAg",
+                "negative",
+                "anti-HBc",
+                "IgM",
+                "positive,",
+                "anti-HCV",
+                "negative."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Chronic",
+                "hepatitis",
+                "B."
+            ],
+            [
+                "2-",
+                "Non-viral",
+                "acute",
+                "hepatitis."
+            ],
+            [
+                "3-",
+                "Acute",
+                "hepatitis",
+                "B."
+            ],
+            [
+                "4-",
+                "D",
+                "(delta)",
+                "virus",
+                "superinfection."
+            ],
+            [
+                "5-",
+                "Acute",
+                "hepatitis",
+                "A",
+                "and",
+                "B."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "An",
+                "interesting",
+                "one",
+                "that",
+                "in",
+                "general",
+                "needs",
+                "to",
+                "be",
+                "studied."
+            ],
+            [
+                "By",
+                "the",
+                "form",
+                "of",
+                "presentation,",
+                "it",
+                "is",
+                "clearly",
+                "an",
+                "acute",
+                "hepatitis,",
+                "so",
+                "option",
+                "1",
+                "is",
+                "ruled",
+                "out."
+            ],
+            [
+                "The",
+                "negative",
+                "IgM",
+                "of",
+                "HAV",
+                "rules",
+                "out",
+                "5",
+                "and",
+                "the",
+                "negative",
+                "HBs",
+                "Ag",
+                "rules",
+                "out",
+                "4",
+                "(to",
+                "have",
+                "delta",
+                "virus",
+                "you",
+                "need",
+                "surface",
+                "antigen",
+                "B)."
+            ],
+            [
+                "When",
+                "having",
+                "IgM",
+                "anti",
+                "HBc",
+                "we",
+                "speak",
+                "of",
+                "an",
+                "acute",
+                "hepatitis",
+                "B",
+                "(3),",
+                "since",
+                "there",
+                "is",
+                "a",
+                "window",
+                "period",
+                "of",
+                "negativization",
+                "of",
+                "the",
+                "antigen."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ]
+        ]
+    },
+    {
+        "id": "372_127",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PNEUMOLOGY",
+                "AND",
+                "THORACIC",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "55-year-old",
+                "man",
+                "who",
+                "consults",
+                "for",
+                "dysphonia."
+            ],
+            [
+                "In",
+                "the",
+                "anamnesis",
+                "he",
+                "refers",
+                "to",
+                "a",
+                "month",
+                "of",
+                "asthenia",
+                "and",
+                "unquantified",
+                "weight",
+                "loss."
+            ],
+            [
+                "Chest",
+                "X-ray",
+                "shows",
+                "increased",
+                "density",
+                "in",
+                "the",
+                "left",
+                "upper",
+                "lobe",
+                "and",
+                "occupation",
+                "of",
+                "the",
+                "aortopulmonary",
+                "window."
+            ],
+            [
+                "Bronchoscopy",
+                "shows",
+                "paralysis",
+                "of",
+                "the",
+                "left",
+                "vocal",
+                "cord,",
+                "without",
+                "endoscopic",
+                "image",
+                "suggestive",
+                "of",
+                "neoplasia."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Pulmonary",
+                "neoplasia."
+            ],
+            [
+                "2-",
+                "Sarcoidosis."
+            ],
+            [
+                "3-",
+                "Silicosis."
+            ],
+            [
+                "4-",
+                "Tuberculosis."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "The",
+                "most",
+                "frequent",
+                "cause",
+                "of",
+                "recurrent",
+                "nerve",
+                "palsy",
+                "is",
+                "bronchopulmonary",
+                "carcinoma."
+            ],
+            [
+                "The",
+                "fact",
+                "that",
+                "it",
+                "is",
+                "not",
+                "accessible",
+                "to",
+                "endoscopic",
+                "vision",
+                "does",
+                "not",
+                "mean",
+                "that",
+                "it",
+                "is",
+                "not",
+                "there."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "377_131",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "65-year-old",
+                "female",
+                "patient",
+                "debuted",
+                "two",
+                "years",
+                "earlier",
+                "with",
+                "an",
+                "apraxia",
+                "of",
+                "speech",
+                "and",
+                "has",
+                "developed",
+                "rigid-akinetic",
+                "parkinsonism",
+                "predominantly",
+                "in",
+                "the",
+                "right",
+                "hemibody",
+                "with",
+                "superimposed",
+                "myoclonias",
+                "and",
+                "alien",
+                "hand",
+                "or",
+                "foreign",
+                "limb",
+                "phenomenon.What",
+                "diagnosis",
+                "do",
+                "you",
+                "consider",
+                "most",
+                "likely?"
+            ],
+            [
+                "1-",
+                "Parkinson's",
+                "disease."
+            ],
+            [
+                "2-",
+                "Corticobasal",
+                "degeneration."
+            ],
+            [
+                "3-",
+                "Alzheimer's",
+                "disease."
+            ],
+            [
+                "4-",
+                "Huntington's",
+                "disease."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "As",
+                "it",
+                "is",
+                "described",
+                "as",
+                "an",
+                "apraxic",
+                "phenomenon",
+                "followed",
+                "by",
+                "an",
+                "asymmetric",
+                "rigid-akinetic",
+                "parkinsonism",
+                "and",
+                "with",
+                "superimposed",
+                "myoclonias,",
+                "it",
+                "is",
+                "typical",
+                "of",
+                "corticobasal",
+                "degeneration."
+            ],
+            [
+                "Parkinson's",
+                "disease",
+                "cannot",
+                "be",
+                "because",
+                "they",
+                "do",
+                "not",
+                "present",
+                "apraxia",
+                "as",
+                "initial",
+                "feature,",
+                "Alzheimer's",
+                "disease",
+                "does",
+                "not",
+                "present",
+                "an",
+                "asymmetric",
+                "parkinsonism",
+                "and",
+                "the",
+                "typical",
+                "Huntinton's",
+                "disease",
+                "is",
+                "not",
+                "of",
+                "so",
+                "old",
+                "people",
+                "and",
+                "when",
+                "it",
+                "debuts",
+                "with",
+                "advanced",
+                "age",
+                "it",
+                "behaves",
+                "like",
+                "a",
+                "chorea."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "145_143",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "1",
+                "month",
+                "old",
+                "infant,",
+                "exclusively",
+                "breastfed,",
+                "consults",
+                "because",
+                "he",
+                "has",
+                "a",
+                "bowel",
+                "movement",
+                "every",
+                "5",
+                "or",
+                "6",
+                "days",
+                "with",
+                "straining",
+                "but",
+                "with",
+                "a",
+                "soft",
+                "consistency,",
+                "what",
+                "would",
+                "our",
+                "attitude",
+                "be?"
+            ],
+            [
+                "1-",
+                "Start",
+                "laxative",
+                "treatment."
+            ],
+            [
+                "2-",
+                "Supplement",
+                "breastfeeding",
+                "with",
+                "anti-constipation",
+                "formula."
+            ],
+            [
+                "3-",
+                "Start",
+                "daily",
+                "rectal",
+                "stimulation."
+            ],
+            [
+                "4-",
+                "It",
+                "is",
+                "considered",
+                "normal",
+                "intestinal",
+                "rhythm."
+            ],
+            [
+                "5-",
+                "Refer",
+                "to",
+                "Pediatric",
+                "Digestive",
+                "to",
+                "rule",
+                "out",
+                "aganglionic",
+                "megacolon."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "4."
+            ],
+            [
+                "The",
+                "normal",
+                "range",
+                "of",
+                "stool",
+                "output",
+                "in",
+                "young",
+                "infants",
+                "is",
+                "very",
+                "wide."
+            ],
+            [
+                "To",
+                "suspect",
+                "aganglionic",
+                "megacolon",
+                "there",
+                "is",
+                "usually",
+                "a",
+                "delay",
+                "in",
+                "the",
+                "evacuation",
+                "of",
+                "meconium",
+                "and",
+                "often",
+                "other",
+                "associated",
+                "symptoms",
+                "such",
+                "as",
+                "abdominal",
+                "distension,",
+                "difficulty",
+                "in",
+                "gaining",
+                "weight,",
+                "etc."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "567_150",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEPHROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "47-year-old",
+                "woman",
+                "consults",
+                "for",
+                "voiding",
+                "syndrome."
+            ],
+            [
+                "She",
+                "is",
+                "diagnosed",
+                "with",
+                "uncomplicated",
+                "urinary",
+                "tract",
+                "infection",
+                "and",
+                "treated",
+                "with",
+                "ciprofloxacin",
+                "for",
+                "5",
+                "days."
+            ],
+            [
+                "A",
+                "week",
+                "later,",
+                "she",
+                "consulted",
+                "again",
+                "for",
+                "general",
+                "malaise,",
+                "arthralgias",
+                "and",
+                "the",
+                "appearance",
+                "of",
+                "a",
+                "skin",
+                "rash."
+            ],
+            [
+                "In",
+                "the",
+                "analytical",
+                "analysis,",
+                "the",
+                "glomerular",
+                "filtration",
+                "rate",
+                "was",
+                "45",
+                "ml/min",
+                "(CKD-EPI),",
+                "whereas",
+                "6",
+                "months",
+                "ago",
+                "it",
+                "was",
+                "100",
+                "ml/min."
+            ],
+            [
+                "In",
+                "the",
+                "sediment",
+                "leukocytes",
+                "are",
+                "identified,",
+                "being",
+                "negative",
+                "for",
+                "nitrites."
+            ],
+            [
+                "Of",
+                "the",
+                "following,",
+                "which",
+                "is",
+                "the",
+                "most",
+                "probable",
+                "cause",
+                "of",
+                "his",
+                "renal",
+                "failure?"
+            ],
+            [
+                "1-",
+                "Postinfectious",
+                "glomerulonephritis."
+            ],
+            [
+                "2-",
+                "Ciprofloxacin",
+                "nephrotoxicity."
+            ],
+            [
+                "3-",
+                "Acute",
+                "pyelonephritis."
+            ],
+            [
+                "4-",
+                "Acute",
+                "interstitial",
+                "nephritis."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "General",
+                "malaise,",
+                "arthralgias,",
+                "skin",
+                "rash,",
+                "acute",
+                "renal",
+                "failure",
+                "and",
+                "active",
+                "sediment",
+                "with",
+                "sterile",
+                "leukocyturia",
+                "following",
+                "the",
+                "intake",
+                "of",
+                "a",
+                "drug",
+                "is",
+                "highly",
+                "suggestive",
+                "of",
+                "AIN",
+                "(option",
+                "4",
+                "correct)."
+            ],
+            [
+                "Among",
+                "drugs,",
+                "antibiotics",
+                "are",
+                "the",
+                "most",
+                "frequent",
+                "cause,",
+                "and",
+                "ciprofloxacin",
+                "is",
+                "one",
+                "of",
+                "the",
+                "most",
+                "common."
+            ],
+            [
+                "Direct",
+                "nephrotoxicity",
+                "is",
+                "very",
+                "rare",
+                "and",
+                "is",
+                "characterized",
+                "by",
+                "crystallization",
+                "in",
+                "the",
+                "renal",
+                "tubules",
+                "(incorrect",
+                "option",
+                "2)."
+            ],
+            [
+                "Postinfectious",
+                "glomerulonephritis",
+                "is",
+                "more",
+                "typical",
+                "of",
+                "children",
+                "and",
+                "adults",
+                "older",
+                "than",
+                "60",
+                "years,",
+                "and",
+                "usually",
+                "manifests",
+                "with",
+                "hematuria",
+                "after",
+                "streptococcal",
+                "infections",
+                "(option",
+                "1",
+                "incorrect)."
+            ],
+            [
+                "Acute",
+                "pyelonephritis",
+                "would",
+                "have",
+                "been",
+                "presented",
+                "with",
+                "high",
+                "fever",
+                "and",
+                "renal",
+                "fossa",
+                "pain",
+                "(option",
+                "3",
+                "incorrect)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "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",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "177_93",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "HEMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "30-year-old",
+                "woman,",
+                "asymptomatic,",
+                "is",
+                "found",
+                "to",
+                "be",
+                "anemic",
+                "on",
+                "routine",
+                "examination."
+            ],
+            [
+                "Physical",
+                "examination",
+                "reveals",
+                "conjunctival",
+                "jaundice",
+                "and",
+                "splenomegaly."
+            ],
+            [
+                "The",
+                "patient",
+                "refers",
+                "to",
+                "a",
+                "family",
+                "history",
+                "of",
+                "biliary",
+                "lithiasis",
+                "at",
+                "an",
+                "early",
+                "age."
+            ],
+            [
+                "All",
+                "this",
+                "suggests",
+                "the",
+                "most",
+                "probable",
+                "diagnosis",
+                "of:"
+            ],
+            [
+                "1-",
+                "Glucose",
+                "6-phosphate",
+                "dehydrogenase",
+                "deficiency."
+            ],
+            [
+                "2-",
+                "Thalassemia",
+                "minor."
+            ],
+            [
+                "3-",
+                "Vitamin",
+                "Bl2",
+                "and/or",
+                "folic",
+                "acid",
+                "deficiency."
+            ],
+            [
+                "4-",
+                "Familial",
+                "pyruvate",
+                "kinase",
+                "deficiency."
+            ],
+            [
+                "5-",
+                "Hereditary",
+                "spherocytosis."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "You",
+                "have",
+                "probably",
+                "looked",
+                "at",
+                "answer",
+                "5,",
+                "hereditary",
+                "spherocytosis,",
+                "associated",
+                "with",
+                "biliary",
+                "lithiasis",
+                "at",
+                "an",
+                "early",
+                "age."
+            ],
+            [
+                "Exactly,",
+                "that",
+                "is",
+                "the",
+                "correct",
+                "one."
+            ],
+            [
+                "In",
+                "the",
+                "statement",
+                "they",
+                "have",
+                "not",
+                "stopped",
+                "giving",
+                "clues:",
+                "conjunctival",
+                "jaundice,",
+                "splenomegaly",
+                "and",
+                "family",
+                "history",
+                "of",
+                "biliary",
+                "lithiasis",
+                "at",
+                "an",
+                "early",
+                "age."
+            ],
+            [
+                "He",
+                "has",
+                "reached",
+                "30",
+                "years",
+                "of",
+                "age",
+                "without",
+                "suffering",
+                "a",
+                "hemolytic",
+                "crisis,",
+                "without",
+                "suffering",
+                "any",
+                "symptoms."
+            ],
+            [
+                "There",
+                "was",
+                "no",
+                "mention",
+                "of",
+                "microcytosis",
+                "or",
+                "macrocytosis",
+                "to",
+                "suggest",
+                "thalassemia",
+                "minor",
+                "or",
+                "B12",
+                "and/or",
+                "folic",
+                "acid",
+                "deficiency."
+            ],
+            [
+                "Nor",
+                "of",
+                "hemolytic",
+                "crisis",
+                "associated",
+                "with",
+                "the",
+                "consumption",
+                "of",
+                "drugs,",
+                "infections",
+                "or",
+                "ingestion",
+                "of",
+                "beans",
+                "or",
+                "peas."
+            ],
+            [
+                "They",
+                "have",
+                "not",
+                "given",
+                "any",
+                "clues",
+                "to",
+                "stop",
+                "to",
+                "think",
+                "about",
+                "other",
+                "possibilities."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "125_105",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEPHROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "19-year-old",
+                "woman,",
+                "weight",
+                "60",
+                "kg,",
+                "with",
+                "acute",
+                "dehydration",
+                "due",
+                "to",
+                "long",
+                "exposure",
+                "to",
+                "the",
+                "sun."
+            ],
+            [
+                "Blood",
+                "pressure",
+                "lying",
+                "down",
+                "100/60",
+                "mmHg."
+            ],
+            [
+                "Standing",
+                "70/50",
+                "mmHg",
+                "with",
+                "dizziness."
+            ],
+            [
+                "Serum",
+                "sodium",
+                "levels",
+                "155",
+                "mmol/L."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "correct",
+                "treatment,",
+                "in",
+                "the",
+                "first",
+                "24",
+                "hours,",
+                "taking",
+                "into",
+                "account",
+                "the",
+                "data",
+                "available",
+                "to",
+                "us?"
+            ],
+            [
+                "1-",
+                "Hypertonic",
+                "saline",
+                "(3%),",
+                "500",
+                "ml",
+                "+",
+                "500",
+                "ml",
+                "of",
+                "5%",
+                "glucose."
+            ],
+            [
+                "2-",
+                "Hyposaline",
+                "saline",
+                "(0.45%),",
+                "3000",
+                "ml."
+            ],
+            [
+                "3-",
+                "Serum",
+                "glucose",
+                "5%",
+                "1000",
+                "ml."
+            ],
+            [
+                "4-",
+                "Oral",
+                "hydration",
+                "with",
+                "1",
+                "liter",
+                "of",
+                "water."
+            ],
+            [
+                "5-",
+                "Isotonic",
+                "saline",
+                "(0.9%),",
+                "2000",
+                "ml."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "This",
+                "question",
+                "is",
+                "not",
+                "an",
+                "easy",
+                "one."
+            ],
+            [
+                "The",
+                "available",
+                "literature",
+                "is",
+                "somewhat",
+                "controversial",
+                "(some",
+                "guidelines",
+                "advise",
+                "using",
+                "glucose",
+                "saline,",
+                "others",
+                "absolutely",
+                "forbid",
+                "it...)",
+                "so",
+                "I",
+                "have",
+                "decided",
+                "to",
+                "rely",
+                "on",
+                "the",
+                "treatment",
+                "recommended",
+                "by",
+                "Harrison,",
+                "which",
+                "is",
+                "the",
+                "manual",
+                "that",
+                "MIR",
+                "examiners",
+                "usually",
+                "rely",
+                "on."
+            ],
+            [
+                "This",
+                "girl",
+                "presents",
+                "with",
+                "hypernatremia",
+                "due",
+                "to",
+                "extrarenal",
+                "free",
+                "water",
+                "losses."
+            ],
+            [
+                "The",
+                "goal",
+                "is",
+                "to",
+                "replace",
+                "the",
+                "lost",
+                "water",
+                "and",
+                "reduce",
+                "the",
+                "natremia",
+                "at",
+                "a",
+                "rate",
+                "of",
+                "no",
+                "more",
+                "than",
+                "12",
+                "mmol/day."
+            ],
+            [
+                "To",
+                "calculate",
+                "fluid",
+                "therapy,",
+                "the",
+                "water",
+                "deficit",
+                "must",
+                "first",
+                "be",
+                "calculated."
+            ],
+            [
+                "Water",
+                "def.",
+                "Water",
+                "=",
+                "(Natremia-140/140)xTotal",
+                "body",
+                "water.",
+                "TBW",
+                "=",
+                "Weight",
+                "in",
+                "kg",
+                "x",
+                "0.4",
+                "in",
+                "females/0.5",
+                "in",
+                "males."
+            ],
+            [
+                "In",
+                "this",
+                "case,",
+                "the",
+                "water",
+                "deficit",
+                "is:",
+                "([[tel:155-140/140|155-140/140]])x60x0.4",
+                "=",
+                "2.57",
+                "liters."
+            ],
+            [
+                "There",
+                "are",
+                "only",
+                "two",
+                "answers",
+                "that",
+                "come",
+                "close",
+                "to",
+                "this",
+                "figure,",
+                "but",
+                "2",
+                "seems",
+                "more",
+                "correct,",
+                "as",
+                "it",
+                "is",
+                "the",
+                "only",
+                "one",
+                "that",
+                "completely",
+                "covers",
+                "the",
+                "water",
+                "deficit",
+                "and",
+                "uses",
+                "a",
+                "hyposodium",
+                "solution."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "510_151",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DIGESTIVE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "43-year-old",
+                "male",
+                "with",
+                "no",
+                "past",
+                "history",
+                "of",
+                "interest",
+                "consults",
+                "for",
+                "a",
+                "ten-day",
+                "history",
+                "of",
+                "jaundice",
+                "of",
+                "the",
+                "skin",
+                "and",
+                "mucous",
+                "membranes,",
+                "choluria",
+                "and",
+                "acholia."
+            ],
+            [
+                "He",
+                "does",
+                "not",
+                "report",
+                "abdominal",
+                "pain,",
+                "weight",
+                "loss",
+                "or",
+                "other",
+                "symptoms,",
+                "except",
+                "generalized",
+                "pruritus."
+            ],
+            [
+                "She",
+                "denies",
+                "alcohol",
+                "consumption."
+            ],
+            [
+                "She",
+                "does",
+                "not",
+                "take",
+                "any",
+                "medication",
+                "except",
+                "occasional",
+                "ibuprofen",
+                "for",
+                "muscle",
+                "pain",
+                "after",
+                "sports",
+                "activities."
+            ],
+            [
+                "The",
+                "CBC",
+                "shows",
+                "increased",
+                "bilirubin",
+                "at",
+                "the",
+                "expense",
+                "of",
+                "direct",
+                "bilirubin."
+            ],
+            [
+                "An",
+                "urgent",
+                "ultrasound",
+                "shows",
+                "a",
+                "normal",
+                "liver,",
+                "vesicular",
+                "cholesterosis",
+                "and",
+                "absence",
+                "of",
+                "bile",
+                "duct",
+                "dilatation,",
+                "with",
+                "no",
+                "other",
+                "alterations",
+                "of",
+                "interest."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Acute",
+                "cholangitis",
+                "due",
+                "to",
+                "biliary",
+                "mud."
+            ],
+            [
+                "2-",
+                "Toxic",
+                "hepatitis",
+                "due",
+                "to",
+                "ibuprofen."
+            ],
+            [
+                "3-",
+                "Cholangiocarcinoma."
+            ],
+            [
+                "4-",
+                "Gilbert's",
+                "syndrome."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "We",
+                "believe",
+                "that",
+                "this",
+                "question",
+                "is",
+                "open",
+                "to",
+                "challenge."
+            ],
+            [
+                "Ibuprofen",
+                "hepatitis",
+                "is",
+                "a",
+                "rare",
+                "adverse",
+                "effect",
+                "with",
+                "a",
+                "prevalence",
+                "of",
+                "about",
+                "3.7/100,000",
+                "users",
+                "and",
+                "1.1/100,000",
+                "prescriptions."
+            ],
+            [
+                "It",
+                "appears",
+                "that",
+                "it",
+                "may",
+                "be",
+                "related",
+                "to",
+                "dose",
+                "and",
+                "duration",
+                "of",
+                "treatment,",
+                "but",
+                "there",
+                "is",
+                "little",
+                "evidence",
+                "on",
+                "this."
+            ],
+            [
+                "Among",
+                "the",
+                "NSAIDs",
+                "with",
+                "the",
+                "highest",
+                "risk",
+                "are",
+                "diclofenac",
+                "and",
+                "sulindac."
+            ],
+            [
+                "In",
+                "terms",
+                "of",
+                "frequency,",
+                "the",
+                "prevalence",
+                "of",
+                "cholangiocarcinoma",
+                "is",
+                "2/100,000",
+                "patients,",
+                "a",
+                "very",
+                "comparable",
+                "frequency."
+            ],
+            [
+                "The",
+                "absence",
+                "of",
+                "bile",
+                "duct",
+                "dilatation",
+                "in",
+                "cholangiocarcinomas",
+                "can",
+                "be",
+                "seen",
+                "in",
+                "cases",
+                "of",
+                "intrahepatic",
+                "cholangiocarcinomas",
+                "or",
+                "in",
+                "those",
+                "with",
+                "mixed",
+                "histology",
+                "with",
+                "hepatocarcinoma."
+            ],
+            [
+                "It",
+                "is",
+                "true",
+                "that",
+                "the",
+                "acute",
+                "course",
+                "and",
+                "the",
+                "absence",
+                "of",
+                "constitutional",
+                "syndrome",
+                "may",
+                "make",
+                "us",
+                "think",
+                "against",
+                "this",
+                "option",
+                "and",
+                "tip",
+                "the",
+                "balance",
+                "towards",
+                "ibuprofen",
+                "hepatitis."
+            ],
+            [
+                "Regarding",
+                "the",
+                "other",
+                "options:",
+                "acute",
+                "cholangitis",
+                "is",
+                "characterized",
+                "by",
+                "the",
+                "triad",
+                "of",
+                "jaundice,",
+                "abdominal",
+                "pain",
+                "and",
+                "fever;",
+                "Gilbert's",
+                "syndrome",
+                "is",
+                "an",
+                "increase",
+                "in",
+                "bilirubin",
+                "at",
+                "the",
+                "expense",
+                "of",
+                "indirectness."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "268_140",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PULMONOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "50-year-old",
+                "patient",
+                "presenting",
+                "with",
+                "a",
+                "pleural",
+                "effusion",
+                "with",
+                "the",
+                "following",
+                "features:",
+                "straw-like",
+                "appearance,",
+                "pH",
+                "7.3,",
+                "pleural",
+                "protein/serum",
+                "ratio",
+                "0.8,",
+                "pleural",
+                "LDH/serum",
+                "ratio",
+                "0.9,",
+                "Gram",
+                "and",
+                "Ziehl's",
+                "negative,",
+                "total",
+                "lipids,",
+                "cholesterol",
+                "and",
+                "triglycerides",
+                "normal,",
+                "mesothelial",
+                "cells",
+                "<5%,",
+                "intense",
+                "lymphocytosis",
+                "without",
+                "atypia,",
+                "ADA",
+                "64",
+                "U/L."
+            ],
+            [
+                "What",
+                "diagnosis",
+                "would",
+                "you",
+                "suggest?"
+            ],
+            [
+                "1-",
+                "Pleural",
+                "empyema."
+            ],
+            [
+                "2-",
+                "Pleural",
+                "effusion",
+                "due",
+                "to",
+                "heart",
+                "failure",
+                "(transudate)."
+            ],
+            [
+                "3-",
+                "Pleural",
+                "mesothelioma."
+            ],
+            [
+                "4-",
+                "Tuberculous",
+                "pleural",
+                "effusion."
+            ],
+            [
+                "5-",
+                "Effusion",
+                "secondary",
+                "to",
+                "pulmonary",
+                "infarction."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "It",
+                "is",
+                "a",
+                "lymphocytic",
+                "exudate",
+                "whose",
+                "main",
+                "diagnoses",
+                "are",
+                "tumor",
+                "and",
+                "tuberculous",
+                "pleuritis."
+            ],
+            [
+                "They",
+                "do",
+                "not",
+                "give",
+                "the",
+                "value",
+                "of",
+                "glucose",
+                "which",
+                "should",
+                "be",
+                "lowered,",
+                "but",
+                "if",
+                "the",
+                "cytology",
+                "shows",
+                "absence",
+                "of",
+                "malignant",
+                "cells",
+                "so",
+                "we",
+                "are",
+                "left",
+                "with",
+                "tuberculous",
+                "pleuritis."
+            ],
+            [
+                "Other",
+                "possible",
+                "diagnoses",
+                "such",
+                "as",
+                "lymphoma",
+                "are",
+                "not",
+                "mentioned",
+                "in",
+                "the",
+                "answers."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "465_116",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "BIOSTATISTICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "In",
+                "a",
+                "subject",
+                "over",
+                "65",
+                "years",
+                "of",
+                "age",
+                "a",
+                "tuberculin",
+                "test",
+                "has",
+                "shown",
+                "an",
+                "induration",
+                "of",
+                "3",
+                "mm."
+            ],
+            [
+                "The",
+                "induration",
+                "on",
+                "a",
+                "second",
+                "test,",
+                "performed",
+                "10",
+                "days",
+                "later,",
+                "is",
+                "13",
+                "mm."
+            ],
+            [
+                "Point",
+                "out",
+                "the",
+                "correct",
+                "answer:"
+            ],
+            [
+                "1-",
+                "The",
+                "first",
+                "reaction",
+                "is",
+                "a",
+                "false",
+                "positive."
+            ],
+            [
+                "2-",
+                "The",
+                "second",
+                "reaction",
+                "is",
+                "a",
+                "true",
+                "positive."
+            ],
+            [
+                "3-",
+                "The",
+                "first",
+                "reaction",
+                "is",
+                "a",
+                "true",
+                "negative."
+            ],
+            [
+                "4-",
+                "The",
+                "second",
+                "reaction",
+                "is",
+                "a",
+                "false",
+                "positive."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Let's",
+                "see,",
+                "if",
+                "that",
+                "subject",
+                "was",
+                "not",
+                "in",
+                "any",
+                "risk",
+                "group,",
+                "the",
+                "positive",
+                "is",
+                "in",
+                "the",
+                "15mm,",
+                "therefore",
+                "both",
+                "tests",
+                "are",
+                "negative,",
+                "and",
+                "as",
+                "only",
+                "one",
+                "answer",
+                "refers",
+                "to",
+                "negative,",
+                "that's",
+                "it."
+            ],
+            [
+                "But",
+                "both",
+                "could",
+                "be",
+                "false",
+                "negatives."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "340_33",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "67-year-old",
+                "woman",
+                "diagnosed",
+                "with",
+                "infiltrating",
+                "ductal",
+                "carcinoma",
+                "of",
+                "the",
+                "breast",
+                "with",
+                "no",
+                "family",
+                "history",
+                "of",
+                "neoplasia."
+            ],
+            [
+                "What",
+                "additional",
+                "studies",
+                "should",
+                "be",
+                "performed",
+                "on",
+                "the",
+                "tumor",
+                "because",
+                "of",
+                "its",
+                "clinical",
+                "and",
+                "therapeutic",
+                "implications?"
+            ],
+            [
+                "1-",
+                "Complete",
+                "phenotypic",
+                "study",
+                "by",
+                "flow",
+                "cytometry."
+            ],
+            [
+                "2-",
+                "Study",
+                "of",
+                "hormone",
+                "receptors",
+                "and",
+                "HER2."
+            ],
+            [
+                "3-",
+                "Study",
+                "of",
+                "hormone",
+                "receptors,",
+                "e-cadherin",
+                "and",
+                "study",
+                "of",
+                "first",
+                "degree",
+                "relatives."
+            ],
+            [
+                "4-",
+                "Study",
+                "of",
+                "BRCA",
+                "1-2",
+                "and",
+                "study",
+                "of",
+                "first-degree",
+                "relatives."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "The",
+                "answer",
+                "is",
+                "2,",
+                "study",
+                "of",
+                "hormone",
+                "receptors",
+                "and",
+                "HER2."
+            ],
+            [
+                "This",
+                "is",
+                "because",
+                "no",
+                "study",
+                "of",
+                "first-degree",
+                "relatives",
+                "is",
+                "appropriate,",
+                "as",
+                "it",
+                "does",
+                "not",
+                "appear",
+                "to",
+                "be",
+                "hereditary",
+                "breast",
+                "cancer",
+                "since",
+                "there",
+                "is",
+                "no",
+                "family",
+                "history",
+                "of",
+                "neoplasia."
+            ],
+            [
+                "On",
+                "the",
+                "other",
+                "hand,",
+                "there",
+                "is",
+                "no",
+                "indication",
+                "for",
+                "BRCA",
+                "1-2",
+                "study."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "O",
+                "B-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "561_180",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "HEMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "26-year-old",
+                "woman",
+                "diagnosed",
+                "with",
+                "systemic",
+                "lupus",
+                "erythematosus,",
+                "on",
+                "treatment",
+                "with",
+                "hydroxychloroquine,",
+                "consults",
+                "for",
+                "a",
+                "feeling",
+                "of",
+                "generalized",
+                "weakness",
+                "that",
+                "has",
+                "progressively",
+                "developed",
+                "in",
+                "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",
+                "tests",
+                "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"
+            ],
+            [
+                "It",
+                "tells",
+                "us",
+                "about",
+                "a",
+                "patient",
+                "with",
+                "a",
+                "diagnosis",
+                "of",
+                "lupus",
+                "and",
+                "macrocytic",
+                "anemia."
+            ],
+            [
+                "In",
+                "the",
+                "end,",
+                "all",
+                "the",
+                "data",
+                "are",
+                "usually",
+                "given",
+                "for",
+                "a",
+                "reason."
+            ],
+            [
+                "The",
+                "onset",
+                "of",
+                "the",
+                "picture",
+                "seems",
+                "relatively",
+                "rapid",
+                "and",
+                "it",
+                "is",
+                "also",
+                "associated",
+                "with",
+                "an",
+                "autoimmune",
+                "disease,",
+                "so",
+                "it",
+                "seems",
+                "that",
+                "they",
+                "want",
+                "you",
+                "to",
+                "associate",
+                "it",
+                "with",
+                "an",
+                "autoimmune",
+                "hemolytic",
+                "anemia."
+            ],
+            [
+                "The",
+                "low",
+                "haptoglobin",
+                "would",
+                "tell",
+                "us",
+                "it",
+                "is",
+                "\"hemolytic\",",
+                "the",
+                "coombs",
+                "test",
+                "would",
+                "tell",
+                "us",
+                "it",
+                "is",
+                "\"autoimmune\"."
+            ],
+            [
+                "Vitamin",
+                "B12,",
+                "probably",
+                "the",
+                "MCV",
+                "would",
+                "be",
+                "higher",
+                "than",
+                "108",
+                "and",
+                "the",
+                "onset",
+                "of",
+                "the",
+                "clinical",
+                "picture",
+                "would",
+                "be",
+                "slower."
+            ],
+            [
+                "The",
+                "ANA",
+                "would",
+                "not",
+                "give",
+                "us",
+                "anything",
+                "in",
+                "relation",
+                "to",
+                "the",
+                "anemia,",
+                "since",
+                "it",
+                "already",
+                "has",
+                "a",
+                "diagnosis."
+            ],
+            [
+                "Therefore,",
+                "correct",
+                "answer",
+                "2."
+            ],
+            [
+                "As",
+                "a",
+                "note,",
+                "autoimmune",
+                "hemolytic",
+                "anemias",
+                "are",
+                "usually",
+                "slightly",
+                "macrocytic",
+                "due",
+                "to",
+                "reticulocytosis."
+            ],
+            [
+                "Remember",
+                "to",
+                "ask",
+                "for",
+                "reticulocytes."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "451_175",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROSURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "36-year-old",
+                "man",
+                "with",
+                "no",
+                "PA",
+                "of",
+                "interest",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "with",
+                "sudden",
+                "onset",
+                "of",
+                "severe",
+                "pain",
+                "in",
+                "the",
+                "posterior",
+                "aspect",
+                "of",
+                "the",
+                "right",
+                "lower",
+                "limb",
+                "extending",
+                "to",
+                "the",
+                "foot."
+            ],
+            [
+                "On",
+                "examination",
+                "he",
+                "presented:",
+                "Positive",
+                "right",
+                "Las\u00e8ge",
+                "at",
+                "10\u00ba,",
+                "decreased",
+                "strength",
+                "in",
+                "plantar",
+                "flexion",
+                "of",
+                "the",
+                "right",
+                "foot,",
+                "hypoesthesia",
+                "in",
+                "the",
+                "external",
+                "border",
+                "of",
+                "the",
+                "right",
+                "foot",
+                "and",
+                "absence",
+                "of",
+                "right",
+                "Achilles",
+                "reflex."
+            ],
+            [
+                "The",
+                "simple",
+                "X-ray",
+                "of",
+                "the",
+                "lumbar",
+                "spine",
+                "does",
+                "not",
+                "show",
+                "significant",
+                "alterations."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "is",
+                "the",
+                "most",
+                "probable",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Herniated",
+                "disc",
+                "L1/L2."
+            ],
+            [
+                "2-",
+                "Horsetail",
+                "syndrome."
+            ],
+            [
+                "3-",
+                "L4/L5",
+                "disc",
+                "herniation."
+            ],
+            [
+                "4-",
+                "Herniated",
+                "disc",
+                "L5/S1."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Acute",
+                "sciatica",
+                "probably",
+                "due",
+                "to",
+                "disc",
+                "extrusion."
+            ],
+            [
+                "Both",
+                "the",
+                "sensory",
+                "distribution,",
+                "the",
+                "paresis",
+                "for",
+                "plantar",
+                "flexion",
+                "(tiptoe)",
+                "and",
+                "the",
+                "absence",
+                "of",
+                "the",
+                "Achilles",
+                "reflex",
+                "are",
+                "typical",
+                "of",
+                "S1",
+                "root",
+                "involvement,",
+                "which",
+                "is",
+                "typically",
+                "affected",
+                "with",
+                "L5/S1",
+                "disc",
+                "herniation",
+                "(posterolateral)."
+            ],
+            [
+                "An",
+                "L1/L2",
+                "(posterolateral)",
+                "herniation",
+                "would",
+                "affect",
+                "the",
+                "L2",
+                "root,",
+                "an",
+                "L4/L5",
+                "herniation",
+                "would",
+                "affect",
+                "the",
+                "L5",
+                "and",
+                "cauda",
+                "equina",
+                "would",
+                "involve",
+                "more",
+                "symptomatology",
+                "than",
+                "simple",
+                "S1",
+                "involvement."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "399_141",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "TRAUMATOLOGY",
+                "AND",
+                "ORTHOPEDICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "20-year-old",
+                "male,",
+                "who",
+                "consults",
+                "for",
+                "lumbosacral",
+                "pain",
+                "of",
+                "inflammatory",
+                "rhythm",
+                "of",
+                "4",
+                "months",
+                "of",
+                "evolution."
+            ],
+            [
+                "Also",
+                "bilateral",
+                "thalalgia",
+                "and",
+                "morning",
+                "stiffness",
+                "for",
+                "1",
+                "hour."
+            ],
+            [
+                "In",
+                "the",
+                "last",
+                "2",
+                "months,",
+                "onset",
+                "of",
+                "diarrhea",
+                "with",
+                "loss",
+                "of",
+                "4",
+                "kg",
+                "of",
+                "weight."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "correct",
+                "diagnostic",
+                "approach?"
+            ],
+            [
+                "1-",
+                "Given",
+                "the",
+                "patient's",
+                "age,",
+                "he",
+                "most",
+                "likely",
+                "suffers",
+                "from",
+                "non-specific",
+                "low",
+                "back",
+                "pain",
+                "and",
+                "tendonitis",
+                "of",
+                "the",
+                "feet.",
+                "If",
+                "the",
+                "diarrhea",
+                "persists,",
+                "a",
+                "digestive",
+                "study",
+                "would",
+                "be",
+                "performed."
+            ],
+            [
+                "2-",
+                "Perform",
+                "a",
+                "digestive",
+                "study",
+                "to",
+                "rule",
+                "out",
+                "tumor",
+                "pathology.",
+                "Low",
+                "back",
+                "pain",
+                "may",
+                "be",
+                "due",
+                "to",
+                "visceral",
+                "pathology."
+            ],
+            [
+                "3-",
+                "The",
+                "clinical",
+                "picture",
+                "is",
+                "very",
+                "suggestive",
+                "of",
+                "spondyloarthritis.",
+                "Inflammatory",
+                "bowel",
+                "disease",
+                "should",
+                "be",
+                "ruled",
+                "out."
+            ],
+            [
+                "4-",
+                "I",
+                "would",
+                "request",
+                "a",
+                "lumbar",
+                "MRI",
+                "to",
+                "rule",
+                "out",
+                "disc",
+                "herniation",
+                "and",
+                "if",
+                "diarrhea",
+                "persists,",
+                "a",
+                "digestive",
+                "study."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "The",
+                "patient",
+                "presents",
+                "the",
+                "clinical",
+                "features",
+                "of",
+                "spondylarthropathy,",
+                "which",
+                "is",
+                "often",
+                "associated",
+                "with",
+                "inflammatory",
+                "bowel",
+                "disease,",
+                "as",
+                "this",
+                "case",
+                "suggests."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "12_92",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "30-year-old",
+                "man",
+                "suffers",
+                "a",
+                "fall",
+                "from",
+                "a",
+                "standing",
+                "height",
+                "of",
+                "2",
+                "meters."
+            ],
+            [
+                "On",
+                "arrival",
+                "at",
+                "the",
+                "emergency",
+                "room",
+                "on",
+                "a",
+                "stretcher,",
+                "he",
+                "is",
+                "conscious",
+                "and",
+                "oriented,",
+                "with",
+                "bladder",
+                "catheterization",
+                "and",
+                "clear",
+                "urine."
+            ],
+            [
+                "He",
+                "shows",
+                "swelling",
+                "of",
+                "the",
+                "left",
+                "heel",
+                "and",
+                "mild",
+                "tingling",
+                "in",
+                "the",
+                "anterior",
+                "aspect",
+                "of",
+                "the",
+                "left",
+                "thigh",
+                "and",
+                "scrotum",
+                "as",
+                "well",
+                "as",
+                "dysesthesia",
+                "in",
+                "both",
+                "feet."
+            ],
+            [
+                "The",
+                "patient",
+                "says",
+                "goodbye",
+                "to",
+                "the",
+                "stretcher-bearer",
+                "with",
+                "a",
+                "handshake",
+                "and",
+                "a",
+                "simultaneous",
+                "pat",
+                "on",
+                "the",
+                "shoulder."
+            ],
+            [
+                "Rotation",
+                "of",
+                "the",
+                "lower",
+                "limbs",
+                "on",
+                "the",
+                "stretcher",
+                "grasped",
+                "by",
+                "the",
+                "ankles",
+                "is",
+                "painless",
+                "and",
+                "compression",
+                "of",
+                "the",
+                "pelvis",
+                "is",
+                "asymptomatic."
+            ],
+            [
+                "Next:"
+            ],
+            [
+                "1-",
+                "The",
+                "patient",
+                "will",
+                "be",
+                "seated",
+                "on",
+                "the",
+                "stretcher",
+                "so",
+                "that",
+                "the",
+                "cervical",
+                "spine",
+                "can",
+                "be",
+                "explored."
+            ],
+            [
+                "2-",
+                "Refer",
+                "to",
+                "radiology",
+                "for",
+                "study",
+                "of",
+                "the",
+                "lower",
+                "extremities",
+                "(feet,",
+                "femurs,",
+                "pelvis)."
+            ],
+            [
+                "3-",
+                "We",
+                "will",
+                "palpate",
+                "the",
+                "abdomen",
+                "and",
+                "roll",
+                "en",
+                "bloc",
+                "to",
+                "palpate",
+                "the",
+                "thoracolumbar",
+                "spine."
+            ],
+            [
+                "4-",
+                "We",
+                "will",
+                "place",
+                "a",
+                "cervical",
+                "collar",
+                "and",
+                "refer",
+                "to",
+                "radiology",
+                "for",
+                "imaging",
+                "of",
+                "the",
+                "lower",
+                "extremities",
+                "and",
+                "cervical",
+                "spine."
+            ],
+            [
+                "5-",
+                "We",
+                "will",
+                "request",
+                "an",
+                "abdominal",
+                "ultrasound."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "I",
+                "believe",
+                "that",
+                "the",
+                "correct",
+                "answer",
+                "is",
+                "3."
+            ],
+            [
+                "The",
+                "patient,",
+                "due",
+                "to",
+                "the",
+                "mechanism",
+                "of",
+                "injury",
+                "(foot",
+                "fall),",
+                "the",
+                "calcaneal",
+                "fracture",
+                "and",
+                "the",
+                "neurological",
+                "symptoms,",
+                "suggests",
+                "a",
+                "low",
+                "spinal",
+                "cord",
+                "injury",
+                "due",
+                "to",
+                "a",
+                "fracture",
+                "of",
+                "the",
+                "lumbar",
+                "spine."
+            ],
+            [
+                "The",
+                "injury",
+                "is",
+                "not",
+                "high",
+                "because",
+                "he",
+                "moves",
+                "his",
+                "arms."
+            ],
+            [
+                "It",
+                "also",
+                "does",
+                "not",
+                "appear",
+                "to",
+                "be",
+                "a",
+                "pelvic",
+                "injury",
+                "because",
+                "of",
+                "the",
+                "absence",
+                "of",
+                "pain",
+                "on",
+                "mobilization",
+                "or",
+                "palpation."
+            ],
+            [
+                "If",
+                "there",
+                "is",
+                "a",
+                "suspicion",
+                "of",
+                "pelvic",
+                "injury",
+                "in",
+                "the",
+                "primary",
+                "evaluation",
+                "of",
+                "all",
+                "polytraumatized",
+                "(ATLS)",
+                "a",
+                "spinal",
+                "exploration",
+                "should",
+                "be",
+                "performed",
+                "by",
+                "rotating",
+                "the",
+                "spine",
+                "en",
+                "bloc",
+                "to",
+                "avoid",
+                "producing",
+                "more",
+                "injury."
+            ],
+            [
+                "Abdominal",
+                "palpation",
+                "is",
+                "also",
+                "part",
+                "of",
+                "the",
+                "initial",
+                "evaluation."
+            ],
+            [
+                "Abdominal",
+                "ultrasound",
+                "may",
+                "be",
+                "indicated",
+                "in",
+                "hemodynamically",
+                "unstable",
+                "patients",
+                "if",
+                "abdominal",
+                "injuries",
+                "are",
+                "suspected",
+                "but",
+                "in",
+                "any",
+                "case",
+                "it",
+                "is",
+                "done",
+                "after",
+                "the",
+                "initial",
+                "evaluation."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
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+                "I-Premise",
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+            ],
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+                "O",
+                "O",
+                "O",
+                "O",
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+                "O",
+                "O",
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+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
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+            ],
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+            [
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
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+                "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-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "605_113",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "TRAUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "35-year-old",
+                "male,",
+                "letter",
+                "carrier,",
+                "with",
+                "no",
+                "history",
+                "of",
+                "interest,",
+                "who",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "for",
+                "acute",
+                "cervical",
+                "pain",
+                "of",
+                "24",
+                "hours",
+                "of",
+                "evolution,",
+                "without",
+                "previous",
+                "trauma,",
+                "which",
+                "radiates",
+                "to",
+                "the",
+                "left",
+                "arm",
+                "up",
+                "to",
+                "the",
+                "hand",
+                "and",
+                "is",
+                "accompanied",
+                "by",
+                "paresthesia",
+                "in",
+                "the",
+                "radial",
+                "border",
+                "of",
+                "the",
+                "forearm."
+            ],
+            [
+                "She",
+                "presents",
+                "no",
+                "objectifiable",
+                "loss",
+                "of",
+                "strength,",
+                "preserves",
+                "neck",
+                "mobility",
+                "although",
+                "it",
+                "is",
+                "painful",
+                "and",
+                "contracture",
+                "of",
+                "the",
+                "paravertebral",
+                "musculature",
+                "is",
+                "appreciated."
+            ],
+            [
+                "The",
+                "first",
+                "attitude",
+                "will",
+                "be:"
+            ],
+            [
+                "1-",
+                "Conservative",
+                "treatment",
+                "with",
+                "non-steroidal",
+                "anti-inflammatory",
+                "drugs,",
+                "local",
+                "heat",
+                "and",
+                "relative",
+                "rest."
+            ],
+            [
+                "2-",
+                "Urgent",
+                "call",
+                "to",
+                "the",
+                "neurosurgeon",
+                "for",
+                "surgical",
+                "evaluation."
+            ],
+            [
+                "3-",
+                "Preferential",
+                "request",
+                "for",
+                "MRI",
+                "and",
+                "electromyogram."
+            ],
+            [
+                "4-",
+                "Preferential",
+                "referral",
+                "to",
+                "traumatology",
+                "outpatients."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "In",
+                "this",
+                "case",
+                "we",
+                "describe",
+                "a",
+                "case",
+                "of",
+                "cervicobrachialgia",
+                "without",
+                "alarm",
+                "signs",
+                "at",
+                "the",
+                "present",
+                "time,",
+                "so",
+                "the",
+                "most",
+                "indicated",
+                "treatment",
+                "at",
+                "this",
+                "time",
+                "would",
+                "be",
+                "conservative,",
+                "based",
+                "on",
+                "NSAIDs,",
+                "local",
+                "heat",
+                "and",
+                "rest."
+            ],
+            [
+                "This",
+                "is",
+                "not",
+                "an",
+                "urgent",
+                "case,",
+                "so",
+                "answer",
+                "2",
+                "would",
+                "not",
+                "be",
+                "valid."
+            ],
+            [
+                "The",
+                "performance",
+                "of",
+                "an",
+                "MRI",
+                "and",
+                "an",
+                "electromyogram",
+                "are",
+                "valid",
+                "options",
+                "for",
+                "the",
+                "etiological",
+                "study",
+                "of",
+                "the",
+                "picture,",
+                "however,",
+                "it",
+                "is",
+                "necessary",
+                "to",
+                "emphasize",
+                "that",
+                "we",
+                "should",
+                "first",
+                "perform",
+                "a",
+                "correct",
+                "pain",
+                "management,",
+                "so",
+                "since",
+                "we",
+                "are",
+                "asked",
+                "about",
+                "the",
+                "first",
+                "attitude,",
+                "option",
+                "1",
+                "would",
+                "be",
+                "more",
+                "valid."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
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+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "443_102",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "64-year-old",
+                "woman,",
+                "without",
+                "relevant",
+                "comorbidities,",
+                "operated",
+                "on",
+                "for",
+                "a",
+                "right",
+                "breast",
+                "cancer",
+                "by",
+                "means",
+                "of",
+                "an",
+                "extended",
+                "lumpectomy",
+                "and",
+                "selective",
+                "sentinel",
+                "lymph",
+                "node",
+                "biopsy,",
+                "with",
+                "the",
+                "following",
+                "anatomopathological",
+                "result:",
+                "Infiltrating",
+                "ductal",
+                "carcinoma",
+                "poorly",
+                "dlferentiated",
+                "(grade",
+                "3),",
+                "size",
+                "2.2",
+                "cm",
+                "(pT2),",
+                "estrogen",
+                "and",
+                "progesterone",
+                "receptor",
+                "positive,",
+                "Ki67",
+                "25%,",
+                "HER2",
+                "negative."
+            ],
+            [
+                "There",
+                "is",
+                "macroscopic",
+                "involvement",
+                "of",
+                "the",
+                "sentinel",
+                "lymph",
+                "node,",
+                "although",
+                "there",
+                "is",
+                "no",
+                "involvement",
+                "of",
+                "the",
+                "rest",
+                "of",
+                "the",
+                "isolated",
+                "axillary",
+                "nodes",
+                "(pN1)."
+            ],
+            [
+                "What",
+                "adjuvant",
+                "systemic",
+                "treatment",
+                "do",
+                "you",
+                "consider",
+                "most",
+                "appropriate",
+                "for",
+                "this",
+                "patient?"
+            ],
+            [
+                "1-",
+                "Adjuvant",
+                "hormone",
+                "therapy",
+                "including",
+                "aromatase",
+                "inhibitors."
+            ],
+            [
+                "2-",
+                "Adjuvant",
+                "chemotherapy,",
+                "preferably",
+                "with",
+                "anthracyclines",
+                "and",
+                "taxanes,",
+                "followed",
+                "by",
+                "hormone",
+                "therapy."
+            ],
+            [
+                "3-",
+                "Adjuvant",
+                "chemotherapy",
+                "in",
+                "association",
+                "with",
+                "the",
+                "monoclonal",
+                "antibody",
+                "trastuzumab,",
+                "followed",
+                "by",
+                "hormone",
+                "therapy."
+            ],
+            [
+                "4-",
+                "Adjuvant",
+                "chemotherapy,",
+                "preferably",
+                "with",
+                "anthracyclines",
+                "and",
+                "taxanes."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "It",
+                "is",
+                "a",
+                "Luminal",
+                "B.",
+                "According",
+                "to",
+                "the",
+                "SEGO,",
+                "this",
+                "patient",
+                "is",
+                "a",
+                "candidate",
+                "for",
+                "chemotherapy",
+                "treatment",
+                "because",
+                "of",
+                "the",
+                "high",
+                "histologic",
+                "grade",
+                "and",
+                "high",
+                "tumor",
+                "proliferation."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "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",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "197_71",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "10-year-old",
+                "boy",
+                "with",
+                "brief",
+                "episodes",
+                "of",
+                "distractibility",
+                "(<",
+                "1",
+                "minute)",
+                "in",
+                "which",
+                "he",
+                "does",
+                "not",
+                "respond",
+                "to",
+                "calls",
+                "and",
+                "blinks."
+            ],
+            [
+                "An",
+                "EEG",
+                "shows",
+                "spike-wave",
+                "discharges",
+                "at",
+                "3",
+                "cycles",
+                "per",
+                "second."
+            ],
+            [
+                "First-line",
+                "elective",
+                "treatment",
+                "would",
+                "be",
+                "with:"
+            ],
+            [
+                "1-",
+                "Valproate."
+            ],
+            [
+                "2-",
+                "Carbamazepine."
+            ],
+            [
+                "3-",
+                "Phenytoin."
+            ],
+            [
+                "4-",
+                "Gabapentin."
+            ],
+            [
+                "5-",
+                "Clonazepam."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Absences",
+                "behave",
+                "as",
+                "brief",
+                "episodes",
+                "of",
+                "abrupt",
+                "loss",
+                "of",
+                "consciousness",
+                "without",
+                "alteration",
+                "of",
+                "postural",
+                "control;",
+                "they",
+                "typically",
+                "last",
+                "seconds",
+                "and",
+                "can",
+                "be",
+                "repeated",
+                "many",
+                "times",
+                "a",
+                "day,",
+                "are",
+                "usually",
+                "accompanied",
+                "by",
+                "small",
+                "bilateral",
+                "motor",
+                "signs",
+                "(blinking,",
+                "chewing)",
+                "and",
+                "consciousness",
+                "is",
+                "recovered",
+                "equally",
+                "abruptly,",
+                "without",
+                "subsequent",
+                "confusion",
+                "or",
+                "memory",
+                "of",
+                "the",
+                "episode",
+                "(MIR",
+                "03-04,",
+                "248;",
+                "MIR",
+                "97-98,",
+                "51)."
+            ],
+            [
+                "The",
+                "age",
+                "of",
+                "onset",
+                "is",
+                "usually",
+                "between",
+                "4",
+                "years",
+                "and",
+                "early",
+                "adolescence,",
+                "being",
+                "the",
+                "most",
+                "frequent",
+                "cause",
+                "of",
+                "seizures",
+                "in",
+                "this",
+                "age",
+                "range."
+            ],
+            [
+                "EEG",
+                "findings",
+                "are",
+                "typically",
+                "generalized",
+                "and",
+                "symmetrical",
+                "spike-wave",
+                "discharges",
+                "at",
+                "3",
+                "Hz",
+                "(MIR",
+                "99-00F,",
+                "67)",
+                "coinciding",
+                "with",
+                "seizures,",
+                "although",
+                "in",
+                "the",
+                "interictal",
+                "EEG",
+                "there",
+                "are",
+                "more",
+                "periods",
+                "of",
+                "abnormal",
+                "activity",
+                "than",
+                "clinically",
+                "visible."
+            ],
+            [
+                "The",
+                "most",
+                "appropriate",
+                "drugs",
+                "for",
+                "the",
+                "treatment",
+                "of",
+                "absences",
+                "are",
+                "Valproate",
+                "and",
+                "Ethosuximide",
+                "(CTO",
+                "Manual)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "478_134",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CRITICAL",
+                "CARE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "35-year-old",
+                "male,",
+                "transferred",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "after",
+                "a",
+                "traffic",
+                "accident."
+            ],
+            [
+                "On",
+                "admission,",
+                "a",
+                "Glasgow",
+                "scale",
+                "score",
+                "of",
+                "15,",
+                "blood",
+                "pressure",
+                "of",
+                "140/90",
+                "mmHg,",
+                "respiratory",
+                "rate",
+                "of",
+                "35",
+                "rpm",
+                "and",
+                "heart",
+                "rate",
+                "of",
+                "110",
+                "bpm,",
+                "with",
+                "a",
+                "baseline",
+                "oxygen",
+                "saturation",
+                "of",
+                "91%."
+            ],
+            [
+                "On",
+                "examination",
+                "there",
+                "is",
+                "right",
+                "thoracic",
+                "hypophonesis",
+                "and",
+                "tympanism",
+                "on",
+                "percussion.What",
+                "is",
+                "the",
+                "presumptive",
+                "diagnosis?"
+            ],
+            [
+                ":"
+            ],
+            [
+                "1-",
+                "Traumatic",
+                "cardiac",
+                "tamponade."
+            ],
+            [
+                "2-",
+                "Right",
+                "tension",
+                "pneumothorax."
+            ],
+            [
+                "3-",
+                "Massive",
+                "right",
+                "hemothorax."
+            ],
+            [
+                "4-",
+                "Pulmonary",
+                "contusion."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "This",
+                "is",
+                "an",
+                "easy",
+                "and",
+                "classic",
+                "question",
+                "that",
+                "you",
+                "can",
+                "also",
+                "apply",
+                "to",
+                "daily",
+                "clinical",
+                "practice."
+            ],
+            [
+                "Hypophonesis",
+                "in",
+                "a",
+                "hemithorax",
+                "+",
+                "tympanism",
+                "=",
+                "pneumothorax."
+            ],
+            [
+                "If",
+                "there",
+                "is",
+                "dullness",
+                "on",
+                "percussion:",
+                "hemothorax."
+            ],
+            [
+                "In",
+                "either",
+                "case,",
+                "in",
+                "case",
+                "of",
+                "hypophonesis",
+                "of",
+                "a",
+                "hemithorax",
+                "in",
+                "a",
+                "severe",
+                "and",
+                "unstable",
+                "polytraumatized",
+                "patient:",
+                "thoracic",
+                "drainage",
+                "(if",
+                "possible,",
+                "large",
+                "caliber",
+                "if",
+                "placed",
+                "in",
+                "a",
+                "hospital",
+                "environment,",
+                "since",
+                "although",
+                "the",
+                "predominant",
+                "lesion",
+                "is",
+                "pneumothorax,",
+                "a",
+                "hemothorax",
+                "component",
+                "can",
+                "be",
+                "found",
+                "which,",
+                "in",
+                "case",
+                "of",
+                "placing",
+                "a",
+                "fine",
+                "drainage,",
+                "could",
+                "obstruct",
+                "it)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "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",
+                "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"
+            ],
+            [
+                "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",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "97_171",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DERMATOLOGY,",
+                "VENEREOLOGY",
+                "AND",
+                "PLASTIC",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "Patient",
+                "presenting",
+                "since",
+                "2",
+                "weeks",
+                "ago",
+                "with",
+                "a",
+                "pruritic",
+                "eruption",
+                "consisting",
+                "of",
+                "multiple",
+                "polygonal",
+                "erythematous-violaceous",
+                "papules,",
+                "flattened",
+                "surface,",
+                "preferentially",
+                "located",
+                "on",
+                "the",
+                "anterior",
+                "aspect",
+                "of",
+                "wrists,",
+                "pretibial",
+                "area",
+                "and",
+                "lumbar",
+                "area."
+            ],
+            [
+                "She",
+                "also",
+                "presents",
+                "whitish",
+                "reticulated",
+                "lesions",
+                "in",
+                "the",
+                "jugal",
+                "mucosa."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "probable",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Pityriasis",
+                "versicolor."
+            ],
+            [
+                "2-",
+                "Mycosis",
+                "fungoides."
+            ],
+            [
+                "3-",
+                "Psoriasis",
+                "in",
+                "drops."
+            ],
+            [
+                "4-",
+                "Pityriasis",
+                "rosea",
+                "of",
+                "Gibert."
+            ],
+            [
+                "5-",
+                "Lichen",
+                "planus."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "They",
+                "are",
+                "undoubtedly",
+                "describing",
+                "the",
+                "typical",
+                "lesions",
+                "(both",
+                "on",
+                "skin",
+                "and",
+                "oral",
+                "mucosa)",
+                "of",
+                "a",
+                "lichen",
+                "planus",
+                "(5)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-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"
+            ]
+        ]
+    },
+    {
+        "id": "426_94",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "73-year-old",
+                "patient...swallowing",
+                "a",
+                "complete",
+                "neurological",
+                "dysphagia",
+                "secondary",
+                "to",
+                "a",
+                "cardioembolic",
+                "stroke",
+                "in",
+                "the",
+                "left",
+                "middle",
+                "cerebral",
+                "artery",
+                "territory.",
+                "will",
+                "require",
+                "long-term",
+                "nutritional",
+                "support."
+            ],
+            [
+                "Of",
+                "the",
+                "following",
+                "treatment",
+                "modalities,",
+                "which",
+                "do",
+                "you",
+                "consider",
+                "most",
+                "appropriate",
+                "for",
+                "this",
+                "case?"
+            ],
+            [
+                "1-",
+                "Enteral",
+                "nutrition",
+                "by",
+                "nasogastric",
+                "tube."
+            ],
+            [
+                "2-",
+                "Enteral",
+                "nutrition",
+                "by",
+                "nasoduodenal",
+                "tube."
+            ],
+            [
+                "3-",
+                "Enteral",
+                "nutrition",
+                "by",
+                "gastrostomy."
+            ],
+            [
+                "4-",
+                "Enteral",
+                "nutrition",
+                "by",
+                "jejunostomy."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Enteral",
+                "nutrition",
+                "is",
+                "a",
+                "nutritional",
+                "support",
+                "technique",
+                "that",
+                "involves",
+                "administering",
+                "nutrients",
+                "directly",
+                "into",
+                "the",
+                "gastrointestinal",
+                "tract",
+                "by",
+                "gavage."
+            ],
+            [
+                "The",
+                "choice",
+                "of",
+                "the",
+                "route",
+                "of",
+                "formula",
+                "administration",
+                "depends",
+                "on",
+                "the",
+                "nutritional",
+                "status,",
+                "age",
+                "of",
+                "the",
+                "patient",
+                "and",
+                "the",
+                "underlying",
+                "disease."
+            ],
+            [
+                "If",
+                "enteral",
+                "nutrition",
+                "is",
+                "considered",
+                "to",
+                "be",
+                "of",
+                "short",
+                "duration,",
+                "the",
+                "route",
+                "of",
+                "choice",
+                "is",
+                "the",
+                "nasogastric",
+                "or",
+                "nasoduodenal-",
+                "nasojejunal",
+                "tube..."
+            ],
+            [
+                "If",
+                "prolonged",
+                "nutrition",
+                "is",
+                "anticipated",
+                "the",
+                "route",
+                "of",
+                "choice",
+                "is",
+                "gastrostomy",
+                "(option",
+                "3),",
+                "with",
+                "jejunostomy",
+                "being",
+                "reserved",
+                "for",
+                "cases",
+                "in",
+                "which",
+                "it",
+                "is",
+                "not",
+                "possible",
+                "to",
+                "use",
+                "the",
+                "gastric",
+                "route."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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",
+                "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",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "262_58",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PHARMACOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "70-year-old",
+                "woman",
+                "with",
+                "a",
+                "history",
+                "of",
+                "hypertension",
+                "and",
+                "moderate",
+                "heart",
+                "failure",
+                "presents",
+                "with",
+                "a",
+                "persistent,",
+                "dry",
+                "cough",
+                "that",
+                "begins",
+                "as",
+                "an",
+                "itchy",
+                "sensation",
+                "in",
+                "the",
+                "throat."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "drug",
+                "suspected",
+                "of",
+                "causing",
+                "the",
+                "patient's",
+                "clinical",
+                "and",
+                "laboratory",
+                "alteration?"
+            ],
+            [
+                "1-",
+                "Hydrochlorothiazide."
+            ],
+            [
+                "2-",
+                "Bisoprolol."
+            ],
+            [
+                "3-",
+                "Furosemide."
+            ],
+            [
+                "4-",
+                "Enalapril."
+            ],
+            [
+                "5-",
+                "Hydralazine."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "These",
+                "are",
+                "typical",
+                "adverse",
+                "effects",
+                "of",
+                "ACEIs,",
+                "in",
+                "the",
+                "case",
+                "of",
+                "cough",
+                "it",
+                "is",
+                "usually",
+                "dry",
+                "and",
+                "irritative",
+                "and",
+                "appears",
+                "in",
+                "up",
+                "to",
+                "3%",
+                "of",
+                "patients."
+            ],
+            [
+                "Hyperkalemia",
+                "may",
+                "also",
+                "appear",
+                "in",
+                "1%."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "346_159",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "69-year-old",
+                "woman",
+                "who",
+                "comes",
+                "to",
+                "your",
+                "office",
+                "referring",
+                "genital",
+                "bleeding",
+                "of",
+                "several",
+                "months",
+                "of",
+                "evolution."
+            ],
+            [
+                "She",
+                "denies",
+                "hormone",
+                "replacement",
+                "therapy",
+                "and",
+                "anticoagulation."
+            ],
+            [
+                "She",
+                "provides",
+                "normal",
+                "cervicovaginal",
+                "cytology."
+            ],
+            [
+                "General",
+                "and",
+                "genital",
+                "physical",
+                "examination",
+                "without",
+                "findings",
+                "of",
+                "interest."
+            ],
+            [
+                "BMI",
+                "of",
+                "38kg/m2."
+            ],
+            [
+                "Indicate",
+                "the",
+                "most",
+                "correct",
+                "attitude:"
+            ],
+            [
+                "1-",
+                "Prescribe",
+                "cyclic",
+                "progesterone."
+            ],
+            [
+                "2-",
+                "Endometrial",
+                "biopsy."
+            ],
+            [
+                "3-",
+                "Random",
+                "cervical",
+                "biopsies."
+            ],
+            [
+                "4-",
+                "Hormonal",
+                "evaluation",
+                "with",
+                "FSH,",
+                "LH",
+                "and",
+                "estradiol."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "2."
+            ],
+            [
+                "We",
+                "are",
+                "dealing",
+                "with",
+                "a",
+                "case",
+                "of",
+                "postmenopausal",
+                "metrorrhagia,",
+                "whose",
+                "most",
+                "frequent",
+                "cause",
+                "is",
+                "genital",
+                "atrophy",
+                "in",
+                "the",
+                "first",
+                "place",
+                "and",
+                "endometrial",
+                "cancer",
+                "in",
+                "the",
+                "second",
+                "place."
+            ],
+            [
+                "The",
+                "data",
+                "given",
+                "on",
+                "obesity",
+                "should",
+                "lead",
+                "us",
+                "to",
+                "suspect",
+                "endometrial",
+                "cancer,",
+                "since",
+                "peripheral",
+                "fat",
+                "is",
+                "converted",
+                "to",
+                "estrone,",
+                "and",
+                "these",
+                "estrogens",
+                "cause",
+                "the",
+                "endometrium",
+                "to",
+                "proliferate."
+            ],
+            [
+                "On",
+                "the",
+                "other",
+                "hand,",
+                "she",
+                "provides",
+                "a",
+                "normal",
+                "cytology,",
+                "which",
+                "rules",
+                "out",
+                "option",
+                "3."
+            ],
+            [
+                "The",
+                "hormonal",
+                "evaluation",
+                "is",
+                "not",
+                "opportune,",
+                "since",
+                "we",
+                "understand",
+                "that",
+                "the",
+                "patient",
+                "is",
+                "in",
+                "menopause."
+            ],
+            [
+                "We",
+                "should",
+                "not",
+                "prescribe",
+                "treatment",
+                "without",
+                "first",
+                "ruling",
+                "out",
+                "organic",
+                "causes."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
+                "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-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "O",
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "170_89",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CARDIOLOGY",
+                "AND",
+                "CARDIOVASCULAR",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "62-year-old",
+                "patient",
+                "who",
+                "has",
+                "had",
+                "a",
+                "pericardial",
+                "bioprosthesis",
+                "in",
+                "mitral",
+                "position",
+                "for",
+                "two",
+                "years."
+            ],
+            [
+                "He",
+                "is",
+                "admitted",
+                "urgently",
+                "for",
+                "acute",
+                "coronary",
+                "syndrome."
+            ],
+            [
+                "Two",
+                "days",
+                "later",
+                "and",
+                "after",
+                "a",
+                "favorable",
+                "evolution,",
+                "he",
+                "suddenly",
+                "presented",
+                "heart",
+                "failure",
+                "with",
+                "acute",
+                "pulmonary",
+                "edema."
+            ],
+            [
+                "Select",
+                "the",
+                "diagnostic",
+                "option",
+                "in",
+                "this",
+                "case",
+                "from",
+                "the",
+                "following",
+                "possibilities:"
+            ],
+            [
+                "1-",
+                "Acute",
+                "post-infarction",
+                "mitral",
+                "insufficiency."
+            ],
+            [
+                "2-",
+                "Left",
+                "ventricular",
+                "aneurysm."
+            ],
+            [
+                "3-",
+                "Acute",
+                "ventricular",
+                "septal",
+                "defect."
+            ],
+            [
+                "4-",
+                "Postinfarction",
+                "atrial",
+                "septal",
+                "defect."
+            ],
+            [
+                "5-",
+                "Dysfunction",
+                "of",
+                "the",
+                "bioprosthesis",
+                "due",
+                "to",
+                "probable",
+                "acute",
+                "endocarditis."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "The",
+                "valve",
+                "is",
+                "biological",
+                "and,",
+                "in",
+                "general,",
+                "the",
+                "veils",
+                "are",
+                "not",
+                "sewn",
+                "to",
+                "the",
+                "papillary",
+                "muscles,",
+                "so",
+                "we",
+                "don't",
+                "care",
+                "what",
+                "happens",
+                "to",
+                "them."
+            ],
+            [
+                "A",
+                "ventricular",
+                "aneurysm",
+                "depresses",
+                "LVEF,",
+                "but",
+                "does",
+                "not",
+                "suddenly",
+                "put",
+                "you",
+                "into",
+                "PAD."
+            ],
+            [
+                "In",
+                "contrast,",
+                "a",
+                "VSD",
+                "sharply",
+                "increases",
+                "flow",
+                "to",
+                "the",
+                "pulmonary",
+                "bed,",
+                "causing",
+                "pulmonary",
+                "edema,",
+                "and",
+                "is",
+                "also",
+                "one",
+                "of",
+                "the",
+                "most",
+                "frequent",
+                "complications",
+                "of",
+                "AMI."
+            ],
+            [
+                "Ischemic",
+                "ASD...",
+                "I",
+                "do",
+                "not",
+                "deny",
+                "that",
+                "it",
+                "exists,",
+                "but",
+                "it",
+                "does",
+                "not",
+                "even",
+                "appear",
+                "in",
+                "the",
+                "guidelines."
+            ],
+            [
+                "And",
+                "endocarditis",
+                "would",
+                "not",
+                "require",
+                "so",
+                "many",
+                "saddlebags."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "40_136",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "OTOLARYNGOLOGY",
+                "AND",
+                "MAXILLOFACIAL",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "64-year-old",
+                "smoker",
+                "and",
+                "heavy",
+                "drinker",
+                "reports",
+                "painless",
+                "right",
+                "jugulodigastric",
+                "lymphadenopathy",
+                "of",
+                "progressive",
+                "growth",
+                "in",
+                "the",
+                "last",
+                "two",
+                "months",
+                "whose",
+                "fine",
+                "needle",
+                "aspiration",
+                "was",
+                "reported",
+                "as",
+                "squamous",
+                "cell",
+                "carcinoma."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "location",
+                "of",
+                "the",
+                "primary",
+                "tumor:"
+            ],
+            [
+                "1-",
+                "Scalp."
+            ],
+            [
+                "2-",
+                "Parotid."
+            ],
+            [
+                "3-",
+                "Lung."
+            ],
+            [
+                "4-",
+                "Esophagus."
+            ],
+            [
+                "5-",
+                "Larynx."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "You",
+                "are",
+                "in",
+                "the",
+                "middle",
+                "of",
+                "the",
+                "ENT",
+                "block."
+            ],
+            [
+                "You",
+                "have",
+                "already",
+                "passed",
+                "the",
+                "Pneumology",
+                "and",
+                "Digestive",
+                "blocks."
+            ],
+            [
+                "Dermatology",
+                "is",
+                "still",
+                "to",
+                "come",
+                "out,",
+                "but",
+                "a",
+                "dermatologist",
+                "(answer",
+                "1)",
+                "would",
+                "not",
+                "ask",
+                "this."
+            ],
+            [
+                "So",
+                "we",
+                "are",
+                "left",
+                "with",
+                "parotid",
+                "and",
+                "larynx;",
+                "but",
+                "parotid",
+                "squamous",
+                "cell",
+                "carcinoma",
+                "is",
+                "rare;",
+                "I",
+                "would",
+                "mark",
+                "5",
+                "and",
+                "rest",
+                "easy."
+            ],
+            [
+                "Perhaps",
+                "because",
+                "all",
+                "the",
+                "adenopathies",
+                "at",
+                "this",
+                "level",
+                "that",
+                "I",
+                "have",
+                "seen",
+                "have",
+                "ended",
+                "up",
+                "corresponding",
+                "to",
+                "carcinomas",
+                "of",
+                "the",
+                "upper",
+                "aerodigestive",
+                "tract."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "126_59",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PNEUMOLOGY",
+                "AND",
+                "THORACIC",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "65-year-old",
+                "man,",
+                "a",
+                "retired",
+                "office",
+                "worker",
+                "and",
+                "smoker",
+                "of",
+                "1",
+                "pack",
+                "of",
+                "cigarettes",
+                "a",
+                "day,",
+                "comes",
+                "to",
+                "the",
+                "clinic",
+                "with",
+                "a",
+                "persistent,",
+                "generally",
+                "dry",
+                "cough",
+                "and",
+                "progressive",
+                "dyspnea",
+                "of",
+                "2",
+                "years",
+                "of",
+                "evolution",
+                "which",
+                "is",
+                "currently",
+                "grade",
+                "2."
+            ],
+            [
+                "The",
+                "patient",
+                "denies",
+                "other",
+                "symptoms."
+            ],
+            [
+                "Physical",
+                "examination",
+                "shows",
+                "no",
+                "relevant",
+                "data."
+            ],
+            [
+                "The",
+                "attitude",
+                "to",
+                "follow",
+                "would",
+                "be:"
+            ],
+            [
+                "1-",
+                "Start",
+                "treatment",
+                "with",
+                "inhaled",
+                "bronchodilators."
+            ],
+            [
+                "2-",
+                "Chest",
+                "X-ray",
+                "and",
+                "spirometry",
+                "with",
+                "bronchodilator",
+                "test."
+            ],
+            [
+                "3-",
+                "Prescribe",
+                "oral",
+                "corticosteroids."
+            ],
+            [
+                "4-",
+                "Thoracic",
+                "CT",
+                "scan."
+            ],
+            [
+                "5-",
+                "Perform",
+                "basal",
+                "arterial",
+                "blood",
+                "gases."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "2",
+                "(Perform",
+                "chest",
+                "X-ray",
+                "and",
+                "spirometry",
+                "with",
+                "bronchodilator",
+                "test)."
+            ],
+            [
+                "It",
+                "is",
+                "probably",
+                "COPD",
+                "but",
+                "we",
+                "must",
+                "confirm",
+                "it",
+                "and",
+                "assess",
+                "the",
+                "severity",
+                "of",
+                "the",
+                "obstruction",
+                "with",
+                "spirometry",
+                "before",
+                "starting",
+                "treatment."
+            ],
+            [
+                "He",
+                "is",
+                "a",
+                "patient",
+                "at",
+                "risk",
+                "for",
+                "lung",
+                "cancer",
+                "so",
+                "it",
+                "is",
+                "mandatory",
+                "to",
+                "perform",
+                "a",
+                "chest",
+                "X-ray",
+                "to",
+                "rule",
+                "out",
+                "this",
+                "or",
+                "other",
+                "pathologies",
+                "that",
+                "would",
+                "justify",
+                "the",
+                "symptoms,",
+                "although",
+                "most",
+                "likely",
+                "they",
+                "are",
+                "due",
+                "to",
+                "the",
+                "debut",
+                "of",
+                "his",
+                "COPD."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "568_151",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEPHROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "22-year-old",
+                "male",
+                "presents",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "with",
+                "\"almost",
+                "black\"",
+                "urine",
+                "for",
+                "the",
+                "past",
+                "12",
+                "hours."
+            ],
+            [
+                "He",
+                "has",
+                "no",
+                "past",
+                "history",
+                "of",
+                "interest",
+                "and",
+                "is",
+                "not",
+                "taking",
+                "any",
+                "medications."
+            ],
+            [
+                "He",
+                "refers",
+                "an",
+                "upper",
+                "respiratory",
+                "catarrhal",
+                "symptoms",
+                "since",
+                "4-5",
+                "days",
+                "ago",
+                "for",
+                "which",
+                "he",
+                "has",
+                "taken",
+                "paracetamol."
+            ],
+            [
+                "Examination:",
+                "temperature",
+                "37.3",
+                "\u00baC,",
+                "BP",
+                "150/95,",
+                "HR",
+                "85",
+                "bpm,",
+                "slight",
+                "pharyngeal",
+                "erythema,",
+                "the",
+                "rest",
+                "normal."
+            ],
+            [
+                "Laboratory",
+                "tests",
+                "showed:",
+                "Hb",
+                "12.8",
+                "g/dl,",
+                "Hcto",
+                "39%,",
+                "leukocytes",
+                "10,500/mm3",
+                "with",
+                "normal",
+                "formula,",
+                "platelets",
+                "250,000/mm3,",
+                "normal",
+                "coagulation,",
+                "urea",
+                "25",
+                "mg/dl,",
+                "creatinine",
+                "0.8",
+                "mg/dl,",
+                "ions,",
+                "hepatic,",
+                "lipid,",
+                "albumin",
+                "and",
+                "total",
+                "proteins",
+                "normal."
+            ],
+            [
+                "Normal",
+                "autoimmunity",
+                "study",
+                "and",
+                "negative",
+                "viral",
+                "serology."
+            ],
+            [
+                "Urine",
+                "24",
+                "h",
+                "with",
+                "proteinuria",
+                "of",
+                "0.75",
+                "g/24",
+                "h,",
+                "sediment",
+                "with",
+                "10",
+                "erythrocytes",
+                "per",
+                "field",
+                "(90%",
+                "dysmorphic),",
+                "no",
+                "leukocyturia."
+            ],
+            [
+                "Renal",
+                "ultrasound",
+                "was",
+                "normal."
+            ],
+            [
+                "Which",
+                "diagnosis",
+                "do",
+                "you",
+                "think",
+                "is",
+                "more",
+                "likely?"
+            ],
+            [
+                "1-",
+                "Nephropathy",
+                "with",
+                "minimal",
+                "changes."
+            ],
+            [
+                "2-",
+                "Postinfectious",
+                "glomerulonephritis."
+            ],
+            [
+                "3-",
+                "IgA",
+                "nephropathy."
+            ],
+            [
+                "4-",
+                "Acute",
+                "interstitial",
+                "nephritis."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "A",
+                "picture",
+                "of",
+                "macroscopic",
+                "hematuria",
+                "and",
+                "mild",
+                "proteinuria",
+                "with",
+                "normal",
+                "creatinine",
+                "levels,",
+                "accompanied",
+                "by",
+                "an",
+                "upper",
+                "tract",
+                "catarrhal",
+                "picture,",
+                "is",
+                "very",
+                "suggestive",
+                "of",
+                "IgA",
+                "nephropathy",
+                "(option",
+                "3",
+                "correct)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "286_60",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "228_75",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CARDIOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "In",
+                "a",
+                "patient",
+                "with",
+                "clinical",
+                "signs",
+                "of",
+                "heart",
+                "failure",
+                "who",
+                "presents",
+                "with",
+                "ascites",
+                "disproportionately",
+                "elevated",
+                "in",
+                "relation",
+                "to",
+                "peripheral",
+                "edema,",
+                "the",
+                "most",
+                "likely",
+                "etiology",
+                "would",
+                "be:"
+            ],
+            [
+                "1-",
+                "Severe",
+                "aortic",
+                "stenosis."
+            ],
+            [
+                "2-",
+                "Dilated",
+                "cardiomyopathy",
+                "with",
+                "significant",
+                "left",
+                "ventricular",
+                "dysfunction."
+            ],
+            [
+                "3-",
+                "Primary",
+                "pulmonary",
+                "hypertension."
+            ],
+            [
+                "4-",
+                "Obstructive",
+                "hypertrophic",
+                "cardiomyopathy."
+            ],
+            [
+                "5-",
+                "Constrictive",
+                "pericarditis."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "They",
+                "tell",
+                "us",
+                "about",
+                "clinical",
+                "symptoms",
+                "of",
+                "right",
+                "failure,",
+                "with",
+                "edema",
+                "and",
+                "ascites."
+            ],
+            [
+                "Therefore,",
+                "we",
+                "rule",
+                "out",
+                "left",
+                "heart",
+                "failure:",
+                "EAo,",
+                "dilated",
+                "with",
+                "DSVI",
+                "and",
+                "a",
+                "MHO."
+            ],
+            [
+                "Of",
+                "the",
+                "two",
+                "we",
+                "are",
+                "left",
+                "with,",
+                "in",
+                "constrictive",
+                "pericarditis",
+                "we",
+                "have",
+                "increased",
+                "filling",
+                "pressures",
+                "in",
+                "right",
+                "chambers,",
+                "which",
+                "cause",
+                "retrograde",
+                "pressure",
+                "increase",
+                "with",
+                "hepatic",
+                "congestion,",
+                "ascites,",
+                "edema,",
+                "etc."
+            ],
+            [
+                "On",
+                "the",
+                "contrary,",
+                "in",
+                "pulmonary",
+                "hypertension,",
+                "the",
+                "tricuspid",
+                "valve",
+                "is",
+                "responsible",
+                "(a",
+                "priori)",
+                "for",
+                "\"containing\"",
+                "this",
+                "overpressure."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "217_122",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEPHROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "54-year-old",
+                "man",
+                "is",
+                "diagnosed",
+                "with",
+                "a",
+                "left",
+                "renal",
+                "tumor",
+                "suggestive",
+                "of",
+                "renal",
+                "cell",
+                "carcinoma."
+            ],
+            [
+                "His",
+                "preoperative",
+                "workup",
+                "shows",
+                "elevated",
+                "levels",
+                "of",
+                "GPT,",
+                "alkaline",
+                "phosphatase",
+                "and",
+                "alpha-2-globulin",
+                "and",
+                "prolonged",
+                "prothrombin",
+                "time."
+            ],
+            [
+                "The",
+                "liver",
+                "is",
+                "diffusely",
+                "enlarged,",
+                "but",
+                "without",
+                "defects",
+                "of",
+                "hepatic",
+                "infiltration."
+            ],
+            [
+                "The",
+                "most",
+                "likely",
+                "rationale",
+                "for",
+                "these",
+                "findings",
+                "is",
+                "due",
+                "to:"
+            ],
+            [
+                "1-",
+                "Hepatic",
+                "metastases."
+            ],
+            [
+                "2-",
+                "Intrahepatic",
+                "tumor",
+                "thrombosis."
+            ],
+            [
+                "3-",
+                "Acute",
+                "hepatitis."
+            ],
+            [
+                "4-",
+                "Presence",
+                "of",
+                "hepatotoxic",
+                "substances",
+                "produced",
+                "by",
+                "the",
+                "tumor."
+            ],
+            [
+                "5-",
+                "Hemochromatosis."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Very",
+                "easy",
+                "question",
+                "in",
+                "which",
+                "we",
+                "are",
+                "being",
+                "presented",
+                "with",
+                "a",
+                "patient",
+                "with",
+                "Stauffer's",
+                "syndrome,",
+                "a",
+                "paraneoplastic",
+                "syndrome",
+                "consisting",
+                "of",
+                "liver",
+                "dysfunction",
+                "secondary",
+                "to",
+                "toxic",
+                "products",
+                "secreted",
+                "by",
+                "a",
+                "number",
+                "of",
+                "tumors",
+                "(most",
+                "frequently,",
+                "renal",
+                "cell",
+                "carcinoma,",
+                "like",
+                "the",
+                "one",
+                "in",
+                "this",
+                "case)."
+            ],
+            [
+                "As",
+                "in",
+                "this",
+                "case,",
+                "cholestasis",
+                "(elevation",
+                "of",
+                "alkaline",
+                "phosphatase),",
+                "mobilization",
+                "of",
+                "hepatic",
+                "enzymes",
+                "and",
+                "lengthening",
+                "of",
+                "the",
+                "prothrombin",
+                "time",
+                "indicate",
+                "liver",
+                "dysfunction."
+            ],
+            [
+                "Metastases",
+                "are",
+                "ruled",
+                "out",
+                "(there",
+                "are",
+                "no",
+                "defects",
+                "of",
+                "hepatic",
+                "infiltration),",
+                "intrahepatic",
+                "tumor",
+                "thrombosis",
+                "(it",
+                "would",
+                "give",
+                "another",
+                "symptomatology",
+                "and",
+                "this",
+                "would",
+                "be",
+                "more",
+                "acute),",
+                "and",
+                "acute",
+                "hepatitis",
+                "and",
+                "hemochromatosis",
+                "(they",
+                "are",
+                "not",
+                "in",
+                "context",
+                "nor",
+                "is",
+                "it",
+                "what",
+                "the",
+                "author",
+                "of",
+                "the",
+                "question",
+                "wants",
+                "us",
+                "to",
+                "think)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Disease",
+                "I-Disease",
+                "I-Disease"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ]
+        ]
+    },
+    {
+        "id": "142_138",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "12-year-old",
+                "girl,",
+                "only",
+                "child",
+                "of",
+                "healthy,",
+                "non-consanguineous",
+                "parents."
+            ],
+            [
+                "There",
+                "is",
+                "no",
+                "personal",
+                "or",
+                "family",
+                "history",
+                "of",
+                "interest."
+            ],
+            [
+                "In",
+                "the",
+                "clinical",
+                "examination",
+                "to",
+                "start",
+                "a",
+                "sports",
+                "activity,",
+                "you",
+                "find",
+                "a",
+                "discrete",
+                "hepatomegaly",
+                "of",
+                "normal",
+                "consistency,",
+                "so",
+                "you",
+                "request",
+                "a",
+                "blood",
+                "test,",
+                "which",
+                "highlights",
+                "an",
+                "ASAT",
+                "of",
+                "80U",
+                "/",
+                "l,",
+                "ALAT",
+                "105",
+                "U",
+                "/",
+                "l,",
+                "electrophoretic",
+                "proteinogram",
+                "with",
+                "all",
+                "protein",
+                "fractions",
+                "in",
+                "normal",
+                "range",
+                "and",
+                "negativity",
+                "of",
+                "serology",
+                "for",
+                "hepatotropic",
+                "viruses."
+            ],
+            [
+                "What",
+                "should",
+                "you",
+                "rule",
+                "out",
+                "and",
+                "what",
+                "test",
+                "would",
+                "you",
+                "indicate",
+                "for",
+                "it?"
+            ],
+            [
+                "1-",
+                "Deficiency",
+                "of",
+                "alpha",
+                "1",
+                "antitrypsin.",
+                "Thoracic",
+                "TAC",
+                "to",
+                "confirm",
+                "emphysema."
+            ],
+            [
+                "2-",
+                "Mucoviscidosis.",
+                "Determination",
+                "of",
+                "chlorine",
+                "in",
+                "sweat."
+            ],
+            [
+                "3-",
+                "Autoimmune",
+                "hepatitis.",
+                "Liver",
+                "biopsy."
+            ],
+            [
+                "4-",
+                "Glycogenosis",
+                "type",
+                "VI",
+                "(phosphorylase",
+                "deficiency).",
+                "Muscle",
+                "biopsy."
+            ],
+            [
+                "5-",
+                "Wilson's",
+                "disease.",
+                "Determine",
+                "ceruloplasmin",
+                "and",
+                "copper",
+                "in",
+                "blood",
+                "and",
+                "urine."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "In",
+                "fact,",
+                "I",
+                "would",
+                "not",
+                "test",
+                "this",
+                "patient",
+                "at",
+                "this",
+                "time,",
+                "and",
+                "I",
+                "would",
+                "check",
+                "if",
+                "the",
+                "transaminase",
+                "level",
+                "has",
+                "normalized",
+                "at",
+                "a",
+                "later",
+                "time,",
+                "since",
+                "the",
+                "most",
+                "frequent",
+                "cause,",
+                "at",
+                "least",
+                "in",
+                "children,",
+                "is",
+                "a",
+                "transient",
+                "elevation",
+                "in",
+                "the",
+                "context",
+                "of",
+                "viral",
+                "diseases",
+                "(most",
+                "frequently",
+                "cytomegalovirus",
+                "and",
+                "Epstein-Barr",
+                "virus)."
+            ],
+            [
+                "The",
+                "minimal",
+                "elevation",
+                "of",
+                "liver",
+                "enzymes",
+                "and",
+                "the",
+                "fact",
+                "that",
+                "it",
+                "has",
+                "a",
+                "normal",
+                "protein",
+                "profile",
+                "goes",
+                "against",
+                "chronicity..."
+            ],
+            [
+                "If",
+                "I",
+                "had",
+                "to",
+                "choose",
+                "I",
+                "would",
+                "choose",
+                "answer",
+                "5,",
+                "which",
+                "seems",
+                "to",
+                "me",
+                "the",
+                "least",
+                "aggressive,",
+                "and",
+                "if",
+                "I",
+                "had",
+                "to",
+                "do",
+                "analytical",
+                "tests",
+                "I",
+                "would",
+                "add",
+                "the",
+                "determination",
+                "of",
+                "alpha-1-antitrypsin",
+                "(without",
+                "CT)",
+                "and",
+                "markers",
+                "of",
+                "celiac",
+                "disease,",
+                "because",
+                "celiac",
+                "disease",
+                "can",
+                "also",
+                "be",
+                "associated",
+                "with",
+                "some",
+                "hypertransaminemia."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "267_139",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PNEUMOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "In",
+                "a",
+                "patient",
+                "with",
+                "liver",
+                "cirrhosis",
+                "and",
+                "ascites,",
+                "who",
+                "develops",
+                "a",
+                "pleural",
+                "effusion",
+                "with",
+                "the",
+                "following",
+                "data",
+                "in",
+                "the",
+                "pleural",
+                "fluid:",
+                "LDH",
+                "45",
+                "U/L",
+                "(serum",
+                "220",
+                "U/L),",
+                "pleural/serum",
+                "protein",
+                "ratio",
+                "0.3",
+                "and",
+                "pleural/serum",
+                "LDH",
+                "ratio",
+                "0.2."
+            ],
+            [
+                "What",
+                "would",
+                "be",
+                "the",
+                "appropriate",
+                "attitude?"
+            ],
+            [
+                "1-",
+                "The",
+                "study",
+                "of",
+                "the",
+                "fluid",
+                "with",
+                "cell",
+                "count,",
+                "glucose,",
+                "pH,",
+                "ADA,",
+                "cholesterol",
+                "and",
+                "culture",
+                "should",
+                "be",
+                "extended.",
+                "ADA,",
+                "cholesterol",
+                "and",
+                "culture."
+            ],
+            [
+                "2-",
+                "Blind",
+                "pleural",
+                "biopsy."
+            ],
+            [
+                "3-",
+                "Diagnostic",
+                "videothoracoscopy."
+            ],
+            [
+                "4-",
+                "Empirical",
+                "antibiotherapy",
+                "for",
+                "suspected",
+                "parapneumonic",
+                "effusion."
+            ],
+            [
+                "5-",
+                "Continue",
+                "treatment",
+                "of",
+                "his",
+                "liver",
+                "disease."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "They",
+                "describe",
+                "pleural",
+                "fluid",
+                "parameters",
+                "of",
+                "transudate,",
+                "so",
+                "if",
+                "the",
+                "patient",
+                "is",
+                "not",
+                "in",
+                "heart",
+                "failure",
+                "it",
+                "is",
+                "a",
+                "hydropic",
+                "decompensation."
+            ],
+            [
+                "No",
+                "other",
+                "studies",
+                "are",
+                "needed."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "99_84",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "60-year-old",
+                "diabetic",
+                "patient",
+                "is",
+                "consulting",
+                "for",
+                "the",
+                "first",
+                "time",
+                "regarding",
+                "the",
+                "treatment",
+                "of",
+                "his",
+                "disease."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "goals",
+                "would",
+                "you",
+                "recommend",
+                "to",
+                "him",
+                "first?"
+            ],
+            [
+                "1-",
+                "Maintain",
+                "blood",
+                "pressure",
+                "below",
+                "110/70",
+                "mmHg."
+            ],
+            [
+                "2-",
+                "Smoking",
+                "cessation."
+            ],
+            [
+                "3-",
+                "Maintain",
+                "a",
+                "body",
+                "mass",
+                "index",
+                "(BMI)",
+                "less",
+                "than",
+                "21."
+            ],
+            [
+                "4-",
+                "Perform",
+                "daily",
+                "basal",
+                "capillary",
+                "glycemia."
+            ],
+            [
+                "5-",
+                "Avoidance",
+                "of",
+                "animal",
+                "fats",
+                "in",
+                "the",
+                "diet."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "The",
+                "rest",
+                "are",
+                "not",
+                "indications."
+            ],
+            [
+                "The",
+                "target",
+                "BP",
+                "is",
+                "<",
+                "130/85",
+                "mmHg."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Treatment",
+                "I-Treatment",
+                "I-Treatment",
+                "I-Treatment",
+                "I-Treatment",
+                "I-Treatment",
+                "I-Treatment"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "380_135",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "25-year-old",
+                "patient,",
+                "during",
+                "a",
+                "tennis",
+                "match,",
+                "has",
+                "intense",
+                "pain",
+                "in",
+                "the",
+                "neck",
+                "and",
+                "in",
+                "the",
+                "left",
+                "eye."
+            ],
+            [
+                "The",
+                "next",
+                "morning",
+                "he",
+                "wakes",
+                "up",
+                "with",
+                "a",
+                "feeling",
+                "of",
+                "gait",
+                "instability",
+                "and",
+                "has",
+                "palpebral",
+                "ptosis",
+                "of",
+                "the",
+                "left",
+                "eye",
+                "and",
+                "anisocoria,",
+                "with",
+                "the",
+                "left",
+                "pupil",
+                "being",
+                "smaller",
+                "than",
+                "the",
+                "right."
+            ],
+            [
+                "The",
+                "patient",
+                "maintains",
+                "good",
+                "visual",
+                "acuity."
+            ],
+            [
+                "Where",
+                "would",
+                "you",
+                "most",
+                "likely",
+                "locate",
+                "the",
+                "lesion?"
+            ],
+            [
+                "1-",
+                "III",
+                "cranial",
+                "pair."
+            ],
+            [
+                "2-",
+                "Optic",
+                "chiasm."
+            ],
+            [
+                "3-",
+                "Superior",
+                "cervical",
+                "ganglion."
+            ],
+            [
+                "4-",
+                "Spinal",
+                "bulb."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "The",
+                "picture",
+                "presented",
+                "to",
+                "us",
+                "is",
+                "that",
+                "of",
+                "a",
+                "Horner",
+                "syndrome",
+                "(miosis",
+                "with",
+                "ptosis)",
+                "so",
+                "the",
+                "possibilities",
+                "are",
+                "reduced",
+                "to",
+                "options",
+                "3",
+                "or",
+                "4,",
+                "but",
+                "they",
+                "specify",
+                "that",
+                "the",
+                "patient",
+                "presents",
+                "gait",
+                "instability,",
+                "which",
+                "is",
+                "not",
+                "justified",
+                "by",
+                "a",
+                "Horner",
+                "due",
+                "to",
+                "carotid",
+                "dissection",
+                "affecting",
+                "the",
+                "superior",
+                "cervical",
+                "ganglion,",
+                "which",
+                "is",
+                "what",
+                "they",
+                "want",
+                "us",
+                "to",
+                "believe",
+                "when",
+                "they",
+                "talk",
+                "about",
+                "pain",
+                "in",
+                "the",
+                "neck",
+                "and",
+                "in",
+                "the",
+                "eye."
+            ],
+            [
+                "If",
+                "the",
+                "patient",
+                "really",
+                "has",
+                "ataxia,",
+                "the",
+                "only",
+                "possible",
+                "location",
+                "would",
+                "be",
+                "the",
+                "spinal",
+                "cord."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "341_33",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "67-year-old",
+                "woman",
+                "diagnosed",
+                "with",
+                "infiltrating",
+                "ductal",
+                "carcinoma",
+                "of",
+                "the",
+                "breast",
+                "with",
+                "no",
+                "family",
+                "history",
+                "of",
+                "neoplasia."
+            ],
+            [
+                "What",
+                "additional",
+                "studies",
+                "should",
+                "be",
+                "performed",
+                "on",
+                "the",
+                "tumor",
+                "because",
+                "of",
+                "its",
+                "clinical",
+                "and",
+                "therapeutic",
+                "implications?"
+            ],
+            [
+                "1-",
+                "Complete",
+                "phenotypic",
+                "study",
+                "by",
+                "flow",
+                "cytometry."
+            ],
+            [
+                "2-",
+                "Study",
+                "of",
+                "hormone",
+                "receptors",
+                "and",
+                "HER2."
+            ],
+            [
+                "3-",
+                "Study",
+                "of",
+                "hormone",
+                "receptors,",
+                "e-cadherin",
+                "and",
+                "study",
+                "of",
+                "first-degree",
+                "relatives."
+            ],
+            [
+                "4-",
+                "Study",
+                "of",
+                "BRCA",
+                "1-2",
+                "and",
+                "study",
+                "of",
+                "first-degree",
+                "relatives."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Study",
+                "of",
+                "hormone",
+                "receptors",
+                "and",
+                "HER2."
+            ],
+            [
+                "Both",
+                "for",
+                "the",
+                "type",
+                "of",
+                "treatment",
+                "and",
+                "to",
+                "study",
+                "the",
+                "prognostic",
+                "factor",
+                "and",
+                "adjuvant",
+                "treatment,",
+                "it",
+                "is",
+                "necessary",
+                "to",
+                "know",
+                "the",
+                "different",
+                "hormonal",
+                "receptors",
+                "(estrogen",
+                "and",
+                "progesterone)",
+                "as",
+                "well",
+                "as",
+                "HER2-neu."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "308_215",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "OPHTHALMOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "47-year-old",
+                "man",
+                "with",
+                "myopia",
+                "magna,",
+                "who",
+                "underwent",
+                "cataract",
+                "surgery",
+                "2",
+                "years",
+                "ago,",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "room",
+                "reporting",
+                "a",
+                "profound",
+                "and",
+                "painless",
+                "loss",
+                "of",
+                "vision",
+                "in",
+                "his",
+                "right",
+                "eye."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "diagnoses",
+                "can",
+                "cause",
+                "this",
+                "symptomatology?"
+            ],
+            [
+                "1-",
+                "Post-surgical",
+                "endophthalmitis."
+            ],
+            [
+                "2-",
+                "Retinal",
+                "detachment."
+            ],
+            [
+                "3-",
+                "Age-related",
+                "macular",
+                "degeneration,",
+                "wet",
+                "form."
+            ],
+            [
+                "4-",
+                "Posterior",
+                "vitreous",
+                "detachment."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "He",
+                "refers",
+                "to",
+                "a",
+                "patient",
+                "post",
+                "cataract",
+                "surgery",
+                "2",
+                "years",
+                "ago",
+                "with",
+                "deep",
+                "and",
+                "painless",
+                "loss",
+                "of",
+                "OD."
+            ],
+            [
+                "Post-surgical",
+                "endophthalmitis",
+                "is",
+                "more",
+                "associated",
+                "with",
+                "patients",
+                "in",
+                "the",
+                "immediate",
+                "postoperative",
+                "period,",
+                "besides",
+                "being",
+                "very",
+                "painful",
+                "with",
+                "rapidly",
+                "progressive",
+                "decrease",
+                "in",
+                "visual",
+                "acuity,",
+                "so",
+                "it",
+                "is",
+                "not",
+                "correct."
+            ],
+            [
+                "Retinal",
+                "detachment",
+                "is",
+                "consistent",
+                "with",
+                "the",
+                "clinical",
+                "case",
+                "because",
+                "it",
+                "is",
+                "also",
+                "a",
+                "myopic",
+                "patient",
+                "who",
+                "tend",
+                "to",
+                "have",
+                "a",
+                "special",
+                "predisposition",
+                "to",
+                "detachment."
+            ],
+            [
+                "ARMD",
+                "usually",
+                "occurs",
+                "in",
+                "older",
+                "patients",
+                "and",
+                "the",
+                "decrease",
+                "in",
+                "vision",
+                "is",
+                "progressive."
+            ],
+            [
+                "In",
+                "PVD",
+                "there",
+                "may",
+                "or",
+                "may",
+                "not",
+                "be",
+                "a",
+                "slight",
+                "decrease",
+                "in",
+                "visual",
+                "acuity",
+                "and",
+                "the",
+                "patient",
+                "usually",
+                "reports",
+                "some",
+                "discomfort",
+                "or",
+                "pain",
+                "at",
+                "the",
+                "onset",
+                "of",
+                "the",
+                "clinical",
+                "picture."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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",
+                "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",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "519_176",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "63_200",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ANATOMY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "31-year-old",
+                "bricklayer",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "with",
+                "tenosynovitis",
+                "caused",
+                "by",
+                "a",
+                "penetrating",
+                "wound."
+            ],
+            [
+                "On",
+                "examination,",
+                "the",
+                "ulnar",
+                "bursa",
+                "is",
+                "found",
+                "to",
+                "be",
+                "infected",
+                "with",
+                "consequent",
+                "tendon",
+                "necrosis."
+            ],
+            [
+                "Which",
+                "tendon",
+                "will",
+                "be",
+                "affected?"
+            ],
+            [
+                "1-",
+                "Tendon",
+                "of",
+                "the",
+                "flexor",
+                "carpi",
+                "ulnaris."
+            ],
+            [
+                "2-",
+                "Tendon",
+                "of",
+                "the",
+                "abductor",
+                "pollicis",
+                "longus."
+            ],
+            [
+                "3-",
+                "Tendon",
+                "of",
+                "the",
+                "deep",
+                "flexor",
+                "of",
+                "the",
+                "fingers."
+            ],
+            [
+                "4-",
+                "Radial",
+                "carpal",
+                "flexor",
+                "tendon."
+            ],
+            [
+                "5-",
+                "Palmaris",
+                "longus",
+                "tendon."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Both",
+                "the",
+                "flexor",
+                "carpi",
+                "radialis",
+                "and",
+                "the",
+                "abductor",
+                "pollicis",
+                "longus",
+                "are",
+                "anatomically",
+                "far",
+                "from",
+                "the",
+                "ulnar."
+            ],
+            [
+                "The",
+                "palmaris",
+                "longus",
+                "is",
+                "medial,",
+                "as",
+                "is",
+                "the",
+                "flexor",
+                "digitorum",
+                "profundus."
+            ],
+            [
+                "The",
+                "tendon",
+                "that",
+                "runs",
+                "alongside",
+                "the",
+                "ulnar",
+                "nerve,",
+                "inserting",
+                "into",
+                "the",
+                "pisiform,",
+                "is",
+                "the",
+                "flexor",
+                "carpi",
+                "ulnaris,",
+                "thus",
+                "answer",
+                "1."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "B-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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+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "30_61",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY",
+                "AND",
+                "THORACIC",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "patient",
+                "previously",
+                "diagnosed",
+                "with",
+                "COPD",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "room",
+                "for",
+                "3",
+                "days",
+                "with",
+                "increased",
+                "dyspnea",
+                "until",
+                "he",
+                "is",
+                "at",
+                "rest,",
+                "cough",
+                "with",
+                "whitish",
+                "expectoration",
+                "and",
+                "marked",
+                "drowsiness."
+            ],
+            [
+                "After",
+                "receiving",
+                "treatment",
+                "with",
+                "oxygen",
+                "at",
+                "low",
+                "concentrations,",
+                "bronchodilators",
+                "and",
+                "coticoids,",
+                "a",
+                "second",
+                "arterial",
+                "blood",
+                "gas",
+                "with",
+                "28%",
+                "inspiratory",
+                "oxygen",
+                "fraction",
+                "shows",
+                "a",
+                "pH",
+                "of",
+                "7.32,",
+                "pO2",
+                "61",
+                "mmHg,",
+                "pCO2",
+                "58",
+                "mmHg,",
+                "HCO3-",
+                "29",
+                "mmol/l."
+            ],
+            [
+                "What",
+                "would",
+                "be",
+                "the",
+                "interpretation",
+                "you",
+                "would",
+                "make",
+                "of",
+                "the",
+                "arterial",
+                "blood",
+                "gas",
+                "and",
+                "what",
+                "treatment",
+                "would",
+                "you",
+                "use?"
+            ],
+            [
+                "1-",
+                "Increase",
+                "oxygen",
+                "flow",
+                "because",
+                "he",
+                "has",
+                "acute",
+                "respiratory",
+                "acidosis",
+                "and",
+                "hypoxemia."
+            ],
+            [
+                "2-",
+                "I",
+                "would",
+                "initiate",
+                "noninvasive",
+                "mechanical",
+                "ventilation",
+                "because",
+                "he",
+                "has",
+                "acute",
+                "hypercapnic",
+                "respiratory",
+                "failure",
+                "with",
+                "moderate",
+                "respiratory",
+                "acidosis."
+            ],
+            [
+                "3-",
+                "I",
+                "would",
+                "add",
+                "sodium",
+                "bicarbonate",
+                "to",
+                "correct",
+                "the",
+                "acute",
+                "metabolic",
+                "acidosis."
+            ],
+            [
+                "4-",
+                "The",
+                "patient",
+                "does",
+                "not",
+                "have",
+                "respiratory",
+                "insufficiency",
+                "so",
+                "he",
+                "would",
+                "continue",
+                "with",
+                "the",
+                "same",
+                "pharmacological",
+                "regimen."
+            ],
+            [
+                "5-",
+                "I",
+                "would",
+                "add",
+                "intravenous",
+                "aminophylline",
+                "as",
+                "a",
+                "respiratory",
+                "stimulant,",
+                "since",
+                "I",
+                "appreciate",
+                "hypoxemia",
+                "and",
+                "hypercapnia."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "This",
+                "is",
+                "a",
+                "very",
+                "bad",
+                "question,",
+                "I",
+                "will",
+                "bet",
+                "on",
+                "one",
+                "answer,",
+                "but",
+                "depending",
+                "on",
+                "data",
+                "that",
+                "we",
+                "are",
+                "not",
+                "given,",
+                "three",
+                "answers",
+                "could",
+                "be",
+                "valid."
+            ],
+            [
+                "The",
+                "trap",
+                "is",
+                "that",
+                "they",
+                "give",
+                "us",
+                "the",
+                "initial",
+                "clinical",
+                "picture",
+                "WITHOUT",
+                "GASOMETRY",
+                "and",
+                "then",
+                "they",
+                "give",
+                "us",
+                "the",
+                "blood",
+                "gases",
+                "afterwards",
+                "WITHOUT",
+                "CLINIC,",
+                "so",
+                "there",
+                "is",
+                "no",
+                "way",
+                "of",
+                "knowing",
+                "what",
+                "the",
+                "evolution",
+                "of",
+                "the",
+                "patient",
+                "has",
+                "been",
+                "with",
+                "our",
+                "treatment,",
+                "so",
+                "it",
+                "is",
+                "impossible",
+                "to",
+                "know",
+                "what",
+                "to",
+                "do."
+            ],
+            [
+                "If",
+                "the",
+                "patient",
+                "initially",
+                "came",
+                "with",
+                "a",
+                "blood",
+                "gas",
+                "with",
+                "a",
+                "pH",
+                "of",
+                "7.05",
+                "and",
+                "now",
+                "has",
+                "the",
+                "one",
+                "we",
+                "are",
+                "given,",
+                "we",
+                "are",
+                "doing",
+                "well",
+                "(although",
+                "we",
+                "are",
+                "not",
+                "told",
+                "the",
+                "time",
+                "interval",
+                "between",
+                "one",
+                "thing",
+                "and",
+                "the",
+                "other)",
+                "and,",
+                "in",
+                "this",
+                "case,",
+                "it",
+                "could",
+                "be",
+                "worthwhile",
+                "to",
+                "continue",
+                "with",
+                "the",
+                "same",
+                "treatment."
+            ],
+            [
+                "If",
+                "nothing",
+                "has",
+                "evolved,",
+                "the",
+                "clinical",
+                "picture",
+                "is",
+                "the",
+                "same",
+                "and",
+                "the",
+                "blood",
+                "gas",
+                "at",
+                "the",
+                "beginning",
+                "was",
+                "similar,",
+                "something",
+                "should",
+                "be",
+                "done",
+                "(also",
+                "depending",
+                "on",
+                "the",
+                "patient's",
+                "baseline",
+                "status,",
+                "which",
+                "they",
+                "do",
+                "not",
+                "tell",
+                "us",
+                "either)."
+            ],
+            [
+                "If",
+                "we",
+                "decide",
+                "to",
+                "do",
+                "something,",
+                "at",
+                "present",
+                "we",
+                "might",
+                "decide",
+                "to",
+                "use",
+                "ventilation",
+                "rather",
+                "than",
+                "theophylline,",
+                "although",
+                "with",
+                "\"so",
+                "little\"",
+                "alteration",
+                "of",
+                "pH",
+                "(and",
+                "even",
+                "more",
+                "so",
+                "if",
+                "we",
+                "think",
+                "that",
+                "this",
+                "is",
+                "a",
+                "chronic",
+                "patient",
+                "who",
+                "may",
+                "have",
+                "a",
+                "baseline",
+                "blood",
+                "gas",
+                "similar",
+                "to",
+                "the",
+                "one",
+                "presented",
+                "to",
+                "us)",
+                "it",
+                "may",
+                "seem",
+                "\"exaggerated\"."
+            ],
+            [
+                "We",
+                "have",
+                "nothing",
+                "\"against\"",
+                "theophylline",
+                "(we",
+                "are",
+                "not",
+                "told",
+                "of",
+                "any",
+                "contraindication),",
+                "but",
+                "nowadays",
+                "it",
+                "is",
+                "rare",
+                "to",
+                "resort",
+                "to",
+                "it."
+            ],
+            [
+                "1:",
+                "Wrong,",
+                "he",
+                "is",
+                "a",
+                "\"retentive\"",
+                "patient",
+                "and",
+                "increasing",
+                "O2",
+                "flow",
+                "is",
+                "highly",
+                "likely",
+                "to",
+                "increase",
+                "hypercapnia",
+                "and,",
+                "therefore,",
+                "acidosis."
+            ],
+            [
+                "2:",
+                "We",
+                "will",
+                "keep",
+                "this",
+                "one",
+                "as",
+                "correct."
+            ],
+            [
+                "3:",
+                "It",
+                "is",
+                "not",
+                "a",
+                "metabolic",
+                "acidosis,",
+                "the",
+                "bicarbonate",
+                "is",
+                "not",
+                "decreased,",
+                "on",
+                "the",
+                "contrary,",
+                "it",
+                "is",
+                "slightly",
+                "increased",
+                "trying",
+                "to",
+                "compensate",
+                "the",
+                "respiratory",
+                "acidosis."
+            ],
+            [
+                "4:",
+                "He",
+                "does",
+                "not",
+                "reach",
+                "respiratory",
+                "failure",
+                "by",
+                "definition",
+                "(pO2",
+                "60),",
+                "but",
+                "he",
+                "has",
+                "hypercapnia",
+                "and",
+                "slight",
+                "acidosis."
+            ],
+            [
+                "If",
+                "we",
+                "knew",
+                "the",
+                "first",
+                "blood",
+                "gas",
+                "and",
+                "she",
+                "was",
+                "much",
+                "worse",
+                "(i.e.",
+                "she",
+                "was",
+                "doing",
+                "very",
+                "well),",
+                "continuing",
+                "with",
+                "the",
+                "same",
+                "medication",
+                "would",
+                "be",
+                "an",
+                "option,",
+                "but",
+                "this",
+                "data",
+                "is",
+                "missing!!!,",
+                "in",
+                "any",
+                "case",
+                "it",
+                "seems",
+                "to",
+                "be",
+                "a",
+                "trick",
+                "answer."
+            ],
+            [
+                "5:",
+                "At",
+                "present",
+                "and",
+                "-as",
+                "already",
+                "mentioned-",
+                "taking",
+                "into",
+                "account",
+                "that",
+                "there",
+                "is",
+                "no",
+                "formal",
+                "contraindication,",
+                "it",
+                "is",
+                "not",
+                "usually",
+                "used."
+            ]
+        ],
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+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
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+                "O"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
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+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
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+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
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+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
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+                "O"
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+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Claim"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
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+                "O",
+                "O",
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+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Premise",
+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
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+            ],
+            [
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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"
+            ],
+            [
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+                "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"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
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+                "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"
+            ],
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "226_71",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CARDIOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "82-year-old",
+                "hypertensive",
+                "woman",
+                "on",
+                "atenolol,",
+                "hydrochlorothiazide",
+                "and",
+                "digoxin."
+            ],
+            [
+                "She",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "room",
+                "for",
+                "atrial",
+                "fibrillation",
+                "and",
+                "is",
+                "administered",
+                "IV",
+                "verapamil."
+            ],
+            [
+                "The",
+                "ECG",
+                "showed",
+                "complete",
+                "atrioventricular",
+                "block."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "probable",
+                "cause",
+                "of",
+                "this",
+                "clinical",
+                "situation?"
+            ],
+            [
+                "1-",
+                "Digitalis",
+                "intoxication",
+                "due",
+                "to",
+                "pharmacokinetic",
+                "interaction",
+                "with",
+                "verapamil."
+            ],
+            [
+                "2-",
+                "Hypokalemia",
+                "due",
+                "to",
+                "administration",
+                "of",
+                "thiazide",
+                "and",
+                "digoxin."
+            ],
+            [
+                "3-",
+                "Pharmacodynamic",
+                "interaction",
+                "of",
+                "beta-blocker,",
+                "digoxin",
+                "and",
+                "verapamil."
+            ],
+            [
+                "4-",
+                "Hypotensive",
+                "effect",
+                "of",
+                "thiazide",
+                "diuretic."
+            ],
+            [
+                "5-",
+                "Cardiac",
+                "arrhythmia",
+                "due",
+                "to",
+                "verapamil."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "He",
+                "already",
+                "takes",
+                "two",
+                "AV",
+                "node",
+                "brakers",
+                "and",
+                "you",
+                "add",
+                "a",
+                "third,",
+                "and",
+                "are",
+                "you",
+                "surprised",
+                "that",
+                "he",
+                "gets",
+                "complete",
+                "AV",
+                "block",
+                "after",
+                "messing",
+                "with",
+                "drugs",
+                "from",
+                "different",
+                "families",
+                "but",
+                "same",
+                "effect",
+                "(pharmacodynamics)?"
+            ],
+            [
+                "Three."
+            ],
+            [
+                "And",
+                "remember",
+                "that",
+                "drugs",
+                "are",
+                "like",
+                "drinks",
+                "when",
+                "you",
+                "go",
+                "to",
+                "a",
+                "bar:",
+                "don't",
+                "mix!"
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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"
+            ],
+            [
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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"
+            ]
+        ]
+    },
+    {
+        "id": "565_148",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "135_38",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ONCOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "64-year-old",
+                "man",
+                "with",
+                "Child",
+                "A",
+                "liver",
+                "cirrhosis",
+                "with",
+                "no",
+                "history",
+                "of",
+                "decompensation."
+            ],
+            [
+                "After",
+                "detection",
+                "of",
+                "a",
+                "focal",
+                "hepatic",
+                "lesion",
+                "on",
+                "screening",
+                "ultrasound,",
+                "the",
+                "study",
+                "is",
+                "completed",
+                "with",
+                "a",
+                "thoracoabdominal",
+                "CT",
+                "scan."
+            ],
+            [
+                "This",
+                "scan",
+                "showed",
+                "the",
+                "presence",
+                "of",
+                "4",
+                "liver",
+                "lesions",
+                "(one",
+                "of",
+                "them",
+                "up",
+                "to",
+                "6",
+                "cm)",
+                "with",
+                "uptake",
+                "pattern",
+                "typical",
+                "of",
+                "hepatocarcinoma,",
+                "tumor",
+                "vascular",
+                "invasion",
+                "and",
+                "a",
+                "metastasis",
+                "in",
+                "the",
+                "right",
+                "adrenal",
+                "gland."
+            ],
+            [
+                "No",
+                "ascites",
+                "is",
+                "observed."
+            ],
+            [
+                "The",
+                "patient",
+                "reports",
+                "only",
+                "asthenia,",
+                "but",
+                "no",
+                "general",
+                "syndrome."
+            ],
+            [
+                "The",
+                "treatment",
+                "of",
+                "this",
+                "patient",
+                "would",
+                "be:"
+            ],
+            [
+                "1-",
+                "Symptomatic",
+                "and",
+                "supportive",
+                "treatment,",
+                "since",
+                "he",
+                "presented",
+                "an",
+                "advanced",
+                "hepatocarcinoma",
+                "with",
+                "vascular",
+                "invasion",
+                "and",
+                "metastasis."
+            ],
+            [
+                "2-",
+                "Transarterial",
+                "chemoembolization",
+                "(TACE),",
+                "since",
+                "the",
+                "treatment",
+                "increases",
+                "survival",
+                "in",
+                "patients",
+                "with",
+                "advanced",
+                "hepatocarcinoma."
+            ],
+            [
+                "3-",
+                "Systemic",
+                "chemotherapy",
+                "with",
+                "doxorubicin",
+                "iv",
+                "since",
+                "he",
+                "presents",
+                "disseminated",
+                "disease",
+                "but",
+                "he",
+                "is",
+                "in",
+                "good",
+                "general",
+                "condition."
+            ],
+            [
+                "4-",
+                "Treatment",
+                "with",
+                "oral",
+                "sorafenib,",
+                "since",
+                "this",
+                "is",
+                "a",
+                "patient",
+                "with",
+                "good",
+                "general",
+                "condition,",
+                "Child",
+                "A",
+                "and",
+                "advanced",
+                "stage",
+                "hepatocarcinoma",
+                "BCLC-C."
+            ],
+            [
+                "5-",
+                "The",
+                "appropriate",
+                "treatment",
+                "is",
+                "liver",
+                "transplantation",
+                "as",
+                "it",
+                "is",
+                "the",
+                "only",
+                "procedure",
+                "that",
+                "completely",
+                "eliminates",
+                "the",
+                "primary",
+                "tumor",
+                "and",
+                "avoids",
+                "future",
+                "complications",
+                "of",
+                "cirrhosis."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Comment:",
+                "The",
+                "patient",
+                "presents",
+                "a",
+                "good",
+                "general",
+                "condition",
+                "with",
+                "a",
+                "recently",
+                "diagnosed",
+                "hepatocarcinoma,",
+                "not",
+                "giving",
+                "him",
+                "any",
+                "type",
+                "of",
+                "treatment",
+                "other",
+                "than",
+                "symptomatic",
+                "and",
+                "supportive",
+                "at",
+                "this",
+                "stage",
+                "would",
+                "not",
+                "be",
+                "the",
+                "right",
+                "thing",
+                "to",
+                "do."
+            ],
+            [
+                "TACE",
+                "would",
+                "not",
+                "be",
+                "indicated",
+                "because",
+                "of",
+                "extrahepatic",
+                "involvement."
+            ],
+            [
+                "Transplantation",
+                "would",
+                "also",
+                "not",
+                "be",
+                "done",
+                "if",
+                "he",
+                "has",
+                "extrahepatic",
+                "disease."
+            ],
+            [
+                "We",
+                "are",
+                "left",
+                "with",
+                "answers",
+                "3",
+                "and",
+                "4,",
+                "both",
+                "with",
+                "systemic",
+                "treatment",
+                "(indicated",
+                "because",
+                "it",
+                "is",
+                "metastatic)",
+                "and",
+                "the",
+                "correct",
+                "answer",
+                "is",
+                "4,",
+                "for",
+                "all",
+                "the",
+                "reasons",
+                "given",
+                "therein."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "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",
+                "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",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "556_55",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "63-year-old",
+                "diabetic",
+                "patient",
+                "whose",
+                "family",
+                "physician",
+                "has",
+                "requested",
+                "a",
+                "blood",
+                "test",
+                "to",
+                "determine",
+                "vitamin",
+                "B12",
+                "levels.What",
+                "is",
+                "the",
+                "antidiabetic",
+                "drug",
+                "he",
+                "is",
+                "taking",
+                "that",
+                "warrants",
+                "such",
+                "a",
+                "request:"
+            ],
+            [
+                "1-",
+                "Gliclazide."
+            ],
+            [
+                "2-",
+                "Metformin."
+            ],
+            [
+                "3-",
+                "Repaglinide."
+            ],
+            [
+                "4-",
+                "Pioglitazone."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Metformin",
+                "is",
+                "an",
+                "oral",
+                "antidiabetic",
+                "widely",
+                "used",
+                "in",
+                "the",
+                "treatment",
+                "of",
+                "type",
+                "2",
+                "diabetes",
+                "mellitus."
+            ],
+            [
+                "The",
+                "best",
+                "known",
+                "side",
+                "effects",
+                "are",
+                "gastrointestinal",
+                "side",
+                "effects",
+                "and",
+                "lactic",
+                "acidosis;",
+                "however,",
+                "vitamin",
+                "B",
+                "12",
+                "malabsorption,",
+                "is",
+                "less",
+                "well",
+                "known."
+            ],
+            [
+                "A",
+                "decrease",
+                "in",
+                "vitamin",
+                "B",
+                "12",
+                "levels",
+                "is",
+                "observed",
+                "in",
+                "patients",
+                "treated",
+                "with",
+                "metformin."
+            ],
+            [
+                "The",
+                "mechanism",
+                "by",
+                "which",
+                "this",
+                "deficit",
+                "occurs",
+                "is",
+                "not",
+                "clear",
+                "and",
+                "it",
+                "is",
+                "known",
+                "to",
+                "be",
+                "reversible",
+                "when",
+                "treatment",
+                "is",
+                "interrupted."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "448_148",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROSURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "59-year-old",
+                "woman",
+                "with",
+                "recent",
+                "onset",
+                "of",
+                "epileptic",
+                "seizures",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department."
+            ],
+            [
+                "The",
+                "examination",
+                "showed",
+                "left",
+                "pyramidal",
+                "signs",
+                "and",
+                "papillary",
+                "edema."
+            ],
+            [
+                "Brain",
+                "MRI",
+                "showed",
+                "a",
+                "right",
+                "hemispheric",
+                "mass",
+                "with",
+                "edema,",
+                "midline",
+                "deviation",
+                "and",
+                "signs",
+                "of",
+                "tentorial",
+                "herniation."
+            ],
+            [
+                "She",
+                "reports",
+                "a",
+                "headache",
+                "that",
+                "has",
+                "been",
+                "progressing",
+                "in",
+                "intensity",
+                "for",
+                "the",
+                "past",
+                "week."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "features",
+                "associated",
+                "with",
+                "headache",
+                "seems",
+                "most",
+                "likely",
+                "in",
+                "this",
+                "patient?"
+            ],
+            [
+                "1-",
+                "Predominance",
+                "in",
+                "the",
+                "morning."
+            ],
+            [
+                "2-",
+                "It",
+                "does",
+                "not",
+                "change",
+                "with",
+                "effort."
+            ],
+            [
+                "3-",
+                "Photophobia."
+            ],
+            [
+                "4-",
+                "Sonophobia."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "They",
+                "describe",
+                "a",
+                "recent",
+                "diagnosis",
+                "of",
+                "cerebral",
+                "LOE",
+                "with",
+                "signs",
+                "of",
+                "intracranial",
+                "hypertension",
+                "(edema,",
+                "midline",
+                "deviation,",
+                "papilledema)."
+            ],
+            [
+                "The",
+                "associated",
+                "headache",
+                "is",
+                "typically",
+                "morning",
+                "headache,",
+                "with",
+                "increasing",
+                "ICP",
+                "values",
+                "at",
+                "night."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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",
+                "B-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"
+            ]
+        ]
+    },
+    {
+        "id": "591_64",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "OPHTHALMOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "68-year-old",
+                "woman",
+                "who",
+                "wears",
+                "+4.00",
+                "diopter",
+                "glasses",
+                "for",
+                "distance",
+                "vision",
+                "in",
+                "both",
+                "eyes."
+            ],
+            [
+                "She",
+                "consults",
+                "because",
+                "since",
+                "a",
+                "few",
+                "weeks",
+                "ago",
+                "she",
+                "has",
+                "been",
+                "having",
+                "eye",
+                "pain",
+                "with",
+                "headache",
+                "and",
+                "blurred",
+                "vision",
+                "at",
+                "night",
+                "when",
+                "she",
+                "is",
+                "watching",
+                "television",
+                "in",
+                "twilight."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "pathologies",
+                "is",
+                "she",
+                "most",
+                "likely",
+                "to",
+                "present?"
+            ],
+            [
+                "1-",
+                "Glaucoma",
+                "due",
+                "to",
+                "primary",
+                "angular",
+                "closure."
+            ],
+            [
+                "2-",
+                "Migraine."
+            ],
+            [
+                "3-",
+                "Actinic",
+                "keratitis."
+            ],
+            [
+                "4-",
+                "Dry",
+                "eye",
+                "syndrome."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "We",
+                "are",
+                "presented",
+                "with",
+                "a",
+                "68-year-old",
+                "woman",
+                "with",
+                "moderate",
+                "hyperopia",
+                "and",
+                "no",
+                "history",
+                "of",
+                "cataract",
+                "surgery."
+            ],
+            [
+                "This",
+                "is",
+                "not",
+                "a",
+                "mere",
+                "coincidence:",
+                "the",
+                "fact",
+                "that",
+                "the",
+                "patient",
+                "is",
+                "hyperopic",
+                "is",
+                "important,",
+                "because",
+                "the",
+                "eyeballs",
+                "of",
+                "hyperopic",
+                "patients",
+                "are",
+                "shorter,",
+                "with",
+                "a",
+                "certain",
+                "conflict",
+                "of",
+                "space",
+                "in",
+                "the",
+                "anterior",
+                "segment",
+                "when",
+                "the",
+                "crystalline",
+                "lens",
+                "undergoes",
+                "a",
+                "process",
+                "of",
+                "intumescence",
+                "secondary",
+                "to",
+                "age",
+                "(what",
+                "patients",
+                "call",
+                "incipient",
+                "cataract)."
+            ],
+            [
+                "In",
+                "the",
+                "clinical",
+                "case,",
+                "moreover,",
+                "the",
+                "ocular",
+                "and",
+                "headache",
+                "pain",
+                "occurs",
+                "in",
+                "scotopic",
+                "situations,",
+                "or",
+                "in",
+                "situations",
+                "of",
+                "dim",
+                "ambient",
+                "lighting,",
+                "which",
+                "produces",
+                "an",
+                "average",
+                "mydriasis",
+                "to",
+                "optimize",
+                "the",
+                "light",
+                "influx",
+                "to",
+                "the",
+                "eyeball."
+            ],
+            [
+                "It",
+                "is",
+                "evident,",
+                "therefore,",
+                "that",
+                "the",
+                "patient",
+                "suffers",
+                "from",
+                "primary",
+                "angular",
+                "closure",
+                "processes",
+                "that",
+                "possibly",
+                "self-resolve",
+                "when",
+                "the",
+                "triggering",
+                "situation",
+                "ceases,",
+                "and",
+                "not",
+                "a",
+                "true",
+                "acute",
+                "glaucoma",
+                "attack."
+            ],
+            [
+                "But",
+                "these",
+                "intermittent",
+                "angular",
+                "closures",
+                "are",
+                "contemplated",
+                "within",
+                "the",
+                "spectrum",
+                "of",
+                "glaucoma",
+                "due",
+                "to",
+                "primary",
+                "angular",
+                "closure",
+                "(option",
+                "1",
+                "correct)."
+            ],
+            [
+                "Migraine,",
+                "not",
+                "being",
+                "a",
+                "Neurology",
+                "question,",
+                "can",
+                "sometimes",
+                "be",
+                "a",
+                "confounder",
+                "in",
+                "the",
+                "usual",
+                "clinic;",
+                "however,",
+                "patients",
+                "are",
+                "usually",
+                "younger,",
+                "or",
+                "at",
+                "least",
+                "have",
+                "a",
+                "clear",
+                "history",
+                "of",
+                "migraine,",
+                "and,",
+                "above",
+                "all,",
+                "they",
+                "present",
+                "symptomatologic",
+                "worsening",
+                "with",
+                "intense",
+                "sensory",
+                "stimuli",
+                "(photophobia",
+                "and",
+                "phonophobia),",
+                "but",
+                "symptoms",
+                "are",
+                "not",
+                "worsened",
+                "precisely",
+                "in",
+                "cases",
+                "of",
+                "dim",
+                "lighting",
+                "(option",
+                "2",
+                "incorrect)."
+            ],
+            [
+                "Actinic",
+                "keratitis",
+                "occurs",
+                "precisely",
+                "in",
+                "patients",
+                "exposed",
+                "to",
+                "ultraviolet",
+                "radiation",
+                "that",
+                "is",
+                "not",
+                "properly",
+                "filtered",
+                "before",
+                "reaching",
+                "the",
+                "cornea;",
+                "it",
+                "is",
+                "typical",
+                "of",
+                "welders",
+                "(it",
+                "is",
+                "called",
+                "welder's",
+                "keratitis),",
+                "skiers",
+                "and",
+                "other",
+                "people",
+                "with",
+                "very",
+                "intense",
+                "light",
+                "exposures",
+                "and",
+                "without",
+                "adequate",
+                "eye",
+                "protection",
+                "(wrong",
+                "option",
+                "3)."
+            ],
+            [
+                "Dry",
+                "eye",
+                "syndrome",
+                "does",
+                "not",
+                "usually",
+                "produce",
+                "headache,",
+                "and",
+                "ocular",
+                "discomfort",
+                "does",
+                "not",
+                "go",
+                "beyond",
+                "the",
+                "persistent",
+                "discomfort",
+                "that",
+                "patients",
+                "might",
+                "define",
+                "as",
+                "pain",
+                "because",
+                "of",
+                "its",
+                "recently",
+                "more",
+                "studied",
+                "neuropathic",
+                "component."
+            ],
+            [
+                "Some",
+                "forms",
+                "of",
+                "dry",
+                "eye",
+                "may",
+                "be",
+                "worse",
+                "in",
+                "the",
+                "evening",
+                "but",
+                "others",
+                "are",
+                "worse",
+                "in",
+                "the",
+                "morning,",
+                "and",
+                "it",
+                "depends",
+                "mainly",
+                "on",
+                "the",
+                "frequency",
+                "of",
+                "blinking."
+            ],
+            [
+                "In",
+                "addition,",
+                "dry",
+                "eye",
+                "syndrome",
+                "is",
+                "an",
+                "outdated",
+                "term;",
+                "nowadays",
+                "it",
+                "is",
+                "preferred",
+                "to",
+                "speak",
+                "of",
+                "dry",
+                "eye",
+                "disease",
+                "(incorrect",
+                "option",
+                "4)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "291_157",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DERMATOLOGY,",
+                "VENEREOLOGY",
+                "AND",
+                "PLASTIC",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "8-year-old",
+                "patient",
+                "presenting",
+                "with",
+                "superficial",
+                "pustular",
+                "lesions,",
+                "erosions",
+                "and",
+                "yellowish",
+                "crusts",
+                "around",
+                "the",
+                "mouth",
+                "for",
+                "the",
+                "last",
+                "3",
+                "days:"
+            ],
+            [
+                "1-",
+                "Exudative",
+                "erythema",
+                "multiforme."
+            ],
+            [
+                "2-",
+                "Contagious",
+                "impetigo."
+            ],
+            [
+                "3-",
+                "Infantile",
+                "acne."
+            ],
+            [
+                "4-",
+                "Pustular",
+                "psoriasis."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "It",
+                "is",
+                "a",
+                "typical",
+                "and",
+                "frequent",
+                "clinical",
+                "picture",
+                "in",
+                "children."
+            ],
+            [
+                "You",
+                "are",
+                "describing",
+                "a",
+                "contagious",
+                "impetigo."
+            ],
+            [
+                "There",
+                "is",
+                "not",
+                "much",
+                "dispute."
+            ],
+            [
+                "The",
+                "most",
+                "frequent",
+                "causative",
+                "agent",
+                "in",
+                "the",
+                "bullous",
+                "form",
+                "is",
+                "S.",
+                "aureus",
+                "phage",
+                "II."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "213_160",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "RHEUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "75-year-old",
+                "woman,",
+                "with",
+                "menopause",
+                "at",
+                "age",
+                "52,",
+                "with",
+                "no",
+                "family",
+                "or",
+                "personal",
+                "history",
+                "of",
+                "fracture,",
+                "diagnosed",
+                "with",
+                "temporal",
+                "arteritis,",
+                "who",
+                "is",
+                "going",
+                "to",
+                "start",
+                "treatment",
+                "with",
+                "high-dose",
+                "prednisone",
+                "and",
+                "expects",
+                "to",
+                "be",
+                "treated",
+                "for",
+                "at",
+                "least",
+                "one",
+                "year."
+            ],
+            [
+                "The",
+                "delay",
+                "of",
+                "densitometry",
+                "(DXA)",
+                "in",
+                "her",
+                "center",
+                "is",
+                "4-5",
+                "months."
+            ],
+            [
+                "Preventive",
+                "treatment",
+                "for",
+                "osteoporosis",
+                "is",
+                "considered."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "is",
+                "the",
+                "most",
+                "appropriate",
+                "approach?"
+            ],
+            [
+                "1-",
+                "Request",
+                "DXA",
+                "and",
+                "wait",
+                "for",
+                "the",
+                "result."
+            ],
+            [
+                "2-",
+                "Assess",
+                "absolute",
+                "risk",
+                "of",
+                "fracture",
+                "using",
+                "the",
+                "FRAX",
+                "questionnaire",
+                "without",
+                "BMD",
+                "and",
+                "treat",
+                "only",
+                "if",
+                "it",
+                "is",
+                "high."
+            ],
+            [
+                "3-",
+                "Start",
+                "treatment",
+                "with",
+                "bisphosphonates",
+                "and",
+                "vitamin",
+                "D",
+                "(800",
+                "IU/day)."
+            ],
+            [
+                "4-",
+                "Administer",
+                "calcium",
+                "supplementation",
+                "(1g)",
+                "and",
+                "vitamin",
+                "D",
+                "(800",
+                "IU/day)."
+            ],
+            [
+                "5-",
+                "Assess",
+                "for",
+                "osteopenia",
+                "on",
+                "radiographs",
+                "and",
+                "treat",
+                "if",
+                "present."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "In",
+                "the",
+                "data",
+                "you",
+                "provide",
+                "there",
+                "are",
+                "no",
+                "clinical",
+                "risk",
+                "factors",
+                "for",
+                "osteoporosis",
+                "prior",
+                "to",
+                "the",
+                "current",
+                "disease."
+            ],
+            [
+                "Since",
+                "a",
+                "prolonged",
+                "and",
+                "high-dose",
+                "prednisone",
+                "regimen",
+                "will",
+                "be",
+                "established,",
+                "it",
+                "is",
+                "advisable,",
+                "in",
+                "addition",
+                "to",
+                "the",
+                "non-pharmacological",
+                "preventive",
+                "measures,",
+                "to",
+                "initiate",
+                "treatment",
+                "in",
+                "any",
+                "case",
+                "to",
+                "minimize",
+                "the",
+                "secondary",
+                "loss",
+                "of",
+                "bone",
+                "mass",
+                "that",
+                "occurs",
+                "with",
+                "the",
+                "administration",
+                "of",
+                "glucocorticoids",
+                "(and,",
+                "above",
+                "all,",
+                "in",
+                "the",
+                "first",
+                "months)."
+            ],
+            [
+                "Therefore,",
+                "and",
+                "for",
+                "this",
+                "reason",
+                "alone,",
+                "options",
+                "1,",
+                "2",
+                "and",
+                "5",
+                "would",
+                "be",
+                "discarded",
+                "(the",
+                "three",
+                "of",
+                "them",
+                "have",
+                "another",
+                "conditioning",
+                "factor)."
+            ],
+            [
+                "In",
+                "this",
+                "context,",
+                "and",
+                "in",
+                "the",
+                "case",
+                "of",
+                "a",
+                "person",
+                "over",
+                "65",
+                "years",
+                "of",
+                "age,",
+                "an",
+                "appropriate",
+                "attitude",
+                "would",
+                "be",
+                "to",
+                "administer",
+                "calcium",
+                "supplements",
+                "(corticosteroids",
+                "are",
+                "osteopenizantes",
+                "because",
+                "they",
+                "produce,",
+                "among",
+                "other",
+                "mechanisms,",
+                "a",
+                "negative",
+                "balance",
+                "of",
+                "this",
+                "element)",
+                "and",
+                "vitamin",
+                "D."
+            ],
+            [
+                "The",
+                "option",
+                "of",
+                "associating",
+                "a",
+                "bisphosphonate",
+                "could",
+                "also",
+                "be",
+                "considered,",
+                "but",
+                "calcium",
+                "supplementation",
+                "is",
+                "missing",
+                "in",
+                "proposal",
+                "3."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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",
+                "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-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "B-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "442_100",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "34-year-old",
+                "woman",
+                "who",
+                "consults",
+                "for",
+                "repeated",
+                "coitorragia."
+            ],
+            [
+                "She",
+                "brings",
+                "a",
+                "cytology",
+                "with",
+                "a",
+                "high",
+                "grade",
+                "intraepithelial",
+                "lesion",
+                "(U-SIL)."
+            ],
+            [
+                "Subsequently,",
+                "colposcopy",
+                "and",
+                "biopsy",
+                "were",
+                "performed",
+                "on",
+                "a",
+                "mosaic",
+                "area",
+                "and",
+                "histology",
+                "showed",
+                "a",
+                "focus",
+                "of",
+                "invasive",
+                "squamous",
+                "cell",
+                "carcinoma",
+                "of",
+                "2",
+                "mm",
+                "in",
+                "length."
+            ],
+            [
+                "Which",
+                "therapeutic",
+                "option",
+                "is",
+                "the",
+                "most",
+                "appropriate",
+                "for",
+                "this",
+                "patient?"
+            ],
+            [
+                "1-",
+                "Conization."
+            ],
+            [
+                "2-",
+                "Total",
+                "hysterectomy",
+                "without",
+                "adnexectomy."
+            ],
+            [
+                "3-",
+                "Pelvic",
+                "radiotherapy",
+                "with",
+                "curative",
+                "intent."
+            ],
+            [
+                "4-",
+                "Repeat",
+                "a",
+                "more",
+                "extensive",
+                "biopsy."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "According",
+                "to",
+                "the",
+                "SEGO:",
+                "\"Excise",
+                "the",
+                "entire",
+                "lesion",
+                "so",
+                "that",
+                "it",
+                "can",
+                "be",
+                "evaluated",
+                "histologically."
+            ],
+            [
+                "It",
+                "involves",
+                "excision",
+                "of",
+                "the",
+                "entire",
+                "transformation",
+                "zone."
+            ],
+            [
+                "In",
+                "general,",
+                "the",
+                "excision",
+                "should",
+                "be",
+                "adapted",
+                "to",
+                "the",
+                "size",
+                "and",
+                "characteristics",
+                "of",
+                "the",
+                "lesion."
+            ],
+            [
+                "Three",
+                "types",
+                "of",
+                "excision",
+                "are",
+                "distinguished",
+                "according",
+                "to",
+                "the",
+                "presence",
+                "of",
+                "the",
+                "endocervical",
+                "component",
+                "of",
+                "the",
+                "lesion."
+            ],
+            [
+                "Excision",
+                "type",
+                "1",
+                "(applicable",
+                "in",
+                "cases",
+                "with",
+                "transformation",
+                "zone",
+                "type",
+                "1,",
+                "in",
+                "which",
+                "the",
+                "diathermic",
+                "loop",
+                "should",
+                "not",
+                "include",
+                "endocervical",
+                "canal",
+                "or",
+                "exceed",
+                "8",
+                "mm",
+                "in",
+                "depth),",
+                "excision",
+                "type",
+                "2",
+                "(indicated",
+                "in",
+                "transformation",
+                "zones",
+                "type",
+                "2,",
+                "involves",
+                "resecting",
+                "a",
+                "small",
+                "part",
+                "of",
+                "endocervical",
+                "canal",
+                "visible",
+                "by",
+                "colposcopy)",
+                "and",
+                "excision",
+                "type",
+                "3",
+                "(indicated",
+                "in",
+                "transformation",
+                "zones",
+                "type",
+                "3,",
+                "includes",
+                "part",
+                "of",
+                "endocervical",
+                "epithelium)\"."
+            ],
+            [
+                "When",
+                "they",
+                "speak",
+                "of",
+                "excision,",
+                "it",
+                "is",
+                "synonymous",
+                "with",
+                "conization;",
+                "as",
+                "the",
+                "lesion",
+                "is",
+                "less",
+                "than",
+                "8mm",
+                "deep,",
+                "this",
+                "is",
+                "the",
+                "indicated",
+                "treatment."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "491_106",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "HEMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "65-year-old",
+                "woman",
+                "referred",
+                "to",
+                "the",
+                "ED",
+                "for",
+                "fever",
+                "and",
+                "alterations",
+                "in",
+                "the",
+                "CBC:",
+                "hemoglobin",
+                "11.4",
+                "g/dL,",
+                "leukocytes",
+                "0.86",
+                "x103/\u03bcL,(neutrophils",
+                "41.9",
+                "%,",
+                "lymphocytes",
+                "55.8",
+                "%),platelets",
+                "48.0",
+                "x103/\u03bcL,",
+                "fibrinogen",
+                "118",
+                "mg/dL,D-dimer",
+                "20.2",
+                "\u03bcg/mL."
+            ],
+            [
+                "A",
+                "bone",
+                "marrow",
+                "examination",
+                "was",
+                "performed",
+                "and",
+                "the",
+                "patient",
+                "was",
+                "diagnosed",
+                "with",
+                "acute",
+                "leukemia",
+                "with",
+                "t(15;17)",
+                "in",
+                "60%",
+                "of",
+                "the",
+                "cells."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "answers",
+                "is",
+                "correct?"
+            ],
+            [
+                "1-",
+                "If",
+                "asymptomatic,",
+                "transretinoic",
+                "acid",
+                "(ATRA)",
+                "will",
+                "be",
+                "initiated",
+                "and",
+                "controls",
+                "in",
+                "day",
+                "hospital",
+                "will",
+                "be",
+                "recommended."
+            ],
+            [
+                "2-",
+                "Treatment",
+                "with",
+                "arsenic",
+                "trioxide,",
+                "ATRA",
+                "and",
+                "supportive",
+                "therapy",
+                "will",
+                "be",
+                "initiated."
+            ],
+            [
+                "3-",
+                "It",
+                "is",
+                "a",
+                "myeloblastic",
+                "leukemia",
+                "type",
+                "M3,",
+                "so",
+                "chemotherapy",
+                "and",
+                "heparin",
+                "treatment",
+                "will",
+                "be",
+                "initiated",
+                "to",
+                "control",
+                "disseminated",
+                "intravascular",
+                "coagulation."
+            ],
+            [
+                "4-",
+                "Antibiotic",
+                "treatment",
+                "should",
+                "be",
+                "started.",
+                "When",
+                "the",
+                "fever",
+                "disappears,",
+                "leukemia",
+                "treatment",
+                "should",
+                "be",
+                "started."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "I",
+                "think",
+                "this",
+                "is",
+                "a",
+                "very",
+                "nice",
+                "question."
+            ],
+            [
+                "There",
+                "is",
+                "no",
+                "doubt",
+                "about",
+                "the",
+                "diagnosis."
+            ],
+            [
+                "Because",
+                "if",
+                "you",
+                "don't",
+                "know",
+                "the",
+                "translocation,",
+                "nothing",
+                "happens...",
+                "the",
+                "answers",
+                "give",
+                "you",
+                "the",
+                "diagnosis."
+            ],
+            [
+                "Now",
+                "it's",
+                "time",
+                "to",
+                "find",
+                "out",
+                "how",
+                "acute",
+                "promyelocytic",
+                "leukemia",
+                "is",
+                "currently",
+                "treated",
+                "(ATRA",
+                "aside...",
+                "which",
+                "I'm",
+                "sure",
+                "you",
+                "know)."
+            ],
+            [
+                "As",
+                "of",
+                "2017,",
+                "the",
+                "PETHEMA",
+                "protocol",
+                "for",
+                "APL",
+                "in",
+                "low",
+                "to",
+                "intermediate",
+                "risk",
+                "patients",
+                "(and/or",
+                "over",
+                "70",
+                "years",
+                "of",
+                "age)",
+                "is",
+                "ATO+ATRA."
+            ],
+            [
+                "In",
+                "high",
+                "risk",
+                "patients,",
+                "it",
+                "is",
+                "treated",
+                "with",
+                "ATRA+chemotherapy."
+            ],
+            [
+                "I",
+                "don't",
+                "think",
+                "they",
+                "want",
+                "you",
+                "to",
+                "know",
+                "how",
+                "risk",
+                "is",
+                "established",
+                "in",
+                "promielos,",
+                "but",
+                "it",
+                "is",
+                "based",
+                "on",
+                "leukocyte",
+                "and",
+                "platelet",
+                "counts."
+            ],
+            [
+                "In",
+                "this",
+                "case,",
+                "it",
+                "doesn't",
+                "score",
+                "anything",
+                "for",
+                "the",
+                "score",
+                "since",
+                "you",
+                "have",
+                "<10,000",
+                "leukocytes",
+                "and",
+                ">40,000",
+                "platelets."
+            ],
+            [
+                "That",
+                "is,",
+                "it",
+                "is",
+                "a",
+                "low",
+                "risk."
+            ],
+            [
+                "Correct",
+                "answer",
+                "2."
+            ],
+            [
+                "Perhaps",
+                "some",
+                "people",
+                "have",
+                "been",
+                "confused",
+                "by",
+                "option",
+                "3."
+            ],
+            [
+                "One",
+                "of",
+                "the",
+                "main",
+                "causes",
+                "of",
+                "mortality",
+                "in",
+                "the",
+                "induction",
+                "of",
+                "a",
+                "promyelocyte",
+                "is",
+                "coagulopathy,",
+                "but",
+                "option",
+                "3",
+                "is",
+                "totally",
+                "incorrect."
+            ],
+            [
+                "We",
+                "could",
+                "only",
+                "mess",
+                "things",
+                "up",
+                "even",
+                "more",
+                "by",
+                "putting",
+                "heparin!!!!"
+            ],
+            [
+                "I",
+                "don't",
+                "know",
+                "what",
+                "they",
+                "are",
+                "explaining",
+                "right",
+                "now",
+                "in",
+                "the",
+                "academies,",
+                "but",
+                "it",
+                "is",
+                "clear",
+                "that",
+                "they",
+                "wanted",
+                "you",
+                "to",
+                "know",
+                "that",
+                "many",
+                "promyelocytes,",
+                "since",
+                "3",
+                "little",
+                "years",
+                "ago,",
+                "are",
+                "not",
+                "treated",
+                "with",
+                "chemotherapy."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise"
+            ],
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
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+            ],
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+                "O",
+                "O"
+            ],
+            [
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+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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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"
+            ],
+            [
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "O"
+            ],
+            [
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+                "O"
+            ],
+            [
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+                "O",
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+            ],
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+            ],
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+            ],
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+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+            ],
+            [
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+                "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"
+            ],
+            [
+                "B-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "277_226",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DIGESTIVE",
+                "TRACT"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "In",
+                "a",
+                "colon",
+                "cancer",
+                "screening",
+                "program,",
+                "a",
+                "52-year-old",
+                "patient",
+                "undergoes",
+                "a",
+                "colonoscopy."
+            ],
+            [
+                "The",
+                "entire",
+                "colon",
+                "is",
+                "normal",
+                "except",
+                "for",
+                "the",
+                "finding",
+                "of",
+                "a",
+                "2",
+                "cm",
+                "pedunculated",
+                "polyp",
+                "in",
+                "the",
+                "sigma",
+                "which",
+                "is",
+                "removed",
+                "with",
+                "a",
+                "diathermy",
+                "loop."
+            ],
+            [
+                "The",
+                "anatomopathological",
+                "result",
+                "indicates",
+                "that",
+                "there",
+                "is",
+                "a",
+                "carcinoma",
+                "in",
+                "situ",
+                "limited",
+                "to",
+                "the",
+                "head",
+                "of",
+                "the",
+                "polyp."
+            ],
+            [
+                "She",
+                "has",
+                "a",
+                "thoracoabdominal",
+                "CT",
+                "scan",
+                "reported",
+                "as",
+                "normal."
+            ],
+            [
+                "Indicate",
+                "the",
+                "correct",
+                "course",
+                "of",
+                "action."
+            ],
+            [
+                "1-",
+                "Segmental",
+                "resection",
+                "of",
+                "the",
+                "affected",
+                "colon."
+            ],
+            [
+                "2-",
+                "Periodic",
+                "endoscopic",
+                "surveillance."
+            ],
+            [
+                "3-",
+                "Local",
+                "resection",
+                "of",
+                "the",
+                "base",
+                "of",
+                "the",
+                "polyp."
+            ],
+            [
+                "4-",
+                "Sigmoidectomy",
+                "plus",
+                "lymphadenectomy."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Carcinoma",
+                "in",
+                "situ",
+                "is",
+                "delimited",
+                "by",
+                "the",
+                "basement",
+                "membrane,",
+                "i.e.",
+                "it",
+                "is",
+                "not",
+                "invasive",
+                "yet,",
+                "and",
+                "therefore",
+                "the",
+                "treatment",
+                "is",
+                "polypectomy,",
+                "which",
+                "is",
+                "already",
+                "done."
+            ],
+            [
+                "Subsequently,",
+                "an",
+                "endoscopic",
+                "follow-up",
+                "(with",
+                "biopsies)",
+                "should",
+                "be",
+                "performed",
+                "at",
+                "an",
+                "interval",
+                "of",
+                "3",
+                "to",
+                "6",
+                "months",
+                "depending",
+                "on",
+                "the",
+                "patient's",
+                "history,",
+                "age",
+                "and",
+                "concomitant",
+                "pathologies."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
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+                "I-Premise",
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+                "I-Premise",
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+                "I-Claim",
+                "I-Claim",
+                "I-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",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "155_83",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "RHEUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "62-year-old",
+                "man",
+                "with",
+                "a",
+                "history",
+                "of",
+                "arterial",
+                "hypertension",
+                "under",
+                "treatment",
+                "with",
+                "captopril,",
+                "duodenal",
+                "ulcer",
+                "and",
+                "uric",
+                "acid",
+                "urolithiasis."
+            ],
+            [
+                "He",
+                "consults",
+                "for",
+                "typical",
+                "podagra",
+                "crisis",
+                "similar",
+                "to",
+                "others",
+                "presented",
+                "in",
+                "the",
+                "last",
+                "two",
+                "years."
+            ],
+            [
+                "Examination",
+                "showed",
+                "tophi",
+                "in",
+                "both",
+                "pinnae."
+            ],
+            [
+                "Analyses",
+                "show",
+                "uric",
+                "acid",
+                "10.1",
+                "mg/dl,",
+                "creatine",
+                "1.5",
+                "mg/dl."
+            ],
+            [
+                "Indicate",
+                "which",
+                "of",
+                "the",
+                "following",
+                "answers",
+                "is",
+                "FALSE",
+                "in",
+                "relation",
+                "to",
+                "his",
+                "possible",
+                "treatment",
+                "with",
+                "allopurinol."
+            ],
+            [
+                "1-",
+                "Its",
+                "use",
+                "is",
+                "second",
+                "choice",
+                "when",
+                "uricosurics",
+                "have",
+                "failed."
+            ],
+            [
+                "2-",
+                "Its",
+                "prolonged",
+                "use",
+                "is",
+                "practically",
+                "obligatory",
+                "because",
+                "there",
+                "are",
+                "tophi."
+            ],
+            [
+                "3-",
+                "Its",
+                "introduction",
+                "should",
+                "be",
+                "delayed",
+                "until",
+                "the",
+                "current",
+                "attack",
+                "has",
+                "resolved",
+                "with",
+                "anti-inflammatory",
+                "drugs",
+                "or",
+                "colchicine."
+            ],
+            [
+                "4-",
+                "Its",
+                "introduction",
+                "should",
+                "be",
+                "gradual",
+                "up",
+                "to",
+                "a",
+                "dose",
+                "that",
+                "achieves",
+                "a",
+                "uricemia",
+                "below",
+                "6",
+                "mg/dL."
+            ],
+            [
+                "5-",
+                "In",
+                "the",
+                "first",
+                "months",
+                "of",
+                "treatment",
+                "it",
+                "is",
+                "advisable",
+                "to",
+                "associate",
+                "low",
+                "doses",
+                "of",
+                "colchicine",
+                "to",
+                "prevent",
+                "new",
+                "attacks."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Allopurinol",
+                "is",
+                "always",
+                "the",
+                "treatment",
+                "of",
+                "choice,",
+                "especially",
+                "in",
+                "the",
+                "case",
+                "of",
+                "tophaceous",
+                "gout."
+            ],
+            [
+                "Moreover,",
+                "in",
+                "this",
+                "case,",
+                "uricosuric",
+                "acid",
+                "could",
+                "worsen",
+                "urolithiasis",
+                "by",
+                "increasing",
+                "uricosuria",
+                "(sorry",
+                "for",
+                "the",
+                "redundancy...)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "B-Treatment",
+                "I-Treatment",
+                "I-Treatment"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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",
+                "O",
+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "373_86",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "We",
+                "are",
+                "referred",
+                "from",
+                "ophthalmology",
+                "to",
+                "a",
+                "31-year-old",
+                "man",
+                "who",
+                "consulted",
+                "for",
+                "loss",
+                "of",
+                "vision",
+                "and",
+                "progressive",
+                "headache."
+            ],
+            [
+                "Physical",
+                "examination",
+                "showed",
+                "temporal",
+                "hemianopsia",
+                "and",
+                "pituitary",
+                "MRI",
+                "showed",
+                "a",
+                "35",
+                "x",
+                "30",
+                "x",
+                "20",
+                "mm",
+                "turnoration",
+                "compressing",
+                "chiasm",
+                "and",
+                "cavernous",
+                "sinus."
+            ],
+            [
+                "The",
+                "results",
+                "of",
+                "the",
+                "functional",
+                "study",
+                "are",
+                "cortisol",
+                "14",
+                "microg/dL,",
+                "TSH",
+                "1.4",
+                "microU/ml,",
+                "T4L",
+                "1.2",
+                "ng/dL,",
+                "prolactin",
+                "480",
+                "microg/L",
+                "(vn",
+                "<",
+                "15),",
+                "testosterone",
+                "160",
+                "ng/dL",
+                "(vn",
+                "300-1200),",
+                "FSH",
+                "1.2",
+                "U/I.,",
+                "(vn",
+                "5-15)",
+                "and",
+                "LH",
+                "2",
+                "U/L",
+                "(vn",
+                "3-15)."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "initial",
+                "therapeutic",
+                "approach?"
+            ],
+            [
+                "1-",
+                "Dopaminergic",
+                "agonists."
+            ],
+            [
+                "2-",
+                "Transsphenoidal",
+                "surgery."
+            ],
+            [
+                "3-",
+                "External",
+                "radiotherapy",
+                "or",
+                "radiosurgery."
+            ],
+            [
+                "4-",
+                "Treatment",
+                "of",
+                "hypogonadotropic",
+                "hypogonadism",
+                "with",
+                "testosterone."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "From",
+                "what",
+                "is",
+                "described",
+                "it",
+                "is",
+                "a",
+                "macroprolactinoma",
+                "as",
+                "it",
+                "is",
+                "a",
+                "pituitary",
+                "tumor",
+                "of",
+                "more",
+                "than",
+                "one",
+                "centimeter,",
+                "which",
+                "secretes",
+                "prolactin",
+                "and",
+                "with",
+                "an",
+                "insufficiency",
+                "of",
+                "the",
+                "rest",
+                "of",
+                "pituitary",
+                "hormones."
+            ],
+            [
+                "The",
+                "first",
+                "line",
+                "treatment",
+                "of",
+                "choice",
+                "is",
+                "dopaminergic",
+                "agonists,",
+                "although",
+                "when",
+                "the",
+                "visual",
+                "field",
+                "is",
+                "affected,",
+                "surgery",
+                "may",
+                "be",
+                "chosen."
+            ],
+            [
+                "In",
+                "this",
+                "case,",
+                "the",
+                "cavernous",
+                "sinus",
+                "is",
+                "pressured",
+                "by",
+                "the",
+                "mass,",
+                "so",
+                "the",
+                "surgical",
+                "risk",
+                "increases."
+            ],
+            [
+                "Therefore,",
+                "in",
+                "this",
+                "particular",
+                "case,",
+                "the",
+                "surgical",
+                "option",
+                "seems",
+                "more",
+                "risky."
+            ],
+            [
+                "Taking",
+                "this",
+                "into",
+                "account",
+                "and",
+                "the",
+                "fact",
+                "that",
+                "it",
+                "is",
+                "a",
+                "tumor",
+                "that",
+                "produces",
+                "high",
+                "levels",
+                "of",
+                "prolactin,",
+                "which",
+                "indicates",
+                "that",
+                "it",
+                "probably",
+                "responds",
+                "to",
+                "pharmacological",
+                "blockade,",
+                "the",
+                "most",
+                "appropriate",
+                "option",
+                "would",
+                "be",
+                "option",
+                "1,",
+                "treatment",
+                "with",
+                "dopaminergic",
+                "agonists."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "523_124",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTIOUS",
+                "DISEASES"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "45-year-old",
+                "patient",
+                "was",
+                "diagnosed",
+                "with",
+                "HIV",
+                "infection",
+                "three",
+                "months",
+                "ago,",
+                "presenting",
+                "at",
+                "that",
+                "time",
+                "with",
+                "CD4",
+                "45",
+                "lymphocytes/\u00b5l",
+                "and",
+                "an",
+                "HIV-1",
+                "viral",
+                "load",
+                "of",
+                "500,000",
+                "copies/ml."
+            ],
+            [
+                "At",
+                "that",
+                "time",
+                "he",
+                "had",
+                "a",
+                "negative",
+                "Mantoux",
+                "test."
+            ],
+            [
+                "He",
+                "started",
+                "treatment",
+                "with",
+                "an",
+                "integrase",
+                "inhibitor",
+                "and",
+                "two",
+                "reverse",
+                "transcriptase",
+                "inhibitors,",
+                "and",
+                "at",
+                "one",
+                "month",
+                "he",
+                "had",
+                "25,000",
+                "copies",
+                "and",
+                "CD4",
+                "had",
+                "risen",
+                "to",
+                "80/\u00b5L."
+            ],
+            [
+                "She",
+                "consulted",
+                "for",
+                "presenting",
+                "a",
+                "picture",
+                "of",
+                "cervical",
+                "lymphadenopathy",
+                "and",
+                "fever",
+                "of",
+                "two",
+                "weeks",
+                "of",
+                "evolution."
+            ],
+            [
+                "The",
+                "puncture",
+                "of",
+                "one",
+                "of",
+                "the",
+                "lymph",
+                "nodes",
+                "showed",
+                "isolated",
+                "acid-fast",
+                "bacilli",
+                "and",
+                "epithelioid",
+                "granulomas:"
+            ],
+            [
+                "1-",
+                "It",
+                "is",
+                "a",
+                "lymph",
+                "node",
+                "tuberculosis",
+                "related",
+                "to",
+                "an",
+                "incomplete",
+                "immunologic",
+                "recovery."
+            ],
+            [
+                "2-",
+                "Treatment",
+                "failure",
+                "and",
+                "it",
+                "is",
+                "an",
+                "opportunistic",
+                "infection."
+            ],
+            [
+                "3-",
+                "This",
+                "is",
+                "an",
+                "opportunistic",
+                "infection",
+                "unmasked",
+                "within",
+                "a",
+                "picture",
+                "of",
+                "immune",
+                "reconstitution."
+            ],
+            [
+                "4-",
+                "A",
+                "negative",
+                "Mantoux",
+                "test",
+                "rules",
+                "out",
+                "tuberculosis."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "We",
+                "are",
+                "dealing",
+                "with",
+                "a",
+                "patient",
+                "with",
+                "HIV",
+                "infection",
+                "in",
+                "a",
+                "situation",
+                "of",
+                "severe",
+                "immunosuppression",
+                "(<50",
+                "CD4+)",
+                "and",
+                "a",
+                "very",
+                "high",
+                "viral",
+                "load,",
+                "who",
+                "has",
+                "followed",
+                "the",
+                "expected",
+                "evolution",
+                "from",
+                "the",
+                "immunovirological",
+                "point",
+                "of",
+                "view",
+                "after",
+                "the",
+                "start",
+                "of",
+                "treatment",
+                "(after",
+                "12",
+                "weeks,",
+                "the",
+                "viral",
+                "load",
+                "has",
+                "ostensibly",
+                "decreased",
+                "-",
+                "answer",
+                "2",
+                "would",
+                "not",
+                "be",
+                "correct,",
+                "remember",
+                "that",
+                "it",
+                "is",
+                "desirable",
+                "that",
+                "it",
+                "becomes",
+                "negative",
+                "24",
+                "weeks",
+                "after",
+                "the",
+                "start",
+                "of",
+                "treatment,",
+                "although",
+                "in",
+                "patients",
+                "with",
+                "higher",
+                "CV",
+                "like",
+                "ours,",
+                "it",
+                "could",
+                "take",
+                "longer",
+                "-",
+                "and",
+                "the",
+                "CD4+",
+                "count",
+                "has",
+                "begun",
+                "to",
+                "rise)."
+            ],
+            [
+                "A",
+                "negative",
+                "Mantoux",
+                "test",
+                "does",
+                "not",
+                "rule",
+                "out",
+                "tuberculosis",
+                "(incorrect",
+                "answer",
+                "4),",
+                "since",
+                "in",
+                "patients",
+                "with",
+                "severe",
+                "immunosuppression",
+                "it",
+                "can",
+                "give",
+                "false",
+                "negatives."
+            ],
+            [
+                "The",
+                "diagnosis",
+                "of",
+                "lymph",
+                "node",
+                "tuberculosis",
+                "is",
+                "immediate",
+                "when",
+                "detecting",
+                "\"isolated",
+                "acid-fast",
+                "bacilli",
+                "and",
+                "epithelioid",
+                "granulomas\"",
+                "in",
+                "the",
+                "puncture",
+                "of",
+                "one",
+                "of",
+                "the",
+                "lymph",
+                "nodes,",
+                "however:",
+                "considering",
+                "the",
+                "patient",
+                "profile,",
+                "this",
+                "process",
+                "will",
+                "have",
+                "been",
+                "clinically",
+                "unmasked",
+                "during",
+                "the",
+                "immunological",
+                "reconstitution",
+                "and",
+                "the",
+                "infection",
+                "is",
+                "not",
+                "the",
+                "consequence",
+                "of",
+                "an",
+                "incomplete",
+                "immunological",
+                "recovery",
+                "(correct",
+                "answer",
+                "number",
+                "3)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "417_76",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GENERAL",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "78-year-old",
+                "woman",
+                "with",
+                "dementia",
+                "and",
+                "institutionalized",
+                "is",
+                "brought",
+                "by",
+                "her",
+                "caregivers",
+                "for",
+                "significant",
+                "abdominal",
+                "pain",
+                "with",
+                "deterioration",
+                "of",
+                "general",
+                "condition",
+                "and",
+                "abdominal",
+                "distension."
+            ],
+            [
+                "CBC",
+                "shows",
+                "leukocytosis,",
+                "elevated",
+                "hematocrit,",
+                "renal",
+                "failure",
+                "and",
+                "metabolic",
+                "acidosis."
+            ],
+            [
+                "ECG",
+                "shows",
+                "atrial",
+                "fibrillation."
+            ],
+            [
+                "Abdominal",
+                "tomography",
+                "shows",
+                "edematous",
+                "small",
+                "bowel",
+                "loops,",
+                "with",
+                "intestinal",
+                "and",
+                "portal",
+                "accumulation."
+            ],
+            [
+                "The",
+                "most",
+                "probable",
+                "diagnosis",
+                "is:"
+            ],
+            [
+                "1-",
+                "Perforation",
+                "of",
+                "gastric",
+                "or",
+                "duodenal",
+                "ulcus."
+            ],
+            [
+                "2-",
+                "Biliary",
+                "leak."
+            ],
+            [
+                "3-",
+                "Obstructive",
+                "neoplasia",
+                "of",
+                "the",
+                "sigma",
+                "with",
+                "perforation."
+            ],
+            [
+                "4-",
+                "Mesenteric",
+                "ischemia."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Typical",
+                "case",
+                "of",
+                "acute",
+                "mesenteric",
+                "ischemia,",
+                "which",
+                "should",
+                "be",
+                "suspected",
+                "in",
+                "elderly",
+                "patients",
+                "with",
+                "abdominal",
+                "pain",
+                "and",
+                "distension",
+                "of",
+                "sudden",
+                "onset,",
+                "diarrhea",
+                "or",
+                "vomiting",
+                "and",
+                "who",
+                "present",
+                "cardiovascular",
+                "risk",
+                "factors,",
+                "especially",
+                "emboligenic",
+                "heart",
+                "disease."
+            ],
+            [
+                "In",
+                "this",
+                "case",
+                "we",
+                "are",
+                "given",
+                "characteristic",
+                "biochemical",
+                "data",
+                "(leukocytosis,",
+                "metabolic",
+                "acidosis",
+                "due",
+                "to",
+                "lactic",
+                "acid,",
+                "hemoconcentration",
+                "due",
+                "to",
+                "loss",
+                "of",
+                "fluid",
+                "to",
+                "the",
+                "third",
+                "space...)",
+                "and",
+                "imaging",
+                "tests",
+                "(dilated",
+                "loops,",
+                "pneumatosis,",
+                "gas",
+                "at",
+                "portal",
+                "level...)",
+                "suggestive",
+                "of",
+                "mesenteric",
+                "ischemia."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+        ]
+    },
+    {
+        "id": "403_135",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "OPHTHALMOLOGY",
+                "(ECTOPIC)"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "25-year-old",
+                "patient,",
+                "during",
+                "a",
+                "tennis",
+                "match,",
+                "has",
+                "severe",
+                "pain",
+                "in",
+                "his",
+                "neck",
+                "and",
+                "left",
+                "eye."
+            ],
+            [
+                "The",
+                "next",
+                "morning",
+                "he",
+                "wakes",
+                "up",
+                "with",
+                "a",
+                "feeling",
+                "of",
+                "gait",
+                "instability",
+                "and",
+                "has",
+                "palpebral",
+                "ptosis",
+                "of",
+                "the",
+                "left",
+                "eye",
+                "and",
+                "anisocoria,",
+                "with",
+                "the",
+                "left",
+                "pupil",
+                "being",
+                "smaller",
+                "than",
+                "the",
+                "right."
+            ],
+            [
+                "The",
+                "patient",
+                "maintains",
+                "good",
+                "visual",
+                "acuity,",
+                "where",
+                "would",
+                "you",
+                "most",
+                "likely",
+                "locate",
+                "the",
+                "lesion?"
+            ],
+            [
+                "1-",
+                "III",
+                "cranial",
+                "nerve."
+            ],
+            [
+                "2-",
+                "Optic",
+                "chiasm."
+            ],
+            [
+                "3-",
+                "Upper",
+                "cervical",
+                "ganglion."
+            ],
+            [
+                "4-",
+                "Spinal",
+                "cord."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Claude-Bernard-Horner",
+                "syndrome",
+                "is",
+                "an",
+                "old",
+                "acquaintance",
+                "of",
+                "the",
+                "MIR",
+                "exam."
+            ],
+            [
+                "We",
+                "do",
+                "not",
+                "see",
+                "it",
+                "daily",
+                "in",
+                "clinical",
+                "practice,",
+                "but",
+                "it",
+                "appears",
+                "in",
+                "many",
+                "exams."
+            ],
+            [
+                "Characteristic",
+                "is",
+                "upper",
+                "eyelid",
+                "ptosis",
+                "and",
+                "miosis",
+                "of",
+                "that",
+                "eye."
+            ],
+            [
+                "This",
+                "occurs",
+                "due",
+                "to",
+                "a",
+                "deficit",
+                "of",
+                "sympathetic",
+                "innervation",
+                "of",
+                "the",
+                "orbital",
+                "territory."
+            ],
+            [
+                "The",
+                "sympathetic",
+                "nervous",
+                "system",
+                "innervates",
+                "the",
+                "M\u00fcller",
+                "muscle,",
+                "which",
+                "is",
+                "an",
+                "accessory",
+                "muscle",
+                "to",
+                "the",
+                "levator",
+                "of",
+                "the",
+                "upper",
+                "eyelid."
+            ],
+            [
+                "If",
+                "the",
+                "M\u00fcller",
+                "ceases",
+                "to",
+                "function,",
+                "the",
+                "eyelid",
+                "descends",
+                "slightly."
+            ],
+            [
+                "It",
+                "also",
+                "innervates",
+                "the",
+                "iris",
+                "dilator",
+                "muscle."
+            ],
+            [
+                "Therefore,",
+                "the",
+                "sphincter",
+                "muscle,",
+                "its",
+                "antagonist,",
+                "is",
+                "unopposed",
+                "and",
+                "the",
+                "balance",
+                "of",
+                "the",
+                "pupil",
+                "shifts",
+                "toward",
+                "miosis."
+            ],
+            [
+                "It",
+                "explains",
+                "ptosis",
+                "and",
+                "miosis",
+                "of",
+                "the",
+                "left",
+                "eye,",
+                "so",
+                "we",
+                "suspect",
+                "Horner's",
+                "in",
+                "that",
+                "eye."
+            ],
+            [
+                "She",
+                "also",
+                "describes",
+                "what",
+                "may",
+                "have",
+                "happened:",
+                "after",
+                "a",
+                "possible",
+                "sudden",
+                "movement",
+                "while",
+                "playing",
+                "tennis,",
+                "she",
+                "has",
+                "neck",
+                "pain",
+                "and",
+                "a",
+                "Horner's."
+            ],
+            [
+                "We",
+                "should",
+                "suspect",
+                "an",
+                "aneurysm."
+            ],
+            [
+                "We",
+                "should",
+                "suspect",
+                "a",
+                "dissecting",
+                "carotid",
+                "aneurysm,",
+                "which",
+                "is",
+                "one",
+                "of",
+                "the",
+                "best",
+                "known",
+                "(and",
+                "most",
+                "serious)",
+                "causes",
+                "of",
+                "an",
+                "acquired",
+                "Horner's",
+                "syndrome."
+            ],
+            [
+                "The",
+                "superior",
+                "cervical",
+                "ganglion",
+                "is",
+                "a",
+                "ganglion",
+                "of",
+                "the",
+                "sympathetic",
+                "nervous",
+                "system",
+                "located",
+                "in",
+                "the",
+                "sheath",
+                "of",
+                "the",
+                "carotid",
+                "artery,",
+                "and",
+                "at",
+                "this",
+                "level",
+                "it",
+                "has",
+                "been",
+                "affected."
+            ],
+            [
+                "We",
+                "can",
+                "also",
+                "try",
+                "to",
+                "get",
+                "this",
+                "answer",
+                "right",
+                "by",
+                "ruling",
+                "out."
+            ],
+            [
+                "An",
+                "alteration",
+                "of",
+                "the",
+                "III",
+                "cranial",
+                "nerve",
+                "can",
+                "produce",
+                "ptosis,",
+                "but",
+                "the",
+                "pupil,",
+                "if",
+                "affected,",
+                "should",
+                "be",
+                "in",
+                "mydriasis."
+            ],
+            [
+                "And",
+                "damage",
+                "to",
+                "the",
+                "third",
+                "cranial",
+                "nerve",
+                "should",
+                "also",
+                "produce",
+                "some",
+                "type",
+                "of",
+                "ophthalmoplegia,",
+                "with",
+                "diplopia."
+            ],
+            [
+                "An",
+                "involvement",
+                "of",
+                "the",
+                "optic",
+                "chiasm",
+                "would",
+                "produce",
+                "a",
+                "bilateral",
+                "loss",
+                "of",
+                "vision",
+                "(probably",
+                "a",
+                "bitemporal",
+                "hemianopsia)."
+            ],
+            [
+                "We",
+                "are",
+                "told",
+                "in",
+                "the",
+                "statement",
+                "that",
+                "he",
+                "maintains",
+                "good",
+                "visual",
+                "acuity."
+            ],
+            [
+                "On",
+                "the",
+                "other",
+                "hand,",
+                "there",
+                "would",
+                "also",
+                "be",
+                "no",
+                "ptosis",
+                "or",
+                "anisocoria."
+            ],
+            [
+                "And",
+                "finally,",
+                "an",
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+                "of",
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+                "medulla",
+                "oblongata",
+                "would",
+                "produce",
+                "different",
+                "neurological",
+                "symptoms",
+                "not",
+                "described,",
+                "and",
+                "there",
+                "should",
+                "be",
+                "no",
+                "ptosis",
+                "or",
+                "pupillary",
+                "alterations,",
+                "because",
+                "the",
+                "third",
+                "pair",
+                "is",
+                "located",
+                "in",
+                "the",
+                "midbrain",
+                "and",
+                "the",
+                "sympathetic",
+                "nuclei",
+                "in",
+                "the",
+                "spinal",
+                "cord."
+            ]
+        ],
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+                "O",
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+                "O"
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+            [
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+            ]
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+    },
+    {
+        "id": "42_150",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "one-and-a-half",
+                "year",
+                "old",
+                "boy",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "room",
+                "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",
+                "for",
+                "peritoneal",
+                "lavage",
+                "will",
+                "be",
+                "performed",
+                "to",
+                "verify",
+                "that",
+                "the",
+                "cyst",
+                "contains",
+                "bile",
+                "in",
+                "order",
+                "to",
+                "leave",
+                "a",
+                "drainage",
+                "to",
+                "improve",
+                "the",
+                "abdominal",
+                "pain."
+            ],
+            [
+                "2-",
+                "An",
+                "exploratory",
+                "laparotomy",
+                "will",
+                "be",
+                "indicated",
+                "and",
+                "a",
+                "radical",
+                "resection",
+                "of",
+                "the",
+                "entire",
+                "biliary",
+                "tract",
+                "will",
+                "be",
+                "performed",
+                "to",
+                "replace",
+                "it",
+                "with",
+                "a",
+                "loop",
+                "of",
+                "intestine."
+            ],
+            [
+                "3-",
+                "A",
+                "laparotomy",
+                "will",
+                "be",
+                "indicated",
+                "to",
+                "drain",
+                "the",
+                "cyst",
+                "and",
+                "when",
+                "the",
+                "dilatation",
+                "remits",
+                "the",
+                "drainage",
+                "will",
+                "be",
+                "removed."
+            ],
+            [
+                "4-",
+                "A",
+                "cholangio-resonance",
+                "will",
+                "be",
+                "performed",
+                "to",
+                "delimit",
+                "the",
+                "cyst",
+                "and",
+                "a",
+                "laparotomy",
+                "will",
+                "be",
+                "indicated",
+                "for",
+                "cyst",
+                "resection",
+                "and",
+                "anastomosis",
+                "of",
+                "the",
+                "biliary",
+                "tract."
+            ],
+            [
+                "5-",
+                "A",
+                "HIDA",
+                "gammagraphic",
+                "study",
+                "is",
+                "necessary",
+                "to",
+                "delimit",
+                "the",
+                "cyst",
+                "and",
+                "to",
+                "be",
+                "able",
+                "to",
+                "perform",
+                "percutaneous",
+                "drainage",
+                "safely."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "4."
+            ],
+            [
+                "A",
+                "common",
+                "bile",
+                "duct",
+                "cyst",
+                "is",
+                "a",
+                "congenital",
+                "pathology",
+                "that",
+                "usually",
+                "presents",
+                "clinically",
+                "beyond",
+                "the",
+                "neonatal",
+                "period."
+            ],
+            [
+                "It",
+                "is",
+                "appropriate",
+                "to",
+                "have",
+                "a",
+                "quality",
+                "image",
+                "that",
+                "delimits",
+                "the",
+                "lesion",
+                "in",
+                "order",
+                "to",
+                "decide",
+                "the",
+                "surgical",
+                "approach."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "445_233",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "45-year-old",
+                "woman."
+            ],
+            [
+                "Two",
+                "previous",
+                "pregnancies",
+                "with",
+                "normal",
+                "deliveries",
+                "(G2PN2)."
+            ],
+            [
+                "Heavy",
+                "menstrual",
+                "bleeding",
+                "for",
+                "approximately",
+                "1",
+                "year."
+            ],
+            [
+                "Ultrasound",
+                "shows",
+                "a",
+                "2",
+                "cm",
+                "subserosal",
+                "myoma",
+                "that",
+                "has",
+                "been",
+                "stable",
+                "for",
+                "several",
+                "years."
+            ],
+            [
+                "Endometrial",
+                "biopsy",
+                "was",
+                "performed",
+                "and",
+                "it",
+                "was",
+                "normal."
+            ],
+            [
+                "The",
+                "patient",
+                "has",
+                "hemoglobin",
+                "10",
+                "g/dL",
+                "despite",
+                "oral",
+                "ferrotherapy",
+                "and",
+                "the",
+                "amount",
+                "of",
+                "menstrual",
+                "flow",
+                "has",
+                "not",
+                "decreased",
+                "despite",
+                "treatment",
+                "with",
+                "tranexamic",
+                "acid",
+                "and",
+                "mefenamic",
+                "acid."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "is",
+                "the",
+                "treatment",
+                "of",
+                "first",
+                "choice",
+                "in",
+                "this",
+                "patient?"
+            ],
+            [
+                "1-",
+                "Total",
+                "hysterectomy",
+                "preserving",
+                "appendages."
+            ],
+            [
+                "2-",
+                "Combined",
+                "oral",
+                "contraceptives."
+            ],
+            [
+                "3-",
+                "Endometrial",
+                "ablation."
+            ],
+            [
+                "4-",
+                "Levonorgestrel",
+                "IUD."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "According",
+                "to",
+                "the",
+                "SEGO,",
+                "in",
+                "perimenopausal",
+                "women",
+                "with",
+                "heavy",
+                "and/or",
+                "prolonged",
+                "menstrual",
+                "bleeding",
+                "who",
+                "require",
+                "contraception,",
+                "the",
+                "levonorgestrel",
+                "IUD",
+                "(also",
+                "called",
+                "MIRENA",
+                "IUD)",
+                "is",
+                "the",
+                "first",
+                "option."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "511_152",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DIGESTIVE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "79-year-old",
+                "hypertensive",
+                "woman",
+                "on",
+                "treatment",
+                "with",
+                "olmesartan",
+                "comes",
+                "for",
+                "consultation",
+                "for",
+                "watery",
+                "diarrhea",
+                "of",
+                "4",
+                "to",
+                "6",
+                "stools",
+                "per",
+                "day",
+                "for",
+                "the",
+                "past",
+                "two",
+                "months."
+            ],
+            [
+                "Three",
+                "months",
+                "ago",
+                "she",
+                "was",
+                "treated",
+                "with",
+                "nonsteroidal",
+                "anti-inflammatory",
+                "drugs",
+                "for",
+                "3",
+                "weeks",
+                "for",
+                "lumbosciatica."
+            ],
+            [
+                "Gastroscopy",
+                "and",
+                "colonoscopy",
+                "were",
+                "performed,",
+                "both",
+                "without",
+                "macroscopic",
+                "alterations."
+            ],
+            [
+                "Duodenal",
+                "biopsies",
+                "were",
+                "normal,",
+                "while",
+                "colon",
+                "biopsies",
+                "showed",
+                "a",
+                "chronic",
+                "inflammatory",
+                "infiltrate",
+                "of",
+                "the",
+                "lamina",
+                "propria",
+                "with",
+                "an",
+                "irregular",
+                "band",
+                "of",
+                "collagen",
+                "immediately",
+                "below",
+                "the",
+                "mucosal",
+                "surface",
+                "epithelium",
+                "with",
+                "a",
+                "thickness",
+                "greater",
+                "than",
+                "10",
+                "mm",
+                "and",
+                "a",
+                "number",
+                "of",
+                "intraepithelial",
+                "lymphocytes",
+                ">20",
+                "per",
+                "100",
+                "epithelial",
+                "cells."
+            ],
+            [
+                "Which",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Microscopic",
+                "colitis."
+            ],
+            [
+                "2-",
+                "Enteropathy",
+                "due",
+                "to",
+                "NSAIDs."
+            ],
+            [
+                "3-",
+                "Olmesartan-associated",
+                "enteropathy."
+            ],
+            [
+                "4-",
+                "Irritable",
+                "bowel",
+                "syndrome."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "The",
+                "diagnostic",
+                "criteria",
+                "for",
+                "microscopic",
+                "colitis",
+                "are:",
+                "a)Chronic",
+                "or",
+                "intermittent",
+                "non-bloody",
+                "watery",
+                "diarrhea",
+                "b)Colonic",
+                "mucosa",
+                "assessed",
+                "by",
+                "colonoscopy",
+                "macroscopically",
+                "normal",
+                "or",
+                "near",
+                "normal",
+                "c)Characteristic",
+                "histopathological",
+                "findings."
+            ],
+            [
+                "In",
+                "our",
+                "case,",
+                "the",
+                "patient",
+                "presents",
+                "findings",
+                "compatible",
+                "with",
+                "collagenous",
+                "colitis",
+                "(band",
+                "of",
+                "collagen",
+                "underlying",
+                "the",
+                "epithelium",
+                "greater",
+                "than",
+                "10",
+                "microns)",
+                "and",
+                "lymphocytic",
+                "(more",
+                "than",
+                "20",
+                "intraepithelial",
+                "lymphocytes)."
+            ],
+            [
+                "The",
+                "treatment",
+                "of",
+                "this",
+                "pathology",
+                "is",
+                "topical",
+                "corticosteroids",
+                "with",
+                "low",
+                "oral",
+                "bioavailability",
+                "(mainly",
+                "budesonide)."
+            ],
+            [
+                "Olmesartan",
+                "enteropathy",
+                "produces",
+                "a",
+                "picture",
+                "similar",
+                "to",
+                "celiac",
+                "disease",
+                "and",
+                "is",
+                "characterized",
+                "by",
+                "duodenal",
+                "biopsy",
+                "with",
+                "villous",
+                "atrophy,",
+                "mucosal",
+                "inflammation",
+                "with",
+                "increased",
+                "intraepithelial",
+                "lymphocytes",
+                "and",
+                "cryptitis."
+            ],
+            [
+                "In",
+                "this",
+                "case",
+                "a",
+                "normal",
+                "duodenal",
+                "biopsy",
+                "is",
+                "described,",
+                "but",
+                "it",
+                "would",
+                "be",
+                "interesting",
+                "to",
+                "keep",
+                "the",
+                "concept",
+                "for",
+                "future",
+                "examinations."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "33_65",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY",
+                "AND",
+                "NEUROSURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "64-year-old",
+                "man,",
+                "diagnosed",
+                "with",
+                "myasthenia",
+                "gravis",
+                "1",
+                "year",
+                "ago,",
+                "treated",
+                "with",
+                "low-dose",
+                "steroids",
+                "(3",
+                "mg/day",
+                "of",
+                "deflazacort)",
+                "and",
+                "anticholinesterase",
+                "drugs,",
+                "asymptomatic",
+                "for",
+                "6",
+                "months,",
+                "consults",
+                "for",
+                "mild",
+                "difficulty",
+                "in",
+                "swallowing",
+                "and",
+                "evening",
+                "diplopia",
+                "for",
+                "a",
+                "few",
+                "days."
+            ],
+            [
+                "He",
+                "was",
+                "admitted",
+                "to",
+                "the",
+                "hospital",
+                "for",
+                "suspected",
+                "myasthenic",
+                "crisis",
+                "and",
+                "treatment",
+                "was",
+                "started."
+            ],
+            [
+                "The",
+                "next",
+                "day",
+                "the",
+                "patient",
+                "alerts",
+                "at",
+                "03",
+                "hours",
+                "in",
+                "the",
+                "morning",
+                "because",
+                "the",
+                "patient",
+                "makes",
+                "a",
+                "strange",
+                "noise",
+                "when",
+                "breathing",
+                "in,",
+                "like",
+                "a",
+                "soft",
+                "snoring,",
+                "the",
+                "patient",
+                "is",
+                "sound",
+                "asleep",
+                "and",
+                "very",
+                "sweaty,",
+                "but",
+                "does",
+                "not",
+                "seem",
+                "to",
+                "be",
+                "fatigued."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "correct",
+                "attitude?"
+            ],
+            [
+                "1-",
+                "Reassure",
+                "the",
+                "nurse",
+                "and",
+                "family",
+                "that",
+                "the",
+                "patient",
+                "is",
+                "a",
+                "habitual",
+                "snorer",
+                "and",
+                "is",
+                "peacefully",
+                "asleep.",
+                "The",
+                "patient",
+                "should",
+                "be",
+                "placed",
+                "in",
+                "lateral",
+                "decubitus."
+            ],
+            [
+                "2-",
+                "Notify",
+                "intensive",
+                "care",
+                "for",
+                "suspected",
+                "acute",
+                "respiratory",
+                "failure,",
+                "to",
+                "assess",
+                "possible",
+                "orotracheal",
+                "intubation",
+                "and",
+                "assisted",
+                "ventilation."
+            ],
+            [
+                "3-",
+                "Perform",
+                "polysomnographic",
+                "study",
+                "to",
+                "rule",
+                "out",
+                "sleep",
+                "apnea."
+            ],
+            [
+                "4-",
+                "Decrease",
+                "steroid",
+                "dose;",
+                "if",
+                "he",
+                "has",
+                "a",
+                "steroid",
+                "myopathy",
+                "he",
+                "will",
+                "improve."
+            ],
+            [
+                "5-",
+                "Order",
+                "a",
+                "thoracic",
+                "CT",
+                "scan",
+                "to",
+                "rule",
+                "out",
+                "compressive",
+                "thymoma",
+                "over",
+                "the",
+                "trachea",
+                "associated",
+                "with",
+                "myasthenia."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "This",
+                "is",
+                "a",
+                "patient",
+                "with",
+                "decompensated",
+                "myasthenia",
+                "with",
+                "bulbar",
+                "symptoms",
+                "(dysphagia)",
+                "and",
+                "therefore",
+                "risk",
+                "of",
+                "respiratory",
+                "muscle",
+                "involvement."
+            ],
+            [
+                "The",
+                "respiratory",
+                "symptoms",
+                "correspond",
+                "to",
+                "an",
+                "exhaustion",
+                "of",
+                "the",
+                "muscles,",
+                "first",
+                "inspiratory",
+                "and",
+                "then",
+                "accessory",
+                "(the",
+                "patient",
+                "does",
+                "not",
+                "appear",
+                "fatigued",
+                "or",
+                "tachypneic",
+                "because",
+                "the",
+                "muscles",
+                "are",
+                "exhausted),",
+                "progressing",
+                "to",
+                "a",
+                "carbonic",
+                "coma."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ]
+        ]
+    },
+    {
+        "id": "129_81",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY",
+                "AND",
+                "NEUROSURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "78-year-old",
+                "male",
+                "consults",
+                "for",
+                "a",
+                "year-long",
+                "history",
+                "of",
+                "progressive",
+                "cognitive",
+                "impairment",
+                "with",
+                "memory",
+                "and",
+                "orientation",
+                "lapses."
+            ],
+            [
+                "His",
+                "family",
+                "reports",
+                "recurrent",
+                "visual",
+                "hallucinations,",
+                "occasional",
+                "falls",
+                "and",
+                "striking",
+                "motor",
+                "slowing."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Multi-infarct",
+                "vascular",
+                "dementia."
+            ],
+            [
+                "2-",
+                "Alzheimer's",
+                "type",
+                "dementia."
+            ],
+            [
+                "3-",
+                "Dementia",
+                "with",
+                "diffuse",
+                "Lewy",
+                "bodies."
+            ],
+            [
+                "4-",
+                "Frontotemporal",
+                "dementia."
+            ],
+            [
+                "5-",
+                "Normal",
+                "pressure",
+                "hydrocephalus."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Dementia",
+                "with",
+                "visual",
+                "hallucinations",
+                "at",
+                "the",
+                "beginning",
+                "of",
+                "the",
+                "course",
+                "(in",
+                "the",
+                "first",
+                "2",
+                "years)",
+                "is",
+                "very",
+                "suggestive",
+                "of",
+                "Lewy",
+                "bodies,",
+                "and",
+                "is",
+                "the",
+                "guiding",
+                "symptom",
+                "in",
+                "these",
+                "questions."
+            ],
+            [
+                "If",
+                "we",
+                "add",
+                "to",
+                "this",
+                "the",
+                "falls",
+                "and",
+                "motor",
+                "slowing",
+                "suggestive",
+                "of",
+                "parkinsonism,",
+                "it",
+                "makes",
+                "the",
+                "question",
+                "easier."
+            ],
+            [
+                "Therefore,",
+                "number",
+                "3",
+                "is",
+                "correct."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-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"
+            ],
+            [
+                "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",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "503_80",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "8-year-old",
+                "boy",
+                "consults",
+                "for",
+                "the",
+                "appearance",
+                "of",
+                "pubic",
+                "hair",
+                "at",
+                "the",
+                "base",
+                "of",
+                "the",
+                "penis",
+                "for",
+                "the",
+                "last",
+                "12",
+                "months."
+            ],
+            [
+                "The",
+                "testicle",
+                "has",
+                "not",
+                "increased",
+                "in",
+                "volume",
+                "and",
+                "the",
+                "penis",
+                "has",
+                "not",
+                "increased",
+                "in",
+                "size."
+            ],
+            [
+                "There",
+                "is",
+                "no",
+                "increase",
+                "in",
+                "growth",
+                "rate",
+                "in",
+                "the",
+                "last",
+                "year."
+            ],
+            [
+                "The",
+                "bone",
+                "age",
+                "is",
+                "one",
+                "year",
+                "older",
+                "than",
+                "the",
+                "chronological",
+                "age."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Central",
+                "precocious",
+                "puberty."
+            ],
+            [
+                "2-",
+                "Peripheral",
+                "precocious",
+                "puberty."
+            ],
+            [
+                "3-",
+                "Early",
+                "adrenarche."
+            ],
+            [
+                "4-",
+                "Adrenal",
+                "tumor."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "In",
+                "the",
+                "male,",
+                "the",
+                "onset",
+                "of",
+                "puberty",
+                "is",
+                "considered",
+                "normal",
+                "from",
+                "the",
+                "age",
+                "of",
+                "9",
+                "years,",
+                "therefore",
+                "in",
+                "this",
+                "case",
+                "it",
+                "is",
+                "a",
+                "premature",
+                "puberty."
+            ],
+            [
+                "The",
+                "onset",
+                "of",
+                "puberty",
+                "is",
+                "defined",
+                "as",
+                "an",
+                "increase",
+                "in",
+                "testicular",
+                "volume",
+                "(greater",
+                "than",
+                "or",
+                "equal",
+                "to",
+                "4cc);",
+                "by",
+                "specifying",
+                "that",
+                "the",
+                "testicular",
+                "size",
+                "has",
+                "not",
+                "increased,",
+                "we",
+                "can",
+                "rule",
+                "out",
+                "options",
+                "1",
+                "and",
+                "2."
+            ],
+            [
+                "The",
+                "excessive",
+                "secretion",
+                "of",
+                "androgens",
+                "produced",
+                "by",
+                "an",
+                "adrenal",
+                "tumor",
+                "would",
+                "cause",
+                "a",
+                "greater",
+                "amount",
+                "of",
+                "hair",
+                "and",
+                "an",
+                "increase",
+                "in",
+                "penile",
+                "size,",
+                "which",
+                "our",
+                "patient",
+                "does",
+                "not",
+                "present."
+            ],
+            [
+                "Therefore,",
+                "the",
+                "correct",
+                "option",
+                "is",
+                "early",
+                "adrenarche."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "300_106",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTIOUS",
+                "DISEASES"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "32-year-old",
+                "man",
+                "from",
+                "Cameroon",
+                "consults",
+                "for",
+                "fever",
+                "cough",
+                "and",
+                "left",
+                "hemithorax",
+                "pain",
+                "of",
+                "1",
+                "month's",
+                "evolution."
+            ],
+            [
+                "He",
+                "took",
+                "amoxicillin-clavulanic",
+                "acid",
+                "for",
+                "1",
+                "week",
+                "without",
+                "improvement",
+                "of",
+                "symptoms."
+            ],
+            [
+                "A",
+                "blood",
+                "test",
+                "showed",
+                "a",
+                "white",
+                "blood",
+                "cell",
+                "count",
+                "of",
+                "8000/microL",
+                "and",
+                "a",
+                "hemoglobin",
+                "of",
+                "12.8",
+                "g/dL."
+            ],
+            [
+                "Chest",
+                "X-ray",
+                "showed",
+                "a",
+                "loculated",
+                "left",
+                "pleural",
+                "effusion",
+                "occupying",
+                "one",
+                "third",
+                "of",
+                "the",
+                "hemithorax."
+            ],
+            [
+                "A",
+                "thoracentesis",
+                "shows",
+                "a",
+                "yellowish",
+                "fluid",
+                "with",
+                "the",
+                "following",
+                "features:",
+                "red",
+                "blood",
+                "cells",
+                "2000/uL,",
+                "leukocytes",
+                "2500/uL,",
+                "with",
+                "90%",
+                "lymphocytes,",
+                "protein",
+                "4.9",
+                "g/dL,",
+                "lactate",
+                "dehydrogenase",
+                "550",
+                "U/L,",
+                "glucose",
+                "67",
+                "mg/dL,",
+                "and",
+                "absence",
+                "of",
+                "malignant",
+                "cells",
+                "on",
+                "cytology."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "tests",
+                "would",
+                "be",
+                "most",
+                "useful",
+                "in",
+                "diagnosing",
+                "the",
+                "cause",
+                "of",
+                "the",
+                "pleural",
+                "effusion?"
+            ],
+            [
+                "1-",
+                "A",
+                "thoracic",
+                "computed",
+                "tomography",
+                "(CT)",
+                "scan."
+            ],
+            [
+                "2-",
+                "Pleural",
+                "fluid",
+                "pH",
+                "measurement."
+            ],
+            [
+                "3-",
+                "Measurement",
+                "of",
+                "adenosine",
+                "deaminase",
+                "in",
+                "pleural",
+                "fluid."
+            ],
+            [
+                "4-",
+                "Tuberculin",
+                "test."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "The",
+                "determination",
+                "of",
+                "ADA,",
+                "in",
+                "the",
+                "presence",
+                "of",
+                "a",
+                "pneumonia",
+                "of",
+                "long",
+                "evolution",
+                "that",
+                "does",
+                "not",
+                "improve",
+                "with",
+                "antibiotic",
+                "treatment,",
+                "with",
+                "an",
+                "effusion",
+                "with",
+                "abundant",
+                "leukocytes",
+                "and",
+                "lymphocytic",
+                "predominance,",
+                "in",
+                "which",
+                "the",
+                "presence",
+                "of",
+                "neoplasia",
+                "is",
+                "ruled",
+                "out,",
+                "with",
+                "values",
+                "higher",
+                "than",
+                "70",
+                "UI/L,",
+                "should",
+                "lead",
+                "us",
+                "to",
+                "have",
+                "a",
+                "high",
+                "degree",
+                "of",
+                "suspicion",
+                "about",
+                "tuberculous",
+                "etiology",
+                "and",
+                "send",
+                "the",
+                "pleural",
+                "fluid",
+                "to",
+                "microbiology",
+                "for",
+                "tuberculosis",
+                "study."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "434_119",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTIOUS",
+                "DISEASES",
+                "AND",
+                "MICROBIOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "38-year-old",
+                "woman",
+                "of",
+                "veterinary",
+                "profession,",
+                "in",
+                "charge",
+                "of",
+                "monitoring",
+                "wild",
+                "animals",
+                "and",
+                "assisting",
+                "in",
+                "the",
+                "delivery",
+                "of",
+                "domestic",
+                "livestock."
+            ],
+            [
+                "She",
+                "starts",
+                "with",
+                "a",
+                "high",
+                "fever",
+                "with",
+                "chills,",
+                "headache,",
+                "myalgia",
+                "and",
+                "non-productive",
+                "cough",
+                "that",
+                "she",
+                "interprets",
+                "as",
+                "a",
+                "flu-like",
+                "process."
+            ],
+            [
+                "She",
+                "presented",
+                "with",
+                "chest",
+                "pain."
+            ],
+            [
+                "Chest",
+                "X-ray",
+                "showed",
+                "bilateral",
+                "pulmonary",
+                "infiltrates",
+                "in",
+                "lower",
+                "fields."
+            ],
+            [
+                "A",
+                "serologic",
+                "test",
+                "was",
+                "performed",
+                "with",
+                "elevated",
+                "antibody",
+                "titers",
+                "against",
+                "phase",
+                "I",
+                "antigens."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "statements",
+                "is",
+                "TRUE?"
+            ],
+            [
+                "1-",
+                "The",
+                "way",
+                "of",
+                "transmission",
+                "of",
+                "this",
+                "entity",
+                "is",
+                "by",
+                "ticks."
+            ],
+            [
+                "2-",
+                "Both",
+                "doxycycline",
+                "and",
+                "hydroxychloroquine",
+                "are",
+                "effective",
+                "in",
+                "treating",
+                "acute",
+                "forms",
+                "of",
+                "this",
+                "disease."
+            ],
+            [
+                "3-",
+                "In",
+                "its",
+                "acute",
+                "form",
+                "it",
+                "also",
+                "presents,",
+                "generally,",
+                "elevation",
+                "of",
+                "antibodies",
+                "against",
+                "phase",
+                "I",
+                "antigens."
+            ],
+            [
+                "4-",
+                "Mortality",
+                "in",
+                "acute",
+                "forms",
+                "is",
+                "almost",
+                "nonexistent."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Acute",
+                "infection",
+                "by",
+                "Coxiella",
+                "burnetii",
+                "manifested",
+                "in",
+                "this",
+                "case",
+                "by",
+                "Pneumonia."
+            ],
+            [
+                "Coxiella",
+                "infection",
+                "is",
+                "not",
+                "transmitted",
+                "by",
+                "ticks."
+            ],
+            [
+                "The",
+                "contact",
+                "can",
+                "be",
+                "with",
+                "high",
+                "probability",
+                "at",
+                "the",
+                "time",
+                "of",
+                "delivery",
+                "of",
+                "an",
+                "infected",
+                "farm",
+                "animal,",
+                "in",
+                "which",
+                "the",
+                "bacterium",
+                "is",
+                "disseminated",
+                "in",
+                "aerosols."
+            ],
+            [
+                "The",
+                "treatment",
+                "of",
+                "choice",
+                "is",
+                "with",
+                "doxycycline",
+                "in",
+                "the",
+                "acute",
+                "phase",
+                "(if",
+                "meningitis",
+                "is",
+                "present,",
+                "quinolones",
+                "are",
+                "preferred",
+                "due",
+                "to",
+                "penetration",
+                "of",
+                "the",
+                "blood-brain",
+                "barrier)."
+            ],
+            [
+                "The",
+                "combination",
+                "of",
+                "doxycycline",
+                "plus",
+                "hicroxychloroquine",
+                "can",
+                "be",
+                "used,",
+                "but",
+                "for",
+                "chronic",
+                "Q",
+                "fever",
+                "(which",
+                "is",
+                "where",
+                "elevation",
+                "of",
+                "antibodies",
+                "against",
+                "phase",
+                "I",
+                "antigens",
+                "is",
+                "observed",
+                "and",
+                "carries",
+                "a",
+                "higher",
+                "risk",
+                "of",
+                "mortality)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "563_175",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PREVENTIVE",
+                "MEDICINE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "62-year-old",
+                "patient",
+                "who",
+                "consults",
+                "because",
+                "of",
+                "close",
+                "contact",
+                "in",
+                "recent",
+                "weeks",
+                "with",
+                "a",
+                "person",
+                "with",
+                "active",
+                "tuberculosis."
+            ],
+            [
+                "Mantoux",
+                "test",
+                "is",
+                "positive",
+                "(12",
+                "mm)."
+            ],
+            [
+                "His",
+                "history",
+                "includes",
+                "treatment",
+                "with",
+                "oral",
+                "anticoagulants",
+                "(acenocoumarol)",
+                "for",
+                "a",
+                "deep",
+                "vein",
+                "thrombosis",
+                "a",
+                "few",
+                "months",
+                "ago."
+            ],
+            [
+                "He",
+                "does",
+                "not",
+                "report",
+                "fever",
+                "or",
+                "cough",
+                "and",
+                "is",
+                "asymptomatic."
+            ],
+            [
+                "Chest",
+                "X-ray",
+                "is",
+                "normal."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "treatments",
+                "is",
+                "the",
+                "most",
+                "advisable?"
+            ],
+            [
+                "1-",
+                "Isoniazid,",
+                "for",
+                "nine",
+                "months."
+            ],
+            [
+                "2-",
+                "Rifampicin,",
+                "for",
+                "four",
+                "months."
+            ],
+            [
+                "3-",
+                "Isoniazid",
+                "and",
+                "rifampicin,",
+                "for",
+                "three",
+                "months."
+            ],
+            [
+                "4-",
+                "Isoniazid",
+                "and",
+                "rifapentine,",
+                "for",
+                "three",
+                "months."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "As",
+                "of",
+                "2018,",
+                "there",
+                "are",
+                "four",
+                "dosing",
+                "schedules",
+                "for",
+                "treatment",
+                "of",
+                "latent",
+                "TB",
+                "infection",
+                "recommended",
+                "by",
+                "the",
+                "CDC",
+                "using",
+                "isoniazid",
+                "(INH),",
+                "rifapentine",
+                "(RPT)",
+                "or",
+                "rifampin",
+                "(RIF)."
+            ],
+            [
+                "All",
+                "treatments",
+                "are",
+                "effective."
+            ],
+            [
+                "Health",
+                "care",
+                "providers",
+                "should",
+                "prescribe",
+                "the",
+                "shorter",
+                "treatments,",
+                "which",
+                "are",
+                "more",
+                "convenient,",
+                "whenever",
+                "possible."
+            ],
+            [
+                "The",
+                "shortest",
+                "combination",
+                "would",
+                "be",
+                "Isoniazid",
+                "+",
+                "Rifapentine",
+                "for",
+                "three",
+                "months",
+                "or",
+                "Rifampicin",
+                "for",
+                "four",
+                "months."
+            ],
+            [
+                "However,",
+                "the",
+                "fact",
+                "that",
+                "he",
+                "is",
+                "taking",
+                "acenocoumarol",
+                "means",
+                "that",
+                "the",
+                "indication",
+                "for",
+                "this",
+                "patient",
+                "is",
+                "Isoniazid",
+                "for",
+                "9",
+                "months,",
+                "since",
+                "there",
+                "is",
+                "interaction",
+                "between",
+                "the",
+                "rifamycin",
+                "derivatives",
+                "(rifapentine",
+                "and",
+                "rifampicin)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "89_57",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CARDIOLOGY",
+                "AND",
+                "VASCULAR",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "64-year-old",
+                "man",
+                "consults",
+                "for",
+                "right",
+                "calf",
+                "pain",
+                "when",
+                "climbing",
+                "hills",
+                "and",
+                "stairs",
+                "and",
+                "when",
+                "walking",
+                "on",
+                "level",
+                "ground",
+                "for",
+                "a",
+                "prolonged",
+                "period",
+                "of",
+                "time."
+            ],
+            [
+                "He",
+                "reports",
+                "that",
+                "the",
+                "pain",
+                "becomes",
+                "so",
+                "intense",
+                "with",
+                "exertion",
+                "that",
+                "he",
+                "is",
+                "forced",
+                "to",
+                "stand",
+                "up,",
+                "which",
+                "causes",
+                "the",
+                "pain",
+                "to",
+                "improve",
+                "in",
+                "a",
+                "matter",
+                "of",
+                "minutes."
+            ],
+            [
+                "As",
+                "personal",
+                "history,",
+                "the",
+                "patient",
+                "is",
+                "a",
+                "smoker",
+                "of",
+                "20",
+                "cigarettes",
+                "a",
+                "day,",
+                "diabetic",
+                "on",
+                "metformin",
+                "and",
+                "hypertensive."
+            ],
+            [
+                "On",
+                "examination,",
+                "there",
+                "is",
+                "good",
+                "peripheral",
+                "perfusion",
+                "of",
+                "the",
+                "right",
+                "foot,",
+                "but",
+                "the",
+                "patient",
+                "has",
+                "a",
+                "decreased",
+                "pedal",
+                "pulse."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "complementary",
+                "tests",
+                "should",
+                "be",
+                "ordered",
+                "initially",
+                "for",
+                "the",
+                "diagnosis",
+                "and",
+                "assessment",
+                "of",
+                "the",
+                "severity",
+                "of",
+                "the",
+                "patient's",
+                "disease?"
+            ],
+            [
+                "1-",
+                "Arteriography",
+                "of",
+                "lower",
+                "extremities."
+            ],
+            [
+                "2-",
+                "Ankle-brachial",
+                "index."
+            ],
+            [
+                "3-",
+                "Computerized",
+                "axial",
+                "tomography",
+                "with",
+                "vascular",
+                "reconstruction",
+                "of",
+                "lower",
+                "extremities."
+            ],
+            [
+                "4-",
+                "Tape",
+                "stress",
+                "test."
+            ],
+            [
+                "5-",
+                "Magnetic",
+                "resonance",
+                "imaging."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Although",
+                "the",
+                "diagnosis",
+                "of",
+                "peripheral",
+                "arteriopathy",
+                "is",
+                "fundamentally",
+                "clinical",
+                "(in",
+                "this",
+                "patient",
+                "the",
+                "picture",
+                "is",
+                "very",
+                "typical),",
+                "we",
+                "can",
+                "objectively",
+                "assess",
+                "the",
+                "severity",
+                "of",
+                "the",
+                "disease",
+                "with",
+                "the",
+                "use",
+                "of",
+                "bloodless",
+                "techniques."
+            ],
+            [
+                "The",
+                "most",
+                "important",
+                "is",
+                "the",
+                "ankle-brachial",
+                "index."
+            ],
+            [
+                "Therefore,",
+                "answer",
+                "2",
+                "is",
+                "correct."
+            ],
+            [
+                "Imaging",
+                "techniques",
+                "(arteriography,",
+                "angioCT",
+                "or",
+                "angioMRI)",
+                "are",
+                "used",
+                "when",
+                "surgical",
+                "repair",
+                "of",
+                "arterial",
+                "occlusion",
+                "is",
+                "considered."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "B-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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "586_75",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "OBSTETRICS",
+                "AND",
+                "GYNECOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "30-year-old",
+                "woman",
+                "requesting",
+                "a",
+                "contraceptive",
+                "method."
+            ],
+            [
+                "She",
+                "has",
+                "a",
+                "history",
+                "of",
+                "an",
+                "emergency",
+                "cesarean",
+                "section",
+                "7",
+                "months",
+                "ago,",
+                "giving",
+                "birth",
+                "to",
+                "a",
+                "3,550",
+                "g",
+                "baby",
+                "girl."
+            ],
+            [
+                "She",
+                "is",
+                "exclusively",
+                "breastfeeding."
+            ],
+            [
+                "Point",
+                "out",
+                "the",
+                "correct",
+                "statement:"
+            ],
+            [
+                "1-",
+                "Explain",
+                "to",
+                "her",
+                "that,",
+                "if",
+                "she",
+                "is",
+                "amenorrheic,",
+                "she",
+                "does",
+                "not",
+                "require",
+                "another",
+                "contraceptive",
+                "method",
+                "since",
+                "breastfeeding",
+                "is",
+                "sufficient",
+                "as",
+                "a",
+                "contraceptive",
+                "method."
+            ],
+            [
+                "2-",
+                "He",
+                "informed",
+                "her",
+                "that",
+                "the",
+                "levonogestrel",
+                "IUD",
+                "is",
+                "contraindicated",
+                "because",
+                "she",
+                "had",
+                "a",
+                "cesarean",
+                "section",
+                "less",
+                "than",
+                "a",
+                "year",
+                "ago."
+            ],
+            [
+                "3-",
+                "He",
+                "explains",
+                "that",
+                "she",
+                "could",
+                "use",
+                "a",
+                "gestagen-only",
+                "hormonal",
+                "method."
+            ],
+            [
+                "4-",
+                "She",
+                "is",
+                "offered",
+                "combined",
+                "hormonal",
+                "contraception."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Given",
+                "her",
+                "circumstances",
+                "and",
+                "taking",
+                "into",
+                "account",
+                "that",
+                "she",
+                "is",
+                "exclusively",
+                "breastfeeding,",
+                "the",
+                "best",
+                "thing",
+                "to",
+                "do",
+                "would",
+                "be",
+                "to",
+                "prescribe",
+                "only",
+                "gestagens."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "461_148",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "OPHTHALMOLOGY",
+                "(ECTOPIC)"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "59-year-old",
+                "woman",
+                "with",
+                "recent",
+                "onset",
+                "of",
+                "epileptic",
+                "seizures",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department."
+            ],
+            [
+                "On",
+                "examination",
+                "she",
+                "presents",
+                "left",
+                "pyramidal",
+                "signs",
+                "and",
+                "papillary",
+                "edema."
+            ],
+            [
+                "A",
+                "brain",
+                "MRI",
+                "shows",
+                "a",
+                "right",
+                "hemispheric",
+                "mass",
+                "with",
+                "edema,",
+                "midline",
+                "deviation",
+                "and",
+                "signs",
+                "of",
+                "tentorial",
+                "herniation."
+            ],
+            [
+                "She",
+                "reports",
+                "that",
+                "for",
+                "the",
+                "past",
+                "week",
+                "she",
+                "has",
+                "been",
+                "suffering",
+                "from",
+                "headache",
+                "that",
+                "has",
+                "been",
+                "progressing",
+                "in",
+                "intensity."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "features",
+                "associated",
+                "with",
+                "headache",
+                "seems",
+                "most",
+                "likely",
+                "for",
+                "this",
+                "patient?"
+            ],
+            [
+                "1-",
+                "Morning",
+                "predominance."
+            ],
+            [
+                "2-",
+                "It",
+                "does",
+                "not",
+                "change",
+                "with",
+                "effort."
+            ],
+            [
+                "3-",
+                "Photophobia."
+            ],
+            [
+                "4-",
+                "Sonophobia."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "It",
+                "is",
+                "a",
+                "headache",
+                "in",
+                "the",
+                "context",
+                "of",
+                "papilledema."
+            ],
+            [
+                "In",
+                "this",
+                "case",
+                "the",
+                "papilledema",
+                "is",
+                "due",
+                "to",
+                "increased",
+                "intracranial",
+                "pressure",
+                "due",
+                "to",
+                "a",
+                "tumor."
+            ],
+            [
+                "The",
+                "headache",
+                "due",
+                "to",
+                "increased",
+                "intracranial",
+                "pressure",
+                "is",
+                "of",
+                "positional",
+                "type",
+                "(it",
+                "increases",
+                "with",
+                "Valsalva",
+                "maneuvers",
+                "and",
+                "when",
+                "bending",
+                "down),",
+                "so",
+                "option",
+                "2",
+                "is",
+                "not",
+                "correct."
+            ],
+            [
+                "In",
+                "addition,",
+                "it",
+                "is",
+                "predominantly",
+                "morning",
+                "(option",
+                "1",
+                "is",
+                "correct)",
+                "because",
+                "in",
+                "the",
+                "morning",
+                "intracranial",
+                "pressure",
+                "naturally",
+                "rises."
+            ],
+            [
+                "Migraine-type",
+                "headaches",
+                "may",
+                "be",
+                "associated",
+                "with",
+                "photophobia",
+                "or",
+                "sonophobia",
+                "(answers",
+                "3",
+                "and",
+                "4)."
+            ],
+            [
+                "But",
+                "this",
+                "headache",
+                "is",
+                "not",
+                "a",
+                "migraine",
+                "headache."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "547_125",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CARDIOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "23-year-old",
+                "male",
+                "diagnosed",
+                "with",
+                "Wolff-Parkinson-White",
+                "syndrome",
+                "who",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "for",
+                "palpitations."
+            ],
+            [
+                "The",
+                "ECG",
+                "shows",
+                "an",
+                "irregular",
+                "wide",
+                "QRS",
+                "tachycardia,",
+                "with",
+                "a",
+                "heart",
+                "rate",
+                "of",
+                "205",
+                "bpm,",
+                "compatible",
+                "with",
+                "pre-excited",
+                "atrial",
+                "fibrillation."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "drugs",
+                "do",
+                "you",
+                "consider",
+                "appropriate",
+                "to",
+                "stop",
+                "the",
+                "tachycardia:"
+            ],
+            [
+                "1-",
+                "Verapamil."
+            ],
+            [
+                "2-",
+                "Digoxin."
+            ],
+            [
+                "3-",
+                "Adenosine."
+            ],
+            [
+                "4-",
+                "Procainamide."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Procainamide."
+            ],
+            [
+                "The",
+                "treatment",
+                "of",
+                "choice",
+                "for",
+                "Wolff-Parkinson-White",
+                "syndrome",
+                "is",
+                "cardioversion",
+                "with",
+                "direct",
+                "current."
+            ],
+            [
+                "Heart",
+                "rate",
+                "slowing",
+                "drugs,",
+                "commonly",
+                "used",
+                "in",
+                "atrial",
+                "fibrillation,",
+                "are",
+                "ineffective,",
+                "and",
+                "digoxin",
+                "and",
+                "non-dihydropyridine",
+                "calcium",
+                "channel",
+                "blockers",
+                "(e.g.,",
+                "verapamil,",
+                "diltiazem)",
+                "are",
+                "contraindicated",
+                "because",
+                "they",
+                "may",
+                "increase",
+                "the",
+                "ventricular",
+                "rate",
+                "and",
+                "cause",
+                "ventricular",
+                "fibrillation."
+            ],
+            [
+                "If",
+                "cardioversion",
+                "is",
+                "not",
+                "possible,",
+                "drugs",
+                "that",
+                "prolong",
+                "the",
+                "refractory",
+                "period",
+                "of",
+                "accessory",
+                "connection",
+                "should",
+                "be",
+                "used."
+            ],
+            [
+                "IV",
+                "procainamide",
+                "or",
+                "amiodarone",
+                "is",
+                "preferred,",
+                "but",
+                "any",
+                "class",
+                "Ia,",
+                "Ic",
+                "or",
+                "III",
+                "antiarrhythmic",
+                "drug",
+                "can",
+                "be",
+                "used."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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",
+                "B-Marker",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "193_161",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "In",
+                "a",
+                "3-month-old",
+                "infant",
+                "all",
+                "the",
+                "clinical",
+                "manifestations",
+                "outlined",
+                "below",
+                "would",
+                "make",
+                "it",
+                "necessary",
+                "to",
+                "rule",
+                "out",
+                "cystic",
+                "fibrosis,",
+                "EXCEPT:"
+            ],
+            [
+                "1-",
+                "Delayed",
+                "meconium",
+                "evacuation."
+            ],
+            [
+                "2-",
+                "Salty",
+                "taste",
+                "of",
+                "the",
+                "skin."
+            ],
+            [
+                "3-",
+                "Isolation",
+                "of",
+                "secretions",
+                "of",
+                "Pseudomonas",
+                "aeruginosa."
+            ],
+            [
+                "4-",
+                "Deterioration/detention",
+                "of",
+                "the",
+                "weight",
+                "curve."
+            ],
+            [
+                "5-",
+                "Hypernatremic",
+                "dehydration."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "Dehydration",
+                "may",
+                "be",
+                "due",
+                "to",
+                "diarrhea",
+                "of",
+                "other",
+                "etiologies."
+            ],
+            [
+                "I",
+                "have",
+                "doubts",
+                "about",
+                "answer",
+                "3",
+                "since",
+                "it",
+                "does",
+                "not",
+                "specify",
+                "which",
+                "secretions",
+                "are",
+                "involved."
+            ],
+            [
+                "We",
+                "have",
+                "to",
+                "understand",
+                "that",
+                "the",
+                "growth",
+                "of",
+                "Pseudomona",
+                "aeruginosa",
+                "is",
+                "in",
+                "the",
+                "culture",
+                "of",
+                "bronchial",
+                "secretions."
+            ],
+            [
+                "Because",
+                "clearly",
+                "the",
+                "indication",
+                "to",
+                "perform",
+                "a",
+                "sweat",
+                "chlorine",
+                "(to",
+                "rule",
+                "out",
+                "FQP)",
+                "are",
+                "the",
+                "HIPOnatremic",
+                "dehydrations",
+                "and",
+                "not",
+                "the",
+                "hypernatremic",
+                "ones",
+                "as",
+                "the",
+                "answer",
+                "says."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "431_116",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTIOUS",
+                "DISEASES",
+                "AND",
+                "MICROBIOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "38-year-old",
+                "man",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "with",
+                "fever",
+                "above",
+                "39\u00baC",
+                "and",
+                "deterioration",
+                "of",
+                "consciousness",
+                "after",
+                "a",
+                "trip",
+                "to",
+                "Equatorial",
+                "Guinea",
+                "without",
+                "antimalarial",
+                "prophylaxis."
+            ],
+            [
+                "Laboratory",
+                "tests",
+                "showed",
+                "creatinine",
+                "3.4",
+                "mg/dL,",
+                "AST",
+                "764",
+                "UlL,",
+                "ALT",
+                "678",
+                "UlL."
+            ],
+            [
+                "The",
+                "laboratory",
+                "reports",
+                "the",
+                "visualization",
+                "of",
+                "Plasmodium",
+                "falciparum",
+                "in",
+                "the",
+                "blood",
+                "with",
+                "a",
+                "parasitemia",
+                "level",
+                "of",
+                "6%."
+            ],
+            [
+                "What",
+                "treatment",
+                "would",
+                "you",
+                "initiate",
+                "at",
+                "this",
+                "time?"
+            ],
+            [
+                "1-",
+                "Mefloquine",
+                "orally."
+            ],
+            [
+                "2-",
+                "Intravenous",
+                "artesunate."
+            ],
+            [
+                "3-",
+                "Doxycycline",
+                "orally."
+            ],
+            [
+                "4-",
+                "Oral",
+                "quinine",
+                "sulfate."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "In",
+                "severe",
+                "cases",
+                "of",
+                "Plasmodium",
+                "infection,",
+                "the",
+                "greatest",
+                "risk",
+                "of",
+                "mortality",
+                "occurs",
+                "in",
+                "the",
+                "first",
+                "24",
+                "hours",
+                "of",
+                "clinical",
+                "presentation,",
+                "so",
+                "treatment",
+                "should",
+                "be",
+                "started",
+                "immediately."
+            ],
+            [
+                "Treatment",
+                "with",
+                "parenteral",
+                "or",
+                "intramuscular",
+                "artesunate",
+                "is",
+                "more",
+                "indicated",
+                "in",
+                "severe",
+                "Plasmodium",
+                "infection,",
+                "both",
+                "in",
+                "adults",
+                "and",
+                "children",
+                "and",
+                "in",
+                "pregnant",
+                "women."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "569_152",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEPHROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "24-year-old",
+                "male",
+                "presenting",
+                "with",
+                "dysmorphic",
+                "microhematuria,",
+                "proteinuria",
+                "of",
+                "3",
+                "g/24",
+                "h,",
+                "eGFR",
+                "(CKD-EPI)",
+                "85",
+                "ml/min",
+                "and",
+                "sensorineural",
+                "hearing",
+                "loss."
+            ],
+            [
+                "He",
+                "reports",
+                "that",
+                "his",
+                "maternal",
+                "grandmother",
+                "required",
+                "dialysis",
+                "at",
+                "70",
+                "years",
+                "of",
+                "age",
+                "and",
+                "both",
+                "his",
+                "mother",
+                "and",
+                "younger",
+                "sister",
+                "have",
+                "isolated",
+                "microhematuria."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "diseases",
+                "is",
+                "more",
+                "likely?"
+            ],
+            [
+                "1-",
+                "Alport",
+                "syndrome."
+            ],
+            [
+                "2-",
+                "IgA",
+                "nephropathy."
+            ],
+            [
+                "3-",
+                "Fabry",
+                "disease."
+            ],
+            [
+                "4-",
+                "Autosomal",
+                "dominant",
+                "polycystic",
+                "kidney",
+                "disease."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Textbook",
+                "case,",
+                "little",
+                "to",
+                "add."
+            ],
+            [
+                "Microhematuria,",
+                "proteinuria",
+                "and",
+                "sensorineural",
+                "hearing",
+                "loss",
+                "in",
+                "a",
+                "young",
+                "male",
+                "with",
+                "a",
+                "family",
+                "history",
+                "of",
+                "women",
+                "with",
+                "hematuria",
+                "=",
+                "Alport",
+                "syndrome."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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",
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "501_76",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "5-year-old",
+                "boy",
+                "diagnosed",
+                "with",
+                "chronic",
+                "renal",
+                "failure."
+            ],
+            [
+                "He",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "with",
+                "vomiting,",
+                "malaise,",
+                "and",
+                "palpitations."
+            ],
+            [
+                "An",
+                "electrocardiogram",
+                "was",
+                "performed",
+                "with",
+                "T-wave",
+                "elevation",
+                "and",
+                "blood",
+                "tests",
+                "showed",
+                "potassium",
+                "levels",
+                "of",
+                "5.9",
+                "mEq/L."
+            ],
+            [
+                "Immediate",
+                "administration",
+                "of",
+                "calcium",
+                "gluconate",
+                "is",
+                "decided."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "purpose",
+                "of",
+                "this",
+                "treatment?"
+            ],
+            [
+                "1-",
+                "Encourage",
+                "the",
+                "displacement",
+                "of",
+                "potassium",
+                "from",
+                "the",
+                "plasma",
+                "space",
+                "to",
+                "the",
+                "intracellular",
+                "space."
+            ],
+            [
+                "2-",
+                "Chelate",
+                "circulating",
+                "potassium",
+                "to",
+                "favor",
+                "its",
+                "hepatic",
+                "elimination."
+            ],
+            [
+                "3-",
+                "Chelate",
+                "circulating",
+                "potassium",
+                "to",
+                "favor",
+                "its",
+                "renal",
+                "elimination."
+            ],
+            [
+                "4-",
+                "Antagonize",
+                "the",
+                "action",
+                "of",
+                "potassium",
+                "on",
+                "the",
+                "myocardial",
+                "cell",
+                "membrane."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Calcium",
+                "gluconate",
+                "has",
+                "no",
+                "effect",
+                "on",
+                "blood",
+                "potassium",
+                "levels",
+                "(therefore",
+                "options",
+                "1,",
+                "2",
+                "and",
+                "3",
+                "are",
+                "ruled",
+                "out)."
+            ],
+            [
+                "Its",
+                "function",
+                "is",
+                "to",
+                "decrease",
+                "the",
+                "excitability",
+                "of",
+                "cardiac",
+                "myocytes",
+                "to",
+                "decrease",
+                "the",
+                "likelihood",
+                "of",
+                "developing",
+                "heart",
+                "rhythm",
+                "disorders."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "242_111",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTIOUS",
+                "DISEASES"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "50-year-old",
+                "man",
+                "with",
+                "chronic",
+                "bronchitis",
+                "is",
+                "admitted",
+                "for",
+                "pneumonia",
+                "with",
+                "positive",
+                "blood",
+                "culture",
+                "for",
+                "Streptococcus",
+                "pneumoniae,",
+                "with",
+                "an",
+                "MIC",
+                "to",
+                "penicillin",
+                "of",
+                "0.0125",
+                "mg/l."
+            ],
+            [
+                "Treatment",
+                "was",
+                "started",
+                "with",
+                "penicillin",
+                "2",
+                "million",
+                "every",
+                "4h."
+            ],
+            [
+                "On",
+                "the",
+                "fifth",
+                "day,",
+                "she",
+                "still",
+                "has",
+                "a",
+                "fever",
+                "of",
+                "38\u00baC."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "decisions",
+                "do",
+                "you",
+                "think",
+                "is",
+                "correct?"
+            ],
+            [
+                "1-",
+                "I",
+                "would",
+                "change",
+                "the",
+                "treatment",
+                "to",
+                "ceftriaxone",
+                "because",
+                "of",
+                "its",
+                "greater",
+                "efficacy."
+            ],
+            [
+                "2-",
+                "I",
+                "would",
+                "add",
+                "a",
+                "quinolone",
+                "to",
+                "the",
+                "treatment."
+            ],
+            [
+                "3-",
+                "I",
+                "would",
+                "switch",
+                "to",
+                "amoxicillin/clavulanic",
+                "acid."
+            ],
+            [
+                "4-",
+                "It",
+                "would",
+                "rule",
+                "out",
+                "the",
+                "presence",
+                "of",
+                "pleural",
+                "empyema."
+            ],
+            [
+                "5-",
+                "I",
+                "would",
+                "continue",
+                "with",
+                "the",
+                "same",
+                "treatment,",
+                "assuming",
+                "it",
+                "is",
+                "simply",
+                "a",
+                "timing",
+                "issue."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "The",
+                "patient",
+                "is",
+                "a",
+                "man",
+                "with",
+                "pneumonia",
+                "with",
+                "isolated",
+                "germ",
+                "in",
+                "blood",
+                "culture",
+                "and",
+                "antibiogram."
+            ],
+            [
+                "According",
+                "to",
+                "the",
+                "data",
+                "provided,",
+                "it",
+                "is",
+                "a",
+                "pneumococcus",
+                "sensitive",
+                "to",
+                "penicillin",
+                "(MIC",
+                "<",
+                "0.125),",
+                "so",
+                "treatment",
+                "is",
+                "started",
+                "with",
+                "penicillin",
+                "at",
+                "high",
+                "doses",
+                "every",
+                "4",
+                "h,",
+                "despite",
+                "which",
+                "the",
+                "fever",
+                "persists."
+            ],
+            [
+                "If",
+                "we",
+                "analyze",
+                "the",
+                "case",
+                "carefully,",
+                "the",
+                "treatment",
+                "should",
+                "be",
+                "effective",
+                "since",
+                "the",
+                "germ",
+                "is",
+                "totally",
+                "sensitive",
+                "to",
+                "the",
+                "drug",
+                "and",
+                "the",
+                "dosage",
+                "is",
+                "adequate",
+                "(so",
+                "that",
+                "high",
+                "concentrations",
+                "of",
+                "the",
+                "drug",
+                "should",
+                "be",
+                "maintained",
+                "at",
+                "all",
+                "times,",
+                "remember",
+                "that",
+                "the",
+                "efficacy",
+                "of",
+                "beta-lactams",
+                "is",
+                "time-dependent",
+                "and",
+                "the",
+                "antibiotic",
+                "concentrations",
+                "in",
+                "blood",
+                "should",
+                "be",
+                "above",
+                "the",
+                "MIC",
+                "permanently",
+                "to",
+                "achieve",
+                "effectiveness",
+                "and",
+                "avoid",
+                "the",
+                "production",
+                "of",
+                "resistance)."
+            ],
+            [
+                "In",
+                "such",
+                "a",
+                "case,",
+                "what",
+                "could",
+                "be",
+                "happening,",
+                "probably,",
+                "although",
+                "the",
+                "antibiotic",
+                "is",
+                "the",
+                "right",
+                "one,",
+                "it",
+                "is",
+                "not",
+                "reaching",
+                "the",
+                "infectious",
+                "focus",
+                "adequately",
+                "because",
+                "an",
+                "empyema",
+                "has",
+                "probably",
+                "occurred."
+            ],
+            [
+                "We",
+                "should",
+                "rule",
+                "out",
+                "the",
+                "existence",
+                "of",
+                "an",
+                "empyema",
+                "and",
+                "drain",
+                "it",
+                "while",
+                "continuing",
+                "with",
+                "the",
+                "antibiotic",
+                "treatment."
+            ],
+            [
+                "If",
+                "the",
+                "dosage",
+                "had",
+                "not",
+                "been",
+                "adequate",
+                "and",
+                "the",
+                "presence",
+                "of",
+                "drug",
+                "resistance",
+                "was",
+                "possible,",
+                "one",
+                "option",
+                "could",
+                "have",
+                "been",
+                "to",
+                "treat",
+                "with",
+                "ceftriaxone",
+                "at",
+                "high",
+                "doses,",
+                "since",
+                "we",
+                "should",
+                "remember",
+                "that",
+                "streptococcus",
+                "does",
+                "not",
+                "produce",
+                "beta-lactamase",
+                "and",
+                "beta-lactam",
+                "resistance",
+                "is",
+                "produced",
+                "by",
+                "another",
+                "mechanism",
+                "(using",
+                "amoxicillin-clavulanate",
+                "would",
+                "not",
+                "provide",
+                "us",
+                "with",
+                "anything)."
+            ],
+            [
+                "With",
+                "quinolone",
+                "we",
+                "do",
+                "not",
+                "increase",
+                "the",
+                "spectrum",
+                "and",
+                "it",
+                "is",
+                "evident",
+                "that",
+                "the",
+                "poor",
+                "evolution",
+                "of",
+                "the",
+                "patient",
+                "is",
+                "not",
+                "only",
+                "a",
+                "problem",
+                "of",
+                "time."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-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",
+                "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",
+                "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",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "487_68",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GENETICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "What",
+                "genetic",
+                "and",
+                "reproductive",
+                "counseling",
+                "would",
+                "you",
+                "indicate",
+                "to",
+                "a",
+                "30-year-old",
+                "woman",
+                "who",
+                "consults",
+                "because",
+                "she",
+                "is",
+                "a",
+                "carrier",
+                "of",
+                "a",
+                "premutation",
+                "in",
+                "the",
+                "FMR1",
+                "gene,",
+                "responsible",
+                "for",
+                "Fragile",
+                "X",
+                "syndrome,",
+                "and",
+                "who",
+                "wishes",
+                "to",
+                "have",
+                "offspring."
+            ],
+            [
+                "Point",
+                "out",
+                "the",
+                "correct",
+                "answer:"
+            ],
+            [
+                "1-",
+                "All",
+                "her",
+                "male",
+                "children",
+                "will",
+                "be",
+                "carriers",
+                "and,",
+                "therefore,",
+                "will",
+                "manifest",
+                "the",
+                "disease."
+            ],
+            [
+                "2-",
+                "There",
+                "is",
+                "a",
+                "phenomenon",
+                "of",
+                "genetic",
+                "anticipation,",
+                "so",
+                "their",
+                "offspring",
+                "will",
+                "present",
+                "more",
+                "severe",
+                "and",
+                "earlier",
+                "symptoms."
+            ],
+            [
+                "3-",
+                "Preimplantation",
+                "genetic",
+                "diagnosis",
+                "for",
+                "sex",
+                "selection",
+                "of",
+                "embryos",
+                "by",
+                "fluorescence",
+                "in",
+                "situ",
+                "hybridization",
+                "(FISH)",
+                "is",
+                "the",
+                "best",
+                "option",
+                "for",
+                "healthy",
+                "offspring."
+            ],
+            [
+                "4-",
+                "50%",
+                "of",
+                "her",
+                "daughters",
+                "will",
+                "be",
+                "carriers,",
+                "but",
+                "will",
+                "not",
+                "present",
+                "clinical",
+                "manifestations",
+                "of",
+                "the",
+                "disease."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Another",
+                "classic",
+                "MIR,",
+                "asked",
+                "in",
+                "2019",
+                "and",
+                "in",
+                "2017,",
+                "fragile",
+                "X",
+                "syndrome."
+            ],
+            [
+                "Also,",
+                "on",
+                "the",
+                "same",
+                "concept",
+                "as",
+                "question",
+                "44,",
+                "the",
+                "phenomenon",
+                "of",
+                "genetic",
+                "anticipation."
+            ],
+            [
+                "Triplet",
+                "expansion",
+                "diseases,",
+                "such",
+                "as",
+                "this",
+                "one,",
+                "can",
+                "have",
+                "the",
+                "anticipation",
+                "phenomenon",
+                "whereby",
+                "females",
+                "with",
+                "premutations",
+                "(between",
+                "55-200",
+                "repeats)",
+                "can",
+                "have",
+                "children",
+                "with",
+                "full",
+                "mutations",
+                "(more",
+                "than",
+                "200",
+                "repeats",
+                "of",
+                "the",
+                "triplet)",
+                "and",
+                "more",
+                "obvious,",
+                "more",
+                "severe",
+                "and/or",
+                "earlier",
+                "clinical,",
+                "in",
+                "both",
+                "males",
+                "and",
+                "females",
+                "(Fragile",
+                "X",
+                "syndrome,",
+                "early",
+                "ovarian",
+                "failure,",
+                "tremor/ataxia",
+                "associated",
+                "with",
+                "Fragile",
+                "X)."
+            ]
+        ],
+        "labels": [
+            [
+                "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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+            [
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+            ],
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "364_176",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "HEMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "78-year-old",
+                "woman",
+                "with",
+                "a",
+                "history",
+                "of",
+                "type",
+                "2",
+                "diabetes",
+                "treated",
+                "with",
+                "oral",
+                "antidiabetics,",
+                "hypertension",
+                "treated",
+                "with",
+                "beta-blockers",
+                "and",
+                "ACE",
+                "inhibitors,",
+                "and",
+                "NYHA",
+                "grade",
+                "1",
+                "congestive",
+                "heart",
+                "failure",
+                "with",
+                "LVEF",
+                "of",
+                "48%,",
+                "and",
+                "currently",
+                "asymptomatic."
+            ],
+            [
+                "Functional",
+                "status:",
+                "ECOG",
+                "0."
+            ],
+            [
+                "History",
+                "of",
+                "2",
+                "years",
+                "of",
+                "evolution",
+                "of",
+                "small",
+                "lumps",
+                "in",
+                "the",
+                "neck."
+            ],
+            [
+                "Biopsy",
+                "of",
+                "cervical",
+                "adenopathy:",
+                "follicular",
+                "lymphoma",
+                "grade",
+                "2."
+            ],
+            [
+                "Extension",
+                "study:",
+                "Hb",
+                "12",
+                "g/dL,",
+                "Leukocytes",
+                "6,900/microL",
+                "(Neutrophils",
+                "60%,",
+                "Lymphocytes",
+                "27%,",
+                "Monocytes",
+                "6%,",
+                "Eosinophils",
+                "4%,",
+                "Basophils",
+                "4%),",
+                "Platelets",
+                "220,000/microL."
+            ],
+            [
+                "MO:",
+                "infiltrate",
+                "by",
+                "follicular",
+                "lymphoma."
+            ],
+            [
+                "Creatinine",
+                "1.5",
+                "mg/dL,",
+                "LDH",
+                "235",
+                "U/L,",
+                "Beta2",
+                "microglobulin",
+                "2.1",
+                "microg/mL."
+            ],
+            [
+                "CT:",
+                "lymphadenopathies",
+                "less",
+                "than",
+                "3",
+                "cm",
+                "in",
+                "cervical,",
+                "axillary,",
+                "retroperitoneal,",
+                "iliac",
+                "and",
+                "inguinal",
+                "territories;",
+                "liver",
+                "and",
+                "spleen",
+                "are",
+                "normal."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "treatments",
+                "is",
+                "the",
+                "most",
+                "appropriate?"
+            ],
+            [
+                "1-",
+                "Rituximab-CHOP",
+                "(Cyclophosphamide,",
+                "Adriamycin,",
+                "Vincristine,",
+                "Prednisone)."
+            ],
+            [
+                "2-",
+                "Rituximab-CVP",
+                "(Cyclophosphamide,",
+                "Vincristine,",
+                "Prednisone)."
+            ],
+            [
+                "3-",
+                "Do",
+                "not",
+                "treat",
+                "and",
+                "monitor",
+                "(wait",
+                "and",
+                "see)."
+            ],
+            [
+                "4-",
+                "Rituxirnab-Bendamustine."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "There",
+                "may",
+                "be",
+                "debate",
+                "about",
+                "whether",
+                "to",
+                "start",
+                "Rituximab",
+                "with",
+                "another",
+                "cytostatic",
+                "drug",
+                "or",
+                "in",
+                "monotherapy,",
+                "but",
+                "given",
+                "the",
+                "lack",
+                "of",
+                "survival",
+                "benefit",
+                "with",
+                "early",
+                "initiation",
+                "of",
+                "treatment,",
+                "the",
+                "NCCN",
+                "guidelines",
+                "recommend",
+                "waiting",
+                "and",
+                "seeing,",
+                "unless",
+                "GELF",
+                "criteria",
+                "are",
+                "met",
+                "to",
+                "initiate",
+                "treatment:",
+                "GELF",
+                "criteria",
+                "(Follicular",
+                "Lymphoma",
+                "Study",
+                "Group):",
+                "-",
+                "Involvement",
+                "of",
+                "\u22653",
+                "nodal",
+                "areas,",
+                "each",
+                "with",
+                "a",
+                "diameter",
+                "\u2265",
+                "3",
+                "cm."
+            ],
+            [
+                "-",
+                "Any",
+                "nodal",
+                "or",
+                "extranodal",
+                "mass",
+                "with",
+                "a",
+                "diameter",
+                "\u2265",
+                "7",
+                "cm."
+            ],
+            [
+                "-",
+                "B",
+                "symptoms."
+            ],
+            [
+                "-",
+                "Splenomegaly."
+            ],
+            [
+                "-",
+                "Pleural",
+                "effusion",
+                "or",
+                "ascites."
+            ],
+            [
+                "-",
+                "Cytopenias",
+                "(leukocytes",
+                "<",
+                "1.0",
+                "x",
+                "109",
+                "/",
+                "L",
+                "and/or",
+                "platelets",
+                "<",
+                "100",
+                "x",
+                "109",
+                "/",
+                "L)."
+            ],
+            [
+                "-",
+                "Leukemia",
+                "(>",
+                "5.0",
+                "x",
+                "109",
+                "/L",
+                "of",
+                "malignant",
+                "cells)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "90_32",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GENERAL",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "35-year-old",
+                "woman",
+                "is",
+                "diagnosed",
+                "with",
+                "colon",
+                "cancer",
+                "located",
+                "in",
+                "the",
+                "hepatic",
+                "angle."
+            ],
+            [
+                "She",
+                "has",
+                "a",
+                "family",
+                "history",
+                "of",
+                "colon",
+                "cancer",
+                "in",
+                "her",
+                "mother,",
+                "an",
+                "aunt",
+                "at",
+                "the",
+                "age",
+                "of",
+                "45",
+                "and",
+                "a",
+                "grandfather."
+            ],
+            [
+                "The",
+                "most",
+                "accepted",
+                "surgical",
+                "intervention",
+                "is:"
+            ],
+            [
+                "1-",
+                "Right",
+                "hemicolectomy."
+            ],
+            [
+                "2-",
+                "Extended",
+                "right",
+                "hemicolectomy."
+            ],
+            [
+                "3-",
+                "Subtotal",
+                "colectomy."
+            ],
+            [
+                "4-",
+                "Total",
+                "colectomy",
+                "with",
+                "ileorectal",
+                "anatomosis."
+            ],
+            [
+                "5-",
+                "Total",
+                "colectomy",
+                "with",
+                "ileoanal",
+                "anatomy."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "The",
+                "statement",
+                "with",
+                "the",
+                "family",
+                "history",
+                "indicates",
+                "that",
+                "this",
+                "is",
+                "a",
+                "case",
+                "of",
+                "hereditary",
+                "nonpolyposis",
+                "colorectal",
+                "cancer",
+                "(Lynch",
+                "syndrome)."
+            ],
+            [
+                "The",
+                "age",
+                "and",
+                "right",
+                "location",
+                "data",
+                "lead",
+                "us",
+                "to",
+                "answer",
+                "4:",
+                "total",
+                "colectomy",
+                "with",
+                "ileorectal",
+                "anastomosis."
+            ],
+            [
+                "If",
+                "a",
+                "conventional",
+                "right",
+                "hemicolectomy",
+                "type",
+                "surgery",
+                "is",
+                "performed,",
+                "the",
+                "chances",
+                "of",
+                "recurrence",
+                "are",
+                "higher",
+                "than",
+                "30%."
+            ],
+            [
+                "Excision",
+                "of",
+                "the",
+                "rectum",
+                "is",
+                "not",
+                "necessary",
+                "prophylactically."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "528_134",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEPHROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "53-year-old",
+                "woman",
+                "with",
+                "a",
+                "personal",
+                "history",
+                "of",
+                "obesity",
+                "and",
+                "migraine."
+            ],
+            [
+                "Her",
+                "blood",
+                "pressure",
+                "has",
+                "been",
+                "taken",
+                "repeatedly",
+                "at",
+                "the",
+                "doctor's",
+                "and",
+                "nurse's",
+                "office,",
+                "presenting",
+                "figures",
+                "below",
+                "140/90",
+                "mmHg."
+            ],
+            [
+                "However,",
+                "an",
+                "approved",
+                "blood",
+                "pressure",
+                "measuring",
+                "device",
+                "has",
+                "been",
+                "purchased",
+                "and",
+                "she",
+                "has",
+                "been",
+                "taught",
+                "how",
+                "to",
+                "use",
+                "it",
+                "correctly."
+            ],
+            [
+                "He",
+                "comes",
+                "in",
+                "showing",
+                "blood",
+                "pressure",
+                "recordings",
+                "taken",
+                "at",
+                "home",
+                "over",
+                "several",
+                "weeks",
+                "with",
+                "values",
+                "above",
+                "140/90",
+                "mmHg."
+            ],
+            [
+                "Mark",
+                "the",
+                "correct",
+                "answer:"
+            ],
+            [
+                "1-",
+                "She",
+                "has",
+                "secondary",
+                "hypertension."
+            ],
+            [
+                "2-",
+                "Presents",
+                "masked",
+                "arterial",
+                "hypertension."
+            ],
+            [
+                "3-",
+                "Presents",
+                "isolated",
+                "clinical",
+                "hypertension."
+            ],
+            [
+                "4-",
+                "Presents",
+                "refractory",
+                "arterial",
+                "hypertension."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "The",
+                "patient",
+                "described",
+                "is",
+                "the",
+                "definition",
+                "of",
+                "masked",
+                "HT,",
+                "normal",
+                "figures",
+                "in",
+                "consultation",
+                "and",
+                "elevated",
+                "on",
+                "AMPA",
+                "or",
+                "ABPM",
+                "(option",
+                "2",
+                "correct)."
+            ],
+            [
+                "It",
+                "is",
+                "not",
+                "secondary",
+                "HT",
+                "because",
+                "no",
+                "study",
+                "has",
+                "been",
+                "done",
+                "to",
+                "confirm",
+                "it",
+                "(option",
+                "1",
+                "incorrect)."
+            ],
+            [
+                "It",
+                "is",
+                "not",
+                "isolated",
+                "HT",
+                "because",
+                "the",
+                "elevated",
+                "figures",
+                "are",
+                "maintained",
+                "for",
+                "several",
+                "weeks",
+                "(option",
+                "3",
+                "incorrect)."
+            ],
+            [
+                "It",
+                "is",
+                "not",
+                "refractory",
+                "HT",
+                "because",
+                "it",
+                "has",
+                "not",
+                "yet",
+                "been",
+                "treated",
+                "(option",
+                "4",
+                "incorrect)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "583_70",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "OBSTETRICS",
+                "AND",
+                "GYNECOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "43-year-old",
+                "woman",
+                "with",
+                "a",
+                "levonorgestrel",
+                "intrauterine",
+                "device",
+                "who",
+                "consults",
+                "for",
+                "lack",
+                "of",
+                "rest",
+                "at",
+                "night",
+                "with",
+                "the",
+                "appearance",
+                "of",
+                "heat",
+                "and",
+                "palpitations."
+            ],
+            [
+                "In",
+                "the",
+                "analytical",
+                "analysis",
+                "highlights",
+                "free",
+                "T4",
+                "10.5",
+                "pmol/L",
+                "(9-19),",
+                "thyrotropin",
+                "2.1",
+                "mIU/L",
+                "(0.30-5.00),",
+                "FSH",
+                "95.6",
+                "IU/L",
+                "(1.38-16.7),",
+                "LH",
+                "21",
+                "IU/L",
+                "(2.4-9.3),",
+                "estradiol",
+                "<",
+                "0.07",
+                "nmol/L",
+                "(0.07",
+                "-",
+                "1.14)."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "appropriate",
+                "treatment?"
+            ],
+            [
+                "1-",
+                "Benzodiazepines."
+            ],
+            [
+                "2-",
+                "Vaginal",
+                "estrogens."
+            ],
+            [
+                "3-",
+                "Oral",
+                "estrogens",
+                "and",
+                "progestogens",
+                "in",
+                "continuous",
+                "regimen."
+            ],
+            [
+                "4-",
+                "Transdermal",
+                "estrogens",
+                "in",
+                "a",
+                "continuous",
+                "regimen."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "The",
+                "hormonal",
+                "profile",
+                "we",
+                "are",
+                "told",
+                "is",
+                "in",
+                "menopausal",
+                "range",
+                "(FSH",
+                ">20;",
+                "estradiol",
+                "<5)",
+                "and",
+                "the",
+                "patient",
+                "has",
+                "systemic",
+                "vasomotor",
+                "symptoms."
+            ],
+            [
+                "Therefore,",
+                "it",
+                "would",
+                "be",
+                "more",
+                "appropriate",
+                "to",
+                "administer",
+                "systemic",
+                "estrogens."
+            ],
+            [
+                "To",
+                "compensate,",
+                "she",
+                "already",
+                "has",
+                "a",
+                "local",
+                "uterine",
+                "progestin",
+                "(levonorgestrel",
+                "IUD)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ]
+        ]
+    },
+    {
+        "id": "195_163",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "15-month-old",
+                "boy,",
+                "who",
+                "during",
+                "dinner,",
+                "after",
+                "eating",
+                "a",
+                "bite",
+                "of",
+                "tortilla,",
+                "suddenly",
+                "presented",
+                "with",
+                "facial",
+                "reddening",
+                "predominantly",
+                "perioral,",
+                "habonous",
+                "lesions",
+                "on",
+                "the",
+                "trunk",
+                "and",
+                "extremities",
+                "and",
+                "cough."
+            ],
+            [
+                "On",
+                "arrival",
+                "at",
+                "the",
+                "center,",
+                "the",
+                "patient",
+                "was",
+                "conscious",
+                "and,",
+                "in",
+                "addition",
+                "to",
+                "what",
+                "was",
+                "described",
+                "above,",
+                "the",
+                "following",
+                "were",
+                "observed:",
+                "suprasternal",
+                "twitching,",
+                "abundant",
+                "watery",
+                "rhinorrhea,",
+                "bilateral",
+                "hypoventilation",
+                "without",
+                "wheezing",
+                "and",
+                "capillary",
+                "refill",
+                "of",
+                "less",
+                "than",
+                "2",
+                "seconds."
+            ],
+            [
+                "Of",
+                "the",
+                "following",
+                "statements,",
+                "indicate",
+                "the",
+                "CORRECT",
+                "answer:"
+            ],
+            [
+                "1-",
+                "The",
+                "priority",
+                "is",
+                "to",
+                "cannulate",
+                "a",
+                "venous",
+                "line."
+            ],
+            [
+                "2-",
+                "Intramuscular",
+                "methylprednisolone",
+                "is",
+                "the",
+                "treatment",
+                "of",
+                "choice."
+            ],
+            [
+                "3-",
+                "It",
+                "is",
+                "a",
+                "picture",
+                "of",
+                "urticaria",
+                "associated",
+                "with",
+                "asthma,",
+                "and",
+                "should",
+                "be",
+                "treated",
+                "with",
+                "antihistamines",
+                "and",
+                "inhaled",
+                "bronchodilators."
+            ],
+            [
+                "4-",
+                "Parents",
+                "should",
+                "be",
+                "advised",
+                "to",
+                "transfer",
+                "to",
+                "a",
+                "hospital",
+                "emergency",
+                "department."
+            ],
+            [
+                "5-",
+                "Intramuscular",
+                "adrenaline",
+                "should",
+                "be",
+                "administered",
+                "without",
+                "further",
+                "delay."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "She",
+                "is",
+                "describing",
+                "egg",
+                "anaphylaxis,",
+                "a",
+                "potentially",
+                "fatal",
+                "condition."
+            ],
+            [
+                "The",
+                "treatment",
+                "of",
+                "choice",
+                "is",
+                "intramuscular",
+                "adrenaline,",
+                "and",
+                "effectively,",
+                "without",
+                "wasting",
+                "too",
+                "much",
+                "time."
+            ],
+            [
+                "The",
+                "first",
+                "thing",
+                "is",
+                "INTRAMUSCULAR",
+                "adrenaline",
+                "NOW!"
+            ],
+            [
+                "The",
+                "venous",
+                "route,",
+                "corticosteroids,",
+                "antihistamines,",
+                "etc.",
+                "will",
+                "come",
+                "later."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "84_49",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CARDIOLOGY",
+                "AND",
+                "VASCULAR",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "75-year-old",
+                "man,",
+                "hypertensive",
+                "and",
+                "dyslipidemic",
+                "with",
+                "a",
+                "history",
+                "of",
+                "heart",
+                "failure",
+                "due",
+                "to",
+                "left",
+                "ventricular",
+                "systolic",
+                "dysfunction",
+                "(EF",
+                "<",
+                "30%)."
+            ],
+            [
+                "He",
+                "comes",
+                "to",
+                "our",
+                "office",
+                "for",
+                "worsening",
+                "of",
+                "his",
+                "usual",
+                "dyspnea",
+                "in",
+                "recent",
+                "weeks."
+            ],
+            [
+                "His",
+                "systolic",
+                "blood",
+                "pressure",
+                "is",
+                "160/95",
+                "mmHg",
+                "with",
+                "a",
+                "heart",
+                "rate",
+                "of",
+                "65",
+                "bpm."
+            ],
+            [
+                "In",
+                "the",
+                "physical",
+                "examination",
+                "no",
+                "crackles",
+                "were",
+                "heard",
+                "and",
+                "his",
+                "jugular",
+                "venous",
+                "pressure",
+                "was",
+                "normal."
+            ],
+            [
+                "He",
+                "provides",
+                "a",
+                "creatinine",
+                "determination",
+                "that",
+                "is",
+                "3.7",
+                "mg/dL",
+                "with",
+                "ions",
+                "within",
+                "normal."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "drugs",
+                "is",
+                "the",
+                "most",
+                "appropriate",
+                "to",
+                "improve",
+                "the",
+                "prognosis",
+                "of",
+                "his",
+                "heart",
+                "failure?"
+            ],
+            [
+                "1-",
+                "Enalapril."
+            ],
+            [
+                "2-",
+                "Losartan."
+            ],
+            [
+                "3-",
+                "Spironolactone."
+            ],
+            [
+                "4-",
+                "Bisoprolol."
+            ],
+            [
+                "5-",
+                "Eplerenone."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "In",
+                "a",
+                "patient",
+                "with",
+                "multiple",
+                "CVRF",
+                "with",
+                "concomitant",
+                "heart",
+                "and",
+                "renal",
+                "failure",
+                "(presumably",
+                "of",
+                "multiple",
+                "etiology:",
+                "renal",
+                "hypoperfusion,",
+                "arteriosclerosis...),",
+                "we",
+                "must",
+                "be",
+                "very",
+                "careful",
+                "when",
+                "using",
+                "diuretics",
+                "and",
+                "ACEI/ARA-II,",
+                "since",
+                "we",
+                "can",
+                "worsen",
+                "renal",
+                "function",
+                "and/or",
+                "increase",
+                "potassium",
+                "levels",
+                "(among",
+                "diuretics,",
+                "spironolactone",
+                "and",
+                "eplerenone",
+                "are",
+                "\"potassium-sparing\")."
+            ],
+            [
+                "Therefore,",
+                "in",
+                "this",
+                "case",
+                "we",
+                "will",
+                "use",
+                "bisoprolol."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "427_95",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "45-year-old",
+                "woman",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "with",
+                "confusional",
+                "symptoms",
+                "accompanied",
+                "by",
+                "dysphonia."
+            ],
+            [
+                "On",
+                "examination",
+                "she",
+                "has",
+                "a",
+                "palpable",
+                "neck",
+                "mass",
+                "and",
+                "a",
+                "blood",
+                "test",
+                "shows",
+                "plasma",
+                "calcium",
+                "levels",
+                "of",
+                "15",
+                "mg/dL",
+                "(normal",
+                "up",
+                "to",
+                "10.2",
+                "mg/dL)."
+            ],
+            [
+                "Given",
+                "these",
+                "findings,",
+                "which",
+                "of",
+                "the",
+                "following",
+                "diagnoses",
+                "should",
+                "be",
+                "suspected?"
+            ],
+            [
+                "1-",
+                "Parathyroid",
+                "carcinoma."
+            ],
+            [
+                "2-",
+                "Medullary",
+                "thyroid",
+                "carcinoma."
+            ],
+            [
+                "3-",
+                "MEN",
+                "type",
+                "I."
+            ],
+            [
+                "4-",
+                "Parathyroid",
+                "adenoma."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Palpable",
+                "mass",
+                "in",
+                "the",
+                "neck:",
+                "suspect",
+                "thyroid/parathyroid",
+                "pathology."
+            ],
+            [
+                "It",
+                "is",
+                "associated",
+                "with",
+                "hypercalcemia,",
+                "therefore,",
+                "the",
+                "option",
+                "of",
+                "medullary",
+                "thyroid",
+                "cancer",
+                "is",
+                "ruled",
+                "out",
+                "(it",
+                "does",
+                "not",
+                "affect",
+                "the",
+                "level",
+                "of",
+                "calcemia)."
+            ],
+            [
+                "To",
+                "think",
+                "of",
+                "MEN",
+                "type",
+                "I",
+                "we",
+                "should",
+                "associate",
+                "other",
+                "pathologies",
+                "(pituitary,",
+                "pancreatic",
+                "or",
+                "duodenal",
+                "tumors)."
+            ],
+            [
+                "The",
+                "presence",
+                "of",
+                "a",
+                "calcemia",
+                "higher",
+                "than",
+                "13mgr/dl,",
+                "together",
+                "with",
+                "dysphonia,",
+                "indicates",
+                "a",
+                "malignant",
+                "tumor",
+                "(higher",
+                "calcemia",
+                "level",
+                "and",
+                "infiltration),",
+                "therefore",
+                "we",
+                "opt",
+                "for",
+                "option",
+                "1."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-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",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "462_151",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "OPHTHALMOLOGY",
+                "(ECTOPIC)"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "13-year-old",
+                "boy",
+                "presents",
+                "with",
+                "subacute",
+                "headache",
+                "and",
+                "diplopia."
+            ],
+            [
+                "Neurologic",
+                "examination",
+                "shows",
+                "vertical",
+                "gaze",
+                "palsy",
+                "and",
+                "MRI",
+                "shows",
+                "a",
+                "contrast-enhancing",
+                "lesion",
+                "in",
+                "the",
+                "pineal",
+                "region",
+                "obstructing",
+                "the",
+                "aqueduct",
+                "of",
+                "Sylvian."
+            ],
+            [
+                "The",
+                "most",
+                "likely",
+                "diagnosis",
+                "is:"
+            ],
+            [
+                "1-",
+                "Glioblastoma."
+            ],
+            [
+                "2-",
+                "Medulloblastoma."
+            ],
+            [
+                "3-",
+                "Germ",
+                "cell",
+                "tumor."
+            ],
+            [
+                "4-",
+                "Meningioma."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Diplopia",
+                "is",
+                "usually",
+                "caused",
+                "by",
+                "acute",
+                "or",
+                "secondary",
+                "strabismus."
+            ],
+            [
+                "Vertical",
+                "gaze",
+                "palsy",
+                "is",
+                "due",
+                "to",
+                "a",
+                "midbrain",
+                "lesion."
+            ],
+            [
+                "In",
+                "this",
+                "case",
+                "the",
+                "MRI",
+                "already",
+                "places",
+                "the",
+                "origin",
+                "of",
+                "the",
+                "symptoms",
+                "in",
+                "the",
+                "pineal",
+                "gland."
+            ],
+            [
+                "The",
+                "most",
+                "frequent",
+                "tumor",
+                "in",
+                "this",
+                "region",
+                "is",
+                "the",
+                "germ",
+                "cell",
+                "tumor",
+                "(answer",
+                "3)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "B-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "557_168",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "58-year-old",
+                "male,",
+                "obese,",
+                "asymptomatic,",
+                "moderate",
+                "drinker,",
+                "who",
+                "presents",
+                "a",
+                "first",
+                "baseline",
+                "blood",
+                "glucose",
+                "of",
+                "153",
+                "mg/d",
+                "with",
+                "negative",
+                "glycosuria."
+            ],
+            [
+                "In",
+                "the",
+                "following",
+                "weeks",
+                "he",
+                "has",
+                "had",
+                "two",
+                "other",
+                "baseline",
+                "blood",
+                "glucose",
+                "readings",
+                "of",
+                "118",
+                "and",
+                "136",
+                "mg/dl."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "is",
+                "the",
+                "most",
+                "appropriate",
+                "approach",
+                "to",
+                "confirm",
+                "the",
+                "diagnosis",
+                "of",
+                "diabetes",
+                "mellitus:"
+            ],
+            [
+                "1-",
+                "Practice",
+                "a",
+                "blood",
+                "glucose",
+                "curve",
+                "with",
+                "75",
+                "g",
+                "of",
+                "glucose."
+            ],
+            [
+                "2-",
+                "Already",
+                "meets",
+                "diagnostic",
+                "criteria",
+                "for",
+                "diabetes",
+                "mellitus."
+            ],
+            [
+                "3-",
+                "Request",
+                "a",
+                "determination",
+                "of",
+                "basal",
+                "insulinemia",
+                "or",
+                "C-peptide."
+            ],
+            [
+                "4-",
+                "Request",
+                "a",
+                "determination",
+                "of",
+                "glycosylated",
+                "hemoglobin."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Diagnostic",
+                "Criteria",
+                "for",
+                "DM",
+                "according",
+                "to",
+                "ISPAD",
+                "2018",
+                "*Classic",
+                "symptoms",
+                "of",
+                "diabetes",
+                "with",
+                "blood",
+                "glucose",
+                ">",
+                "200mgr/dl",
+                "or:",
+                "*",
+                "Fasting",
+                "glycemia",
+                "\u2265",
+                "126mgr/dl",
+                "(fasting",
+                "at",
+                "least",
+                "8h)",
+                "or",
+                "*",
+                "Glycemia",
+                "at",
+                "2h",
+                "SOG",
+                "\u2265",
+                "200mgr/dl",
+                "(on",
+                "2",
+                "occasions)",
+                "or",
+                "*",
+                "HbA1C",
+                "\u2265",
+                "6.5%."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "35_68",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY",
+                "AND",
+                "NEUROSURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "56-year-old",
+                "patient",
+                "with",
+                "no",
+                "personal",
+                "or",
+                "family",
+                "history",
+                "of",
+                "interest",
+                "is",
+                "studied",
+                "because",
+                "he",
+                "has",
+                "been",
+                "having",
+                "difficulty",
+                "walking",
+                "with",
+                "his",
+                "right",
+                "leg",
+                "for",
+                "six",
+                "months."
+            ],
+            [
+                "He",
+                "reports",
+                "no",
+                "other",
+                "symptoms."
+            ],
+            [
+                "The",
+                "examination",
+                "shows",
+                "a",
+                "4/5",
+                "weakness",
+                "for",
+                "dorsal",
+                "flexion",
+                "and",
+                "eversion",
+                "of",
+                "the",
+                "foot",
+                "and",
+                "4/5",
+                "for",
+                "flexion",
+                "and",
+                "inversion",
+                "of",
+                "the",
+                "foot,",
+                "with",
+                "increased",
+                "muscle",
+                "reflexes",
+                "and",
+                "Babinski",
+                "present,",
+                "the",
+                "rest",
+                "being",
+                "normal."
+            ],
+            [
+                "The",
+                "syndromic",
+                "diagnosis",
+                "would",
+                "be:"
+            ],
+            [
+                "1-",
+                "Mononeuropathy",
+                "of",
+                "the",
+                "right",
+                "common",
+                "peroneal",
+                "nerve."
+            ],
+            [
+                "2-",
+                "Focal",
+                "involvement",
+                "of",
+                "the",
+                "first",
+                "motor",
+                "neuron",
+                "and",
+                "probably",
+                "of",
+                "the",
+                "second."
+            ],
+            [
+                "3-",
+                "Right",
+                "hemimedullary",
+                "involvement",
+                "(Brown-Sequard)."
+            ],
+            [
+                "4-",
+                "Multiple",
+                "mononeuropathy",
+                "with",
+                "involvement",
+                "of",
+                "the",
+                "common",
+                "peroneal",
+                "and",
+                "right",
+                "posterior",
+                "tibial",
+                "nerve."
+            ],
+            [
+                "5-",
+                "Right",
+                "lumbar",
+                "plexopathy."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Answer",
+                "1",
+                "incorrect:",
+                "It",
+                "does",
+                "not",
+                "explain",
+                "pyramidalism."
+            ],
+            [
+                "Answer",
+                "2",
+                "correct:",
+                "A",
+                "nonspecific",
+                "answer,",
+                "but",
+                "probably",
+                "the",
+                "correct",
+                "answer."
+            ],
+            [
+                "Answer",
+                "3",
+                "incorrect:",
+                "We",
+                "would",
+                "lack",
+                "data",
+                "to",
+                "think",
+                "of",
+                "a",
+                "Brown",
+                "Sequard",
+                "hemimedullary",
+                "syndrome."
+            ],
+            [
+                "It",
+                "would",
+                "explain",
+                "the",
+                "pyramidalism,",
+                "but",
+                "we",
+                "would",
+                "be",
+                "missing",
+                "data",
+                "suggestive",
+                "of",
+                "this",
+                "picture",
+                "such",
+                "as",
+                "a",
+                "contralateral",
+                "hypoesthesia."
+            ],
+            [
+                "Incorrect",
+                "answer",
+                "4:",
+                "It",
+                "could",
+                "explain",
+                "the",
+                "difficulty",
+                "in",
+                "dorsiflexion",
+                "and",
+                "plantar",
+                "flexion",
+                "of",
+                "the",
+                "foot,",
+                "but",
+                "not",
+                "the",
+                "pyramidalism."
+            ],
+            [
+                "Incorrect",
+                "answer",
+                "5:",
+                "In",
+                "a",
+                "similar",
+                "way",
+                "to",
+                "the",
+                "previous",
+                "one,",
+                "it",
+                "could",
+                "explain",
+                "part",
+                "of",
+                "the",
+                "clinical",
+                "picture,",
+                "but",
+                "not",
+                "the",
+                "pyramidalism."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "271_170",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ANESTHESIOLOGY",
+                "AND",
+                "CRITICAL",
+                "CARE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "80-year-old",
+                "man",
+                "comes",
+                "to",
+                "your",
+                "office",
+                "for",
+                "evaluation",
+                "of",
+                "a",
+                "scheduled",
+                "cholecystectomy",
+                "by",
+                "laparoscopy."
+            ],
+            [
+                "He",
+                "has",
+                "a",
+                "history",
+                "of",
+                "arterial",
+                "hypertension",
+                "under",
+                "treatment",
+                "for",
+                "10",
+                "years."
+            ],
+            [
+                "He",
+                "denies",
+                "heart",
+                "or",
+                "pulmonary",
+                "disease."
+            ],
+            [
+                "She",
+                "has",
+                "no",
+                "chest",
+                "pain."
+            ],
+            [
+                "She",
+                "has",
+                "an",
+                "active",
+                "life",
+                "and",
+                "goes",
+                "daily",
+                "to",
+                "the",
+                "gym",
+                "where",
+                "she",
+                "alternates",
+                "swimming",
+                "and",
+                "walking",
+                "on",
+                "the",
+                "treadmill",
+                "for",
+                "at",
+                "least",
+                "one",
+                "hour."
+            ],
+            [
+                "Usual",
+                "treatment:",
+                "nebivolol",
+                "5",
+                "mg",
+                "every",
+                "24",
+                "hours",
+                "and",
+                "hydrochlorothiazide",
+                "12.5",
+                "mg",
+                "daily."
+            ],
+            [
+                "Physical",
+                "examination:",
+                "weight",
+                "73",
+                "kgs;",
+                "height",
+                "179",
+                "cm;",
+                "blood",
+                "pressure",
+                "138/80",
+                "mmHg;",
+                "heart",
+                "rate",
+                "60",
+                "beats/minute."
+            ],
+            [
+                "No",
+                "murmurs",
+                "are",
+                "auscultated",
+                "Which",
+                "of",
+                "the",
+                "following",
+                "is",
+                "the",
+                "most",
+                "appropriate",
+                "preoperative",
+                "approach?"
+            ],
+            [
+                "1-",
+                "Perform",
+                "a",
+                "stress",
+                "test."
+            ],
+            [
+                "2-",
+                "Perform",
+                "echocardiography"
+            ],
+            [
+                "3-",
+                "Perform",
+                "a",
+                "thallium",
+                "and",
+                "dipyridamole",
+                "scan."
+            ],
+            [
+                "4-",
+                "Perform",
+                "electrocardiogram."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "This",
+                "is",
+                "a",
+                "completely",
+                "gratuitous",
+                "question,",
+                "from",
+                "a",
+                "healthier",
+                "gentleman",
+                "than",
+                "me",
+                "who",
+                "is",
+                "going",
+                "to",
+                "undergo",
+                "low-risk",
+                "surgery",
+                "on",
+                "a",
+                "scheduled",
+                "basis."
+            ],
+            [
+                "The",
+                "answer",
+                "is",
+                "obviously",
+                "4."
+            ],
+            [
+                "Had",
+                "there",
+                "been",
+                "a",
+                "fifth",
+                "option",
+                "it",
+                "would",
+                "have",
+                "been",
+                "that",
+                "nothing",
+                "needs",
+                "to",
+                "be",
+                "done,",
+                "which",
+                "might",
+                "have",
+                "generated",
+                "some",
+                "doubt",
+                "in",
+                "the",
+                "student,",
+                "but",
+                "since",
+                "the",
+                "question",
+                "does",
+                "not",
+                "exist",
+                "it",
+                "is",
+                "a",
+                "piece",
+                "of",
+                "candy."
+            ],
+            [
+                "Although",
+                "there",
+                "are",
+                "many",
+                "protocols",
+                "on",
+                "preoperative",
+                "procedures,",
+                "almost",
+                "as",
+                "many",
+                "as",
+                "there",
+                "are",
+                "hospitals,",
+                "the",
+                "question",
+                "makes",
+                "it",
+                "easy",
+                "by",
+                "putting",
+                "a",
+                "very",
+                "old",
+                "patient,",
+                "80",
+                "years",
+                "old."
+            ],
+            [
+                "The",
+                "age",
+                "range",
+                "from",
+                "which",
+                "it",
+                "is",
+                "considered",
+                "mandatory",
+                "to",
+                "request",
+                "an",
+                "ECG",
+                "varies",
+                "between",
+                "45,",
+                "50,",
+                "60",
+                "or",
+                "even",
+                "some",
+                "say",
+                "70",
+                "years."
+            ],
+            [
+                "For",
+                "example:",
+                ">",
+                "50",
+                "years:",
+                "always,",
+                "except",
+                "if",
+                "a",
+                "previous",
+                "ECG",
+                "is",
+                "available",
+                "<",
+                "50",
+                "years:",
+                "only",
+                "if",
+                "there",
+                "is",
+                "known",
+                "or",
+                "suspected",
+                "heart",
+                "disease",
+                "(CVRF),",
+                "severe",
+                "DM,",
+                "hyperthyroidism",
+                "or",
+                "severe",
+                "COPD."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "306_207",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "OPHTHALMOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "34-year-old",
+                "patient",
+                "playing",
+                "tennis",
+                "is",
+                "hit",
+                "by",
+                "a",
+                "tennis",
+                "ball",
+                "in",
+                "the",
+                "left",
+                "orbit."
+            ],
+            [
+                "On",
+                "examination",
+                "he",
+                "presents",
+                "significant",
+                "palpebral",
+                "hematoma,",
+                "hyposphagmia,",
+                "diplopia",
+                "to",
+                "the",
+                "upper",
+                "vision",
+                "with",
+                "limitation",
+                "of",
+                "the",
+                "upper",
+                "version",
+                "of",
+                "the",
+                "eyeball."
+            ],
+            [
+                "What",
+                "would",
+                "you",
+                "suspect?"
+            ],
+            [
+                "1-",
+                "Fracture",
+                "of",
+                "the",
+                "inferior",
+                "wall",
+                "of",
+                "the",
+                "floor",
+                "of",
+                "the",
+                "orbit",
+                "with",
+                "entrapment",
+                "of",
+                "the",
+                "inferior",
+                "rectus",
+                "muscle."
+            ],
+            [
+                "2-",
+                "Zygomatic",
+                "arch",
+                "fracture."
+            ],
+            [
+                "3-",
+                "Fracture",
+                "of",
+                "the",
+                "superior",
+                "wall",
+                "of",
+                "the",
+                "orbit",
+                "with",
+                "entrapment",
+                "of",
+                "the",
+                "superior",
+                "rectus",
+                "muscle."
+            ],
+            [
+                "4-",
+                "Dentoalveolar",
+                "fracture."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "The",
+                "statement",
+                "describes",
+                "diplopia",
+                "to",
+                "superior",
+                "vision",
+                "with",
+                "limitation",
+                "of",
+                "upper",
+                "eyeball",
+                "extension."
+            ],
+            [
+                "As",
+                "the",
+                "mechanical",
+                "function",
+                "of",
+                "the",
+                "left",
+                "inferior",
+                "rectus",
+                "is",
+                "compromised,",
+                "it",
+                "would",
+                "not",
+                "allow",
+                "to",
+                "complete",
+                "the",
+                "supraduccion",
+                "movement",
+                "generating",
+                "vertical",
+                "diplopia,",
+                "this",
+                "plus",
+                "the",
+                "traumatic",
+                "antecedent",
+                "allows",
+                "to",
+                "suspect",
+                "a",
+                "fracture",
+                "of",
+                "the",
+                "orbital",
+                "floor",
+                "with",
+                "muscular",
+                "entrapment",
+                "of",
+                "the",
+                "inferior",
+                "rectus."
+            ],
+            [
+                "Fracture",
+                "of",
+                "the",
+                "roof",
+                "is",
+                "much",
+                "less",
+                "frequent",
+                "and",
+                "the",
+                "entrapment",
+                "of",
+                "the",
+                "superior",
+                "rectus",
+                "would",
+                "cause",
+                "limitation",
+                "for",
+                "infraduction."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "328_83",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "49-year-old",
+                "man",
+                "who",
+                "consults",
+                "for",
+                "severe",
+                "polyuria",
+                "and",
+                "polydipsia",
+                "and",
+                "unintentional",
+                "weight",
+                "loss",
+                "of",
+                "10",
+                "kg",
+                "and",
+                "is",
+                "diagnosed",
+                "with",
+                "diabetes",
+                "mellitus",
+                "due",
+                "to",
+                "a",
+                "plasma",
+                "blood",
+                "glucose",
+                "of",
+                "322",
+                "mg/dL",
+                "and",
+                "a",
+                "glycosylated",
+                "hemoglobin",
+                "of",
+                "9.8%."
+            ],
+            [
+                "His",
+                "physician",
+                "gave",
+                "him",
+                "dietary",
+                "recommendations,",
+                "the",
+                "convenience",
+                "of",
+                "physical",
+                "exercise,",
+                "and",
+                "he",
+                "started",
+                "treatment",
+                "with",
+                "metformin",
+                "850",
+                "mg/12",
+                "hours",
+                "and",
+                "glimepiride",
+                "6",
+                "mg/day."
+            ],
+            [
+                "In",
+                "the",
+                "following",
+                "weeks",
+                "the",
+                "glycemic",
+                "controls",
+                "are",
+                "progressively",
+                "reduced."
+            ],
+            [
+                "At",
+                "4",
+                "months",
+                "glycemia",
+                "is",
+                "94",
+                "mg/dL",
+                "and",
+                "HbA1c",
+                "is",
+                "5.9%."
+            ],
+            [
+                "The",
+                "patient",
+                "complains",
+                "of",
+                "frequent",
+                "episodes",
+                "of",
+                "dizziness,",
+                "epigastric",
+                "pain,",
+                "blurred",
+                "vision,",
+                "sweating",
+                "and",
+                "tremor,",
+                "which",
+                "improve",
+                "with",
+                "food",
+                "and",
+                "occur",
+                "mainly",
+                "in",
+                "the",
+                "late",
+                "morning",
+                "and",
+                "late",
+                "afternoon."
+            ],
+            [
+                "What",
+                "modification",
+                "would",
+                "you",
+                "propose",
+                "in",
+                "his",
+                "treatment?"
+            ],
+            [
+                "1-",
+                "Review",
+                "dietary",
+                "carbohydrate",
+                "distribution."
+            ],
+            [
+                "2-",
+                "Discontinue",
+                "metformin."
+            ],
+            [
+                "3-",
+                "Discontinue",
+                "sulfonylurea."
+            ],
+            [
+                "4-",
+                "Substitute",
+                "metformin",
+                "with",
+                "a",
+                "DPP4",
+                "inhibitor."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Discontinue",
+                "sulfonylurea",
+                "because",
+                "of",
+                "Risk",
+                "of",
+                "hypoglycemia."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "223_62",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CARDIOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "In",
+                "a",
+                "60-year-old",
+                "diabetic",
+                "patient",
+                "with",
+                "stable",
+                "angina",
+                "secondary",
+                "to",
+                "ischemic",
+                "heart",
+                "disease",
+                "due",
+                "to",
+                "subtotal",
+                "obstruction",
+                "in",
+                "the",
+                "middle",
+                "third",
+                "of",
+                "the",
+                "anterior",
+                "descending",
+                "coronary",
+                "artery,",
+                "what",
+                "treatment",
+                "would",
+                "you",
+                "propose?"
+            ],
+            [
+                "1-",
+                "Medical",
+                "with",
+                "vasodilators",
+                "and",
+                "beta-blockers",
+                "to",
+                "avoid",
+                "angina."
+            ],
+            [
+                "2-",
+                "Expectorant",
+                "with",
+                "rigorous",
+                "rest,",
+                "since",
+                "decreasing",
+                "myocardial",
+                "oxygen",
+                "demand",
+                "should",
+                "decrease",
+                "angina."
+            ],
+            [
+                "3-",
+                "Surgical",
+                "revascularization",
+                "of",
+                "the",
+                "ischemic",
+                "myocardium",
+                "by",
+                "means",
+                "of",
+                "a",
+                "left",
+                "mammary",
+                "artery",
+                "bypass",
+                "distal",
+                "to",
+                "the",
+                "lesion",
+                "in",
+                "the",
+                "diseased",
+                "coronary",
+                "artery."
+            ],
+            [
+                "4-",
+                "Dilatation",
+                "of",
+                "the",
+                "coronary",
+                "artery",
+                "lesion",
+                "by",
+                "therapeutic",
+                "catheterization."
+            ],
+            [
+                "5-",
+                "Therapeutic",
+                "catheterization",
+                "to",
+                "dilate",
+                "the",
+                "lesion",
+                "of",
+                "the",
+                "diseased",
+                "artery",
+                "and",
+                "implantation",
+                "of",
+                "a",
+                "stent",
+                "in",
+                "the",
+                "dilated",
+                "area."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "Stable",
+                "angina",
+                "in",
+                "diabetics:",
+                "this",
+                "question",
+                "is",
+                "a",
+                "nod",
+                "to",
+                "the",
+                "BARI-2D",
+                "study",
+                "(NEJM",
+                "2009),",
+                "which",
+                "showed",
+                "that",
+                "medical",
+                "management",
+                "was",
+                "not",
+                "inferior",
+                "to",
+                "revascularization",
+                "(in",
+                "fact,",
+                "the",
+                "new",
+                "guidelines",
+                "reflect",
+                "the",
+                "trend",
+                "that",
+                "not",
+                "all",
+                "coronary",
+                "stenosis",
+                "should",
+                "be",
+                "systematically",
+                "opened)."
+            ],
+            [
+                "Answer",
+                "1",
+                "is",
+                "along",
+                "these",
+                "lines,",
+                "although",
+                "I",
+                "miss",
+                "statins,",
+                "ACE",
+                "inhibitors",
+                "and",
+                "antiplatelet",
+                "agents,",
+                "and",
+                "I",
+                "have",
+                "too",
+                "many",
+                "vasodilators",
+                "(nitrates",
+                "are",
+                "class",
+                "IIb,",
+                "if",
+                "my",
+                "memory",
+                "serves",
+                "me",
+                "correctly)."
+            ],
+            [
+                "2",
+                "is",
+                "absurd:",
+                "sitting",
+                "down",
+                "to",
+                "avoid",
+                "angina?"
+            ],
+            [
+                "That's",
+                "like",
+                "cutting",
+                "down",
+                "the",
+                "forest",
+                "to",
+                "prevent",
+                "fires."
+            ],
+            [
+                "3",
+                "to",
+                "5",
+                "are",
+                "about",
+                "revascularization:",
+                "since",
+                "it",
+                "is",
+                "a",
+                "single",
+                "vessel",
+                "and",
+                "not",
+                "a",
+                "proximal",
+                "LAD,",
+                "revascularization",
+                "would",
+                "have",
+                "to",
+                "be",
+                "percutaneous,",
+                "so",
+                "we",
+                "discard",
+                "3."
+            ],
+            [
+                "Between",
+                "4",
+                "and",
+                "5,",
+                "the",
+                "fifth",
+                "is",
+                "more",
+                "complete:",
+                "not",
+                "only",
+                "would",
+                "it",
+                "be",
+                "necessary",
+                "to",
+                "dilate,",
+                "but",
+                "also",
+                "to",
+                "implant",
+                "a",
+                "stent."
+            ],
+            [
+                "So",
+                "the",
+                "doubt",
+                "would",
+                "be",
+                "between",
+                "1",
+                "and",
+                "5."
+            ],
+            [
+                "Applying",
+                "the",
+                "general",
+                "rules",
+                "of",
+                "response",
+                "in",
+                "the",
+                "MIR,",
+                "if",
+                "two",
+                "options",
+                "are",
+                "similar",
+                "except",
+                "in",
+                "one",
+                "detail,",
+                "the",
+                "correct",
+                "one",
+                "is",
+                "one",
+                "of",
+                "these,",
+                "so",
+                "we",
+                "would",
+                "mark",
+                "5",
+                "(and",
+                "this",
+                "is",
+                "what",
+                "would",
+                "be",
+                "done",
+                "in",
+                "any",
+                "hospital",
+                "nowadays:",
+                "a",
+                "suboccluded",
+                "artery",
+                "is",
+                "dilated",
+                "directly)."
+            ],
+            [
+                "On",
+                "the",
+                "other",
+                "hand,",
+                "and",
+                "although",
+                "1",
+                "is",
+                "incomplete,",
+                "I",
+                "suppose",
+                "the",
+                "author",
+                "wanted",
+                "to",
+                "be",
+                "clever",
+                "and",
+                "show",
+                "that",
+                "he",
+                "has",
+                "read",
+                "the",
+                "latest",
+                "articles."
+            ],
+            [
+                "Conclusion:",
+                "I",
+                "would",
+                "mark",
+                "5...",
+                "but",
+                "I",
+                "would",
+                "not",
+                "be",
+                "surprised",
+                "if",
+                "it",
+                "was",
+                "1."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Premise",
+                "I-Premise",
+                "I-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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "468_122",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ORTHOPEDIC",
+                "SURGERY",
+                "AND",
+                "TRAUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "70-year-old",
+                "man",
+                "consults",
+                "for",
+                "non-radiating",
+                "lumbar",
+                "pain",
+                "of",
+                "1",
+                "week's",
+                "duration,",
+                "of",
+                "progressive",
+                "intensity,",
+                "accompanied",
+                "by",
+                "marked",
+                "limitation",
+                "of",
+                "spinal",
+                "mobility",
+                "and",
+                "febrile",
+                "fever."
+            ],
+            [
+                "The",
+                "lumbar",
+                "spine",
+                "X-ray",
+                "shows",
+                "no",
+                "alterations."
+            ],
+            [
+                "What",
+                "diagnosis",
+                "should",
+                "we",
+                "rule",
+                "out",
+                "first",
+                "and",
+                "with",
+                "what",
+                "technique?"
+            ],
+            [
+                "1-",
+                "Vertebral",
+                "crush",
+                "with",
+                "computed",
+                "tomography",
+                "(CT)."
+            ],
+            [
+                "2-",
+                "Bone",
+                "metastases",
+                "with",
+                "technetium",
+                "bone",
+                "scan."
+            ],
+            [
+                "3-",
+                "Vertebral",
+                "ankylosing",
+                "hyperostosis",
+                "with",
+                "dorsolumbar",
+                "spine",
+                "x-ray."
+            ],
+            [
+                "4-",
+                "Pyogenic",
+                "spondylodiscitis",
+                "with",
+                "magnetic",
+                "resonance",
+                "imaging",
+                "(MRI)."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "We",
+                "suspect",
+                "spondylodiscitis",
+                "-",
+                "the",
+                "febrile",
+                "fever",
+                "and",
+                "the",
+                "limitation",
+                "of",
+                "mobility",
+                "of",
+                "the",
+                "spine",
+                "with",
+                "the",
+                "acute",
+                "course",
+                "give",
+                "the",
+                "key",
+                "-,",
+                "and",
+                "the",
+                "indicated",
+                "test",
+                "is",
+                "the",
+                "MRI."
+            ],
+            [
+                "\"The",
+                "most",
+                "demonstrative",
+                "test",
+                "is",
+                "magnetic",
+                "resonance",
+                "imaging",
+                "(MRI),",
+                "which",
+                "is",
+                "positive",
+                "even",
+                "in",
+                "the",
+                "first",
+                "2",
+                "weeks",
+                "of",
+                "the",
+                "picture,",
+                "which",
+                "facilitates",
+                "early",
+                "diagnosis,",
+                "with",
+                "a",
+                "sensitivity",
+                "of",
+                "90%\"."
+            ],
+            [
+                "Vertebral",
+                "crushing",
+                "would",
+                "be",
+                "seen",
+                "in",
+                "the",
+                "simple",
+                "X-ray,",
+                "as",
+                "well",
+                "as",
+                "vertebral",
+                "ankylosing",
+                "hyperostosis",
+                "and",
+                "many",
+                "metastases."
+            ],
+            [
+                "In",
+                "addition,",
+                "there",
+                "is",
+                "no",
+                "data",
+                "in",
+                "the",
+                "history",
+                "pointing",
+                "to",
+                "bone",
+                "metastases",
+                "(oncologic",
+                "history,",
+                "weight",
+                "loss",
+                "etc)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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"
+            ]
+        ]
+    },
+    {
+        "id": "96_170",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DERMATOLOGY,",
+                "VENEREOLOGY",
+                "AND",
+                "PLASTIC",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "60-year-old",
+                "male",
+                "patient",
+                "who",
+                "refers",
+                "10",
+                "days",
+                "ago",
+                "the",
+                "appearance",
+                "of",
+                "blistering",
+                "lesions",
+                "on",
+                "dorsum",
+                "of",
+                "hands",
+                "after",
+                "sun",
+                "exposure."
+            ],
+            [
+                "The",
+                "picture",
+                "is",
+                "accompanied",
+                "by",
+                "skin",
+                "fragility."
+            ],
+            [
+                "Histopathologically",
+                "there",
+                "is",
+                "a",
+                "subepidermal",
+                "blister",
+                "with",
+                "PAS+",
+                "deposits",
+                "in",
+                "and",
+                "around",
+                "the",
+                "superficial",
+                "dermal",
+                "vessels."
+            ],
+            [
+                "The",
+                "most",
+                "plausible",
+                "diagnosis",
+                "is:"
+            ],
+            [
+                "1-",
+                "Familial",
+                "benign",
+                "pemphigus."
+            ],
+            [
+                "2-",
+                "Pemphigoid."
+            ],
+            [
+                "3-",
+                "Porphyria",
+                "cutanea",
+                "tarda."
+            ],
+            [
+                "4-",
+                "Pemphigus",
+                "vulgaris."
+            ],
+            [
+                "5-",
+                "Scalded",
+                "skin",
+                "syndrome."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Porphyria",
+                "cutanea",
+                "tarda",
+                "(PCT)",
+                "is",
+                "the",
+                "most",
+                "common",
+                "porphyria",
+                "and",
+                "can",
+                "present",
+                "with",
+                "three",
+                "major",
+                "clinical",
+                "forms:",
+                "familial,",
+                "sporadic",
+                "and",
+                "toxic."
+            ],
+            [
+                "Clinically,",
+                "it",
+                "is",
+                "characterized",
+                "by",
+                "marked",
+                "skin",
+                "fragility",
+                "with",
+                "the",
+                "appearance",
+                "of",
+                "erosions,",
+                "vesicles",
+                "and",
+                "blisters",
+                "after",
+                "minimal",
+                "trauma."
+            ],
+            [
+                "The",
+                "most",
+                "frequent",
+                "sites",
+                "are",
+                "the",
+                "back",
+                "of",
+                "the",
+                "hands",
+                "and",
+                "the",
+                "face,",
+                "i.e.",
+                "the",
+                "areas",
+                "of",
+                "greatest",
+                "photoexposure."
+            ],
+            [
+                "Clinically,",
+                "the",
+                "most",
+                "important",
+                "differential",
+                "diagnosis",
+                "should",
+                "be",
+                "established",
+                "with",
+                "pseudoporphyria",
+                "or",
+                "phototoxic",
+                "bullous",
+                "dermatitis,",
+                "in",
+                "which",
+                "the",
+                "blisters",
+                "and",
+                "cutaneous",
+                "erosions",
+                "are",
+                "produced",
+                "by",
+                "photosensitivity,",
+                "induced",
+                "by",
+                "drugs",
+                "such",
+                "as",
+                "tetracyclines,",
+                "sulfonamides,",
+                "etc."
+            ],
+            [
+                "However,",
+                "unlike",
+                "porphyria,",
+                "porphyrin",
+                "levels",
+                "in",
+                "serum,",
+                "feces",
+                "and",
+                "urine",
+                "are",
+                "normal."
+            ],
+            [
+                "The",
+                "histopathological",
+                "differential",
+                "diagnosis",
+                "should",
+                "be",
+                "established",
+                "with",
+                "those",
+                "diseases",
+                "showing",
+                "dermal",
+                "hyaline",
+                "deposits,",
+                "such",
+                "as:",
+                "hyalinosis",
+                "cutis,",
+                "in",
+                "which",
+                "unlike",
+                "porphyria,",
+                "PAS-positive",
+                "hyaline",
+                "deposits",
+                "are",
+                "extensive",
+                "and",
+                "massively",
+                "occupy",
+                "the",
+                "deep",
+                "dermis",
+                "and",
+                "subcutaneous",
+                "cellular",
+                "tissue;",
+                "Milium",
+                "colloid",
+                "in",
+                "which",
+                "hyaline",
+                "material,",
+                "usually",
+                "PAS",
+                "negative",
+                "expands",
+                "the",
+                "papillary",
+                "dermis,",
+                "forming",
+                "characteristic",
+                "clefts",
+                "and",
+                "fissures;",
+                "and",
+                "lipoid",
+                "proteinosis,",
+                "in",
+                "which",
+                "the",
+                "material",
+                "is",
+                "deposited",
+                "throughout",
+                "the",
+                "dermis,",
+                "has",
+                "a",
+                "distribution",
+                "not",
+                "only",
+                "perivascular",
+                "but",
+                "more",
+                "extensive",
+                "than",
+                "in",
+                "porphyria,",
+                "and",
+                "usually",
+                "affects",
+                "sweat",
+                "glands."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "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",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "603_112",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "TRAUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "61-year-old",
+                "woman,",
+                "administrative,",
+                "with",
+                "a",
+                "history",
+                "of",
+                "overweight,",
+                "hypertension,",
+                "dyslipidemia",
+                "and",
+                "metabolic",
+                "syndrome,",
+                "who",
+                "consults",
+                "for",
+                "pain",
+                "in",
+                "both",
+                "buttocks,",
+                "left",
+                "trochanteric",
+                "region,",
+                "lateral",
+                "aspect",
+                "of",
+                "the",
+                "left",
+                "thigh",
+                "up",
+                "to",
+                "the",
+                "knee",
+                "and",
+                "left",
+                "leg",
+                "up",
+                "to",
+                "the",
+                "middle",
+                "third."
+            ],
+            [
+                "The",
+                "pain",
+                "appears",
+                "when",
+                "the",
+                "lower",
+                "limb",
+                "is",
+                "lifted",
+                "with",
+                "the",
+                "knee",
+                "extended,",
+                "but",
+                "is",
+                "relieved",
+                "when",
+                "the",
+                "knee",
+                "is",
+                "flexed."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "first",
+                "clinical",
+                "suspicion?"
+            ],
+            [
+                "1-",
+                "Gouty",
+                "arthritis",
+                "of",
+                "the",
+                "left",
+                "hip."
+            ],
+            [
+                "2-",
+                "Left",
+                "coxofemoral",
+                "arthrosis."
+            ],
+            [
+                "3-",
+                "Radiated",
+                "low",
+                "back",
+                "pain",
+                "/",
+                "lumbosciatica."
+            ],
+            [
+                "4-",
+                "Claudication",
+                "due",
+                "to",
+                "canal",
+                "stenosis."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "The",
+                "most",
+                "common",
+                "symptomatology",
+                "of",
+                "a",
+                "patient",
+                "with",
+                "coxarthrosis",
+                "includes:",
+                "hip",
+                "pain",
+                "that",
+                "limits",
+                "ambulation,",
+                "nocturnal",
+                "discomfort",
+                "and",
+                "even",
+                "at",
+                "rest,",
+                "hip",
+                "stiffness",
+                "and",
+                "locking."
+            ],
+            [
+                "Coxo-femoral",
+                "osteoarthrosis",
+                "presents",
+                "with",
+                "a",
+                "negative",
+                "Lasegue",
+                "test."
+            ],
+            [
+                "Wrong",
+                "answer",
+                "2."
+            ],
+            [
+                "Low",
+                "back",
+                "pain",
+                "of",
+                "a",
+                "neuropathic",
+                "nature",
+                "usually",
+                "presents",
+                "with",
+                "unilateral",
+                "and",
+                "distributed",
+                "radiculopathy",
+                "according",
+                "to",
+                "dermatomes."
+            ],
+            [
+                "The",
+                "recognized",
+                "risk",
+                "factors",
+                "are",
+                "most",
+                "frequently:",
+                "women,",
+                "obesity,",
+                "smoking",
+                "and",
+                "sedentary",
+                "lifestyle",
+                "or",
+                "situations",
+                "of",
+                "prolonged",
+                "sitting."
+            ],
+            [
+                "The",
+                "lumbosciatica",
+                "is",
+                "usually",
+                "referred",
+                "to",
+                "the",
+                "buttock,",
+                "posterior",
+                "aspect",
+                "of",
+                "the",
+                "thighs",
+                "and",
+                "even",
+                "inguinal."
+            ],
+            [
+                "The",
+                "clinical",
+                "case",
+                "describes",
+                "the",
+                "Lasegue",
+                "maneuver",
+                "or",
+                "test;",
+                "a",
+                "provocation",
+                "test",
+                "that",
+                "evidences",
+                "radicular",
+                "irritation",
+                "in",
+                "the",
+                "lumbosacral",
+                "region",
+                "(Answer",
+                "3",
+                "correct)."
+            ],
+            [
+                "Claudication",
+                "due",
+                "to",
+                "canal",
+                "stenosis",
+                "typically",
+                "presents",
+                "with",
+                "pain",
+                "that",
+                "worsens",
+                "with",
+                "trunk",
+                "extension",
+                "(walking,",
+                "standing)",
+                "and",
+                "is",
+                "relieved",
+                "with",
+                "flexion",
+                "(sitting,",
+                "sleeping",
+                "in",
+                "the",
+                "fetal",
+                "position...)",
+                "Wrong",
+                "answer",
+                "4."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "574_100",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "80-year-old",
+                "woman",
+                "with",
+                "a",
+                "history",
+                "of",
+                "arterial",
+                "hypertension",
+                "and",
+                "diabetes",
+                "mellitus",
+                "who",
+                "suddenly",
+                "presents",
+                "with",
+                "language",
+                "impairment."
+            ],
+            [
+                "On",
+                "arrival",
+                "at",
+                "the",
+                "hospital,",
+                "an",
+                "unknown",
+                "atrial",
+                "fibrillation",
+                "is",
+                "observed,",
+                "and",
+                "on",
+                "examination",
+                "she",
+                "presents",
+                "fluent",
+                "speech",
+                "with",
+                "a",
+                "tendency",
+                "to",
+                "slurred",
+                "speech,",
+                "poor",
+                "language",
+                "comprehension,",
+                "inability",
+                "to",
+                "repeat",
+                "and",
+                "dysnomia."
+            ],
+            [
+                "Semiologically",
+                "she",
+                "presents",
+                "a",
+                "picture",
+                "compatible",
+                "with:"
+            ],
+            [
+                "1-",
+                "Broca's",
+                "aphasia."
+            ],
+            [
+                "2-",
+                "Conduction",
+                "aphasia."
+            ],
+            [
+                "3-",
+                "Sensitive",
+                "transcortical",
+                "aphasia."
+            ],
+            [
+                "4-",
+                "Wernicke's",
+                "aphasia."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "It",
+                "is",
+                "a",
+                "semiology",
+                "question",
+                "that",
+                "helps",
+                "us",
+                "to",
+                "remember",
+                "the",
+                "types",
+                "of",
+                "aphasia."
+            ],
+            [
+                "The",
+                "following",
+                "aspects",
+                "should",
+                "be",
+                "taken",
+                "into",
+                "account:",
+                "language",
+                "emission",
+                "(fluent,",
+                "non-fluent,",
+                "non-emission),",
+                "comprehension",
+                "(yes",
+                "or",
+                "no),",
+                "repetition",
+                "(yes",
+                "or",
+                "no)",
+                "and",
+                "nomination."
+            ],
+            [
+                "Wernicke's",
+                "aphasia",
+                "or",
+                "sensitive",
+                "aphasia",
+                "has",
+                "a",
+                "fluent",
+                "language,",
+                "does",
+                "not",
+                "understand,",
+                "does",
+                "not",
+                "repeat",
+                "and",
+                "does",
+                "not",
+                "nominate,",
+                "just",
+                "like",
+                "the",
+                "patient",
+                "in",
+                "the",
+                "question."
+            ],
+            [
+                "Sensory",
+                "transcortical",
+                "aphasia",
+                "differs",
+                "from",
+                "sensory",
+                "aphasia",
+                "in",
+                "that",
+                "patients",
+                "are",
+                "able",
+                "to",
+                "repeat."
+            ],
+            [
+                "Conduction",
+                "aphasia",
+                "differs",
+                "from",
+                "sensory",
+                "aphasia",
+                "in",
+                "that",
+                "comprehension",
+                "is",
+                "preserved,",
+                "all",
+                "else",
+                "being",
+                "equal."
+            ],
+            [
+                "Finally,",
+                "in",
+                "broca's",
+                "aphasia",
+                "the",
+                "language",
+                "is",
+                "non-fluent,",
+                "comprehension",
+                "is",
+                "preserved,",
+                "it",
+                "does",
+                "not",
+                "repeat",
+                "and",
+                "does",
+                "not",
+                "nominate."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
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+                "O",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "67_111",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ANESTHESIOLOGY,",
+                "CRITICAL",
+                "CARE",
+                "AND",
+                "EMERGENCY",
+                "MEDICINE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "45-year-old",
+                "male",
+                "patient",
+                "with",
+                "a",
+                "history",
+                "of",
+                "uric",
+                "lithiasis",
+                "and",
+                "repeated",
+                "expulsive",
+                "nephritic",
+                "colic",
+                "for",
+                "the",
+                "past",
+                "25",
+                "years",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "room",
+                "reporting",
+                "palpitations",
+                "and",
+                "severe",
+                "right",
+                "lumbar",
+                "pain",
+                "for",
+                "the",
+                "past",
+                "2",
+                "hours."
+            ],
+            [
+                "Urinalysis",
+                "shows",
+                "a",
+                "pH",
+                "of",
+                "5.5",
+                "and",
+                "leukocyturia",
+                "without",
+                "proteinuria."
+            ],
+            [
+                "The",
+                "electrocardiogram",
+                "confirms",
+                "a",
+                "previously",
+                "unknown",
+                "AF."
+            ],
+            [
+                "Blood",
+                "biochemistry",
+                "shows",
+                "a",
+                "Creat",
+                "of",
+                "0.9,",
+                "Ca",
+                "of",
+                "11",
+                "and",
+                "LDH",
+                "of",
+                "950."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "useful",
+                "diagnostic",
+                "maneuver",
+                "to",
+                "perform?"
+            ],
+            [
+                "1-",
+                "Plain",
+                "abdominal",
+                "x-ray."
+            ],
+            [
+                "2-",
+                "Intravenous",
+                "urography."
+            ],
+            [
+                "3-",
+                "Spiral",
+                "CT",
+                "with",
+                "contrast."
+            ],
+            [
+                "4-",
+                "Abdominal",
+                "ultrasound."
+            ],
+            [
+                "5-",
+                "Doppler",
+                "ultrasound."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "In",
+                "principle,",
+                "what",
+                "you",
+                "tell",
+                "us",
+                "does",
+                "not",
+                "fit",
+                "with",
+                "a",
+                "nephritic",
+                "colic."
+            ],
+            [
+                "The",
+                "urine",
+                "is",
+                "normal",
+                "(without",
+                "hematuria,",
+                "caused",
+                "by",
+                "the",
+                "lithiasis",
+                "as",
+                "it",
+                "progresses),",
+                "the",
+                "Creat",
+                "is",
+                "normal",
+                "(it",
+                "can",
+                "rise",
+                "up",
+                "to",
+                "1.9",
+                "in",
+                "nephritic",
+                "colic)."
+            ],
+            [
+                "The",
+                "increase",
+                "in",
+                "LDH",
+                "is",
+                "non-specific",
+                "and",
+                "can",
+                "be",
+                "found",
+                "in",
+                "hepatic",
+                "parenchymal",
+                "lesions,",
+                "AMI",
+                "or",
+                "pulmonary",
+                "embolism,",
+                "as",
+                "well",
+                "as",
+                "in",
+                "many",
+                "other",
+                "less",
+                "frequent",
+                "cases",
+                "(tumors,",
+                "myopathies,",
+                "etc.)."
+            ],
+            [
+                "In",
+                "this",
+                "case,",
+                "we",
+                "have",
+                "an",
+                "important",
+                "risk",
+                "factor",
+                "for",
+                "embolism,",
+                "which",
+                "is",
+                "atrial",
+                "fibrillation,",
+                "which,",
+                "in",
+                "addition,",
+                "being",
+                "a",
+                "45-year-old",
+                "male,",
+                "with",
+                "no",
+                "previous",
+                "history,",
+                "does",
+                "not",
+                "seem",
+                "to",
+                "respond",
+                "to",
+                "an",
+                "underlying",
+                "structural",
+                "heart",
+                "disease",
+                "together",
+                "with",
+                "right",
+                "lumbar",
+                "pain,",
+                "which",
+                "could",
+                "correspond",
+                "to",
+                "irritation",
+                "of",
+                "the",
+                "pleura",
+                "at",
+                "the",
+                "level",
+                "of",
+                "the",
+                "right",
+                "lumbar",
+                "spine."
+            ],
+            [
+                "Spiral",
+                "CT",
+                "with",
+                "contrast",
+                "has",
+                "acquired",
+                "great",
+                "value",
+                "in",
+                "the",
+                "diagnosis",
+                "of",
+                "PTE,",
+                "due",
+                "to",
+                "its",
+                "rapidity",
+                "and",
+                "good",
+                "sensitivity,",
+                "higher",
+                "than",
+                "83-92%",
+                "in",
+                "most",
+                "studies,",
+                "and",
+                "according",
+                "to",
+                "some",
+                "it",
+                "can",
+                "reach",
+                "100%",
+                "for",
+                "central",
+                "thrombi,",
+                "located",
+                "in",
+                "main,",
+                "lobar",
+                "or",
+                "segmental",
+                "pulmonary",
+                "arteries."
+            ],
+            [
+                "Its",
+                "specificity",
+                "is",
+                "greater",
+                "than",
+                "90%."
+            ],
+            [
+                "Nodes",
+                "can",
+                "produce",
+                "false",
+                "positives."
+            ],
+            [
+                "It",
+                "can",
+                "also",
+                "provide",
+                "an",
+                "alternative",
+                "diagnosis",
+                "in",
+                "case",
+                "PTE",
+                "is",
+                "not",
+                "confirmed,",
+                "so",
+                "it",
+                "would",
+                "be",
+                "a",
+                "very",
+                "useful",
+                "test."
+            ],
+            [
+                "Doppler",
+                "ultrasound",
+                "would",
+                "be",
+                "the",
+                "most",
+                "useful",
+                "test",
+                "to",
+                "diagnose",
+                "the",
+                "source",
+                "of",
+                "the",
+                "emboli,",
+                "so",
+                "it",
+                "could",
+                "also",
+                "be",
+                "a",
+                "valid",
+                "answer",
+                "depending",
+                "on",
+                "what",
+                "they",
+                "mean",
+                "by",
+                "\"useful\"."
+            ],
+            [
+                "It",
+                "is",
+                "a",
+                "noninvasive",
+                "technique",
+                "that",
+                "has",
+                "demonstrated",
+                "its",
+                "good",
+                "sensitivity",
+                "and",
+                "specificity",
+                "in",
+                "the",
+                "diagnosis",
+                "of",
+                "DVT",
+                "compared",
+                "to",
+                "phlebography."
+            ],
+            [
+                "It",
+                "also",
+                "allows",
+                "the",
+                "diagnosis",
+                "of",
+                "other",
+                "pathologies",
+                "that",
+                "could",
+                "justify",
+                "the",
+                "patient's",
+                "symptoms."
+            ],
+            [
+                "Its",
+                "limitations",
+                "are",
+                "the",
+                "assessment",
+                "of",
+                "infrapopliteal",
+                "thrombi",
+                "and,",
+                "in",
+                "many",
+                "cases,",
+                "in",
+                "patients",
+                "who",
+                "are",
+                "not",
+                "thin,",
+                "of",
+                "the",
+                "iliac",
+                "and",
+                "cava",
+                "veins."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "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-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "77_31",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DIGESTIVE",
+                "SYSTEM"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "17-year-old",
+                "boy",
+                "with",
+                "Crohn's",
+                "disease",
+                "with",
+                "colonic",
+                "involvement",
+                "of",
+                "2",
+                "years",
+                "of",
+                "evolution,",
+                "in",
+                "maintenance",
+                "treatment",
+                "with",
+                "azathioprine,",
+                "consults",
+                "for",
+                "the",
+                "appearance",
+                "since",
+                "5",
+                "days",
+                "ago",
+                "of",
+                "purplish-red,",
+                "hot,",
+                "painful,",
+                "bilateral",
+                "subcutaneous",
+                "nodules",
+                "of",
+                "pretibial",
+                "location,",
+                "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",
+                "opioid",
+                "analgesics",
+                "at",
+                "the",
+                "beginning."
+            ],
+            [
+                "3-",
+                "Biopsy",
+                "skin",
+                "areas",
+                "away",
+                "from",
+                "the",
+                "injured",
+                "areas",
+                "and",
+                "prescribe",
+                "opioid",
+                "analgesics",
+                "at",
+                "the",
+                "beginning."
+            ],
+            [
+                "4-",
+                "Suspect",
+                "bilateral",
+                "lower",
+                "extremity",
+                "ischemia",
+                "of",
+                "drug",
+                "origin."
+            ],
+            [
+                "5-",
+                "Adjustment",
+                "of",
+                "the",
+                "treatment",
+                "of",
+                "the",
+                "disease."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "It",
+                "appears",
+                "that",
+                "the",
+                "patient",
+                "has",
+                "erythema",
+                "nodosum",
+                "lesions",
+                "associated",
+                "with",
+                "a",
+                "flare",
+                "of",
+                "his",
+                "disease,",
+                "which",
+                "is",
+                "common."
+            ],
+            [
+                "Treatment",
+                "of",
+                "the",
+                "disease",
+                "and",
+                "its",
+                "control",
+                "usually",
+                "improves",
+                "the",
+                "cutaneous",
+                "lesions."
+            ],
+            [
+                "The",
+                "lesions",
+                "should",
+                "not",
+                "be",
+                "biopsied."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "440_97",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "203_47",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GENERAL",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "55-year-old",
+                "woman,",
+                "operated",
+                "on",
+                "for",
+                "appendicitis",
+                "24",
+                "years",
+                "ago,",
+                "who",
+                "comes",
+                "in",
+                "because",
+                "while",
+                "previously",
+                "well,",
+                "she",
+                "has",
+                "started",
+                "with",
+                "repeated",
+                "vomiting",
+                "after",
+                "breakfast,",
+                "about",
+                "12",
+                "hours",
+                "ago,",
+                "associated",
+                "with",
+                "abdominal",
+                "distention."
+            ],
+            [
+                "She",
+                "presented",
+                "a",
+                "diarrhea",
+                "stool",
+                "a",
+                "few",
+                "hours",
+                "after",
+                "the",
+                "onset",
+                "of",
+                "the",
+                "symptoms."
+            ],
+            [
+                "Examination",
+                "revealed",
+                "abdominal",
+                "distension,",
+                "tympanism",
+                "and",
+                "increased",
+                "bowel",
+                "sounds,",
+                "but",
+                "no",
+                "peritoneal",
+                "irritation."
+            ],
+            [
+                "Laboratory",
+                "tests",
+                "showed",
+                "no",
+                "abnormalities."
+            ],
+            [
+                "The",
+                "abdominal",
+                "X-ray",
+                "showed",
+                "dilatation",
+                "of",
+                "the",
+                "small",
+                "bowel",
+                "loops,",
+                "without",
+                "gas",
+                "in",
+                "the",
+                "rectal",
+                "ampulla."
+            ],
+            [
+                "Regarding",
+                "this",
+                "case",
+                "it",
+                "is",
+                "true",
+                "that:"
+            ],
+            [
+                "1-",
+                "This",
+                "is",
+                "a",
+                "picture",
+                "of",
+                "intestinal",
+                "flange",
+                "obstruction",
+                "requiring",
+                "emergency",
+                "laparotomy."
+            ],
+            [
+                "2-",
+                "Most",
+                "likely",
+                "we",
+                "are",
+                "facing",
+                "a",
+                "case",
+                "of",
+                "obstruction",
+                "at",
+                "the",
+                "level",
+                "of",
+                "the",
+                "large",
+                "intestine."
+            ],
+            [
+                "3-",
+                "The",
+                "fact",
+                "that",
+                "the",
+                "patient",
+                "presented",
+                "a",
+                "diarrheal",
+                "stool",
+                "allows",
+                "us",
+                "to",
+                "exclude",
+                "the",
+                "diagnosis",
+                "of",
+                "intestinal",
+                "obstruction.",
+                "Further",
+                "imaging",
+                "studies",
+                "are",
+                "necessary",
+                "to",
+                "ensure",
+                "a",
+                "diagnosis."
+            ],
+            [
+                "4-",
+                "We",
+                "should",
+                "indicate",
+                "the",
+                "practice",
+                "of",
+                "a",
+                "decompressive",
+                "colonoscopy."
+            ],
+            [
+                "5-",
+                "Initial",
+                "management",
+                "should",
+                "be",
+                "conservative,",
+                "with",
+                "serum",
+                "therapy,",
+                "nasogastric",
+                "aspiration",
+                "and",
+                "periodic",
+                "clinical,",
+                "analytical",
+                "and",
+                "radiographic",
+                "monitoring."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "This",
+                "is",
+                "a",
+                "typical",
+                "description",
+                "of",
+                "a",
+                "picture",
+                "of",
+                "intestinal",
+                "obstruction",
+                "due",
+                "to",
+                "bridging",
+                "or",
+                "adhesions",
+                "due",
+                "to",
+                "previous",
+                "surgery."
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "5",
+                "and",
+                "not",
+                "1",
+                "because",
+                "most",
+                "of",
+                "these",
+                "situations",
+                "resolve",
+                "spontaneously",
+                "with",
+                "conservative",
+                "treatment."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "B-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"
+            ]
+        ]
+    },
+    {
+        "id": "158_133",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "TRAUMATOLOGY",
+                "AND",
+                "ORTHOPEDICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "Obese",
+                "12-year-old",
+                "boy",
+                "(87",
+                "kg)."
+            ],
+            [
+                "He",
+                "has",
+                "been",
+                "complaining",
+                "of",
+                "mechanical",
+                "pain",
+                "in",
+                "the",
+                "right",
+                "thigh",
+                "and",
+                "knee",
+                "for",
+                "4",
+                "months."
+            ],
+            [
+                "Clinical",
+                "examination",
+                "reveals",
+                "a",
+                "1",
+                "cm",
+                "discrepancy",
+                "in",
+                "the",
+                "length",
+                "of",
+                "the",
+                "lower",
+                "extremities",
+                "and",
+                "an",
+                "attitude",
+                "of",
+                "the",
+                "right",
+                "lower",
+                "extremity",
+                "in",
+                "external",
+                "rotation",
+                "with",
+                "loss",
+                "of",
+                "internal",
+                "rotation."
+            ],
+            [
+                "We",
+                "should",
+                "suspect",
+                "that",
+                "he",
+                "presents:"
+            ],
+            [
+                "1-",
+                "Juvenile",
+                "chronic",
+                "arthritis."
+            ],
+            [
+                "2-",
+                "Epiphysiolysis",
+                "capitis",
+                "femoris."
+            ],
+            [
+                "3-",
+                "Fracture",
+                "of",
+                "the",
+                "femoral",
+                "neck",
+                "due",
+                "to",
+                "overload."
+            ],
+            [
+                "4-",
+                "Perthes",
+                "disease."
+            ],
+            [
+                "5-",
+                "Sequelae",
+                "of",
+                "developmental",
+                "dysplasia",
+                "of",
+                "the",
+                "hip."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "We",
+                "are",
+                "presented",
+                "with",
+                "an",
+                "adolescent",
+                "patient",
+                "who",
+                "is",
+                "overweight",
+                "with",
+                "pain",
+                "in",
+                "the",
+                "thigh",
+                "and",
+                "knee,",
+                "a",
+                "length",
+                "discrepancy",
+                "of",
+                "1",
+                "cm",
+                "and",
+                "the",
+                "limb",
+                "in",
+                "external",
+                "rotation."
+            ],
+            [
+                "This",
+                "picture",
+                "should",
+                "automatically",
+                "lead",
+                "us",
+                "to",
+                "mark",
+                "epiphysiolysis",
+                "capitis",
+                "femoris",
+                "(proximal",
+                "femoral",
+                "epiphysiolysis,",
+                "the",
+                "fact",
+                "of",
+                "reading",
+                "it",
+                "in",
+                "Latin",
+                "nomina",
+                "is",
+                "a",
+                "bit",
+                "of",
+                "a",
+                "misunderstanding",
+                "but",
+                "it",
+                "should",
+                "not",
+                "mislead",
+                "us)."
+            ],
+            [
+                "We",
+                "should",
+                "think",
+                "of",
+                "this",
+                "one",
+                "because",
+                "it",
+                "is",
+                "the",
+                "most",
+                "frequent",
+                "and",
+                "possible",
+                "(correct",
+                "answer",
+                "2)."
+            ],
+            [
+                "The",
+                "other",
+                "options",
+                "are",
+                "not",
+                "impossible",
+                "but",
+                "they",
+                "are",
+                "less",
+                "frequent",
+                "and",
+                "they",
+                "would",
+                "not",
+                "ask",
+                "us",
+                "this",
+                "if",
+                "they",
+                "wanted",
+                "us",
+                "to",
+                "choose",
+                "another",
+                "option."
+            ],
+            [
+                "If",
+                "they",
+                "were",
+                "sequelae",
+                "of",
+                "hip",
+                "dysplasia,",
+                "it",
+                "would",
+                "not",
+                "have",
+                "this",
+                "4-month",
+                "onset",
+                "and",
+                "the",
+                "age",
+                "of",
+                "onset",
+                "would",
+                "be",
+                "earlier."
+            ],
+            [
+                "Complications",
+                "of",
+                "dysplasia",
+                "are",
+                "dislocations",
+                "and",
+                "subluxations",
+                "that",
+                "may",
+                "require",
+                "surgery",
+                "and",
+                "avascular",
+                "necrosis",
+                "of",
+                "the",
+                "head",
+                "(false",
+                "answer",
+                "5)."
+            ],
+            [
+                "Perthes",
+                "disease",
+                "occurs",
+                "in",
+                "younger",
+                "children",
+                "(4-9",
+                "years)",
+                "with",
+                "episodes",
+                "of",
+                "limping",
+                "and",
+                "pain",
+                "in",
+                "the",
+                "hip",
+                "and",
+                "knee",
+                "(false",
+                "answer",
+                "4)."
+            ],
+            [
+                "In",
+                "a",
+                "child",
+                "the",
+                "most",
+                "typical",
+                "would",
+                "be",
+                "a",
+                "fracture",
+                "at",
+                "the",
+                "level",
+                "of",
+                "the",
+                "physis,",
+                "not",
+                "at",
+                "the",
+                "level",
+                "of",
+                "the",
+                "femoral",
+                "neck,",
+                "so",
+                "we",
+                "discard",
+                "3."
+            ],
+            [
+                "For",
+                "us",
+                "to",
+                "consider",
+                "this",
+                "option",
+                "we",
+                "would",
+                "have",
+                "to",
+                "have",
+                "been",
+                "presented",
+                "with",
+                "a",
+                "bone",
+                "cyst,",
+                "something",
+                "that",
+                "would",
+                "justify",
+                "a",
+                "weakness",
+                "in",
+                "the",
+                "femoral",
+                "neck",
+                "area."
+            ],
+            [
+                "As",
+                "for",
+                "juvenile",
+                "chronic",
+                "arthritis,",
+                "it",
+                "is",
+                "a",
+                "rheumatoid",
+                "option",
+                "surrounded",
+                "by",
+                "trauma",
+                "options."
+            ],
+            [
+                "They",
+                "do",
+                "not",
+                "speak",
+                "to",
+                "us",
+                "of",
+                "rheumatologic",
+                "factors",
+                "in",
+                "an",
+                "analytical",
+                "analysis,",
+                "nor",
+                "of",
+                "a",
+                "polyarticular",
+                "picture."
+            ],
+            [
+                "Perhaps",
+                "we",
+                "could",
+                "think",
+                "about",
+                "this",
+                "one",
+                "because",
+                "they",
+                "talk",
+                "about",
+                "pain",
+                "in",
+                "the",
+                "right",
+                "knee,",
+                "but",
+                "this",
+                "picture",
+                "that",
+                "they",
+                "present",
+                "us",
+                "is",
+                "limited",
+                "to",
+                "the",
+                "right",
+                "lower",
+                "limb,",
+                "they",
+                "do",
+                "not",
+                "talk",
+                "about",
+                "other",
+                "joints",
+                "or",
+                "fever",
+                "or",
+                "other",
+                "accompanying",
+                "systemic",
+                "symptoms,",
+                "so",
+                "it",
+                "is",
+                "not",
+                "an",
+                "option",
+                "to",
+                "evaluate,",
+                "especially",
+                "with",
+                "the",
+                "other",
+                "options",
+                "presented",
+                "to",
+                "us",
+                "that",
+                "would",
+                "be",
+                "more",
+                "likely",
+                "in",
+                "view",
+                "of",
+                "the",
+                "picture",
+                "presented",
+                "to",
+                "us",
+                "(option",
+                "1",
+                "false)."
+            ],
+            [
+                "In",
+                "addition,",
+                "the",
+                "knee",
+                "pain",
+                "in",
+                "this",
+                "case",
+                "refers",
+                "to",
+                "a",
+                "referred",
+                "pain",
+                "of",
+                "the",
+                "hip,",
+                "without",
+                "involvement",
+                "of",
+                "the",
+                "knee."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+            ],
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim"
+            ],
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+                "I-Claim"
+            ],
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+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim"
+            ],
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+                "B-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
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+            ],
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+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "46_155",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "1-year-old",
+                "boy",
+                "whose",
+                "mother",
+                "has",
+                "just",
+                "been",
+                "diagnosed",
+                "with",
+                "bacilliferous",
+                "pulmonary",
+                "tuberculosis,",
+                "having",
+                "started",
+                "correct",
+                "treatment."
+            ],
+            [
+                "The",
+                "child",
+                "is",
+                "asymptomatic",
+                "with",
+                "a",
+                "normal",
+                "examination,",
+                "negative",
+                "tuberculin",
+                "test",
+                "(PT)",
+                "and",
+                "normal",
+                "chest",
+                "Rx."
+            ],
+            [
+                "What",
+                "would",
+                "be",
+                "the",
+                "attitude",
+                "to",
+                "adopt",
+                "in",
+                "the",
+                "child?"
+            ],
+            [
+                "1-",
+                "Only",
+                "separate",
+                "him",
+                "from",
+                "the",
+                "mother",
+                "until",
+                "her",
+                "treatment",
+                "is",
+                "completed",
+                "(at",
+                "least",
+                "6",
+                "months)."
+            ],
+            [
+                "2-",
+                "Perform",
+                "a",
+                "high-resolution",
+                "CT",
+                "scan",
+                "of",
+                "the",
+                "lung,",
+                "and",
+                "if",
+                "normal,",
+                "repeat",
+                "PT",
+                "at",
+                "8-12",
+                "weeks."
+            ],
+            [
+                "3-",
+                "Chemoprophylaxis",
+                "with",
+                "isoniazid",
+                "(INH)",
+                "until",
+                "the",
+                "mother's",
+                "smear",
+                "test",
+                "is",
+                "negative."
+            ],
+            [
+                "4-",
+                "Chemoprophylaxis",
+                "with",
+                "INH",
+                "6-9",
+                "months.",
+                "New",
+                "PT",
+                "and",
+                "chest",
+                "X-ray",
+                "at",
+                "the",
+                "end",
+                "of",
+                "treatment,",
+                "to",
+                "decide",
+                "whether",
+                "or",
+                "not",
+                "to",
+                "conclude",
+                "treatment."
+            ],
+            [
+                "5-",
+                "Chemoprophylaxis",
+                "with",
+                "INH,",
+                "8-12",
+                "weeks.",
+                "Repeat",
+                "PT.",
+                "If",
+                "negative,",
+                "stop",
+                "treatment.",
+                "If",
+                "positive,",
+                "perform",
+                "chest",
+                "X-ray",
+                "to",
+                "decide",
+                "whether",
+                "or",
+                "not",
+                "there",
+                "is",
+                "disease."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "5."
+            ],
+            [
+                "The",
+                "mother",
+                "should",
+                "be",
+                "isolated",
+                "for",
+                "the",
+                "first",
+                "2-4",
+                "weeks",
+                "of",
+                "treatment,",
+                "after",
+                "which",
+                "she",
+                "would",
+                "no",
+                "longer",
+                "be",
+                "contagious."
+            ],
+            [
+                "If",
+                "the",
+                "result",
+                "of",
+                "the",
+                "repeat",
+                "PT",
+                "is",
+                "still",
+                "negative,",
+                "the",
+                "child",
+                "should",
+                "not",
+                "be",
+                "tested",
+                "again."
+            ],
+            [
+                "If",
+                "it",
+                "is",
+                "positive,",
+                "the",
+                "X-ray",
+                "(or",
+                "pulmonary",
+                "CT",
+                "in",
+                "younger",
+                "children)",
+                "should",
+                "be",
+                "repeated."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "593_146",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "395_136",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "424_91",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "27-year-old",
+                "woman",
+                "consults",
+                "for",
+                "secondary",
+                "amenorrhea",
+                "of",
+                "one",
+                "year",
+                "of",
+                "evolution."
+            ],
+            [
+                "She",
+                "has",
+                "no",
+                "iatrogenic",
+                "history."
+            ],
+            [
+                "Analytically,",
+                "the",
+                "estradiol",
+                "concentration",
+                "is",
+                "below",
+                "normal",
+                "and",
+                "the",
+                "prolactin",
+                "value",
+                "is",
+                "12",
+                "ng/mL."
+            ],
+            [
+                "Indicate",
+                "which",
+                "of",
+                "the",
+                "following",
+                "examinations",
+                "would",
+                "you",
+                "request",
+                "as",
+                "a",
+                "first",
+                "step",
+                "to",
+                "try",
+                "to",
+                "identify",
+                "the",
+                "origin",
+                "of",
+                "the",
+                "disorder:"
+            ],
+            [
+                "1-",
+                "Hypothalamohypophyseal",
+                "MRI."
+            ],
+            [
+                "2-",
+                "Karyotype."
+            ],
+            [
+                "3-",
+                "Basal",
+                "FSH."
+            ],
+            [
+                "4-",
+                "Chorionic",
+                "gonadotropin",
+                "stimulation."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Young",
+                "woman",
+                "with",
+                "secondary",
+                "amenorrhea,",
+                "with",
+                "no",
+                "history",
+                "of",
+                "interest."
+            ],
+            [
+                "Prolactin",
+                "values",
+                "are",
+                "normal",
+                "(values",
+                "above",
+                "20ngr/ml",
+                "are",
+                "considered",
+                "hyperprolectinemia),",
+                "thus",
+                "ruling",
+                "out",
+                "hyperprolactinemia",
+                "as",
+                "the",
+                "cause",
+                "of",
+                "amenorrhea."
+            ],
+            [
+                "They",
+                "tell",
+                "us",
+                "that",
+                "the",
+                "estrogen",
+                "level",
+                "is",
+                "low."
+            ],
+            [
+                "In",
+                "this",
+                "case",
+                "we",
+                "should",
+                "suspect",
+                "early",
+                "ovarian",
+                "failure."
+            ],
+            [
+                "For",
+                "its",
+                "diagnosis",
+                "we",
+                "will",
+                "ask",
+                "for",
+                "a",
+                "basal",
+                "FSH",
+                "(in",
+                "cases",
+                "of",
+                "premature",
+                "ovarian",
+                "failure",
+                "it",
+                "would",
+                "be",
+                "elevated)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "169_87",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CARDIOLOGY",
+                "AND",
+                "CARDIOVASCULAR",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "70-year-old",
+                "woman,",
+                "hypertensive",
+                "and",
+                "diabetic,",
+                "who",
+                "has",
+                "worked",
+                "as",
+                "a",
+                "sales",
+                "clerk",
+                "all",
+                "her",
+                "life."
+            ],
+            [
+                "She",
+                "consults",
+                "for",
+                "an",
+                "internal",
+                "malleolar",
+                "lesion",
+                "in",
+                "the",
+                "right",
+                "leg",
+                "with",
+                "intense",
+                "pain",
+                "throughout",
+                "the",
+                "day",
+                "that",
+                "worsens",
+                "at",
+                "night."
+            ],
+            [
+                "On",
+                "examination,",
+                "there",
+                "are",
+                "uncomplicated",
+                "varicose",
+                "cords",
+                "in",
+                "both",
+                "extremities",
+                "and",
+                "normal",
+                "femoral",
+                "and",
+                "popliteal",
+                "pulses",
+                "with",
+                "absence",
+                "of",
+                "distal",
+                "pulses."
+            ],
+            [
+                "What",
+                "examination",
+                "should",
+                "we",
+                "perform",
+                "first?"
+            ],
+            [
+                "1-",
+                "Venous",
+                "echo-Doppler",
+                "of",
+                "lower",
+                "limbs."
+            ],
+            [
+                "2-",
+                "Angioresonance",
+                "of",
+                "lower",
+                "limbs."
+            ],
+            [
+                "3-",
+                "Arteriography."
+            ],
+            [
+                "4-",
+                "Ankle-brachial",
+                "index."
+            ],
+            [
+                "5-",
+                "AngioCT."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "At",
+                "least",
+                "for",
+                "me,",
+                "as",
+                "a",
+                "family",
+                "physician,",
+                "I",
+                "usually",
+                "start",
+                "with",
+                "the",
+                "least",
+                "invasive",
+                "and",
+                "most",
+                "cost-effective",
+                "tests,",
+                "and",
+                "in",
+                "the",
+                "case",
+                "described,",
+                "an",
+                "ischemic",
+                "problem",
+                "in",
+                "the",
+                "lower",
+                "limbs",
+                "is",
+                "the",
+                "ankle-brachial",
+                "index."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "95_170",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DERMATOLOGY,",
+                "VENEREOLOGY",
+                "AND",
+                "PLASTIC",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "60-year-old",
+                "male",
+                "patient",
+                "who",
+                "reported",
+                "10",
+                "days",
+                "ago",
+                "the",
+                "appearance",
+                "of",
+                "blistering",
+                "lesions",
+                "on",
+                "the",
+                "dorsum",
+                "of",
+                "the",
+                "hands",
+                "after",
+                "sun",
+                "exposure."
+            ],
+            [
+                "The",
+                "picture",
+                "is",
+                "accompanied",
+                "by",
+                "skin",
+                "fragility."
+            ],
+            [
+                "Histopathologically",
+                "there",
+                "is",
+                "a",
+                "subepidermal",
+                "blister",
+                "with",
+                "PAS+",
+                "deposits",
+                "in",
+                "and",
+                "around",
+                "the",
+                "superficial",
+                "dermal",
+                "vessels."
+            ],
+            [
+                "The",
+                "most",
+                "plausible",
+                "diagnosis",
+                "is:"
+            ],
+            [
+                "1-",
+                "Familial",
+                "benign",
+                "pemphigus."
+            ],
+            [
+                "2-",
+                "Pemphigoid."
+            ],
+            [
+                "3-",
+                "Porphyria",
+                "cutanea",
+                "tarda."
+            ],
+            [
+                "4-",
+                "Pemphigus",
+                "vulgaris."
+            ],
+            [
+                "5-",
+                "Scalded",
+                "skin",
+                "syndrome."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "The",
+                "fact",
+                "of",
+                "being",
+                "a",
+                "photoinduced",
+                "picture,",
+                "the",
+                "histology",
+                "and",
+                "the",
+                "age",
+                "make",
+                "the",
+                "diagnosis",
+                "of",
+                "PCT",
+                "more",
+                "probable",
+                "(3)."
+            ],
+            [
+                "The",
+                "rest",
+                "of",
+                "the",
+                "answers",
+                "do",
+                "not",
+                "fit",
+                "with",
+                "the",
+                "clinical",
+                "picture",
+                "or",
+                "the",
+                "histology."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "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",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "537_1",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "363_97",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "HEMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "35-year-old",
+                "patient",
+                "who,",
+                "due",
+                "to",
+                "hematemesis",
+                "due",
+                "to",
+                "ulcus,",
+                "receives",
+                "a",
+                "transfusion",
+                "of",
+                "2",
+                "packed",
+                "red",
+                "blood",
+                "cells."
+            ],
+            [
+                "5-10",
+                "minutes",
+                "after",
+                "starting",
+                "the",
+                "transfusion,",
+                "she",
+                "begins",
+                "with",
+                "fever,",
+                "chills,",
+                "hypotension",
+                "and",
+                "pain",
+                "in",
+                "the",
+                "lumbar",
+                "region."
+            ],
+            [
+                "What",
+                "would",
+                "be",
+                "the",
+                "most",
+                "likely",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Bacterial",
+                "contamination",
+                "of",
+                "the",
+                "blood."
+            ],
+            [
+                "2-",
+                "Febrile",
+                "reaction",
+                "secondary",
+                "to",
+                "transfusion."
+            ],
+            [
+                "3-",
+                "Febrile",
+                "reaction",
+                "due",
+                "to",
+                "plasma",
+                "contaminating",
+                "red",
+                "blood",
+                "cells."
+            ],
+            [
+                "4-",
+                "Hemolytic",
+                "transfusion",
+                "reaction."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Acute",
+                "hemolytic",
+                "transfusion",
+                "reactions",
+                "can",
+                "occur",
+                "within",
+                "minutes."
+            ],
+            [
+                "Clinically",
+                "they",
+                "are",
+                "characterized",
+                "by",
+                "chills,",
+                "fever,",
+                "urticaria,",
+                "tachycardia,",
+                "nausea",
+                "and",
+                "vomiting,",
+                "lumbar",
+                "pain,",
+                "hemorrhage",
+                "due",
+                "to",
+                "disseminated",
+                "intravascular",
+                "coagulation",
+                "(DIC)....."
+            ],
+            [
+                "We",
+                "are",
+                "told",
+                "of",
+                "a",
+                "patient",
+                "who,",
+                "within",
+                "minutes",
+                "of",
+                "starting",
+                "a",
+                "transfusion,",
+                "presented",
+                "with",
+                "an",
+                "acute",
+                "and",
+                "very",
+                "serious",
+                "condition",
+                "(with",
+                "shock)."
+            ],
+            [
+                "Such",
+                "an",
+                "acute",
+                "and",
+                "severe",
+                "situation",
+                "only",
+                "fits",
+                "option",
+                "4."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "339_33",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "67-year-old",
+                "woman",
+                "diagnosed",
+                "with",
+                "an",
+                "infiltrating",
+                "ductal",
+                "carcinoma",
+                "of",
+                "the",
+                "breast",
+                "and",
+                "no",
+                "family",
+                "history",
+                "of",
+                "neoplasia."
+            ],
+            [
+                "What",
+                "additional",
+                "studies",
+                "should",
+                "be",
+                "performed",
+                "on",
+                "the",
+                "tumor",
+                "for",
+                "its",
+                "clinical-therapeutic",
+                "implications?"
+            ],
+            [
+                "1-",
+                "Complete",
+                "phenotypic",
+                "study",
+                "by",
+                "flow",
+                "cytometry."
+            ],
+            [
+                "2-",
+                "Study",
+                "of",
+                "hormone",
+                "receptors",
+                "and",
+                "HER2."
+            ],
+            [
+                "3-",
+                "Study",
+                "of",
+                "hormone",
+                "receptors,",
+                "e-cadherin",
+                "and",
+                "study",
+                "of",
+                "first-degree",
+                "relatives."
+            ],
+            [
+                "4-",
+                "BRCA",
+                "1-2",
+                "study",
+                "and",
+                "study",
+                "of",
+                "first-degree",
+                "relatives."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "All",
+                "breast",
+                "carcinomas",
+                "should",
+                "be",
+                "accompanied",
+                "by",
+                "the",
+                "study",
+                "of",
+                "hormone",
+                "receptors",
+                "and",
+                "HER-2",
+                "for",
+                "the",
+                "prognostic",
+                "implications",
+                "of",
+                "the",
+                "tumor,",
+                "as",
+                "well",
+                "as",
+                "the",
+                "adequacy",
+                "of",
+                "the",
+                "treatment",
+                "of",
+                "the",
+                "same,",
+                "since",
+                "depending",
+                "on",
+                "the",
+                "result",
+                "will",
+                "apply",
+                "some",
+                "drugs",
+                "or",
+                "others."
+            ],
+            [
+                "The",
+                "study",
+                "of",
+                "relatives",
+                "and",
+                "the",
+                "BCRA",
+                "gene",
+                "is",
+                "not",
+                "indicated",
+                "since",
+                "she",
+                "does",
+                "not",
+                "have",
+                "a",
+                "family",
+                "history",
+                "of",
+                "neoplasia."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ]
+        ]
+    },
+    {
+        "id": "144_142",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "13-year-old",
+                "girl",
+                "consults",
+                "us",
+                "for",
+                "weight",
+                "loss,",
+                "asthenia,",
+                "secondary",
+                "amenorrhea",
+                "and",
+                "constipation."
+            ],
+            [
+                "Examination",
+                "revealed",
+                "a",
+                "temperature",
+                "of",
+                "35\u00baC,",
+                "weight",
+                "below",
+                "the",
+                "3rd",
+                "percentile,",
+                "bradycardia",
+                "and",
+                "orthostatic",
+                "hypotension."
+            ],
+            [
+                "Laboratory",
+                "tests",
+                "showed",
+                "anemia",
+                "with",
+                "mild",
+                "leukopenia,",
+                "cholesterol",
+                "of",
+                "230",
+                "mg/dL",
+                "and",
+                "on",
+                "the",
+                "electrocardiogram",
+                "a",
+                "flattened",
+                "T",
+                "wave",
+                "with",
+                "ST-segment",
+                "elevation",
+                "and",
+                "prolonged",
+                "QTc."
+            ],
+            [
+                "What",
+                "process",
+                "would",
+                "you",
+                "suspect",
+                "and",
+                "what",
+                "would",
+                "you",
+                "do",
+                "next?"
+            ],
+            [
+                "1-",
+                "Suspect",
+                "anorexia",
+                "nervosa",
+                "and",
+                "inquire",
+                "about",
+                "intake,",
+                "body",
+                "image,",
+                "etc."
+            ],
+            [
+                "2-",
+                "Suspect",
+                "hypothyroidism",
+                "and",
+                "request",
+                "TSH",
+                "and",
+                "thyroid",
+                "hormones."
+            ],
+            [
+                "3-",
+                "Suspect",
+                "cardiomyopathy",
+                "and",
+                "request",
+                "echocardiography."
+            ],
+            [
+                "4-",
+                "I",
+                "would",
+                "suspect",
+                "celiac",
+                "disease",
+                "and",
+                "request",
+                "anti-transglutaminase",
+                "IgA",
+                "antibodies."
+            ],
+            [
+                "5-",
+                "Suspect",
+                "panhypopituitarism",
+                "and",
+                "request",
+                "a",
+                "cranial",
+                "CT",
+                "scan."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "1."
+            ],
+            [
+                "The",
+                "symptoms",
+                "and",
+                "signs",
+                "described",
+                "are",
+                "the",
+                "biological",
+                "findings",
+                "associated",
+                "with",
+                "anorexia",
+                "nervosa."
+            ],
+            [
+                "The",
+                "ECG",
+                "disturbances",
+                "are",
+                "derived",
+                "from",
+                "electrolyte",
+                "disturbances."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "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",
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
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+    },
+    {
+        "id": "356_166",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
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+                "10",
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+                "with",
+                "a",
+                "blood",
+                "pressure",
+                "of",
+                "160/105",
+                "mmHg."
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+            [
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+                "is",
+                "in",
+                "good",
+                "general",
+                "condition,",
+                "with",
+                "only",
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+                "headache,",
+                "which",
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+                "the",
+                "reason",
+                "for",
+                "taking",
+                "her",
+                "blood",
+                "pressure."
+            ],
+            [
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+                "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",
+                "does",
+                "she",
+                "have?"
+            ],
+            [
+                "1-",
+                "Moderate",
+                "pre-eclampsia."
+            ],
+            [
+                "2-",
+                "Pregnancy-induced",
+                "hypertension."
+            ],
+            [
+                "3-",
+                "Chronic",
+                "hypertension."
+            ],
+            [
+                "4-",
+                "Eclampsia."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
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+                "hypertension."
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+            [
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+                "I-Premise",
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+            [
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+            [
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+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "495_64",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "MEDICAL",
+                "ONCOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
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+                "woman",
+                "with",
+                "no",
+                "comorbidities,",
+                "undergoing",
+                "left",
+                "breast-conserving",
+                "surgery",
+                "with",
+                "selective",
+                "sentinel",
+                "lymph",
+                "node",
+                "biopsy."
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+            [
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+                "anatomy",
+                "of",
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+                "shows",
+                "an",
+                "infiltrating",
+                "ductal",
+                "carcinoma",
+                "grade",
+                "III",
+                "of",
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+                "mm,",
+                "two",
+                "negative",
+                "sentinel",
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+                "estrogen",
+                "receptors:",
+                "0%,",
+                "progesterone",
+                "receptors:",
+                "0%,",
+                "Ki",
+                "67:",
+                "70%,",
+                "HER2:",
+                "negative."
+            ],
+            [
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+                "study",
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+                "negative."
+            ],
+            [
+                "Adjuvant",
+                "treatment",
+                "would",
+                "be:"
+            ],
+            [
+                "1-",
+                "Chemotherapy",
+                "based",
+                "on",
+                "anthracyclines",
+                "and",
+                "taxanes,",
+                "radiotherapy",
+                "and",
+                "trastuzumab."
+            ],
+            [
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+                "Chemotherapy",
+                "based",
+                "on",
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+                "and",
+                "taxanes,",
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+                "and",
+                "tamoxifen."
+            ],
+            [
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+                "based",
+                "on",
+                "anthracyclines",
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+                "taxanes,",
+                "and",
+                "radiotherapy."
+            ],
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+                "postmenopausal."
+            ],
+            [
+                "5-",
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+            ],
+            [
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+        ],
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+                "I-Claim",
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+                "I-Claim",
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+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "355_166",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
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+                "A",
+                "pregnant",
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+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "room",
+                "with",
+                "a",
+                "blood",
+                "pressure",
+                "of",
+                "160/105",
+                "mmHg."
+            ],
+            [
+                "She",
+                "is",
+                "in",
+                "good",
+                "general",
+                "condition,",
+                "with",
+                "only",
+                "mild",
+                "headache,",
+                "which",
+                "is",
+                "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."
+            ],
+            [
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+                "nan"
+            ],
+            [
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+                "ANSWER:",
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+            ],
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+                "refers",
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+                "is",
+                "chronic",
+                "hypertension,",
+                "although",
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+                "in",
+                "pregnancy."
+            ],
+            [
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+                "at",
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+                "severe",
+                "preeclampsia)."
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+        ],
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+                "I-Premise",
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+                "I-Claim"
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+            [
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+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "94_31",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DERMATOLOGY,",
+                "VENEREOLOGY",
+                "AND",
+                "PLASTIC",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "17-year-old",
+                "boy",
+                "with",
+                "Crohn's",
+                "disease",
+                "with",
+                "colonic",
+                "involvement",
+                "of",
+                "2",
+                "years",
+                "of",
+                "evolution,",
+                "in",
+                "maintenance",
+                "treatment",
+                "with",
+                "azathioprine,",
+                "consults",
+                "for",
+                "the",
+                "appearance",
+                "for",
+                "5",
+                "days",
+                "of",
+                "subcutaneous",
+                "red",
+                "purplish,",
+                "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",
+                "areas",
+                "of",
+                "skin",
+                "away",
+                "from",
+                "the",
+                "injured",
+                "areas",
+                "and",
+                "prescribe",
+                "opioid",
+                "analgesics",
+                "for",
+                "entry."
+            ],
+            [
+                "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-induced",
+                "origin."
+            ],
+            [
+                "5-",
+                "Adjustment",
+                "of",
+                "bowel",
+                "disease",
+                "treatment."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "The",
+                "patient's",
+                "presenting",
+                "picture",
+                "is",
+                "presumably",
+                "erythema",
+                "nodosum."
+            ],
+            [
+                "About",
+                "10%",
+                "of",
+                "cases",
+                "of",
+                "erythema",
+                "nodosum",
+                "are",
+                "associated",
+                "with",
+                "inflammatory",
+                "bowel",
+                "disease,",
+                "both",
+                "ulcerative",
+                "colitis",
+                "and",
+                "Crohn's",
+                "disease."
+            ],
+            [
+                "As",
+                "mentioned,",
+                "in",
+                "most",
+                "cases,",
+                "erythema",
+                "nodosum",
+                "has",
+                "a",
+                "self-limited",
+                "course."
+            ],
+            [
+                "When",
+                "associated",
+                "with",
+                "inflammatory",
+                "bowel",
+                "disease,",
+                "erythema",
+                "nodosum",
+                "usually",
+                "resolves",
+                "with",
+                "treatment",
+                "of",
+                "the",
+                "intestinal",
+                "flare,",
+                "and",
+                "recurs",
+                "with",
+                "disease",
+                "recurrences."
+            ],
+            [
+                "Local",
+                "measures",
+                "include",
+                "elevation",
+                "of",
+                "the",
+                "legs",
+                "and",
+                "bed",
+                "rest."
+            ],
+            [
+                "In",
+                "particularly",
+                "severe",
+                "cases,",
+                "oral",
+                "administration",
+                "of",
+                "potassium",
+                "iodide",
+                "has",
+                "been",
+                "shown",
+                "to",
+                "be",
+                "helpful."
+            ],
+            [
+                "Although",
+                "the",
+                "use",
+                "of",
+                "aspirin",
+                "and",
+                "other",
+                "NSAIDs",
+                "is",
+                "effective",
+                "for",
+                "erythema",
+                "nodosum,",
+                "their",
+                "use",
+                "in",
+                "patients",
+                "with",
+                "inflammatory",
+                "bowel",
+                "disease",
+                "should",
+                "be",
+                "limited,",
+                "as",
+                "they",
+                "may",
+                "worsen",
+                "the",
+                "intestinal",
+                "picture,",
+                "the",
+                "usefulness",
+                "of",
+                "antidepressants",
+                "in",
+                "this",
+                "picture",
+                "has",
+                "not",
+                "been",
+                "described,",
+                "so",
+                "answer",
+                "n\u00ba1",
+                "would",
+                "not",
+                "be",
+                "correct."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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"
+            ]
+        ]
+    },
+    {
+        "id": "39_134",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "OTORHINOLARYNGOLOGY",
+                "AND",
+                "MAXILLOFACIAL",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "60-year-old",
+                "woman,",
+                "diagnosed",
+                "with",
+                "breast",
+                "cancer",
+                "treated",
+                "with",
+                "surgery",
+                "and",
+                "radiotherapy",
+                "10",
+                "years",
+                "ago."
+            ],
+            [
+                "Currently",
+                "with",
+                "metastases",
+                "in",
+                "the",
+                "dorsal",
+                "spine",
+                "and",
+                "sacroiliac",
+                "joint,",
+                "for",
+                "which",
+                "she",
+                "has",
+                "received",
+                "monthly",
+                "treatment",
+                "with",
+                "i.v.",
+                "zoledronic",
+                "acid",
+                "for",
+                "the",
+                "last",
+                "two",
+                "years."
+            ],
+            [
+                "The",
+                "patient",
+                "presented",
+                "spontaneous",
+                "bone",
+                "exposure",
+                "at",
+                "the",
+                "level",
+                "of",
+                "the",
+                "mandibular",
+                "bone",
+                "of",
+                "approximately",
+                "2",
+                "cm."
+            ],
+            [
+                "There",
+                "are",
+                "no",
+                "signs",
+                "of",
+                "acute",
+                "infection",
+                "and",
+                "the",
+                "gum",
+                "around",
+                "the",
+                "bone",
+                "exposure",
+                "is",
+                "strictly",
+                "normal."
+            ],
+            [
+                "The",
+                "mandibular",
+                "CT",
+                "scan",
+                "shows",
+                "an",
+                "area",
+                "of",
+                "bone",
+                "sclerosis."
+            ],
+            [
+                "What",
+                "would",
+                "be",
+                "the",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Odontogenic",
+                "abscess."
+            ],
+            [
+                "2-",
+                "Osteonecrosis",
+                "due",
+                "to",
+                "bisphosphonates."
+            ],
+            [
+                "3-",
+                "Osteoradionecrosis."
+            ],
+            [
+                "4-",
+                "Dental",
+                "root",
+                "included."
+            ],
+            [
+                "5-",
+                "Metastasis",
+                "of",
+                "breast",
+                "carcinoma."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "This",
+                "one",
+                "has",
+                "been",
+                "difficult",
+                "for",
+                "me,",
+                "we",
+                "are",
+                "going",
+                "to",
+                "rule",
+                "it",
+                "out."
+            ],
+            [
+                "1",
+                "cannot",
+                "be,",
+                "because",
+                "there",
+                "would",
+                "be",
+                "infectious",
+                "signs."
+            ],
+            [
+                "Answer",
+                "2",
+                "is",
+                "possible",
+                "because",
+                "bisphosphonates",
+                "create",
+                "mandibular",
+                "necrosis."
+            ],
+            [
+                "3",
+                "seems",
+                "unlikely",
+                "to",
+                "me",
+                "because",
+                "the",
+                "radiotherapy",
+                "that",
+                "the",
+                "patient",
+                "received",
+                "would",
+                "be",
+                "oriented",
+                "on",
+                "the",
+                "breast",
+                "and",
+                "not",
+                "on",
+                "the",
+                "mandible."
+            ],
+            [
+                "I",
+                "rule",
+                "out",
+                "number",
+                "4,",
+                "as",
+                "it",
+                "is",
+                "not",
+                "a",
+                "case",
+                "of",
+                "dental",
+                "root",
+                "involvement."
+            ],
+            [
+                "5",
+                "is",
+                "possible;",
+                "after",
+                "all,",
+                "the",
+                "patient",
+                "already",
+                "has",
+                "bone",
+                "metastases."
+            ],
+            [
+                "So,",
+                "I",
+                "hesitate",
+                "between",
+                "2",
+                "and",
+                "5,",
+                "which",
+                "one",
+                "to",
+                "choose?"
+            ],
+            [
+                "I",
+                "am",
+                "certainly",
+                "not",
+                "sure",
+                "what",
+                "a",
+                "bone",
+                "sclerosis",
+                "means",
+                "on",
+                "a",
+                "CT",
+                "scan,",
+                "but",
+                "a",
+                "bone",
+                "metastasis",
+                "would",
+                "be",
+                "more",
+                "destructive",
+                "than",
+                "sclerotizing."
+            ],
+            [
+                "On",
+                "the",
+                "other",
+                "hand,",
+                "using",
+                "reverse",
+                "psychology,",
+                "what",
+                "did",
+                "the",
+                "questioner",
+                "want",
+                "me",
+                "to",
+                "know?"
+            ],
+            [
+                "That",
+                "bisphosphonates",
+                "can",
+                "create",
+                "mandibular",
+                "necrosis?"
+            ],
+            [
+                "Or",
+                "that",
+                "a",
+                "woman",
+                "with",
+                "several",
+                "bone",
+                "metastases",
+                "can",
+                "have",
+                "a",
+                "metastasis",
+                "also",
+                "in",
+                "the",
+                "mandible?"
+            ],
+            [
+                "The",
+                "latter",
+                "seems",
+                "too",
+                "simple,",
+                "and",
+                "would",
+                "make",
+                "me",
+                "lean",
+                "more",
+                "towards",
+                "2,",
+                "but",
+                "it's",
+                "not",
+                "clear",
+                "to",
+                "me."
+            ],
+            [
+                "Be",
+                "that",
+                "as",
+                "it",
+                "may,",
+                "between",
+                "two",
+                "possible",
+                "answers",
+                "you",
+                "have",
+                "to",
+                "always",
+                "answer,",
+                "and",
+                "between",
+                "2",
+                "and",
+                "5,",
+                "you",
+                "have",
+                "to",
+                "check",
+                "2,",
+                "which",
+                "is",
+                "more",
+                "likely."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-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",
+                "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-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-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",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "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"
+            ],
+            [
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "252_83",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DIGESTIVE",
+                "SYSTEM"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "What",
+                "disease",
+                "would",
+                "we",
+                "suspect",
+                "in",
+                "a",
+                "young",
+                "patient",
+                "with",
+                "a",
+                "frequent",
+                "history",
+                "of",
+                "dysphagia",
+                "to",
+                "solids",
+                "and",
+                "liquids",
+                "with",
+                "repeated",
+                "food",
+                "impactions,",
+                "without",
+                "symptoms",
+                "of",
+                "heartburn",
+                "and",
+                "in",
+                "whom",
+                "oral",
+                "endoscopy",
+                "shows",
+                "multiple",
+                "concentric",
+                "esophageal",
+                "rings",
+                "with",
+                "normal",
+                "mucosa",
+                "(trachealized",
+                "appearance)?"
+            ],
+            [
+                "1-",
+                "Herpetic",
+                "esophagitis."
+            ],
+            [
+                "2-",
+                "Eosinophilic",
+                "esophagitis."
+            ],
+            [
+                "3-",
+                "Candidiasis",
+                "esophagitis."
+            ],
+            [
+                "4-",
+                "Cytomegalovirus",
+                "esophagitis."
+            ],
+            [
+                "5-",
+                "Adenocarcinoma",
+                "of",
+                "the",
+                "esophagus."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "The",
+                "endoscopic",
+                "appearance",
+                "of",
+                "trachealized",
+                "esophagus",
+                "is",
+                "very",
+                "typical",
+                "of",
+                "eosinophilic",
+                "esophagitis,",
+                "which",
+                "presents",
+                "with",
+                "dysphagia",
+                "and",
+                "repeated",
+                "food",
+                "impactions."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "57_77",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "In",
+                "a",
+                "42-year-old",
+                "obese",
+                "woman,",
+                "cortisol",
+                "levels",
+                "in",
+                "blood,",
+                "urine",
+                "and",
+                "saliva",
+                "are",
+                "determined",
+                "and",
+                "in",
+                "all",
+                "the",
+                "determinations",
+                "they",
+                "are",
+                "elevated."
+            ],
+            [
+                "After",
+                "performing",
+                "the",
+                "nocturnal",
+                "suppression",
+                "test",
+                "with",
+                "dexamethasone,",
+                "cortisol",
+                "levels",
+                "in",
+                "blood",
+                "remain",
+                "elevated,",
+                "so",
+                "ACTH",
+                "independent",
+                "Cushing's",
+                "syndrome",
+                "is",
+                "suspected,",
+                "what",
+                "additional",
+                "test",
+                "would",
+                "you",
+                "request",
+                "to",
+                "confirm",
+                "the",
+                "diagnosis",
+                "at",
+                "this",
+                "time?"
+            ],
+            [
+                "1-",
+                "A",
+                "petrosal",
+                "sinus",
+                "catheterization."
+            ],
+            [
+                "2-",
+                "A",
+                "gammagraphy",
+                "with",
+                "labeled",
+                "somatostatin",
+                "(Octreoscan)."
+            ],
+            [
+                "3-",
+                "A",
+                "scan",
+                "with",
+                "Sesta-MIBI."
+            ],
+            [
+                "4-",
+                "An",
+                "abdominal",
+                "ultrasound."
+            ],
+            [
+                "5-",
+                "An",
+                "adrenal",
+                "CT",
+                "scan."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "Anyway,",
+                "I",
+                "think",
+                "that",
+                "the",
+                "clinical",
+                "case",
+                "is",
+                "poorly",
+                "stated,",
+                "since",
+                "before",
+                "doing",
+                "the",
+                "CT",
+                "scan,",
+                "ACTH",
+                "should",
+                "be",
+                "measured",
+                "and,",
+                "once",
+                "ACTH",
+                "is",
+                "suppressed,",
+                "the",
+                "CT",
+                "scan",
+                "should",
+                "be",
+                "done."
+            ],
+            [
+                "But",
+                "since",
+                "the",
+                "question",
+                "is",
+                "\"what",
+                "would",
+                "you",
+                "do",
+                "to",
+                "confirm",
+                "the",
+                "diagnosis",
+                "of",
+                "suspected",
+                "ACTH",
+                "independent",
+                "Cushing's",
+                "syndrome\",",
+                "the",
+                "answer",
+                "is",
+                "CT."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Marker",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "595_88",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "98_171",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DERMATOLOGY,",
+                "VENEREOLOGY",
+                "AND",
+                "PLASTIC",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "The",
+                "patient",
+                "presents",
+                "since",
+                "2",
+                "weeks",
+                "ago",
+                "a",
+                "pruritic",
+                "eruption",
+                "consisting",
+                "of",
+                "multiple",
+                "polygonal",
+                "erythematous-violaceous",
+                "papules,",
+                "with",
+                "flattened",
+                "surface,",
+                "preferentially",
+                "located",
+                "on",
+                "the",
+                "anterior",
+                "aspect",
+                "of",
+                "the",
+                "wrists,",
+                "pretibial",
+                "area",
+                "and",
+                "lumbar",
+                "area."
+            ],
+            [
+                "She",
+                "also",
+                "presents",
+                "whitish",
+                "reticulated",
+                "lesions",
+                "in",
+                "the",
+                "jugal",
+                "mucosa."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "probable",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Pityriasis",
+                "versicolor."
+            ],
+            [
+                "2-",
+                "Mycosis",
+                "fungoides."
+            ],
+            [
+                "3-",
+                "Psoriasis",
+                "in",
+                "drops."
+            ],
+            [
+                "4-",
+                "Pityriasis",
+                "rosea",
+                "of",
+                "Gibert."
+            ],
+            [
+                "5-",
+                "Lichen",
+                "planus."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "Lichen",
+                "planus",
+                "is",
+                "a",
+                "very",
+                "common",
+                "dermatosis",
+                "of",
+                "unknown",
+                "etiology",
+                "characterized",
+                "by",
+                "the",
+                "appearance",
+                "of",
+                "pruritic",
+                "polygonal",
+                "papules,",
+                "with",
+                "a",
+                "purplish",
+                "color",
+                "and",
+                "shiny",
+                "surface,",
+                "preferentially",
+                "located",
+                "in",
+                "the",
+                "distal",
+                "areas",
+                "of",
+                "the",
+                "extremities."
+            ],
+            [
+                "Characteristically",
+                "these",
+                "papules",
+                "show",
+                "a",
+                "symmetrical",
+                "distribution",
+                "and",
+                "are",
+                "preferentially",
+                "located",
+                "on",
+                "the",
+                "anterior",
+                "aspect",
+                "of",
+                "the",
+                "wrists",
+                "(Figure",
+                "1)",
+                "and",
+                "ankles."
+            ],
+            [
+                "Oral",
+                "mucosal",
+                "involvement",
+                "is",
+                "very",
+                "frequent,",
+                "and",
+                "approximately",
+                "75%",
+                "of",
+                "patients",
+                "with",
+                "lichen",
+                "planus",
+                "show",
+                "an",
+                "asymptomatic",
+                "whitish",
+                "reticulation",
+                "affecting",
+                "the",
+                "jugal",
+                "or",
+                "lingual",
+                "mucosa."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "118_117",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "14-year-old",
+                "asymptomatic",
+                "boy",
+                "whose",
+                "father",
+                "has",
+                "just",
+                "been",
+                "diagnosed",
+                "with",
+                "pulmonary",
+                "TB",
+                "undergoes",
+                "a",
+                "Mantoux",
+                "test,",
+                "with",
+                "a",
+                "negative",
+                "result."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "appropriate",
+                "course",
+                "of",
+                "action?"
+            ],
+            [
+                "1-",
+                "Reassure",
+                "her",
+                "that",
+                "she",
+                "is",
+                "not",
+                "at",
+                "risk."
+            ],
+            [
+                "2-",
+                "Chest",
+                "X-ray."
+            ],
+            [
+                "3-",
+                "Start",
+                "chemoprophylaxis",
+                "and",
+                "repeat",
+                "skin",
+                "test",
+                "after",
+                "3",
+                "months."
+            ],
+            [
+                "4-",
+                "Repeat",
+                "skin",
+                "test",
+                "at",
+                "one",
+                "month."
+            ],
+            [
+                "5-",
+                "A",
+                "sputum",
+                "study",
+                "should",
+                "be",
+                "performed",
+                "before",
+                "starting",
+                "chemoprophylaxis",
+                "with",
+                "Isoniazid",
+                "for",
+                "1",
+                "year."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "In",
+                "young",
+                "contacts,",
+                "chemoprophylaxis",
+                "should",
+                "be",
+                "started",
+                "even",
+                "if",
+                "the",
+                "mantoux",
+                "test",
+                "is",
+                "negative",
+                "and",
+                "repeated",
+                "after",
+                "2-3",
+                "months",
+                "to",
+                "decide",
+                "whether",
+                "to",
+                "continue",
+                "treatment",
+                "for",
+                "6",
+                "months",
+                "(if",
+                "it",
+                "turns",
+                "positive)",
+                "or",
+                "to",
+                "stop",
+                "it."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "388_233",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "421_78",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GENERAL",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "52-year-old",
+                "man",
+                "was",
+                "referred",
+                "to",
+                "the",
+                "gastroenterology",
+                "department",
+                "for",
+                "hematochezia,",
+                "tenesmus",
+                "and",
+                "reduction",
+                "of",
+                "stool",
+                "diameter."
+            ],
+            [
+                "A",
+                "series",
+                "of",
+                "tests",
+                "were",
+                "performed",
+                "and",
+                "a",
+                "diagnosis",
+                "of",
+                "adenocarcinoma",
+                "of",
+                "the",
+                "sigma",
+                "without",
+                "distant",
+                "metastasis",
+                "was",
+                "made."
+            ],
+            [
+                "The",
+                "patient",
+                "underwent",
+                "surgery",
+                "and",
+                "was",
+                "referred",
+                "to",
+                "the",
+                "medical",
+                "oncology",
+                "department",
+                "for",
+                "evaluation",
+                "of",
+                "complementary",
+                "chemotherapy",
+                "treatment."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "is",
+                "a",
+                "poor",
+                "prognostic",
+                "factor",
+                "after",
+                "surgical",
+                "resection",
+                "and",
+                "should",
+                "be",
+                "taken",
+                "into",
+                "account",
+                "when",
+                "planning",
+                "chemotherapy",
+                "treatment?"
+            ],
+            [
+                "1-",
+                "The",
+                "presence",
+                "of",
+                "anemia",
+                "at",
+                "diagnosis."
+            ],
+            [
+                "2-",
+                "The",
+                "existence",
+                "of",
+                "a",
+                "family",
+                "history",
+                "of",
+                "colorectal",
+                "cancer."
+            ],
+            [
+                "3-",
+                "The",
+                "size",
+                "of",
+                "the",
+                "primary",
+                "lesion",
+                "and",
+                "histological",
+                "differentiation."
+            ],
+            [
+                "4-",
+                "Perforation",
+                "or",
+                "adhesion",
+                "of",
+                "the",
+                "tumor",
+                "to",
+                "adjacent",
+                "organs."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "On",
+                "this",
+                "occasion,",
+                "we",
+                "are",
+                "asked",
+                "about",
+                "which",
+                "factors",
+                "have",
+                "the",
+                "greatest",
+                "influence",
+                "in",
+                "order",
+                "to",
+                "carry",
+                "out",
+                "adjuvant",
+                "chemotherapy",
+                "in",
+                "colorectal",
+                "cancer."
+            ],
+            [
+                "In",
+                "order",
+                "to",
+                "do",
+                "so,",
+                "we",
+                "must",
+                "know",
+                "which",
+                "are",
+                "the",
+                "poor",
+                "prognostic",
+                "factors",
+                "in",
+                "this",
+                "pathology",
+                "where",
+                "obstruction",
+                "or",
+                "intestinal",
+                "perforation",
+                "due",
+                "to",
+                "the",
+                "lesion,",
+                "invasion",
+                "of",
+                "adjacent",
+                "organs,",
+                "elevation",
+                "of",
+                "tumor",
+                "markers",
+                "such",
+                "as",
+                "CEA",
+                "and",
+                "the",
+                "histology",
+                "of",
+                "the",
+                "neoplasm",
+                "stand",
+                "out."
+            ],
+            [
+                "Among",
+                "these,",
+                "less",
+                "importance",
+                "is",
+                "given",
+                "to",
+                "the",
+                "size",
+                "of",
+                "the",
+                "lesion",
+                "than",
+                "to",
+                "its",
+                "degree",
+                "of",
+                "invasion",
+                "of",
+                "the",
+                "intestinal",
+                "wall",
+                "or",
+                "other",
+                "adjacent",
+                "structures,",
+                "a",
+                "criterion",
+                "that",
+                "must",
+                "be",
+                "taken",
+                "into",
+                "account",
+                "for",
+                "staging",
+                "by",
+                "TNM",
+                "or",
+                "Astler-Coller",
+                "classification,",
+                "which",
+                "guide",
+                "the",
+                "indication",
+                "of",
+                "adjuvant",
+                "treatment",
+                "after",
+                "the",
+                "surgical",
+                "approach."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "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",
+                "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",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "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",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "500_45",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "15-year-old",
+                "female",
+                "presenting",
+                "with",
+                "delayed",
+                "menarche",
+                "and",
+                "short",
+                "stature."
+            ],
+            [
+                "She",
+                "does",
+                "not",
+                "have",
+                "intellectual",
+                "disability."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "genetic",
+                "tests",
+                "would",
+                "be",
+                "routinely",
+                "used",
+                "for",
+                "the",
+                "diagnosis",
+                "of",
+                "this",
+                "patient:"
+            ],
+            [
+                "1-",
+                "Massive",
+                "sequencing",
+                "(NGS)."
+            ],
+            [
+                "2-",
+                "FISH."
+            ],
+            [
+                "3-",
+                "DNA",
+                "and/or",
+                "RNA",
+                "microarrays."
+            ],
+            [
+                "4-",
+                "Karyotype."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "In",
+                "a",
+                "woman",
+                "with",
+                "delayed",
+                "puberty",
+                "and",
+                "short",
+                "stature",
+                "we",
+                "should",
+                "always",
+                "think",
+                "about",
+                "and",
+                "rule",
+                "out",
+                "Turner",
+                "syndrome,",
+                "whose",
+                "diagnosis",
+                "is",
+                "made",
+                "by",
+                "karyotyping",
+                "(45X0)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "611_116",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "TRAUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "95-year-old",
+                "woman",
+                "living",
+                "in",
+                "a",
+                "nursing",
+                "home,",
+                "independent",
+                "for",
+                "her",
+                "basic",
+                "activities",
+                "of",
+                "daily",
+                "living,",
+                "goes",
+                "out",
+                "to",
+                "the",
+                "garden",
+                "for",
+                "walks."
+            ],
+            [
+                "She",
+                "has",
+                "a",
+                "history",
+                "of",
+                "hypertension,",
+                "dyslipidemia,",
+                "osteoporosis",
+                "and",
+                "mild",
+                "cognitive",
+                "impairment."
+            ],
+            [
+                "She",
+                "suffers",
+                "a",
+                "fall",
+                "when",
+                "getting",
+                "up",
+                "at",
+                "night",
+                "to",
+                "go",
+                "to",
+                "the",
+                "bathroom."
+            ],
+            [
+                "X-ray",
+                "shows",
+                "a",
+                "displaced",
+                "subcapital",
+                "fracture",
+                "of",
+                "the",
+                "right",
+                "hip."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "recommended",
+                "treatment?"
+            ],
+            [
+                "1-",
+                "Hip",
+                "hemiarthroplasty."
+            ],
+            [
+                "2-",
+                "Trochanteric",
+                "nail",
+                "fixation."
+            ],
+            [
+                "3-",
+                "Fixation",
+                "with",
+                "cannulated",
+                "screws."
+            ],
+            [
+                "4-",
+                "Conservative:",
+                "bed-chair",
+                "life."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "We",
+                "are",
+                "told",
+                "of",
+                "a",
+                "case",
+                "of",
+                "a",
+                "95-year-old",
+                "patient",
+                "with",
+                "a",
+                "displaced",
+                "intracapsular",
+                "(subcapital)",
+                "hip",
+                "fracture."
+            ],
+            [
+                "In",
+                "this",
+                "case,",
+                "the",
+                "surgical",
+                "options",
+                "may",
+                "be",
+                "the",
+                "use",
+                "of",
+                "cannulated",
+                "screws",
+                "or",
+                "hip",
+                "arthroplasty."
+            ],
+            [
+                "Cannulated",
+                "screws",
+                "are",
+                "reserved",
+                "for",
+                "cases",
+                "of",
+                "non-displaced",
+                "fractures",
+                "(Wrong",
+                "answer",
+                "2)",
+                "so",
+                "the",
+                "most",
+                "indicated",
+                "option",
+                "would",
+                "be",
+                "arthroplasty,",
+                "in",
+                "this",
+                "case",
+                "hemiarthroplasty",
+                "(Correct",
+                "answer",
+                "1)."
+            ],
+            [
+                "Trochanteric",
+                "pins",
+                "are",
+                "reserved",
+                "for",
+                "extracapsular",
+                "fractures",
+                "(Wrong",
+                "answer",
+                "2)",
+                "and",
+                "conservative",
+                "treatment",
+                "is",
+                "only",
+                "considered",
+                "in",
+                "patients",
+                "with",
+                "very",
+                "low",
+                "functional",
+                "demand",
+                "or",
+                "surgical",
+                "contraindication",
+                "(Wrong",
+                "answer",
+                "4)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "542_38",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ALLERGOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "25-year-old",
+                "woman",
+                "with",
+                "a",
+                "history",
+                "of",
+                "allergic",
+                "bronchial",
+                "asthma",
+                "due",
+                "to",
+                "sensitization",
+                "to",
+                "grass",
+                "pollens",
+                "and",
+                "atopic",
+                "dermatitis."
+            ],
+            [
+                "She",
+                "suddenly",
+                "presents",
+                "hypotension,",
+                "tachycardia,",
+                "urticaria",
+                "and",
+                "bronchospasm",
+                "after",
+                "ingesting",
+                "peanuts",
+                "and",
+                "is",
+                "transferred",
+                "to",
+                "the",
+                "emergency",
+                "department."
+            ],
+            [
+                "What",
+                "would",
+                "be",
+                "the",
+                "order",
+                "of",
+                "drugs",
+                "to",
+                "be",
+                "administered",
+                "and",
+                "what",
+                "laboratory",
+                "test",
+                "could",
+                "be",
+                "requested",
+                "for",
+                "further",
+                "evaluation?"
+            ],
+            [
+                "1-",
+                "Intramuscular",
+                "adrenaline,",
+                "followed",
+                "by",
+                "an",
+                "inhaled",
+                "bronchodilator",
+                "of",
+                "the",
+                "SABA",
+                "type",
+                "and",
+                "intramuscular",
+                "dexchlorpheniramine.",
+                "Then",
+                "request",
+                "serum",
+                "tryptase."
+            ],
+            [
+                "2-",
+                "An",
+                "inhaled",
+                "SABA-type",
+                "bronchodilator,",
+                "followed",
+                "by",
+                "intramuscular",
+                "dexchlorpheniramine",
+                "and",
+                "intramuscular",
+                "adrenaline.",
+                "Then",
+                "order",
+                "serum",
+                "tryptase."
+            ],
+            [
+                "3-",
+                "Intramuscular",
+                "dexchlorpheniramine,",
+                "followed",
+                "by",
+                "an",
+                "inhaled",
+                "bronchodilator",
+                "of",
+                "the",
+                "SABA",
+                "type",
+                "and",
+                "intramuscular",
+                "adrenaline.",
+                "Then",
+                "request",
+                "eosinophil",
+                "cationic",
+                "protein."
+            ],
+            [
+                "4-",
+                "Intramuscular",
+                "adrenaline,",
+                "followed",
+                "by",
+                "an",
+                "inhaled",
+                "bronchodilator",
+                "of",
+                "the",
+                "SABA",
+                "type",
+                "and",
+                "intramuscular",
+                "dexchlorpheniramine.",
+                "Then",
+                "request",
+                "eosinophil",
+                "cationic",
+                "protein."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "The",
+                "patient",
+                "is",
+                "suffering",
+                "from",
+                "anaphylactic",
+                "shock",
+                "secondary",
+                "to",
+                "peanut",
+                "ingestion."
+            ],
+            [
+                "The",
+                "treatment",
+                "of",
+                "anaphylaxis",
+                "and",
+                "anaphylactic",
+                "shock",
+                "of",
+                "first",
+                "choice",
+                "is",
+                "intramuscular",
+                "adrenaline",
+                "1mg/ml",
+                "(dose",
+                "0.01",
+                "mg/kg,",
+                "in",
+                "adults",
+                "0.5",
+                "mg",
+                "maximum)."
+            ],
+            [
+                "Followed",
+                "by",
+                "symptomatic",
+                "treatment",
+                "to",
+                "stabilize",
+                "the",
+                "airway",
+                "with",
+                "100%",
+                "high",
+                "flow",
+                "O2,",
+                "ensure",
+                "large",
+                "caliber",
+                "venous",
+                "access,",
+                "fluid",
+                "replacement",
+                "and",
+                "continuous",
+                "monitoring",
+                "(HR,",
+                "BP,",
+                "SatO2",
+                ",",
+                "diuresis)."
+            ],
+            [
+                "As",
+                "adjuvant",
+                "treatment,",
+                "an",
+                "inhaled",
+                "bronchodilator",
+                "such",
+                "as",
+                "SABA,",
+                "intramuscular",
+                "dexchlorpheniramine",
+                "or",
+                "corticosteroids",
+                "such",
+                "as",
+                "hydrocortisone",
+                "IV",
+                "or",
+                "methylprednisolone",
+                "IV",
+                "can",
+                "be",
+                "administered."
+            ],
+            [
+                "Adrenaline",
+                "can",
+                "be",
+                "repeated",
+                "at",
+                "the",
+                "same",
+                "doses",
+                "every",
+                "5",
+                "minutes",
+                "a",
+                "maximum",
+                "of",
+                "3",
+                "times",
+                "and",
+                "if",
+                "after",
+                "15",
+                "minutes",
+                "there",
+                "is",
+                "no",
+                "response,",
+                "IV",
+                "adrenaline",
+                "infusion",
+                "should",
+                "be",
+                "started,",
+                "Glucagon",
+                "(if",
+                "treatment",
+                "with",
+                "beta-blockers),",
+                "Atropine",
+                "(if",
+                "prolonged",
+                "bradycardia)",
+                "or",
+                "Vasopressors",
+                "(if",
+                "refractory",
+                "hypotension)."
+            ],
+            [
+                "The",
+                "laboratory",
+                "marker",
+                "that",
+                "should",
+                "be",
+                "requested",
+                "if",
+                "anaphylaxis",
+                "is",
+                "suspected",
+                "is",
+                "serum",
+                "tryptase",
+                "in",
+                "the",
+                "first",
+                "hour",
+                "for",
+                "a",
+                "basal",
+                "determination",
+                "and",
+                "another",
+                "at",
+                "4-6",
+                "hours",
+                "to",
+                "observe",
+                "its",
+                "elevation",
+                "curve."
+            ],
+            [
+                "It",
+                "is",
+                "not",
+                "an",
+                "emergency",
+                "marker",
+                "but",
+                "it",
+                "is",
+                "very",
+                "useful",
+                "for",
+                "future",
+                "allergological",
+                "study."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "79_36",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DIGESTIVE",
+                "SYSTEM"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "clinical",
+                "data,",
+                "recorded",
+                "during",
+                "the",
+                "clinical",
+                "history",
+                "taking",
+                "of",
+                "a",
+                "patient",
+                "with",
+                "diarrhea",
+                "of",
+                "more",
+                "than",
+                "4",
+                "weeks",
+                "of",
+                "evolution,",
+                "can",
+                "be",
+                "found",
+                "in",
+                "people",
+                "without",
+                "organic",
+                "pathology:"
+            ],
+            [
+                "1-",
+                "Weight",
+                "loss",
+                "with",
+                "or",
+                "without",
+                "rectorrhagia."
+            ],
+            [
+                "2-",
+                "Persistence",
+                "of",
+                "diarrhea",
+                "during",
+                "the",
+                "night."
+            ],
+            [
+                "3-",
+                "Onset",
+                "of",
+                "symptoms",
+                "after",
+                "age",
+                "50."
+            ],
+            [
+                "4-",
+                "Presence",
+                "of",
+                "dermatitis",
+                "and/or",
+                "arthritis",
+                "during",
+                "the",
+                "examination."
+            ],
+            [
+                "5-",
+                "Expulsion",
+                "of",
+                "mucus",
+                "in",
+                "more",
+                "than",
+                "25%",
+                "of",
+                "defecations."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "Although",
+                "mucus",
+                "is",
+                "usually",
+                "more",
+                "frightening",
+                "in",
+                "the",
+                "consultation,",
+                "it",
+                "falls",
+                "within",
+                "the",
+                "Rome",
+                "II",
+                "criteria",
+                "for",
+                "the",
+                "diagnosis",
+                "of",
+                "Irritable",
+                "Bowel",
+                "Syndrome."
+            ],
+            [
+                "All",
+                "the",
+                "rest",
+                "are",
+                "typical",
+                "signs",
+                "of",
+                "organicity,",
+                "although",
+                "I",
+                "think",
+                "the",
+                "question",
+                "is",
+                "poorly",
+                "phrased,",
+                "since",
+                "any",
+                "of",
+                "these",
+                "data",
+                "(especially",
+                "age)",
+                "can",
+                "be",
+                "found",
+                "in",
+                "patients",
+                "who",
+                "in",
+                "the",
+                "end",
+                "have",
+                "nothing,",
+                "what",
+                "happens",
+                "is",
+                "that",
+                "in",
+                "these",
+                "cases",
+                "we",
+                "must",
+                "always",
+                "look",
+                "for",
+                "organicity."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ]
+        ]
+    },
+    {
+        "id": "524_54",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "STATISTICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "86-year-old",
+                "woman",
+                "in",
+                "whom",
+                "nonvalvular",
+                "atrial",
+                "fibrillation",
+                "has",
+                "been",
+                "detected."
+            ],
+            [
+                "She",
+                "has",
+                "a",
+                "CHADS2",
+                "score",
+                "of",
+                "3",
+                "points."
+            ],
+            [
+                "In",
+                "the",
+                "literature,",
+                "similar",
+                "patients",
+                "on",
+                "warfarin",
+                "therapy",
+                "have",
+                "a",
+                "stroke",
+                "risk",
+                "of",
+                "2.2%",
+                "vs.",
+                "5.2%",
+                "in",
+                "patients",
+                "without",
+                "warfarin."
+            ],
+            [
+                "What",
+                "would",
+                "be",
+                "the",
+                "number",
+                "needed",
+                "to",
+                "treat",
+                "(NNT)",
+                "to",
+                "prevent",
+                "an",
+                "emboligenic",
+                "stroke",
+                "with",
+                "anticoagulation",
+                "therapy:"
+            ],
+            [
+                "1-",
+                "3"
+            ],
+            [
+                "2-",
+                "19,2."
+            ],
+            [
+                "3-",
+                "33,3."
+            ],
+            [
+                "4-",
+                "49,5."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "On",
+                "average,",
+                "if",
+                "100",
+                "patients",
+                "like",
+                "this",
+                "woman",
+                "are",
+                "treated",
+                "with",
+                "warfarin,",
+                "the",
+                "number",
+                "of",
+                "strokes",
+                "is",
+                "reduced",
+                "by",
+                "3",
+                "(from",
+                "5.2",
+                "untreated",
+                "to",
+                "3.2",
+                "treated)."
+            ],
+            [
+                "Therefore,",
+                "if",
+                "you",
+                "treat",
+                "33.3",
+                "patients",
+                "like",
+                "this",
+                "woman",
+                "with",
+                "warfarin,",
+                "you",
+                "reduce",
+                "the",
+                "number",
+                "of",
+                "strokes",
+                "by",
+                "1:",
+                "the",
+                "NNT",
+                "is",
+                "33.3."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "319_141",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "RHEUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "20-year-old",
+                "boy",
+                "consults",
+                "for",
+                "lumbosacral",
+                "pain",
+                "of",
+                "inflammatory",
+                "rhythm",
+                "of",
+                "4",
+                "months",
+                "of",
+                "evolution."
+            ],
+            [
+                "Also",
+                "bilateral",
+                "thalalgia",
+                "and",
+                "morning",
+                "stiffness",
+                "for",
+                "1",
+                "hour."
+            ],
+            [
+                "In",
+                "the",
+                "last",
+                "2",
+                "months,",
+                "onset",
+                "of",
+                "diarrhea",
+                "with",
+                "loss",
+                "of",
+                "4",
+                "kg",
+                "of",
+                "weight."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "correct",
+                "diagnostic",
+                "approach?"
+            ],
+            [
+                "1-",
+                "Given",
+                "the",
+                "patient's",
+                "age,",
+                "he",
+                "most",
+                "likely",
+                "suffers",
+                "from",
+                "non-specific",
+                "low",
+                "back",
+                "pain",
+                "and",
+                "tendonitis",
+                "in",
+                "the",
+                "feet.",
+                "If",
+                "the",
+                "diarrhea",
+                "persists,",
+                "a",
+                "digestive",
+                "study",
+                "would",
+                "be",
+                "performed."
+            ],
+            [
+                "2-",
+                "I",
+                "would",
+                "perform",
+                "a",
+                "digestive",
+                "study",
+                "to",
+                "rule",
+                "out",
+                "tumor",
+                "pathology.",
+                "The",
+                "lumbar",
+                "pain",
+                "may",
+                "be",
+                "due",
+                "to",
+                "visceral",
+                "pathology."
+            ],
+            [
+                "3-",
+                "The",
+                "clinical",
+                "picture",
+                "is",
+                "very",
+                "suggestive",
+                "of",
+                "spondyloarthritis.",
+                "Inflammatory",
+                "bowel",
+                "disease",
+                "should",
+                "be",
+                "ruled",
+                "out."
+            ],
+            [
+                "4-",
+                "I",
+                "would",
+                "request",
+                "a",
+                "lumbar",
+                "MRI",
+                "to",
+                "rule",
+                "out",
+                "disc",
+                "herniation",
+                "and",
+                "if",
+                "diarrhea",
+                "persists,",
+                "a",
+                "digestive",
+                "study."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "The",
+                "clinical",
+                "picture",
+                "is",
+                "typical",
+                "of",
+                "spondyloarthritis,",
+                "and",
+                "together",
+                "with",
+                "the",
+                "digestive",
+                "symptoms",
+                "it",
+                "is",
+                "probably",
+                "associated",
+                "with",
+                "inflammatory",
+                "bowel",
+                "disease."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "400_147",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "TRAUMATOLOGY",
+                "AND",
+                "ORTHOPEDICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "13-year-old",
+                "boy",
+                "presents",
+                "dorsal",
+                "pain",
+                "of",
+                "several",
+                "months",
+                "of",
+                "evolution,",
+                "only",
+                "on",
+                "standing",
+                "and",
+                "walking,",
+                "what",
+                "diagnosis",
+                "should",
+                "we",
+                "consider?"
+            ],
+            [
+                "1-",
+                "Scheuermann's",
+                "disease."
+            ],
+            [
+                "2-",
+                "Thoracic",
+                "scoliosis."
+            ],
+            [
+                "3-",
+                "Malignant",
+                "tumor",
+                "of",
+                "the",
+                "vertebral",
+                "body."
+            ],
+            [
+                "4-",
+                "It",
+                "is",
+                "a",
+                "mechanical",
+                "overload."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "The",
+                "pain",
+                "is",
+                "of",
+                "mechanical",
+                "characteristics,",
+                "and",
+                "the",
+                "most",
+                "frequent",
+                "cause",
+                "of",
+                "mechanical",
+                "back",
+                "pain",
+                "in",
+                "adolescents",
+                "is",
+                "mechanical",
+                "overload."
+            ],
+            [
+                "There",
+                "is",
+                "no",
+                "data",
+                "in",
+                "the",
+                "statement",
+                "to",
+                "suggest",
+                "any",
+                "of",
+                "the",
+                "other",
+                "etiologies."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ]
+        ]
+    },
+    {
+        "id": "196_164",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "4-year-old",
+                "boy",
+                "consulted",
+                "for",
+                "the",
+                "appearance",
+                "over",
+                "the",
+                "last",
+                "three",
+                "days",
+                "of",
+                "skin",
+                "lesions",
+                "on",
+                "the",
+                "legs",
+                "and",
+                "buttocks."
+            ],
+            [
+                "His",
+                "parents",
+                "reported",
+                "that",
+                "his",
+                "pediatrician",
+                "had",
+                "diagnosed",
+                "an",
+                "upper",
+                "respiratory",
+                "tract",
+                "infection",
+                "10",
+                "days",
+                "earlier."
+            ],
+            [
+                "In",
+                "the",
+                "last",
+                "12",
+                "hours",
+                "she",
+                "presented",
+                "intense",
+                "colicky",
+                "abdominal",
+                "pain",
+                "and",
+                "had",
+                "two",
+                "diarrheal",
+                "stools."
+            ],
+            [
+                "Afebrile."
+            ],
+            [
+                "No",
+                "weight",
+                "loss."
+            ],
+            [
+                "On",
+                "examination",
+                "she",
+                "has",
+                "numerous",
+                "petechiae",
+                "and",
+                "palpable",
+                "purpuric",
+                "lesions",
+                "predominantly",
+                "on",
+                "the",
+                "buttocks",
+                "and",
+                "lower",
+                "extremities."
+            ],
+            [
+                "Good",
+                "general",
+                "condition",
+                "although",
+                "she",
+                "has",
+                "intense",
+                "abdominal",
+                "pain."
+            ],
+            [
+                "Abdominal",
+                "palpation",
+                "is",
+                "difficult",
+                "to",
+                "assess",
+                "due",
+                "to",
+                "diffuse",
+                "pain."
+            ],
+            [
+                "No",
+                "visceromegaly."
+            ],
+            [
+                "No",
+                "other",
+                "findings",
+                "of",
+                "interest",
+                "on",
+                "examination."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "data",
+                "does",
+                "NOT",
+                "support",
+                "your",
+                "diagnostic",
+                "suspicion?"
+            ],
+            [
+                "1-",
+                "Knee",
+                "and",
+                "ankle",
+                "arthritis."
+            ],
+            [
+                "2-",
+                "Hematuria."
+            ],
+            [
+                "3-",
+                "Plateletopenia."
+            ],
+            [
+                "4-",
+                "Fecal",
+                "occult",
+                "blood."
+            ],
+            [
+                "5-",
+                "Scrotal",
+                "edema."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "You",
+                "are",
+                "describing",
+                "a",
+                "Sch\u00f6nlein-Henoch",
+                "purpura",
+                "which",
+                "is",
+                "a",
+                "vasculitic",
+                "phenomenon,",
+                "so",
+                "the",
+                "lesions",
+                "are",
+                "not",
+                "due",
+                "to",
+                "plateletopenia."
+            ],
+            [
+                "Scrotal",
+                "edema",
+                "(sometimes",
+                "even",
+                "torsion",
+                "of",
+                "Morgani's",
+                "capsid",
+                "of",
+                "the",
+                "testis)",
+                "is",
+                "not",
+                "exceptional",
+                "in",
+                "males",
+                "with",
+                "S.",
+                "Sch\u00f6nlein-Henoch."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "509_150",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DIGESTIVE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "83-year-old",
+                "male",
+                "who",
+                "consults",
+                "for",
+                "a",
+                "recurrent",
+                "picture",
+                "of",
+                "abdominal",
+                "pain",
+                "in",
+                "the",
+                "left",
+                "iliac",
+                "fossa,",
+                "accompanied",
+                "by",
+                "diarrhea",
+                "of",
+                "up",
+                "to",
+                "6",
+                "stools",
+                "per",
+                "day",
+                "without",
+                "pathological",
+                "products,",
+                "of",
+                "10-15",
+                "days",
+                "of",
+                "evolution."
+            ],
+            [
+                "No",
+                "fever",
+                "or",
+                "general",
+                "condition",
+                "was",
+                "reported."
+            ],
+            [
+                "A",
+                "recent",
+                "blood",
+                "test",
+                "showed",
+                "no",
+                "leukocytosis",
+                "and",
+                "a",
+                "negative",
+                "fecal",
+                "occult",
+                "blood",
+                "test."
+            ],
+            [
+                "On",
+                "examination",
+                "there",
+                "is",
+                "mild",
+                "pain",
+                "on",
+                "palpation",
+                "of",
+                "the",
+                "left",
+                "iliac",
+                "fossa",
+                "without",
+                "peritoneal",
+                "irritation."
+            ],
+            [
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+                "had",
+                "a",
+                "colonoscopy",
+                "three",
+                "years",
+                "ago",
+                "in",
+                "which",
+                "diverticula",
+                "were",
+                "reported",
+                "along",
+                "the",
+                "entire",
+                "colon,",
+                "more",
+                "numerous",
+                "in",
+                "the",
+                "left",
+                "colon,",
+                "with",
+                "no",
+                "other",
+                "associated",
+                "lesions."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "would",
+                "be",
+                "the",
+                "best",
+                "approach",
+                "to",
+                "follow?"
+            ],
+            [
+                "1-",
+                "Empirical",
+                "treatment",
+                "with",
+                "antibiotics."
+            ],
+            [
+                "2-",
+                "Request",
+                "a",
+                "preferential",
+                "colonoscopy."
+            ],
+            [
+                "3-",
+                "Request",
+                "urgent",
+                "abdominal",
+                "ultrasound."
+            ],
+            [
+                "4-",
+                "Refer",
+                "to",
+                "surgery",
+                "to",
+                "evaluate",
+                "sigmoidectomy."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
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+                "refer",
+                "to",
+                "a",
+                "concept",
+                "that",
+                "has",
+                "emerged",
+                "relatively",
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+                "and",
+                "is",
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+                "in",
+                "all",
+                "clinical",
+                "guidelines",
+                "as",
+                "uncomplicated",
+                "symptomatic",
+                "diverticular",
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+                "the",
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+                "that",
+                "she",
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+                "not",
+                "have",
+                "acute",
+                "diverticulitis",
+                "at",
+                "the",
+                "time",
+                "of",
+                "consultation",
+                "that",
+                "would",
+                "lead",
+                "us",
+                "to",
+                "request",
+                "an",
+                "imaging",
+                "test",
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+                "out."
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise"
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+            [
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
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+            [
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+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
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+                "O",
+                "O"
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
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+                "O",
+                "O"
+            ],
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "549_128",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "221_48",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ANATOMIC",
+                "PATHOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "20-year-old",
+                "man",
+                "with",
+                "ataxia,",
+                "headaches",
+                "and",
+                "solid-cystic",
+                "mass",
+                "in",
+                "the",
+                "right",
+                "cerebellar",
+                "hemisphere",
+                "underwent",
+                "surgery",
+                "and",
+                "a",
+                "lesion",
+                "was",
+                "resected,",
+                "histologically",
+                "showing",
+                "cells",
+                "with",
+                "long",
+                "thin",
+                "cytoplasmic",
+                "processes,",
+                "fascicular",
+                "and",
+                "microcystic",
+                "pattern,",
+                "numerous",
+                "vessels",
+                "and",
+                "Rosenthal's",
+                "fibers."
+            ],
+            [
+                "The",
+                "most",
+                "probable",
+                "anatomopathologic",
+                "diagnosis",
+                "is:"
+            ],
+            [
+                "1-",
+                "Pilocytic",
+                "astrocytoma."
+            ],
+            [
+                "2-",
+                "Pleomorphic",
+                "xanthoastrocytoma."
+            ],
+            [
+                "3-",
+                "Central",
+                "neurocytoma."
+            ],
+            [
+                "4-",
+                "Liponeurocytoma."
+            ],
+            [
+                "5-",
+                "Prion",
+                "disease."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "A",
+                "question",
+                "that",
+                "does",
+                "not",
+                "seem",
+                "to",
+                "have",
+                "a",
+                "second",
+                "intention,",
+                "as",
+                "there",
+                "are",
+                "no",
+                "confusing",
+                "elements."
+            ],
+            [
+                "The",
+                "statement",
+                "concisely",
+                "summarizes",
+                "the",
+                "description",
+                "of",
+                "pilocytic",
+                "astrocytoma."
+            ],
+            [
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+                "fibers",
+                "may",
+                "confuse",
+                "us",
+                "as",
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+                "are",
+                "not",
+                "very",
+                "specific,",
+                "and",
+                "make",
+                "us",
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+                "which",
+                "they",
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+                "be",
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+                "described",
+                "(long",
+                "and",
+                "thin",
+                "cytoplasmic",
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+                "which",
+                "are",
+                "the",
+                "ones",
+                "that",
+                "give",
+                "the",
+                "name",
+                "\"pilocytic\")",
+                "keeps",
+                "us",
+                "the",
+                "first",
+                "option",
+                "as",
+                "the",
+                "correct",
+                "one."
+            ],
+            [
+                "We",
+                "can",
+                "find",
+                "a",
+                "good",
+                "description",
+                "of",
+                "the",
+                "entity,",
+                "explaining",
+                "what",
+                "distinguishes",
+                "it",
+                "from",
+                "other",
+                "glial",
+                "tumors",
+                "in",
+                "Practical",
+                "Surgical",
+                "Neuropathology."
+            ],
+            [
+                "A",
+                "Diagnostic",
+                "Approach."
+            ],
+            [
+                "A."
+            ],
+            [
+                "Perry,",
+                "D.J."
+            ],
+            [
+                "Brat."
+            ],
+            [
+                "p82-88."
+            ],
+            [
+                "Churchill",
+                "Livingstone",
+                "Elsevier."
+            ],
+            [
+                "2010."
+            ],
+            [
+                "(Philadephia)."
+            ]
+        ],
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+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+            [
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+                "O",
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+                "I-Claim"
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+            ],
+            [
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+                "O",
+                "O"
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+            ],
+            [
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+    {
+        "id": "606_113",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "TRAUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
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+                "although",
+                "it",
+                "is",
+                "painful",
+                "and",
+                "contracture",
+                "of",
+                "the",
+                "paravertebral",
+                "musculature",
+                "is",
+                "appreciated."
+            ],
+            [
+                "The",
+                "first",
+                "attitude",
+                "will",
+                "be:"
+            ],
+            [
+                "1-",
+                "Conservative",
+                "treatment",
+                "with",
+                "non-steroidal",
+                "anti-inflammatory",
+                "drugs,",
+                "local",
+                "heat",
+                "and",
+                "relative",
+                "rest."
+            ],
+            [
+                "2-",
+                "Urgent",
+                "call",
+                "to",
+                "the",
+                "neurosurgeon",
+                "for",
+                "surgical",
+                "evaluation."
+            ],
+            [
+                "3-",
+                "Preferential",
+                "request",
+                "for",
+                "MRI",
+                "and",
+                "electromyogram."
+            ],
+            [
+                "4-",
+                "Preferential",
+                "referral",
+                "to",
+                "traumatology",
+                "outpatients."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Correct",
+                "answer",
+                "1."
+            ],
+            [
+                "75%",
+                "of",
+                "patients",
+                "with",
+                "radiculopathy",
+                "improve",
+                "with",
+                "non-surgical",
+                "treatment,",
+                "this",
+                "being",
+                "the",
+                "treatment",
+                "of",
+                "choice",
+                "in",
+                "the",
+                "initial",
+                "stages."
+            ],
+            [
+                "Magnetic",
+                "resonance",
+                "imaging",
+                "is",
+                "of",
+                "choice",
+                "in",
+                "certain",
+                "\"red",
+                "flags\":",
+                "fever,",
+                "weight",
+                "loss,",
+                "nocturnal",
+                "pain,",
+                "persistence",
+                "of",
+                "symptoms",
+                "despite",
+                "conservative",
+                "treatment",
+                "and",
+                "loss",
+                "of",
+                "strength",
+                "(incorrect",
+                "answer",
+                "3)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "436_223",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "220_126",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "483_174",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CRITICAL",
+                "CARE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "22-year-old",
+                "woman",
+                "presents",
+                "with",
+                "sudden",
+                "cardiac",
+                "arrest",
+                "with",
+                "a",
+                "rhythm",
+                "that",
+                "is",
+                "considered",
+                "amenable",
+                "to",
+                "defibrillation."
+            ],
+            [
+                "Chest",
+                "compressions",
+                "and",
+                "ventilations",
+                "are",
+                "being",
+                "performed,",
+                "a",
+                "defibrillator",
+                "shock",
+                "has",
+                "been",
+                "delivered,",
+                "and",
+                "a",
+                "peripheral",
+                "venous",
+                "line",
+                "has",
+                "been",
+                "cannulated."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "would",
+                "be",
+                "correct",
+                "next:"
+            ],
+            [
+                "1-",
+                "Administration",
+                "of",
+                "150",
+                "mg",
+                "of",
+                "intravenous",
+                "amiodarone."
+            ],
+            [
+                "2-",
+                "Administration",
+                "of",
+                "300",
+                "mg",
+                "of",
+                "intravenous",
+                "amiodarone."
+            ],
+            [
+                "3-",
+                "Administration",
+                "of",
+                "1",
+                "mg",
+                "of",
+                "intravenous",
+                "atropine."
+            ],
+            [
+                "4-",
+                "Administer",
+                "2",
+                "mg",
+                "of",
+                "intravenous",
+                "atropine."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Controversial",
+                "question,",
+                "since",
+                "amiodarone",
+                "(the",
+                "dose",
+                "is",
+                "correct,",
+                "300mg),",
+                "is",
+                "administered",
+                "after",
+                "the",
+                "third",
+                "shock,",
+                "and",
+                "not",
+                "after",
+                "the",
+                "first",
+                "defibrillation,",
+                "which",
+                "is",
+                "what",
+                "we",
+                "are",
+                "told",
+                "in",
+                "the",
+                "statement."
+            ],
+            [
+                "Although,",
+                "be",
+                "careful,",
+                "that",
+                "is",
+                "what",
+                "the",
+                "guidelines",
+                "say."
+            ],
+            [
+                "I",
+                "am",
+                "sure",
+                "that",
+                "more",
+                "than",
+                "one",
+                "of",
+                "us",
+                "has",
+                "administered",
+                "amiodarone",
+                "as",
+                "soon",
+                "as",
+                "we",
+                "have",
+                "had",
+                "venous",
+                "access",
+                "available",
+                "in",
+                "the",
+                "event",
+                "of",
+                "a",
+                "shockable",
+                "rhythm."
+            ],
+            [
+                "The",
+                "other",
+                "options",
+                "are",
+                "incorrect."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "113_93",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "HEMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "35-year-old",
+                "healthy",
+                "woman",
+                "consults",
+                "for",
+                "asthenia."
+            ],
+            [
+                "The",
+                "CBC",
+                "shows",
+                "microcytic",
+                "and",
+                "hypochromic",
+                "anemia",
+                "(hemoglobin",
+                "7",
+                "g/dL,",
+                "mean",
+                "corpuscular",
+                "volume",
+                "68",
+                "fl,",
+                "mean",
+                "corpuscular",
+                "hemoglobin",
+                "24",
+                "pg)",
+                "with",
+                "an",
+                "elevated",
+                "red",
+                "cell",
+                "distribution",
+                "amplitude",
+                "(ADE",
+                "20%),",
+                "decreased",
+                "reticulocytes",
+                "(0.3%,",
+                "30000/l",
+                "absolute),",
+                "decreased",
+                "hemoglobin",
+                "content",
+                "in",
+                "reticulocytes",
+                "(17",
+                "pg)",
+                "and",
+                "discrete",
+                "thrombocytosis",
+                "(500000",
+                "platelets)."
+            ],
+            [
+                "With",
+                "the",
+                "CBC",
+                "data,",
+                "what",
+                "would",
+                "be",
+                "your",
+                "diagnostic",
+                "suspicion",
+                "even",
+                "without",
+                "having",
+                "the",
+                "patient's",
+                "biochemistry?"
+            ],
+            [
+                "1-",
+                "Thalassemic",
+                "trait."
+            ],
+            [
+                "2-",
+                "Central",
+                "anemia,",
+                "arregenerative,",
+                "due",
+                "to",
+                "folic",
+                "acid",
+                "deficiency."
+            ],
+            [
+                "3-",
+                "Peripheral,",
+                "regenerative,",
+                "hemolytic",
+                "anemia."
+            ],
+            [
+                "4-",
+                "Peripheral",
+                "anemia,",
+                "regenerative,",
+                "due",
+                "to",
+                "acute",
+                "active",
+                "hemorrhage."
+            ],
+            [
+                "5-",
+                "Central",
+                "anemia,",
+                "arregenerative,",
+                "due",
+                "to",
+                "iron",
+                "deficiency."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "With",
+                "the",
+                "data",
+                "we",
+                "are",
+                "given,",
+                "the",
+                "first",
+                "thing",
+                "that",
+                "comes",
+                "to",
+                "mind",
+                "is",
+                "that",
+                "it",
+                "is",
+                "an",
+                "arregenerative",
+                "anemia,",
+                "since",
+                "the",
+                "bone",
+                "marrow",
+                "has",
+                "not",
+                "responded",
+                "with",
+                "an",
+                "exaltation",
+                "of",
+                "erythropoiesis;",
+                "in",
+                "this",
+                "way",
+                "we",
+                "have",
+                "already",
+                "eliminated",
+                "the",
+                "options",
+                "that",
+                "speak",
+                "of",
+                "regenerative",
+                "anemia."
+            ],
+            [
+                "The",
+                "next",
+                "thing",
+                "that",
+                "orients",
+                "us",
+                "towards",
+                "the",
+                "cause",
+                "is",
+                "that",
+                "it",
+                "is",
+                "microcytic",
+                "and",
+                "hypochromic,",
+                "which",
+                "is",
+                "characteristic",
+                "of",
+                "iron",
+                "deficiency",
+                "anemia,",
+                "since",
+                "folic",
+                "deficiency",
+                "gives",
+                "rise",
+                "to",
+                "megaloblastic",
+                "anemia",
+                "and",
+                "active",
+                "hemorrhage",
+                "does",
+                "not",
+                "give",
+                "microcytosis",
+                "or",
+                "hypochromia,",
+                "but",
+                "normocytosis",
+                "and",
+                "normochromia."
+            ],
+            [
+                "We",
+                "are",
+                "almost",
+                "inclined",
+                "to",
+                "answer",
+                "5,",
+                "central",
+                "arregenerative",
+                "anemia",
+                "due",
+                "to",
+                "iron",
+                "deficiency...but",
+                "there",
+                "remains",
+                "answer",
+                "1,",
+                "\"thalassemic",
+                "trait\",",
+                "which",
+                "makes",
+                "us",
+                "uncomfortable",
+                "and",
+                "makes",
+                "us",
+                "doubt",
+                "if",
+                "we",
+                "are",
+                "not",
+                "going",
+                "for",
+                "the",
+                "apparently",
+                "easy",
+                "thing...until",
+                "we",
+                "remember",
+                "that",
+                "in",
+                "thalassemia",
+                "the",
+                "ADE",
+                "is",
+                "normal."
+            ],
+            [
+                "Definitely,",
+                "this",
+                "girl",
+                "of",
+                "childbearing",
+                "age",
+                "has",
+                "iron",
+                "deficiency",
+                "anemia,",
+                "something",
+                "quite",
+                "common."
+            ],
+            [
+                "Those",
+                "who",
+                "have",
+                "doubts",
+                "can",
+                "consult",
+                "\"Hematology."
+            ],
+            [
+                "Manual",
+                "b\u00e1sico",
+                "razonado\"",
+                "by",
+                "Jes\u00fas",
+                "San",
+                "Miguel."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "59_51",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ANESTHESIOLOGY",
+                "AND",
+                "CRITICAL",
+                "CARE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "47-year-old",
+                "male",
+                "patient",
+                "who",
+                "consults",
+                "the",
+                "emergency",
+                "department",
+                "for",
+                "sudden",
+                "loss",
+                "of",
+                "consciousness",
+                "Which",
+                "of",
+                "the",
+                "following",
+                "has",
+                "a",
+                "higher",
+                "diagnostic",
+                "yield?"
+            ],
+            [
+                "1-",
+                "Clinical",
+                "history."
+            ],
+            [
+                "2-",
+                "Electrocardiogram."
+            ],
+            [
+                "3-",
+                "Holter",
+                "recording."
+            ],
+            [
+                "4-",
+                "EEG."
+            ],
+            [
+                "5-",
+                "Cranial",
+                "CT",
+                "scan."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Obviously,",
+                "it",
+                "is",
+                "the",
+                "only",
+                "answer",
+                "that",
+                "encompasses",
+                "all",
+                "the",
+                "causes",
+                "of",
+                "sudden",
+                "loss",
+                "of",
+                "consciousness",
+                "and",
+                "that",
+                "allows",
+                "us",
+                "to",
+                "somehow",
+                "filter",
+                "the",
+                "diagnosis."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ]
+        ]
+    },
+    {
+        "id": "412_54",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "BIOSTATISTICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "Elizabeth",
+                "has",
+                "three",
+                "sons",
+                "and",
+                "one",
+                "daughter",
+                "(Mary),",
+                "all",
+                "of",
+                "whom",
+                "are",
+                "healthy."
+            ],
+            [
+                "A",
+                "brother",
+                "and",
+                "a",
+                "maternal",
+                "uncle",
+                "of",
+                "Isabel",
+                "died",
+                "of",
+                "Duchenne",
+                "disease:",
+                "an",
+                "X-linked",
+                "recessive",
+                "disease."
+            ],
+            [
+                "At",
+                "present,",
+                "Maria",
+                "wants",
+                "to",
+                "become",
+                "pregnant",
+                "and",
+                "wants",
+                "to",
+                "know",
+                "the",
+                "risk",
+                "of",
+                "transmitting",
+                "the",
+                "disease",
+                "to",
+                "her",
+                "offspring."
+            ],
+            [
+                "With",
+                "the",
+                "data",
+                "collected,",
+                "what",
+                "is",
+                "the",
+                "probability",
+                "that",
+                "Maria",
+                "is",
+                "a",
+                "carrier",
+                "of",
+                "Duchenne",
+                "disease?"
+            ],
+            [
+                "1-",
+                "2/3."
+            ],
+            [
+                "2-",
+                "1/2."
+            ],
+            [
+                "3-",
+                "1/4."
+            ],
+            [
+                "4-",
+                "Less",
+                "than",
+                "1/4."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "The",
+                "maternal",
+                "grandmother",
+                "carried",
+                "the",
+                "mutation",
+                "in",
+                "one",
+                "copy",
+                "of",
+                "the",
+                "gene",
+                "on",
+                "an",
+                "X",
+                "chromosome",
+                "(we",
+                "are",
+                "not",
+                "told",
+                "that",
+                "she",
+                "had",
+                "the",
+                "disease,",
+                "but",
+                "a",
+                "son",
+                "of",
+                "hers,",
+                "Isabel's",
+                "maternal",
+                "uncle,",
+                "did",
+                "have",
+                "the",
+                "disease)."
+            ],
+            [
+                "Isabel's",
+                "mother",
+                "continues",
+                "to",
+                "carry",
+                "it,",
+                "since",
+                "one",
+                "of",
+                "Isabel's",
+                "brothers",
+                "has",
+                "suffered",
+                "from",
+                "the",
+                "disease",
+                "but",
+                "not",
+                "her",
+                "father."
+            ],
+            [
+                "Thus,",
+                "Isabel",
+                "has",
+                "a",
+                "50%",
+                "chance",
+                "of",
+                "having",
+                "inherited",
+                "the",
+                "mutated",
+                "gene",
+                "from",
+                "her",
+                "mother",
+                "(as",
+                "her",
+                "children",
+                "are",
+                "all",
+                "healthy,",
+                "we",
+                "are",
+                "not",
+                "sure",
+                "if",
+                "she",
+                "is",
+                "a",
+                "carrier),",
+                "and",
+                "therefore",
+                "her",
+                "daughter",
+                "has",
+                "a",
+                "25%",
+                "chance",
+                "of",
+                "having",
+                "inherited",
+                "the",
+                "mutated",
+                "gene",
+                "from",
+                "her",
+                "grandmother."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-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",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "347_159",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "69-year-old",
+                "woman",
+                "who",
+                "comes",
+                "to",
+                "your",
+                "office",
+                "referring",
+                "genital",
+                "bleeding",
+                "of",
+                "several",
+                "months",
+                "of",
+                "evolution."
+            ],
+            [
+                "She",
+                "denies",
+                "hormone",
+                "replacement",
+                "therapy",
+                "and",
+                "anticoagulation."
+            ],
+            [
+                "She",
+                "provides",
+                "normal",
+                "cervicovaginal",
+                "cytology."
+            ],
+            [
+                "General",
+                "and",
+                "genital",
+                "physical",
+                "examination",
+                "without",
+                "findings",
+                "of",
+                "interest."
+            ],
+            [
+                "BMI",
+                "of",
+                "38kg/m2."
+            ],
+            [
+                "Indicate",
+                "the",
+                "most",
+                "correct",
+                "attitude:"
+            ],
+            [
+                "1-",
+                "Prescribe",
+                "cyclic",
+                "progesterone."
+            ],
+            [
+                "2-",
+                "Endometrial",
+                "biopsy."
+            ],
+            [
+                "3-",
+                "Random",
+                "biopsies",
+                "of",
+                "the",
+                "cervix."
+            ],
+            [
+                "4-",
+                "Hormonal",
+                "assessment",
+                "with",
+                "FSH,",
+                "LH",
+                "and",
+                "estradiol."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Endometrial",
+                "biopsy."
+            ],
+            [
+                "Peri-",
+                "or",
+                "menopause:",
+                "-",
+                "Due",
+                "to",
+                "the",
+                "high",
+                "prevalence",
+                "of",
+                "organic",
+                "pathology",
+                "during",
+                "this",
+                "period",
+                "it",
+                "is",
+                "necessary",
+                "to",
+                "systematically",
+                "perform",
+                "endometrial",
+                "biopsy",
+                "(Cornier",
+                "or",
+                "Hysteroscopy)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "325_56",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CRITICAL,",
+                "PALLIATIVE",
+                "AND",
+                "EMERGENCY",
+                "CARE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "54-year-old",
+                "patient",
+                "is",
+                "admitted",
+                "for",
+                "thermometric",
+                "fever",
+                "of",
+                "38\u00b0C",
+                "in",
+                "the",
+                "previous",
+                "five",
+                "days",
+                "and",
+                "dyspnea",
+                "at",
+                "rest",
+                "(NYHA",
+                "lV)",
+                "that",
+                "appeared",
+                "6",
+                "hours",
+                "before",
+                "coming",
+                "to",
+                "the",
+                "hospital."
+            ],
+            [
+                "Examination",
+                "in",
+                "the",
+                "emergency",
+                "room",
+                "was",
+                "compatible",
+                "with",
+                "heart",
+                "failure",
+                "and",
+                "the",
+                "ECG",
+                "showed",
+                "complete",
+                "atrioventricular",
+                "block",
+                "with",
+                "an",
+                "escape",
+                "ventricular",
+                "rate",
+                "of",
+                "45",
+                "bpm."
+            ],
+            [
+                "Signs",
+                "of",
+                "heart",
+                "failure",
+                "are",
+                "refractory",
+                "to",
+                "medical",
+                "treatment",
+                "and",
+                "transesophageal",
+                "echocardiography",
+                "shows",
+                "an",
+                "aortic",
+                "valve",
+                "with",
+                "an",
+                "effective",
+                "regurgitant",
+                "orifice",
+                "of",
+                "0.5",
+                "cm2."
+            ],
+            [
+                "Serial",
+                "cultures",
+                "are",
+                "positive",
+                "for",
+                "Streptococcus",
+                "gallolyticus."
+            ],
+            [
+                "Indicate",
+                "the",
+                "best",
+                "course",
+                "of",
+                "action:"
+            ],
+            [
+                "1-",
+                "Cardiac",
+                "surgery",
+                "for",
+                "aortic",
+                "valve",
+                "replacement",
+                "by",
+                "mechanical",
+                "prosthesis",
+                "with",
+                "antibiotic",
+                "therapy",
+                "according",
+                "to",
+                "antibiogram."
+            ],
+            [
+                "2-",
+                "Antibiotic",
+                "therapy",
+                "according",
+                "to",
+                "antibiogram",
+                "and",
+                "implantation",
+                "of",
+                "intra-aortic",
+                "balloon",
+                "counterpulsation",
+                "and",
+                "transient",
+                "pacemaker",
+                "for",
+                "up",
+                "to",
+                "3",
+                "weeks,",
+                "after",
+                "which",
+                "a",
+                "permanent",
+                "pacemaker",
+                "will",
+                "be",
+                "implanted."
+            ],
+            [
+                "3-",
+                "Implantation",
+                "of",
+                "transient",
+                "pacemaker,",
+                "antibiotic",
+                "therapy",
+                "according",
+                "to",
+                "antibiogram",
+                "and",
+                "percutaneous",
+                "implantation",
+                "of",
+                "aortic",
+                "valve",
+                "prosthesis."
+            ],
+            [
+                "4-",
+                "Urgent",
+                "implantation",
+                "of",
+                "definitive",
+                "pacemaker",
+                "with",
+                "antibiotic",
+                "therapy",
+                "according",
+                "to",
+                "antibiogram",
+                "for",
+                "6",
+                "weeks."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "1,",
+                "since",
+                "the",
+                "indications",
+                "for",
+                "cardiac",
+                "surgery",
+                "include",
+                "the",
+                "appearance",
+                "of",
+                "heart",
+                "failure",
+                "or",
+                "new",
+                "conduction",
+                "disorders,",
+                "and",
+                "in",
+                "this",
+                "case",
+                "it",
+                "presents",
+                "both."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "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",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "335_175",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PHARMACOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "88-year-old",
+                "man",
+                "comes",
+                "for",
+                "consultation",
+                "because",
+                "he",
+                "has",
+                "fallen",
+                "3",
+                "times",
+                "in",
+                "the",
+                "last",
+                "6",
+                "months."
+            ],
+            [
+                "None",
+                "of",
+                "the",
+                "falls",
+                "was",
+                "accompanied",
+                "by",
+                "dizziness",
+                "or",
+                "syncope."
+            ],
+            [
+                "One",
+                "fall",
+                "occurred",
+                "while",
+                "he",
+                "was",
+                "walking",
+                "in",
+                "the",
+                "garden."
+            ],
+            [
+                "His",
+                "medical",
+                "history",
+                "includes",
+                "hypertension",
+                "without",
+                "postural",
+                "changes",
+                "in",
+                "blood",
+                "pressure,",
+                "gout,",
+                "osteoarthritis,",
+                "and",
+                "depression."
+            ],
+            [
+                "She",
+                "takes",
+                "5",
+                "medications",
+                "regularly."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "is",
+                "most",
+                "likely",
+                "to",
+                "contribute",
+                "to",
+                "falls",
+                "in",
+                "this",
+                "patient?"
+            ],
+            [
+                "1-",
+                "Allopurinol."
+            ],
+            [
+                "2-",
+                "Hydrochlorothiazide."
+            ],
+            [
+                "3-",
+                "Lisinopril."
+            ],
+            [
+                "4-",
+                "Paroxetine."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Paroxetine;",
+                "complicated",
+                "question",
+                "since",
+                "both",
+                "hydrochlorothiazide",
+                "and",
+                "lisinopril",
+                "can",
+                "also",
+                "produce",
+                "falls",
+                "in",
+                "the",
+                "elderly,",
+                "but",
+                "they",
+                "would",
+                "generally",
+                "be",
+                "accompanied",
+                "by",
+                "dizziness."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "B-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"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "O",
+                "O",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "19_109",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTIOUS",
+                "DISEASES"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "32-year-old",
+                "woman",
+                "has",
+                "traveled",
+                "to",
+                "Cuba",
+                "from",
+                "where",
+                "she",
+                "arrived",
+                "three",
+                "days",
+                "ago."
+            ],
+            [
+                "The",
+                "day",
+                "after",
+                "her",
+                "return,",
+                "she",
+                "goes",
+                "to",
+                "her",
+                "family",
+                "doctor",
+                "for",
+                "high",
+                "fever,",
+                "intense",
+                "arthromyalgia",
+                "and",
+                "headache",
+                "that",
+                "had",
+                "started",
+                "before",
+                "the",
+                "return",
+                "trip",
+                "and",
+                "he",
+                "prescribes",
+                "her",
+                "paracetamol."
+            ],
+            [
+                "Three",
+                "days",
+                "later",
+                "and",
+                "with",
+                "no",
+                "improvement,",
+                "he",
+                "presented",
+                "in",
+                "the",
+                "morning",
+                "with",
+                "a",
+                "generalized",
+                "pruritic",
+                "maculo-papular",
+                "rash,",
+                "which",
+                "was",
+                "more",
+                "intense",
+                "on",
+                "the",
+                "lower",
+                "limbs",
+                "where",
+                "it",
+                "developed",
+                "into",
+                "petechiae,",
+                "for",
+                "which",
+                "he",
+                "went",
+                "to",
+                "the",
+                "emergency",
+                "department."
+            ],
+            [
+                "There",
+                "is",
+                "no",
+                "relevant",
+                "data",
+                "in",
+                "the",
+                "EC",
+                "except",
+                "platelets",
+                "75000/mm3",
+                "(htco",
+                "36%,",
+                "leukocytes",
+                "4100",
+                "79%",
+                "neutrophils)."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Infectious",
+                "mononucleosis."
+            ],
+            [
+                "2-",
+                "Allergic",
+                "exanthema."
+            ],
+            [
+                "3-",
+                "P.",
+                "falciparum",
+                "malaria."
+            ],
+            [
+                "4-",
+                "Typhoid",
+                "fever."
+            ],
+            [
+                "5-",
+                "Dengue",
+                "fever."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "In",
+                "this",
+                "case",
+                "I",
+                "believe",
+                "that",
+                "the",
+                "correct",
+                "answer",
+                "is",
+                "5."
+            ],
+            [
+                "The",
+                "1",
+                "should",
+                "not",
+                "be",
+                "because",
+                "although",
+                "the",
+                "clinical",
+                "picture",
+                "is",
+                "suggestive,",
+                "it",
+                "does",
+                "not",
+                "present",
+                "lymphocytosis."
+            ],
+            [
+                "It",
+                "does",
+                "not",
+                "seem",
+                "to",
+                "be",
+                "an",
+                "allergic",
+                "exanthema",
+                "from",
+                "the",
+                "clinical",
+                "picture."
+            ],
+            [
+                "And",
+                "certainly",
+                "she",
+                "does",
+                "not",
+                "have",
+                "symptoms",
+                "or",
+                "clinical",
+                "signs",
+                "compatible",
+                "with",
+                "malaria",
+                "or",
+                "typhoid",
+                "fever."
+            ],
+            [
+                "What",
+                "points",
+                "to",
+                "dengue,",
+                "in",
+                "addition",
+                "to",
+                "the",
+                "clinical",
+                "signs,",
+                "is",
+                "the",
+                "plateletopenia."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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-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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ]
+        ]
+    },
+    {
+        "id": "401_147",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "TRAUMATOLOGY",
+                "AND",
+                "ORTHOPEDICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "13-year-old",
+                "boy",
+                "presents",
+                "dorsal",
+                "pain",
+                "of",
+                "several",
+                "months",
+                "of",
+                "evolution,",
+                "only",
+                "when",
+                "standing",
+                "and",
+                "walking,",
+                "what",
+                "diagnosis",
+                "should",
+                "we",
+                "consider?"
+            ],
+            [
+                "1-",
+                "Scheuermann's",
+                "disease."
+            ],
+            [
+                "2-",
+                "Thoracic",
+                "scoliosis."
+            ],
+            [
+                "3-",
+                "Malignant",
+                "tumor",
+                "of",
+                "the",
+                "vertebral",
+                "body."
+            ],
+            [
+                "4-",
+                "It",
+                "is",
+                "a",
+                "mechanical",
+                "overload."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "A",
+                "malignant",
+                "tumor",
+                "would",
+                "also",
+                "hurt",
+                "at",
+                "rest."
+            ],
+            [
+                "As",
+                "for",
+                "Scheuermann",
+                "and",
+                "scoliosis,",
+                "we",
+                "should",
+                "be",
+                "given",
+                "some",
+                "physical",
+                "data",
+                "because",
+                "the",
+                "patient",
+                "presents",
+                "with",
+                "a",
+                "specific",
+                "examination",
+                "that",
+                "would",
+                "give",
+                "us",
+                "the",
+                "diagnosis."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "607_115",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "453_150",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "25-year-old",
+                "man",
+                "consults",
+                "for",
+                "tremor."
+            ],
+            [
+                "Examination",
+                "reveals",
+                "dysarthria",
+                "and",
+                "dystonia."
+            ],
+            [
+                "He",
+                "has",
+                "a",
+                "family",
+                "history",
+                "of",
+                "psychiatric",
+                "illness",
+                "and",
+                "movement",
+                "disorders."
+            ],
+            [
+                "Which",
+                "diagnostic",
+                "test",
+                "do",
+                "you",
+                "consider",
+                "most",
+                "accurate?"
+            ],
+            [
+                "1-",
+                "DATS",
+                "CAN."
+            ],
+            [
+                "2-",
+                "Nerve",
+                "conduction",
+                "study."
+            ],
+            [
+                "3-",
+                "Electroencephalogram."
+            ],
+            [
+                "4-",
+                "Copper",
+                "in",
+                "urine",
+                "of",
+                "24."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "If",
+                "they",
+                "are",
+                "talking",
+                "about",
+                "a",
+                "young",
+                "man",
+                "20-30",
+                "years",
+                "old,",
+                "with",
+                "tremor",
+                "and",
+                "dystonia,",
+                "whether",
+                "or",
+                "not",
+                "he",
+                "has",
+                "a",
+                "family",
+                "history,",
+                "and",
+                "especially",
+                "if",
+                "one",
+                "of",
+                "the",
+                "options",
+                "tells",
+                "me",
+                "about",
+                "copper",
+                "in",
+                "urine,",
+                "they",
+                "are",
+                "telling",
+                "me",
+                "to",
+                "think",
+                "of",
+                "Wilson's",
+                "disease."
+            ],
+            [
+                "I",
+                "do",
+                "not",
+                "think",
+                "of",
+                "juvenile",
+                "Parkinson's,",
+                "nor",
+                "an",
+                "epileptic",
+                "clinic."
+            ],
+            [
+                "So",
+                "the",
+                "correct",
+                "answer",
+                "is",
+                "4."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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"
+            ],
+            [
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "529_166",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEPHROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "18-year-old",
+                "patient",
+                "consulted",
+                "for",
+                "edema."
+            ],
+            [
+                "A",
+                "complete",
+                "blood",
+                "test",
+                "showed",
+                "proteinuria",
+                "of",
+                "8",
+                "g/day",
+                "without",
+                "microhematuria,",
+                "hypoalbuminemia",
+                "and",
+                "hypercholesterolemia",
+                "with",
+                "normal",
+                "renal",
+                "function."
+            ],
+            [
+                "He",
+                "was",
+                "empirically",
+                "administered",
+                "corticosteroids."
+            ],
+            [
+                "After",
+                "one",
+                "month,",
+                "the",
+                "clinical",
+                "picture",
+                "has",
+                "completely",
+                "disappeared."
+            ],
+            [
+                "What",
+                "is",
+                "your",
+                "diagnostic",
+                "hypothesis?"
+            ],
+            [
+                "1-",
+                "Amyloidosis."
+            ],
+            [
+                "2-",
+                "IgA",
+                "nephropathy",
+                "or",
+                "Berger's",
+                "disease."
+            ],
+            [
+                "3-",
+                "Alport",
+                "syndrome."
+            ],
+            [
+                "4-",
+                "Nephropathy",
+                "with",
+                "minimal",
+                "changes."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "We",
+                "describe",
+                "a",
+                "young",
+                "patient",
+                "with",
+                "criteria",
+                "of",
+                "nephrotic",
+                "syndrome",
+                "with",
+                "excellent",
+                "response",
+                "to",
+                "corticosteroids."
+            ],
+            [
+                "Without",
+                "biopsy,",
+                "the",
+                "clinical",
+                "presentation",
+                "and",
+                "evolution",
+                "suggest",
+                "a",
+                "nephropathy",
+                "with",
+                "minimal",
+                "changes,",
+                "which",
+                "usually",
+                "presents",
+                "with",
+                "normal",
+                "or",
+                "slightly",
+                "altered",
+                "renal",
+                "function",
+                "together",
+                "with",
+                "nephrotic",
+                "syndrome,",
+                "and",
+                "which",
+                "in",
+                "85-90%",
+                "of",
+                "cases",
+                "resolves",
+                "with",
+                "steroid",
+                "treatment."
+            ],
+            [
+                "The",
+                "age",
+                "is",
+                "the",
+                "only",
+                "data",
+                "that",
+                "is",
+                "a",
+                "bit",
+                "shaky,",
+                "since",
+                "although",
+                "it",
+                "is",
+                "the",
+                "most",
+                "frequent",
+                "cause",
+                "of",
+                "idiopathic",
+                "nephrotic",
+                "syndrome",
+                "in",
+                "children",
+                "and",
+                "adolescents,",
+                "it",
+                "is",
+                "usually",
+                "recommended",
+                "to",
+                "perform",
+                "a",
+                "biopsy",
+                "prior",
+                "to",
+                "treatment",
+                "in",
+                "those",
+                "older",
+                "than",
+                "16",
+                "years,",
+                "in",
+                "any",
+                "case",
+                "it",
+                "does",
+                "not",
+                "admit",
+                "much",
+                "discussion."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "258_96",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "62-year-old",
+                "man",
+                "with",
+                "type",
+                "2",
+                "diabetes",
+                "mellitus",
+                "of",
+                "10",
+                "years",
+                "of",
+                "evolution",
+                "is",
+                "treated",
+                "with",
+                "metformin",
+                "and",
+                "sitagliptin."
+            ],
+            [
+                "He",
+                "does",
+                "little",
+                "physical",
+                "exercise",
+                "and",
+                "follows",
+                "an",
+                "adequate",
+                "diet."
+            ],
+            [
+                "In",
+                "the",
+                "last",
+                "6",
+                "months",
+                "he",
+                "has",
+                "lost",
+                "weight",
+                "and",
+                "has",
+                "more",
+                "asthenia."
+            ],
+            [
+                "Her",
+                "glycemic",
+                "controls",
+                "have",
+                "deteriorated",
+                "from",
+                "baseline",
+                "blood",
+                "glucose",
+                "levels",
+                "of",
+                "110-140",
+                "mg/dL",
+                "to",
+                "170-200",
+                "mg/dL,",
+                "as",
+                "well",
+                "as",
+                "her",
+                "glycosylated",
+                "hemoglobin",
+                "which",
+                "has",
+                "gone",
+                "from",
+                "7.1",
+                "to",
+                "8.5%."
+            ],
+            [
+                "The",
+                "most",
+                "appropriate",
+                "therapeutic",
+                "measure",
+                "to",
+                "be",
+                "taken",
+                "is:"
+            ],
+            [
+                "1-",
+                "Increase",
+                "dietary",
+                "protein",
+                "and",
+                "long-chain",
+                "carbohydrate",
+                "intake",
+                "to",
+                "improve",
+                "asthenia",
+                "and",
+                "weight",
+                "loss."
+            ],
+            [
+                "2-",
+                "To",
+                "associate",
+                "a",
+                "basal",
+                "insulin",
+                "dose",
+                "to",
+                "the",
+                "treatment."
+            ],
+            [
+                "3-",
+                "Associate",
+                "with",
+                "ascarbose",
+                "treatment."
+            ],
+            [
+                "4-",
+                "Substitute",
+                "sitagliptin",
+                "for",
+                "pioglitazone."
+            ],
+            [
+                "5-",
+                "Substitute",
+                "metformin",
+                "for",
+                "glimepiride."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "To",
+                "associate",
+                "a",
+                "basal",
+                "insulin",
+                "dose",
+                "to",
+                "the",
+                "treatment."
+            ],
+            [
+                "Expected",
+                "question",
+                "on",
+                "a",
+                "very",
+                "important",
+                "subject:",
+                "diabetes",
+                "and",
+                "its",
+                "treatment."
+            ],
+            [
+                "Patient",
+                "poorly",
+                "controlled",
+                "with",
+                "metformin",
+                "and",
+                "sitagliptin",
+                "with",
+                "discrete",
+                "cardinal",
+                "symptoms",
+                "(weight",
+                "loss,",
+                "asthenia)."
+            ],
+            [
+                "The",
+                "best",
+                "option",
+                "is",
+                "insulin",
+                "to",
+                "control",
+                "cardinal",
+                "symptoms",
+                "and",
+                "decrease",
+                "HbA1c",
+                "to",
+                "<",
+                "7%."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "375_128",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "45-year-old",
+                "patient",
+                "under",
+                "study",
+                "for",
+                "possible",
+                "meningitis,",
+                "with",
+                "fever,",
+                "headache",
+                "and",
+                "vomiting",
+                "of",
+                "2",
+                "days",
+                "of",
+                "evolution."
+            ],
+            [
+                "A",
+                "brain",
+                "MRI",
+                "and",
+                "lumbar",
+                "puncture",
+                "were",
+                "performed."
+            ],
+            [
+                "Twenty",
+                "hours",
+                "later,",
+                "on",
+                "getting",
+                "up",
+                "to",
+                "go",
+                "to",
+                "the",
+                "bathroom,",
+                "he",
+                "complains",
+                "of",
+                "severe",
+                "headache,",
+                "very",
+                "marked",
+                "when",
+                "he",
+                "sits",
+                "up",
+                "but",
+                "disappears",
+                "when",
+                "he",
+                "lies",
+                "down."
+            ],
+            [
+                "She",
+                "no",
+                "longer",
+                "has",
+                "fever",
+                "or",
+                "vomiting."
+            ],
+            [
+                "What",
+                "is",
+                "most",
+                "likely",
+                "the",
+                "origin",
+                "of",
+                "this",
+                "headache?"
+            ],
+            [
+                "1-",
+                "Meningitis",
+                "remains",
+                "the",
+                "fundamental",
+                "cause",
+                "of",
+                "her",
+                "headache,",
+                "as",
+                "it",
+                "is",
+                "the",
+                "same",
+                "type",
+                "of",
+                "headache",
+                "as",
+                "at",
+                "the",
+                "onset",
+                "of",
+                "symptoms."
+            ],
+            [
+                "2-",
+                "It",
+                "is",
+                "a",
+                "post",
+                "lumbar",
+                "puncture",
+                "headache."
+            ],
+            [
+                "3-",
+                "It",
+                "is",
+                "necessary",
+                "to",
+                "look",
+                "for",
+                "a",
+                "different",
+                "cause",
+                "to",
+                "this",
+                "headache,",
+                "because",
+                "it",
+                "is",
+                "not",
+                "typical",
+                "of",
+                "post-lumbar",
+                "puncture",
+                "syndrome",
+                "or",
+                "meningitis."
+            ],
+            [
+                "4-",
+                "Most",
+                "likely",
+                "it",
+                "was",
+                "not",
+                "a",
+                "viral",
+                "meningitis,",
+                "but",
+                "a",
+                "subarachnoid",
+                "hemorrhage.",
+                "For",
+                "this",
+                "reason,",
+                "the",
+                "initial",
+                "headache",
+                "disappears",
+                "almost",
+                "completely",
+                "when",
+                "lying",
+                "down."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "The",
+                "picture",
+                "they",
+                "describe",
+                "of",
+                "intense",
+                "headache",
+                "with",
+                "orthostatism",
+                "that",
+                "disappears",
+                "when",
+                "lying",
+                "down,",
+                "although",
+                "it",
+                "is",
+                "true",
+                "that",
+                "the",
+                "most",
+                "typical",
+                "presentation",
+                "is",
+                "between",
+                "the",
+                "first",
+                "24-48",
+                "hours",
+                "and",
+                "in",
+                "this",
+                "case",
+                "it",
+                "is",
+                "somewhat",
+                "earlier."
+            ],
+            [
+                "Even",
+                "so,",
+                "the",
+                "rest",
+                "of",
+                "the",
+                "answers",
+                "are",
+                "improbable:",
+                "the",
+                "first",
+                "cannot",
+                "be",
+                "because",
+                "we",
+                "have",
+                "not",
+                "been",
+                "told",
+                "what",
+                "the",
+                "initial",
+                "headache",
+                "was",
+                "like;",
+                "the",
+                "third,",
+                "although",
+                "it",
+                "could",
+                "be",
+                "due",
+                "to",
+                "the",
+                "time",
+                "of",
+                "onset",
+                "(as",
+                "I",
+                "said",
+                "a",
+                "little",
+                "earlier",
+                "than",
+                "expected),",
+                "the",
+                "reality",
+                "is",
+                "that",
+                "the",
+                "headache",
+                "with",
+                "orthostasis",
+                "is",
+                "so",
+                "typical",
+                "that",
+                "it",
+                "would",
+                "be",
+                "the",
+                "most",
+                "probable",
+                "cause;",
+                "the",
+                "last",
+                "one",
+                "could",
+                "not",
+                "be",
+                "either",
+                "because",
+                "SAH",
+                "does",
+                "not",
+                "follow",
+                "this",
+                "pattern",
+                "in",
+                "relation",
+                "to",
+                "orthostasis."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "352_161",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "27-year-old",
+                "woman",
+                "referred",
+                "to",
+                "the",
+                "gynecology",
+                "office",
+                "for",
+                "evaluation",
+                "referring",
+                "dyspareunia",
+                "for",
+                "about",
+                "8",
+                "months,",
+                "along",
+                "with",
+                "dyschezia",
+                "and",
+                "occasional",
+                "rectorrhagia",
+                "coinciding",
+                "with",
+                "menstruation",
+                "for",
+                "3-4",
+                "months."
+            ],
+            [
+                "She",
+                "also",
+                "reports",
+                "dysmenorrhea",
+                "for",
+                "years,",
+                "which",
+                "she",
+                "controls",
+                "well",
+                "with",
+                "ibuprofen."
+            ],
+            [
+                "She",
+                "has",
+                "been",
+                "trying",
+                "to",
+                "get",
+                "pregnant",
+                "for",
+                "16",
+                "months",
+                "without",
+                "success."
+            ],
+            [
+                "In",
+                "the",
+                "gynecological",
+                "examination",
+                "she",
+                "only",
+                "shows",
+                "pain",
+                "when",
+                "pressing",
+                "on",
+                "the",
+                "posterior",
+                "vaginal",
+                "fornix."
+            ],
+            [
+                "Which",
+                "test",
+                "do",
+                "you",
+                "consider",
+                "would",
+                "allow",
+                "you",
+                "to",
+                "reach",
+                "a",
+                "diagnosis",
+                "of",
+                "certainty",
+                "of",
+                "her",
+                "pathology?"
+            ],
+            [
+                "1-",
+                "Transvaginal",
+                "ultrasound."
+            ],
+            [
+                "2-",
+                "Diagnostic",
+                "laparoscopy."
+            ],
+            [
+                "3-",
+                "Magnetic",
+                "resonance",
+                "imaging."
+            ],
+            [
+                "4-",
+                "Colonoscopy."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "2."
+            ],
+            [
+                "We",
+                "are",
+                "facing",
+                "a",
+                "suspicion",
+                "of",
+                "endometriosis,",
+                "due",
+                "to",
+                "the",
+                "symptoms",
+                "and",
+                "signs",
+                "given",
+                "in",
+                "the",
+                "statement."
+            ],
+            [
+                "We",
+                "are",
+                "asked",
+                "for",
+                "a",
+                "diagnosis",
+                "of",
+                "certainty,",
+                "and",
+                "the",
+                "Gold",
+                "Standard",
+                "for",
+                "the",
+                "diagnosis",
+                "of",
+                "this",
+                "disease",
+                "is",
+                "diagnostic",
+                "laparoscopy."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "575_102",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "29-year-old",
+                "woman",
+                "with",
+                "a",
+                "history",
+                "of",
+                "febrile",
+                "seizures",
+                "and",
+                "a",
+                "heavy",
+                "smoker."
+            ],
+            [
+                "She",
+                "consults",
+                "for",
+                "frequent,",
+                "stereotyped",
+                "episodes",
+                "that",
+                "begin",
+                "with",
+                "an",
+                "ascending",
+                "epigastric",
+                "sensation",
+                "and",
+                "an",
+                "unpleasant",
+                "odor,",
+                "followed",
+                "by",
+                "disconnection",
+                "from",
+                "the",
+                "environment."
+            ],
+            [
+                "Family",
+                "members",
+                "who",
+                "are",
+                "with",
+                "her",
+                "observe",
+                "that",
+                "she",
+                "makes",
+                "sucking",
+                "movements",
+                "and",
+                "repeated",
+                "opening",
+                "and",
+                "closing",
+                "movements",
+                "of",
+                "the",
+                "left",
+                "hand."
+            ],
+            [
+                "After",
+                "two",
+                "minutes",
+                "the",
+                "movements",
+                "subside,",
+                "but",
+                "she",
+                "has",
+                "difficulty",
+                "responding",
+                "appropriately",
+                "and",
+                "only",
+                "partially",
+                "remembers",
+                "what",
+                "happened."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Complex",
+                "focal",
+                "temporal",
+                "lobe",
+                "seizures."
+            ],
+            [
+                "2-",
+                "Transient",
+                "ischemic",
+                "attacks",
+                "in",
+                "right",
+                "carotid",
+                "territory."
+            ],
+            [
+                "3-",
+                "Simple",
+                "focal",
+                "motor",
+                "seizures."
+            ],
+            [
+                "4-",
+                "Episodes",
+                "of",
+                "transient",
+                "global",
+                "amnesia."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "The",
+                "clinical",
+                "case",
+                "makes",
+                "a",
+                "textbook",
+                "description",
+                "of",
+                "a",
+                "medial",
+                "temporal",
+                "seizure."
+            ],
+            [
+                "The",
+                "aura",
+                "of",
+                "ascending",
+                "epigastric",
+                "sensation",
+                "and",
+                "olfactory",
+                "alteration",
+                "and",
+                "the",
+                "subsequent",
+                "description",
+                "of",
+                "the",
+                "seizure",
+                "with",
+                "alteration",
+                "of",
+                "the",
+                "level",
+                "of",
+                "consciousness",
+                "(disconnection",
+                "from",
+                "the",
+                "environment)",
+                "with",
+                "oral",
+                "and",
+                "manual",
+                "automatisms."
+            ],
+            [
+                "The",
+                "current",
+                "classification",
+                "is",
+                "the",
+                "2017",
+                "ILAE",
+                "classification",
+                "that",
+                "would",
+                "describe",
+                "this",
+                "seizure",
+                "as",
+                "focal",
+                "seizure",
+                "with",
+                "altered",
+                "level",
+                "of",
+                "consciousness,",
+                "but",
+                "in",
+                "the",
+                "MIR",
+                "they",
+                "still",
+                "use",
+                "the",
+                "old",
+                "terminology",
+                "(complex",
+                "is",
+                "what",
+                "altered",
+                "level",
+                "of",
+                "consciousness",
+                "was",
+                "called)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "278_31",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PATHOLOGICAL",
+                "ANATOMY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "20-year-old",
+                "woman",
+                "with",
+                "a",
+                "15",
+                "cm",
+                "solid-cystic",
+                "ovarian",
+                "tumor",
+                "detected",
+                "by",
+                "ultrasound",
+                "after",
+                "presenting",
+                "with",
+                "non-specific",
+                "abdominal",
+                "symptoms."
+            ],
+            [
+                "In",
+                "the",
+                "anatomopathological",
+                "study",
+                "of",
+                "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:",
+                "2"
+            ],
+            [
+                "After",
+                "reading",
+                "the",
+                "question",
+                "and",
+                "the",
+                "possible",
+                "answers,",
+                "we",
+                "have",
+                "two",
+                "tumor",
+                "and",
+                "two",
+                "non-tumor",
+                "options."
+            ],
+            [
+                "At",
+                "no",
+                "time",
+                "are",
+                "atypical",
+                "cellular",
+                "features",
+                "mentioned,",
+                "so",
+                "we",
+                "can",
+                "safely",
+                "rule",
+                "out",
+                "tumor",
+                "lesions,",
+                "leaving",
+                "doubts",
+                "between",
+                "answers",
+                "2",
+                "and",
+                "3."
+            ],
+            [
+                "In",
+                "this",
+                "case,",
+                "we",
+                "would",
+                "have",
+                "to",
+                "opt",
+                "for",
+                "IMMATURE",
+                "TERATOMA,",
+                "mentioning",
+                "the",
+                "presence",
+                "of",
+                "embryonic",
+                "remains."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "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",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "225_64",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CARDIOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "82-year-old",
+                "patient",
+                "presents",
+                "with",
+                "sudden",
+                "and",
+                "frequent",
+                "dizziness,",
+                "without",
+                "prodromes,",
+                "of",
+                "short",
+                "duration",
+                "and",
+                "which",
+                "subsides",
+                "spontaneously,",
+                "without",
+                "ever",
+                "presenting",
+                "syncope."
+            ],
+            [
+                "Physical",
+                "examination",
+                "and",
+                "baseline",
+                "electrocardiogram",
+                "are",
+                "normal."
+            ],
+            [
+                "In",
+                "an",
+                "ambulatory",
+                "electrocardiogram",
+                "recording",
+                "during",
+                "24",
+                "hours,",
+                "short",
+                "phases",
+                "of",
+                "absence",
+                "of",
+                "P",
+                "waves",
+                "prior",
+                "to",
+                "QRS",
+                "with",
+                "an",
+                "escape",
+                "rhythm",
+                "of",
+                "the",
+                "atrioventricular",
+                "junction",
+                "with",
+                "narrow",
+                "QRS",
+                "at",
+                "40",
+                "bpm",
+                "and",
+                "a",
+                "wave",
+                "at",
+                "the",
+                "beginning",
+                "of",
+                "the",
+                "ST",
+                "segment",
+                "corresponding",
+                "to",
+                "a",
+                "retrograde",
+                "P",
+                "were",
+                "detected",
+                "in",
+                "the",
+                "vigil",
+                "period."
+            ],
+            [
+                "No",
+                "asystole",
+                "periods",
+                "longer",
+                "than",
+                "3",
+                "seconds",
+                "are",
+                "detected."
+            ],
+            [
+                "Given",
+                "this",
+                "you",
+                "would",
+                "say:"
+            ],
+            [
+                "1-",
+                "The",
+                "patient",
+                "has",
+                "a",
+                "third-degree",
+                "AVB",
+                "and",
+                "requires",
+                "pacemaker",
+                "implantation."
+            ],
+            [
+                "2-",
+                "The",
+                "absence",
+                "of",
+                "periods",
+                "of",
+                "asystole",
+                ">3",
+                "seconds",
+                "excludes",
+                "a",
+                "cardiac",
+                "cause",
+                "of",
+                "dizziness."
+            ],
+            [
+                "3-",
+                "Drug",
+                "treatment",
+                "to",
+                "increase",
+                "conduction",
+                "in",
+                "the",
+                "AV",
+                "node",
+                "would",
+                "be",
+                "indicated."
+            ],
+            [
+                "4-",
+                "The",
+                "patient",
+                "presents",
+                "sinus",
+                "dysfunction",
+                "with",
+                "sinoatrial",
+                "block",
+                "and",
+                "requires",
+                "pacemaker",
+                "implantation",
+                "due",
+                "to",
+                "symptoms."
+            ],
+            [
+                "5-",
+                "The",
+                "alterations",
+                "detected",
+                "in",
+                "the",
+                "ambulatory",
+                "electrocardiogram",
+                "are",
+                "typical",
+                "of",
+                "patients",
+                "of",
+                "this",
+                "age",
+                "and",
+                "there",
+                "is",
+                "no",
+                "indication",
+                "for",
+                "therapeutic",
+                "intervention."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "What",
+                "are",
+                "these",
+                "findings",
+                "in",
+                "the",
+                "Holter?"
+            ],
+            [
+                "If",
+                "the",
+                "sinus",
+                "node",
+                "fails,",
+                "the",
+                "AV",
+                "node",
+                "takes",
+                "over",
+                "and",
+                "stimulates",
+                "the",
+                "ventricle."
+            ],
+            [
+                "In",
+                "10%",
+                "of",
+                "people",
+                "there",
+                "is",
+                "retrograde",
+                "conduction,",
+                "so",
+                "that",
+                "beat",
+                "generated",
+                "in",
+                "the",
+                "AVN",
+                "stimulates",
+                "both",
+                "ventricles",
+                "and",
+                "atria,",
+                "giving",
+                "a",
+                "retrograde",
+                "P",
+                "as",
+                "reported",
+                "in",
+                "the",
+                "study."
+            ],
+            [
+                "In",
+                "this",
+                "sense,",
+                "no",
+                "problem."
+            ],
+            [
+                "Likewise,",
+                "there",
+                "are",
+                "also",
+                "no",
+                "pauses",
+                "longer",
+                "than",
+                "3",
+                "seconds",
+                "that",
+                "could",
+                "cause",
+                "cardiogenic",
+                "syncope",
+                "(which,",
+                "in",
+                "fact,",
+                "he",
+                "has",
+                "never",
+                "suffered)."
+            ],
+            [
+                "Option",
+                "1",
+                "is",
+                "ruled",
+                "out:",
+                "it",
+                "is",
+                "not",
+                "a",
+                "complete",
+                "AVB."
+            ],
+            [
+                "Option",
+                "2",
+                "cannot",
+                "be",
+                "answered",
+                "either:",
+                "to",
+                "exclude,",
+                "what",
+                "is",
+                "said",
+                "to",
+                "exclude..."
+            ],
+            [
+                "It",
+                "is",
+                "like",
+                "never/always."
+            ],
+            [
+                "Option",
+                "3",
+                "does",
+                "not",
+                "make",
+                "much",
+                "sense:",
+                "we",
+                "could",
+                "suspend",
+                "those",
+                "that",
+                "impair",
+                "conduction",
+                "(beta-blockers,",
+                "calcium",
+                "antagonists),",
+                "but",
+                "drugs",
+                "that",
+                "facilitate,",
+                "as",
+                "long",
+                "as",
+                "we",
+                "do",
+                "not",
+                "give",
+                "him",
+                "a",
+                "perfusion",
+                "of",
+                "atropine",
+                "to",
+                "take",
+                "home..."
+            ],
+            [
+                "In",
+                "option",
+                "4,",
+                "stating",
+                "that",
+                "he",
+                "has",
+                "sinoatrial",
+                "block",
+                "is",
+                "a",
+                "bit",
+                "of",
+                "a",
+                "rap:",
+                "without",
+                "an",
+                "electrophysiological",
+                "study",
+                "it",
+                "cannot",
+                "be",
+                "said,",
+                "he",
+                "does",
+                "not",
+                "necessarily",
+                "have",
+                "SA",
+                "block,",
+                "and",
+                "this",
+                "alone",
+                "would",
+                "not",
+                "indicate",
+                "the",
+                "implantation",
+                "of",
+                "a",
+                "pacemaker."
+            ],
+            [
+                "So,",
+                "finally,",
+                "I",
+                "would",
+                "check",
+                "option",
+                "5."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "370_125",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PULMONOLOGY",
+                "AND",
+                "THORACIC",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "former",
+                "smoker",
+                "patient,",
+                "previously",
+                "diagnosed",
+                "with",
+                "COPD",
+                "comes",
+                "in",
+                "for",
+                "a",
+                "checkup."
+            ],
+            [
+                "The",
+                "physical",
+                "examination",
+                "reveals",
+                "digital",
+                "hypokratism",
+                "of",
+                "recent",
+                "onset."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "acceptable",
+                "explanation",
+                "for",
+                "this",
+                "finding",
+                "in",
+                "the",
+                "clinical",
+                "context",
+                "described?"
+            ],
+            [
+                "1-",
+                "Pulmonary",
+                "carcinoma."
+            ],
+            [
+                "2-",
+                "Bronchiectasis."
+            ],
+            [
+                "3-",
+                "Pulmonary",
+                "fibrosis."
+            ],
+            [
+                "4-",
+                "Cyanotic",
+                "heart",
+                "disease."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "In",
+                "a",
+                "digital",
+                "hypokratitis",
+                "of",
+                "recent",
+                "onset",
+                "in",
+                "a",
+                "smoking",
+                "patient,",
+                "the",
+                "first",
+                "option",
+                "to",
+                "rule",
+                "out",
+                "is",
+                "bronchopulmonary",
+                "carcinoma."
+            ],
+            [
+                "Other",
+                "pathologies",
+                "can",
+                "also",
+                "occur",
+                "but",
+                "not",
+                "so",
+                "suddenly."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "332_88",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "78_33",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DIGESTIVE",
+                "SYSTEM"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "55-year-old",
+                "postmenopausal",
+                "woman",
+                "consults",
+                "for",
+                "asthenia",
+                "and",
+                "dyspnea",
+                "on",
+                "exertion."
+            ],
+            [
+                "In",
+                "the",
+                "anamnesis",
+                "she",
+                "reported",
+                "slight",
+                "epigastralgia",
+                "and",
+                "occasional",
+                "heartburn."
+            ],
+            [
+                "No",
+                "metrorrhagia."
+            ],
+            [
+                "Laboratory",
+                "tests:",
+                "Hb6",
+                "gr/dL,",
+                "MCV",
+                "69",
+                "fl,",
+                "sideremia",
+                "13",
+                "micrograms/dL,",
+                "ferritin",
+                "4",
+                "ngr/mL."
+            ],
+            [
+                "Gastrointestinal",
+                "endoscopy:",
+                "small",
+                "sliding",
+                "hiatal",
+                "hernia",
+                "with",
+                "no",
+                "signs",
+                "of",
+                "esophagitis."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "correct",
+                "approach?"
+            ],
+            [
+                "1-",
+                "Administer",
+                "oral",
+                "iron",
+                "and",
+                "monitor",
+                "the",
+                "evolution",
+                "of",
+                "anemia."
+            ],
+            [
+                "2-",
+                "Treat",
+                "with",
+                "proton",
+                "pump",
+                "inhibitors",
+                "and",
+                "evaluate",
+                "at",
+                "three",
+                "months."
+            ],
+            [
+                "3-",
+                "Recommend",
+                "a",
+                "complete",
+                "colonoscopy."
+            ],
+            [
+                "4-",
+                "Perform",
+                "an",
+                "endoscopic",
+                "capsule",
+                "study."
+            ],
+            [
+                "5-",
+                "Request",
+                "a",
+                "gynecological",
+                "evaluation."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "We",
+                "have",
+                "a",
+                "case",
+                "of",
+                "chronic",
+                "iron",
+                "deficiency",
+                "anemia,",
+                "without",
+                "obvious",
+                "bleeding."
+            ],
+            [
+                "The",
+                "first",
+                "cause",
+                "of",
+                "iron",
+                "deficiency",
+                "anemia",
+                "is",
+                "occult",
+                "bleeding",
+                "of",
+                "digestive",
+                "origin."
+            ],
+            [
+                "The",
+                "existence",
+                "of",
+                "clinical",
+                "symptoms",
+                "suggestive",
+                "of",
+                "pathology",
+                "of",
+                "the",
+                "upper",
+                "digestive",
+                "tract",
+                "has",
+                "led",
+                "us",
+                "to",
+                "begin",
+                "the",
+                "study",
+                "with",
+                "upper",
+                "endoscopy,",
+                "but",
+                "there",
+                "is",
+                "no",
+                "pathology",
+                "to",
+                "justify",
+                "the",
+                "anemia,",
+                "so",
+                "further",
+                "investigation",
+                "is",
+                "necessary,",
+                "which",
+                "rules",
+                "out",
+                "answers",
+                "1",
+                "and",
+                "2."
+            ],
+            [
+                "Between",
+                "3",
+                "and",
+                "4,",
+                "large",
+                "bowel",
+                "lesions",
+                "are",
+                "much",
+                "more",
+                "common",
+                "and",
+                "should",
+                "be",
+                "ruled",
+                "out",
+                "before",
+                "small",
+                "bowel",
+                "lesions."
+            ],
+            [
+                "In",
+                "fact",
+                "the",
+                "recommendations",
+                "of",
+                "capsule",
+                "endoscopy",
+                "in",
+                "anemia",
+                "studies",
+                "are",
+                "restricted."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "397_140",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "TRAUMATOLOGY",
+                "AND",
+                "ORTHOPEDICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "You",
+                "assess",
+                "a",
+                "66-year-old",
+                "patient",
+                "with",
+                "accentuated",
+                "groin",
+                "pain",
+                "with",
+                "prolonged",
+                "standing",
+                "a",
+                "few",
+                "days",
+                "a",
+                "month."
+            ],
+            [
+                "A",
+                "plain",
+                "radiograph",
+                "of",
+                "the",
+                "hips",
+                "shows",
+                "narrowing",
+                "of",
+                "the",
+                "femoroacetabular",
+                "joint",
+                "space,",
+                "sclerosis",
+                "and",
+                "osteophytes."
+            ],
+            [
+                "What",
+                "is",
+                "your",
+                "attitude?"
+            ],
+            [
+                "1-",
+                "I",
+                "make",
+                "the",
+                "diagnosis",
+                "of",
+                "coxarthrosis",
+                "and",
+                "send",
+                "to",
+                "the",
+                "traumatologist",
+                "to",
+                "place",
+                "a",
+                "hip",
+                "prosthesis."
+            ],
+            [
+                "2-",
+                "Start",
+                "treatment",
+                "with",
+                "weak",
+                "opioids",
+                "that",
+                "have",
+                "shown",
+                "evidence",
+                "of",
+                "halting",
+                "disease",
+                "progression."
+            ],
+            [
+                "3-",
+                "I",
+                "instigate",
+                "treatment",
+                "with",
+                "paracetamol,",
+                "explain",
+                "that",
+                "the",
+                "evolution",
+                "is",
+                "very",
+                "variable",
+                "and",
+                "the",
+                "surgical",
+                "indication",
+                "depends",
+                "on",
+                "functionality",
+                "and",
+                "pain",
+                "control."
+            ],
+            [
+                "4-",
+                "Because",
+                "of",
+                "the",
+                "radiological",
+                "features",
+                "described,",
+                "I",
+                "need",
+                "a",
+                "hip",
+                "MRI",
+                "before",
+                "making",
+                "a",
+                "therapeutic",
+                "decision."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "You",
+                "present",
+                "with",
+                "coxarthrosis",
+                "(no",
+                "further",
+                "imaging",
+                "tests",
+                "are",
+                "needed),",
+                "and",
+                "conservative",
+                "options",
+                "are",
+                "exhausted",
+                "before",
+                "opting",
+                "for",
+                "surgical",
+                "treatment."
+            ],
+            [
+                "Weak",
+                "opioids",
+                "are",
+                "not",
+                "the",
+                "initial",
+                "treatment",
+                "of",
+                "choice."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "275_74",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DIGESTIVE",
+                "SYSTEM"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "67-year-old",
+                "man,",
+                "diagnosed",
+                "with",
+                "cirrhosis",
+                "of",
+                "the",
+                "liver",
+                "and",
+                "an",
+                "active",
+                "drinker,",
+                "is",
+                "admitted",
+                "for",
+                "progressive",
+                "abdominal",
+                "distension",
+                "with",
+                "diffuse",
+                "malaise,",
+                "of",
+                "two",
+                "weeks",
+                "of",
+                "evolution."
+            ],
+            [
+                "He",
+                "reported",
+                "no",
+                "fever",
+                "or",
+                "other",
+                "symptoms."
+            ],
+            [
+                "On",
+                "examination,",
+                "there",
+                "was",
+                "a",
+                "changeable",
+                "dullness",
+                "on",
+                "abdominal",
+                "percussion,",
+                "with",
+                "absence",
+                "of",
+                "edema."
+            ],
+            [
+                "A",
+                "diagnostic",
+                "paracentesis",
+                "is",
+                "performed,",
+                "finding",
+                "a",
+                "slightly",
+                "cloudy",
+                "fluid,",
+                "with",
+                "2,300",
+                "cells/mL,",
+                "of",
+                "which",
+                "30%",
+                "are",
+                "lymphocytes,",
+                "60%",
+                "polymorphonuclear",
+                "and",
+                "10%",
+                "red",
+                "blood",
+                "cells."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "first",
+                "therapeutic",
+                "measure",
+                "you",
+                "would",
+                "prescribe",
+                "for",
+                "this",
+                "patient",
+                "immediately?"
+            ],
+            [
+                "1-",
+                "Salt",
+                "and",
+                "fluid",
+                "restriction."
+            ],
+            [
+                "2-",
+                "Diuretic",
+                "treatment",
+                "with",
+                "oral",
+                "spironolactone."
+            ],
+            [
+                "3-",
+                "Treatment",
+                "with",
+                "a",
+                "third",
+                "generation",
+                "cephalosporin."
+            ],
+            [
+                "4-",
+                "Evacuative",
+                "paracentesis."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "This",
+                "is",
+                "spontaneous",
+                "bacterial",
+                "peritonitis",
+                "(SBP),",
+                "defined",
+                "by",
+                "the",
+                "presence",
+                "of",
+                ">",
+                "250",
+                "polymorphonuclears/mL",
+                "in",
+                "the",
+                "ascitic",
+                "fluid",
+                "(in",
+                "this",
+                "case",
+                "there",
+                "are",
+                "1,380,",
+                "which",
+                "is",
+                "60%",
+                "of",
+                "2,300)."
+            ],
+            [
+                "It",
+                "is",
+                "an",
+                "indication",
+                "to",
+                "start",
+                "3rd",
+                "generation",
+                "cephalosporins",
+                "(ceftriaxone",
+                "or",
+                "cefotaxime)",
+                "and",
+                "albumin."
+            ],
+            [
+                "The",
+                "rest",
+                "are",
+                "treatments",
+                "that",
+                "can",
+                "wait",
+                "for",
+                "improvement",
+                "(they",
+                "do",
+                "not",
+                "speak",
+                "of",
+                "tension",
+                "ascites)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
+                "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-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "418_77",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GENERAL",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "80-year-old",
+                "woman",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "room",
+                "with",
+                "abdominal",
+                "pain",
+                "starting",
+                "in",
+                "the",
+                "epigastrium",
+                "and",
+                "radiating",
+                "later",
+                "to",
+                "the",
+                "left",
+                "iliac",
+                "fossa."
+            ],
+            [
+                "An",
+                "abdominal",
+                "CT",
+                "scan",
+                "is",
+                "performed,",
+                "showing",
+                "inflammation",
+                "in",
+                "the",
+                "walls",
+                "of",
+                "the",
+                "sigma",
+                "and",
+                "mesenteric",
+                "abscess",
+                "of",
+                "2",
+                "cm."
+            ],
+            [
+                "The",
+                "treatment",
+                "of",
+                "choice",
+                "is:"
+            ],
+            [
+                "1-",
+                "Admission",
+                "to",
+                "the",
+                "ward",
+                "with",
+                "absolute",
+                "diet",
+                "and",
+                "broad-spectrum",
+                "antibiotic",
+                "treatment."
+            ],
+            [
+                "2-",
+                "Discharge",
+                "colostomy."
+            ],
+            [
+                "3-",
+                "Drainage",
+                "by",
+                "laparoscopic",
+                "surgery."
+            ],
+            [
+                "4-",
+                "Urgent",
+                "surgery",
+                "with",
+                "sigmoidectomy",
+                "and",
+                "colorectal",
+                "anastomosis."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "We",
+                "are",
+                "asked",
+                "about",
+                "the",
+                "management",
+                "of",
+                "a",
+                "very",
+                "common",
+                "pathology,",
+                "diverticulitis."
+            ],
+            [
+                "And",
+                "we",
+                "are",
+                "asked",
+                "about",
+                "the",
+                "different",
+                "therapeutic",
+                "options",
+                "depending",
+                "on",
+                "how",
+                "advanced",
+                "it",
+                "is."
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "1,",
+                "it",
+                "does",
+                "not",
+                "meet",
+                "the",
+                "criteria",
+                "to",
+                "require",
+                "drainage",
+                "by",
+                "guided",
+                "puncture",
+                "(the",
+                "abscess",
+                "is",
+                "not",
+                "larger",
+                "than",
+                "5-6",
+                "cm)."
+            ],
+            [
+                "Discharge",
+                "colostomy",
+                "in",
+                "this",
+                "case",
+                "makes",
+                "no",
+                "sense",
+                "whatsoever,",
+                "since",
+                "it",
+                "is",
+                "not",
+                "a",
+                "question",
+                "of",
+                "solving",
+                "an",
+                "obstructive",
+                "condition."
+            ],
+            [
+                "Drainage",
+                "by",
+                "laparoscopic",
+                "surgery",
+                "is",
+                "not",
+                "indicated",
+                "in",
+                "this",
+                "case."
+            ],
+            [
+                "It",
+                "could",
+                "be",
+                "indicated",
+                "in",
+                "the",
+                "absence",
+                "of",
+                "the",
+                "possibility",
+                "of",
+                "percutaneous",
+                "drainage",
+                "after",
+                "failure",
+                "of",
+                "conservative",
+                "treatment,",
+                "although",
+                "it",
+                "is",
+                "a",
+                "very",
+                "controversial",
+                "option",
+                "at",
+                "this",
+                "time."
+            ],
+            [
+                "Sigmoidectomy",
+                "and",
+                "anastomosis",
+                "is",
+                "also",
+                "not",
+                "required."
+            ],
+            [
+                "In",
+                "a",
+                "high",
+                "number",
+                "of",
+                "cases,",
+                "after",
+                "the",
+                "resolution",
+                "of",
+                "the",
+                "symptoms,",
+                "the",
+                "outbreaks",
+                "are",
+                "reduced",
+                "and",
+                "they",
+                "can",
+                "be",
+                "prevented",
+                "with",
+                "diet",
+                "and",
+                "hygienic",
+                "dietary",
+                "habits."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
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+                "I-Claim"
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+            [
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+            [
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+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+    },
+    {
+        "id": "200_75",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "469_137",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ORTHOPEDIC",
+                "SURGERY",
+                "AND",
+                "TRAUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "93-year-old",
+                "woman",
+                "with",
+                "a",
+                "history",
+                "of",
+                "COPD,",
+                "AHT,",
+                "dyslipidemia,",
+                "atrial",
+                "fibrillation",
+                "and",
+                "ischemic",
+                "heart",
+                "disease."
+            ],
+            [
+                "She",
+                "lives",
+                "alone."
+            ],
+            [
+                "She",
+                "has",
+                "ventricular",
+                "ejection",
+                "fraction",
+                "53%,",
+                "creatinine",
+                "1.5",
+                "mg/dL,",
+                "normal",
+                "coagulation."
+            ],
+            [
+                "She",
+                "receives",
+                "treatment",
+                "with",
+                "inhaled",
+                "bronchodilators",
+                "and",
+                "ASA",
+                "100",
+                "mg",
+                "per",
+                "day."
+            ],
+            [
+                "She",
+                "suffers",
+                "a",
+                "fall",
+                "in",
+                "the",
+                "street,",
+                "after",
+                "which",
+                "it",
+                "is",
+                "impossible",
+                "for",
+                "her",
+                "to",
+                "stand",
+                "or",
+                "sit",
+                "up,",
+                "with",
+                "intense",
+                "pain",
+                "in",
+                "the",
+                "right",
+                "hip",
+                "on",
+                "mobilization,",
+                "great",
+                "shortening",
+                "and",
+                "external",
+                "rotation",
+                "of",
+                "the",
+                "leg."
+            ],
+            [
+                "When",
+                "and",
+                "how",
+                "should",
+                "she",
+                "be",
+                "treated?"
+            ],
+            [
+                "1-",
+                "Admission",
+                "for",
+                "transthoracic",
+                "ultrasound,",
+                "assessment",
+                "by",
+                "Cardiology",
+                "and",
+                "then",
+                "closed",
+                "reduction",
+                "and",
+                "fixation",
+                "with",
+                "plate",
+                "screw."
+            ],
+            [
+                "2-",
+                "Admission",
+                "for",
+                "evaluation",
+                "by",
+                "Nephrology",
+                "and",
+                "Cardiology,",
+                "and",
+                "then",
+                "Traumatology",
+                "will",
+                "decide",
+                "whether",
+                "to",
+                "use",
+                "an",
+                "arthroplasty",
+                "or",
+                "a",
+                "trochanteric",
+                "nail."
+            ],
+            [
+                "3-",
+                "Admission",
+                "to",
+                "Internal",
+                "Medicine",
+                "/",
+                "Geriatrics,",
+                "progressive",
+                "stabilization",
+                "of",
+                "comorbidities,",
+                "conservative",
+                "orthopedic",
+                "treatment."
+            ],
+            [
+                "4-",
+                "Closed",
+                "reduction",
+                "and",
+                "fixation",
+                "of",
+                "the",
+                "fracture",
+                "within",
+                "48",
+                "hours,",
+                "very",
+                "early",
+                "sedation,",
+                "orthogeriatric",
+                "management."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "A",
+                "new",
+                "approach",
+                "is",
+                "currently",
+                "being",
+                "developed",
+                "for",
+                "the",
+                "treatment",
+                "of",
+                "these",
+                "patients,",
+                "which",
+                "tries",
+                "to",
+                "coordinate",
+                "from",
+                "the",
+                "beginning",
+                "the",
+                "activity",
+                "of",
+                "the",
+                "different",
+                "sectors",
+                "involved,",
+                "avoiding",
+                "that",
+                "the",
+                "transfer",
+                "of",
+                "the",
+                "patient",
+                "from",
+                "one",
+                "to",
+                "another",
+                "takes",
+                "place",
+                "at",
+                "the",
+                "end",
+                "of",
+                "the",
+                "treatment",
+                "of",
+                "each",
+                "part."
+            ],
+            [
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+                "idea",
+                "gave",
+                "rise",
+                "to",
+                "the",
+                "so-called",
+                "orthogeriatric",
+                "units\",",
+                "which",
+                "combine",
+                "the",
+                "surgeon's",
+                "surgical",
+                "activity",
+                "with",
+                "that",
+                "of",
+                "the",
+                "patient's",
+                "immediate",
+                "rehabilitation",
+                "and",
+                "the",
+                "controls",
+                "and",
+                "follow-up",
+                "of",
+                "internal",
+                "medicine."
+            ],
+            [
+                "From",
+                "the",
+                "very",
+                "beginning",
+                "of",
+                "the",
+                "process,",
+                "the",
+                "social",
+                "workers",
+                "and",
+                "the",
+                "various",
+                "vital",
+                "and",
+                "support",
+                "aids",
+                "are",
+                "put",
+                "in",
+                "place",
+                "to",
+                "ensure",
+                "that",
+                "recovery",
+                "is",
+                "as",
+                "rapid",
+                "and",
+                "complete",
+                "as",
+                "possible.",
+                "..."
+            ],
+            [
+                "In",
+                "most",
+                "cases,",
+                "surgery",
+                "should",
+                "be",
+                "performed",
+                "as",
+                "soon",
+                "as",
+                "possible,",
+                "as",
+                "soon",
+                "as",
+                "the",
+                "patient",
+                "is",
+                "medically",
+                "stabilized."
+            ],
+            [
+                "There",
+                "is",
+                "a",
+                "contraindication",
+                "to",
+                "surgery",
+                "in",
+                "patients",
+                "with",
+                "unstable",
+                "medical",
+                "comorbidity,",
+                "but",
+                "several",
+                "studies",
+                "have",
+                "shown",
+                "that",
+                "delaying",
+                "surgery",
+                "beyond",
+                "48",
+                "h",
+                "after",
+                "admission",
+                "increases",
+                "mortality."
+            ],
+            [
+                "This",
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+                "why",
+                "the",
+                "ideal",
+                "time",
+                "to",
+                "intervene",
+                "in",
+                "these",
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+                "is",
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+                "this",
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+                "before",
+                "48",
+                "h",
+                "have",
+                "elapsed.\"",
+                "There",
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+                "no",
+                "data",
+                "to",
+                "suggest",
+                "that",
+                "he",
+                "has",
+                "any",
+                "unstable",
+                "comorbidity",
+                "at",
+                "the",
+                "present",
+                "time,",
+                "so",
+                "surgery",
+                "in",
+                "less",
+                "than",
+                "48",
+                "hours",
+                "and",
+                "orthogeriatric",
+                "management",
+                "is",
+                "of",
+                "interest."
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+        ],
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+            ],
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+                "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",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "378_132",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "72-year-old",
+                "patient",
+                "presents",
+                "with",
+                "progressive",
+                "memory",
+                "loss",
+                "and",
+                "word",
+                "finding",
+                "difficulty",
+                "of",
+                "one",
+                "year's",
+                "duration."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "useful",
+                "examination",
+                "to",
+                "characterize",
+                "the",
+                "type",
+                "of",
+                "cognitive",
+                "deficit",
+                "he",
+                "presents",
+                "with?"
+            ],
+            [
+                "1-",
+                "Neuropsychological",
+                "evaluation."
+            ],
+            [
+                "2-",
+                "Brain",
+                "magnetic",
+                "resonance",
+                "imaging."
+            ],
+            [
+                "3-",
+                "Positron",
+                "Emission",
+                "Tomography."
+            ],
+            [
+                "4-",
+                "Electroencephalogram."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "The",
+                "characterization",
+                "of",
+                "cognitive",
+                "deterioration",
+                "processes",
+                "is",
+                "still",
+                "clinical,",
+                "with",
+                "imaging",
+                "tests",
+                "(MRI",
+                "or",
+                "PET)",
+                "being",
+                "a",
+                "support",
+                "tool",
+                "in",
+                "some",
+                "occasions."
+            ],
+            [
+                "The",
+                "first",
+                "option",
+                "would",
+                "be",
+                "the",
+                "correct",
+                "one",
+                "because",
+                "it",
+                "allows",
+                "us",
+                "to",
+                "measure",
+                "in",
+                "a",
+                "standardized",
+                "way",
+                "each",
+                "of",
+                "the",
+                "cognitive",
+                "domains,",
+                "which",
+                "will",
+                "allow",
+                "us",
+                "to",
+                "frame",
+                "the",
+                "patient's",
+                "deficits",
+                "in",
+                "a",
+                "specific",
+                "syndrome",
+                "and",
+                "to",
+                "monitor",
+                "the",
+                "deterioration",
+                "with",
+                "repeated",
+                "scans",
+                "over",
+                "time."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "582_208",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "53-year-old",
+                "man",
+                "with",
+                "no",
+                "history",
+                "of",
+                "interest",
+                "who",
+                "after",
+                "a",
+                "bad",
+                "movement",
+                "in",
+                "the",
+                "gym",
+                "notices",
+                "low",
+                "back",
+                "pain",
+                "that",
+                "after",
+                "a",
+                "few",
+                "hours",
+                "radiates",
+                "to",
+                "the",
+                "back",
+                "of",
+                "the",
+                "right",
+                "leg",
+                "and",
+                "reaches",
+                "the",
+                "lateral",
+                "edge",
+                "of",
+                "the",
+                "foot."
+            ],
+            [
+                "On",
+                "examination",
+                "he",
+                "presents",
+                "positive",
+                "Las\u00e8gue",
+                "maneuver",
+                "at",
+                "40o,",
+                "abolished",
+                "hamstring",
+                "reflex",
+                "and",
+                "he",
+                "cannot",
+                "stand",
+                "on",
+                "tiptoe."
+            ],
+            [
+                "The",
+                "most",
+                "probable",
+                "etiological",
+                "diagnosis",
+                "is:"
+            ],
+            [
+                "1-",
+                "Right",
+                "L2-L3",
+                "disc",
+                "herniation."
+            ],
+            [
+                "2-",
+                "Right",
+                "L3-L4",
+                "disc",
+                "herniation."
+            ],
+            [
+                "3-",
+                "Right",
+                "L4-L5",
+                "disc",
+                "herniation."
+            ],
+            [
+                "4-",
+                "Right",
+                "L5-S1",
+                "disc",
+                "herniation."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "He",
+                "describes",
+                "S1",
+                "root",
+                "involvement",
+                "by",
+                "the",
+                "inability",
+                "to",
+                "tiptoe",
+                "and",
+                "the",
+                "absence",
+                "of",
+                "the",
+                "Achilles",
+                "reflex,",
+                "in",
+                "addition",
+                "to",
+                "the",
+                "distribution",
+                "of",
+                "pain",
+                "down",
+                "the",
+                "leg."
+            ],
+            [
+                "Of",
+                "our",
+                "options,",
+                "the",
+                "cause",
+                "that",
+                "can",
+                "produce",
+                "damage",
+                "to",
+                "S1",
+                "is",
+                "L5-S1",
+                "disc",
+                "herniation."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "160_117",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEPHROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "35-year-old",
+                "man",
+                "presenting",
+                "hematuria",
+                "after",
+                "respiratory",
+                "infections",
+                "for",
+                "several",
+                "years,",
+                "a",
+                "blood",
+                "test",
+                "shows",
+                "creatinine",
+                "1",
+                "mg/dl",
+                "with",
+                "no",
+                "other",
+                "alterations",
+                "and",
+                "urine",
+                "hematocytes",
+                "50/field",
+                "being",
+                "80%",
+                "dysmorphic,",
+                "with",
+                "proteinuria",
+                "of",
+                "0.8",
+                "grams",
+                "in",
+                "24",
+                "hours."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Minimal",
+                "change",
+                "nephropathy."
+            ],
+            [
+                "2-",
+                "Membranous",
+                "glomerulonephritis."
+            ],
+            [
+                "3-",
+                "IgA",
+                "nephropathy."
+            ],
+            [
+                "4-",
+                "Proliferative",
+                "and",
+                "diffuse",
+                "glomerulonephritis."
+            ],
+            [
+                "5-",
+                "Focal",
+                "and",
+                "primary",
+                "segmental",
+                "glomerulosclerosis."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is:",
+                "3."
+            ],
+            [
+                "IgA",
+                "nephropathy."
+            ],
+            [
+                "Given",
+                "that",
+                "the",
+                "clinical",
+                "presentation",
+                "of",
+                "this",
+                "nephropathy",
+                "appears",
+                "in",
+                "a",
+                "very",
+                "unspecific",
+                "way,",
+                "to",
+                "identify",
+                "the",
+                "responsible",
+                "disease",
+                "we",
+                "must",
+                "rely",
+                "on",
+                "its",
+                "epidemiology."
+            ],
+            [
+                "Since",
+                "he",
+                "is",
+                "a",
+                "young",
+                "male,",
+                "with",
+                "a",
+                "history",
+                "of",
+                "previous",
+                "respiratory",
+                "infections,",
+                "a",
+                "relationship",
+                "between",
+                "these",
+                "infections",
+                "and",
+                "renal",
+                "pathology",
+                "is",
+                "established."
+            ],
+            [
+                "Based",
+                "on",
+                "this",
+                "we",
+                "think",
+                "about",
+                "IgA",
+                "nephropathy,",
+                "which",
+                "besides",
+                "being",
+                "the",
+                "most",
+                "frequent",
+                "glomerulonephritis,",
+                "it",
+                "is",
+                "presented",
+                "in",
+                "most",
+                "of",
+                "the",
+                "cases",
+                "as",
+                "described."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "312_217",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "OPHTHALMOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "84-year-old",
+                "woman",
+                "presents",
+                "with",
+                "loss",
+                "of",
+                "vision",
+                "in",
+                "the",
+                "left",
+                "eye",
+                "of",
+                "4",
+                "days",
+                "of",
+                "evolution",
+                "accompanied",
+                "by",
+                "metamorphopsia."
+            ],
+            [
+                "The",
+                "macula",
+                "shows",
+                "abundant",
+                "hard",
+                "exudates,",
+                "two",
+                "small",
+                "deep",
+                "hemorrhages",
+                "and",
+                "a",
+                "localized",
+                "neurosensory",
+                "retinal",
+                "detachment."
+            ],
+            [
+                "In",
+                "the",
+                "contralateral",
+                "eye",
+                "there",
+                "are",
+                "abundant",
+                "soft",
+                "drusen."
+            ],
+            [
+                "Given",
+                "this",
+                "picture,",
+                "which",
+                "of",
+                "the",
+                "following",
+                "diagnoses",
+                "do",
+                "you",
+                "think",
+                "is",
+                "the",
+                "most",
+                "likely?"
+            ],
+            [
+                "1-",
+                "Acute",
+                "posterior",
+                "vitreous",
+                "detachment."
+            ],
+            [
+                "2-",
+                "Exudative",
+                "age-related",
+                "macular",
+                "degeneration",
+                "(AMD)."
+            ],
+            [
+                "3-",
+                "Central",
+                "retinal",
+                "artery",
+                "obstruction."
+            ],
+            [
+                "4-",
+                "Non-arteritic",
+                "anterior",
+                "ischemic",
+                "optic",
+                "neuropathy."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "In",
+                "principle,",
+                "this",
+                "is",
+                "an",
+                "easy",
+                "question,",
+                "as",
+                "it",
+                "deals",
+                "with",
+                "a",
+                "disease",
+                "that",
+                "is",
+                "frequently",
+                "repeated",
+                "in",
+                "the",
+                "MIR",
+                "exams."
+            ],
+            [
+                "The",
+                "description",
+                "is",
+                "typical",
+                "of",
+                "option",
+                "2."
+            ],
+            [
+                "It",
+                "is",
+                "an",
+                "exudative",
+                "AMD",
+                "(although",
+                "as",
+                "we",
+                "said",
+                "in",
+                "question",
+                "215,",
+                "with",
+                "the",
+                "new",
+                "classification,",
+                "we",
+                "would",
+                "speak",
+                "of",
+                "an",
+                "advanced",
+                "AMD",
+                "in",
+                "its",
+                "neovascular",
+                "variant)."
+            ],
+            [
+                "In",
+                "any",
+                "case,",
+                "we",
+                "have",
+                "an",
+                "elderly",
+                "patient",
+                "with",
+                "vision",
+                "loss",
+                "and",
+                "metamorphopsia",
+                "in",
+                "one",
+                "eye."
+            ],
+            [
+                "In",
+                "the",
+                "examination",
+                "there",
+                "are",
+                "lesions",
+                "in",
+                "the",
+                "macula."
+            ],
+            [
+                "With",
+                "that",
+                "we",
+                "can",
+                "rule",
+                "out",
+                "acute",
+                "posterior",
+                "vitreous",
+                "detachment,",
+                "which",
+                "does",
+                "not",
+                "produce",
+                "visual",
+                "loss,",
+                "nor",
+                "metamorphopsia,",
+                "nor",
+                "lesions",
+                "in",
+                "the",
+                "macula."
+            ],
+            [
+                "And",
+                "also",
+                "non-arteritic",
+                "anterior",
+                "ischemic",
+                "optic",
+                "neuropathy,",
+                "because",
+                "although",
+                "it",
+                "produces",
+                "visual",
+                "loss",
+                "and",
+                "is",
+                "typical",
+                "of",
+                "older",
+                "people,",
+                "it",
+                "does",
+                "not",
+                "produce",
+                "metamorphopsia."
+            ],
+            [
+                "And",
+                "there",
+                "are",
+                "no",
+                "lesions",
+                "in",
+                "the",
+                "macula",
+                "but",
+                "papilla",
+                "edema."
+            ],
+            [
+                "In",
+                "central",
+                "retinal",
+                "artery",
+                "obstruction,",
+                "metamorphopsia",
+                "is",
+                "not",
+                "particularly",
+                "characteristic",
+                "(visual",
+                "loss",
+                "and",
+                "advanced",
+                "age",
+                "are),",
+                "but",
+                "the",
+                "lesions",
+                "in",
+                "the",
+                "fundus",
+                "of",
+                "the",
+                "eye",
+                "vary."
+            ],
+            [
+                "In",
+                "the",
+                "case",
+                "of",
+                "arterial",
+                "occlusion,",
+                "there",
+                "is",
+                "intracellular",
+                "edema",
+                "that",
+                "is",
+                "seen",
+                "as",
+                "absence",
+                "of",
+                "hemorrhages",
+                "and",
+                "a",
+                "whitish,",
+                "pale",
+                "fundus."
+            ],
+            [
+                "In",
+                "addition,",
+                "the",
+                "entire",
+                "retina",
+                "is",
+                "globally",
+                "affected,",
+                "and",
+                "a",
+                "cherry-red",
+                "spot",
+                "may",
+                "appear",
+                "in",
+                "the",
+                "macula."
+            ],
+            [
+                "In",
+                "this",
+                "case",
+                "the",
+                "lesions",
+                "are",
+                "totally",
+                "different."
+            ],
+            [
+                "They",
+                "describe",
+                "hard",
+                "exudates,",
+                "deep",
+                "hemorrhages",
+                "and",
+                "localized",
+                "neurosensory",
+                "retinal",
+                "detachment."
+            ],
+            [
+                "All",
+                "this",
+                "in",
+                "the",
+                "macula."
+            ],
+            [
+                "These",
+                "are",
+                "the",
+                "characteristic",
+                "findings",
+                "of",
+                "neovascular",
+                "(or",
+                "exudative)",
+                "AMD."
+            ],
+            [
+                "As",
+                "a",
+                "clue,",
+                "in",
+                "the",
+                "other",
+                "eye",
+                "there",
+                "are",
+                "abundant",
+                "soft",
+                "drusen."
+            ],
+            [
+                "Drusen",
+                "are",
+                "the",
+                "typical",
+                "findings",
+                "of",
+                "AMD."
+            ],
+            [
+                "So",
+                "he",
+                "has",
+                "AMD",
+                "in",
+                "both",
+                "eyes",
+                "and",
+                "in",
+                "the",
+                "right",
+                "eye",
+                "it",
+                "has",
+                "recently",
+                "become",
+                "complicated",
+                "by",
+                "the",
+                "appearance",
+                "of",
+                "neovascularization."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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-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"
+            ],
+            [
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "24_115",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTIOUS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "68-year-old",
+                "man",
+                "is",
+                "evaluated",
+                "for",
+                "fever,",
+                "weight",
+                "loss",
+                "and",
+                "dyspnea",
+                "on",
+                "exertion."
+            ],
+            [
+                "The",
+                "EP",
+                "reveals",
+                "a",
+                "new",
+                "aortic",
+                "diastolic",
+                "murmur",
+                "and",
+                "stigmata",
+                "of",
+                "peripheral",
+                "embolisms."
+            ],
+            [
+                "Echocardiography",
+                "showed",
+                "a",
+                "1",
+                "cm",
+                "vegetation",
+                "on",
+                "the",
+                "aortic",
+                "valve",
+                "and",
+                "two",
+                "blood",
+                "cultures",
+                "isolated",
+                "penicillin-sensitive",
+                "Streptococcus",
+                "bovis."
+            ],
+            [
+                "After",
+                "starting",
+                "treatment",
+                "for",
+                "endocarditis,",
+                "which",
+                "of",
+                "the",
+                "following",
+                "examinations",
+                "could",
+                "help",
+                "us",
+                "in",
+                "the",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Glucose",
+                "tolerance",
+                "test."
+            ],
+            [
+                "2-",
+                "Chest",
+                "X-ray."
+            ],
+            [
+                "3-",
+                "Upper",
+                "gastrointestinal",
+                "endoscopy."
+            ],
+            [
+                "4-",
+                "Colonoscopy."
+            ],
+            [
+                "5-",
+                "Abdominal",
+                "ultrasound."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Another",
+                "gift",
+                "of",
+                "a",
+                "question,",
+                "the",
+                "association",
+                "of",
+                "S.bovis",
+                "endocarditis",
+                "and",
+                "colon",
+                "cancer."
+            ],
+            [
+                "By",
+                "the",
+                "way,",
+                "it",
+                "is",
+                "funny",
+                "that",
+                "they",
+                "give",
+                "Chest",
+                "Rx",
+                "as",
+                "a",
+                "test",
+                "to",
+                "be",
+                "performed.....",
+                "are",
+                "you",
+                "telling",
+                "me",
+                "that",
+                "a",
+                "patient",
+                "with",
+                "fever",
+                "and",
+                "dyspnea",
+                "will",
+                "have",
+                "an",
+                "echocardiogram",
+                "before",
+                "a",
+                "simple",
+                "chest",
+                "x-ray?"
+            ],
+            [
+                "And",
+                "on",
+                "the",
+                "other",
+                "hand...",
+                "why",
+                "don't",
+                "those",
+                "who",
+                "write",
+                "the",
+                "MIR",
+                "ask",
+                "shorter",
+                "questions",
+                "without",
+                "so",
+                "much",
+                "back",
+                "and",
+                "forth?"
+            ],
+            [
+                "If",
+                "what",
+                "they",
+                "want",
+                "is",
+                "to",
+                "ask",
+                "the",
+                "test",
+                "to",
+                "be",
+                "performed",
+                "on",
+                "a",
+                "patient",
+                "with",
+                "S.",
+                "bovis",
+                "endocarditis,",
+                "they",
+                "could",
+                "ask",
+                "the",
+                "question",
+                "directly",
+                "without",
+                "telling",
+                "us",
+                "about",
+                "the",
+                "patient's",
+                "moles..."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "260_99",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "45-year-old",
+                "woman",
+                "comes",
+                "to",
+                "the",
+                "clinic",
+                "referred",
+                "from",
+                "surgery",
+                "with",
+                "the",
+                "diagnosis",
+                "of",
+                "a",
+                "neuroendocrine",
+                "tumor",
+                "diagnosed",
+                "after",
+                "partial",
+                "pancreatectomy",
+                "for",
+                "a",
+                "2-cm",
+                "tumor",
+                "in",
+                "the",
+                "tail",
+                "of",
+                "the",
+                "pancreas."
+            ],
+            [
+                "The",
+                "tumor",
+                "had",
+                "been",
+                "detected",
+                "by",
+                "chance",
+                "in",
+                "an",
+                "abdominal",
+                "CT",
+                "scan",
+                "requested",
+                "to",
+                "complete",
+                "the",
+                "study",
+                "of",
+                "a",
+                "simple",
+                "hepatic",
+                "cyst."
+            ],
+            [
+                "On",
+                "questioning",
+                "the",
+                "patient,",
+                "the",
+                "history",
+                "of",
+                "irregular",
+                "menstruation,",
+                "amenorrhea",
+                "for",
+                "the",
+                "last",
+                "6",
+                "months,",
+                "and",
+                "repeated",
+                "renal",
+                "colic",
+                "since",
+                "she",
+                "was",
+                "20",
+                "years",
+                "old,",
+                "for",
+                "which",
+                "she",
+                "has",
+                "required",
+                "lithotripsy",
+                "on",
+                "several",
+                "occasions,",
+                "stand",
+                "out."
+            ],
+            [
+                "She",
+                "also",
+                "has",
+                "a",
+                "family",
+                "history",
+                "of",
+                "renoureteral",
+                "colic."
+            ],
+            [
+                "What",
+                "is",
+                "her",
+                "suspected",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Multiple",
+                "endocrine",
+                "neoplasia",
+                "type",
+                "1",
+                "or",
+                "Wermer's",
+                "syndrome."
+            ],
+            [
+                "2-",
+                "Multiple",
+                "endocrine",
+                "neoplasia",
+                "type",
+                "2",
+                "A",
+                "or",
+                "Sipple's",
+                "syndrome."
+            ],
+            [
+                "3-",
+                "Multiple",
+                "endocrine",
+                "neoplasia",
+                "type",
+                "2B."
+            ],
+            [
+                "4-",
+                "Somatostatinoma."
+            ],
+            [
+                "5-",
+                "A",
+                "PTH-producing",
+                "neuroendocrine",
+                "tumor."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Very",
+                "nice",
+                "clinical",
+                "question",
+                "from",
+                "MEN."
+            ],
+            [
+                "Pancreatic",
+                "neuroendocrine",
+                "tumor",
+                "+",
+                "pituitary",
+                "adenoma",
+                "(prolactinoma)",
+                "+",
+                "hyperparathyroidism",
+                "(renoureteral",
+                "colic",
+                "in",
+                "young",
+                "people):",
+                "MEN",
+                "1."
+            ],
+            [
+                "Medium",
+                "difficulty",
+                "because",
+                "you",
+                "have",
+                "to",
+                "know",
+                "the",
+                "MEN",
+                "triad",
+                "and",
+                "recognize",
+                "the",
+                "different",
+                "tumors."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "211_87",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GENERAL",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "78-year-old",
+                "woman",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "for",
+                "left",
+                "iliac",
+                "fossa",
+                "pain",
+                "of",
+                "24",
+                "hours",
+                "of",
+                "evolution",
+                "associated",
+                "with",
+                "fever",
+                "and",
+                "occasional",
+                "vomiting."
+            ],
+            [
+                "On",
+                "examination,",
+                "there",
+                "is",
+                "selective",
+                "pain",
+                "on",
+                "palpation",
+                "in",
+                "the",
+                "left",
+                "iliac",
+                "fossa",
+                "with",
+                "a",
+                "feeling",
+                "of",
+                "occupation,",
+                "defense",
+                "and",
+                "positive",
+                "decompression."
+            ],
+            [
+                "When",
+                "acute",
+                "diverticulitis",
+                "is",
+                "suspected,",
+                "which",
+                "of",
+                "the",
+                "following",
+                "statements",
+                "is",
+                "correct?"
+            ],
+            [
+                "1-",
+                "The",
+                "safest",
+                "and",
+                "best",
+                "performing",
+                "complementary",
+                "examination",
+                "is",
+                "the",
+                "barium",
+                "contrast",
+                "enema."
+            ],
+            [
+                "2-",
+                "In",
+                "case",
+                "of",
+                "contained",
+                "pelvic",
+                "abscess,",
+                "percutaneous",
+                "drainage",
+                "guided",
+                "by",
+                "CT",
+                "or",
+                "ultrasound",
+                "is",
+                "indicated."
+            ],
+            [
+                "3-",
+                "If",
+                "surgical",
+                "intervention",
+                "is",
+                "required",
+                "after",
+                "resolution",
+                "of",
+                "the",
+                "acute",
+                "episode,",
+                "the",
+                "laparoscopic",
+                "approach",
+                "is",
+                "contraindicated."
+            ],
+            [
+                "4-",
+                "In",
+                "case",
+                "of",
+                "acute",
+                "uncomplicated",
+                "diverticulitis,",
+                "elective",
+                "sigmoidectomy",
+                "is",
+                "indicated",
+                "after",
+                "cure",
+                "of",
+                "the",
+                "first",
+                "acute",
+                "episode."
+            ],
+            [
+                "5-",
+                "If",
+                "generalized",
+                "peritonitis",
+                "occurs,",
+                "the",
+                "most",
+                "appropriate",
+                "surgical",
+                "technique",
+                "is",
+                "the",
+                "practice",
+                "of",
+                "a",
+                "derivative",
+                "colostomy",
+                "without",
+                "resection",
+                "of",
+                "the",
+                "affected",
+                "sigmoid",
+                "segment."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Answer",
+                "1",
+                "is",
+                "incorrect",
+                "because",
+                "the",
+                "imaging",
+                "tests",
+                "of",
+                "choice",
+                "would",
+                "be",
+                "ultrasound",
+                "or",
+                "CT;",
+                "answer",
+                "3",
+                "is",
+                "incorrect",
+                "because",
+                "the",
+                "laparoscopic",
+                "approach",
+                "is",
+                "indicated",
+                "from",
+                "the",
+                "start;",
+                "answer",
+                "4",
+                "is",
+                "incorrect",
+                "because",
+                "the",
+                "indication",
+                "in",
+                "the",
+                "first",
+                "episode",
+                "is",
+                "for",
+                "those",
+                "under",
+                "50",
+                "years",
+                "of",
+                "age,",
+                "in",
+                "the",
+                "rest",
+                "it",
+                "is",
+                "indicated",
+                "after",
+                "the",
+                "second",
+                "episode",
+                "or",
+                "in",
+                "cases",
+                "of",
+                "persistent",
+                "symptoms",
+                "or",
+                "suspected",
+                "neoplasia;",
+                "and",
+                "answer",
+                "5",
+                "is",
+                "incorrect",
+                "because",
+                "surgery",
+                "in",
+                "cases",
+                "of",
+                "perforation",
+                "with",
+                "peritonitis",
+                "should",
+                "always",
+                "resect",
+                "the",
+                "affected",
+                "segment",
+                "of",
+                "colon",
+                "to",
+                "control",
+                "the",
+                "focus",
+                "of",
+                "the",
+                "infection."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "B-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"
+            ]
+        ]
+    },
+    {
+        "id": "162_121",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEPHROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "52-year-old",
+                "patient",
+                "with",
+                "stage",
+                "V",
+                "chronic",
+                "kidney",
+                "disease,",
+                "secondary",
+                "to",
+                "autosomal",
+                "dominant",
+                "polycystic",
+                "kidney",
+                "disease,",
+                "receives",
+                "a",
+                "cadaver",
+                "donor",
+                "kidney",
+                "graft."
+            ],
+            [
+                "A",
+                "34-year-old",
+                "brother",
+                "of",
+                "his",
+                "comes",
+                "to",
+                "visit",
+                "him",
+                "and",
+                "says",
+                "he",
+                "does",
+                "not",
+                "know",
+                "if",
+                "he",
+                "has",
+                "the",
+                "disease",
+                "because",
+                "he",
+                "has",
+                "never",
+                "seen",
+                "a",
+                "doctor",
+                "since",
+                "he",
+                "was",
+                "a",
+                "teenager."
+            ],
+            [
+                "What",
+                "attitude",
+                "or",
+                "test",
+                "do",
+                "you",
+                "think",
+                "is",
+                "the",
+                "most",
+                "appropriate",
+                "to",
+                "recommend",
+                "at",
+                "that",
+                "moment?"
+            ],
+            [
+                "1-",
+                "Genetic",
+                "mutational",
+                "and",
+                "linkage",
+                "study."
+            ],
+            [
+                "2-",
+                "Abdomino-pelvic",
+                "ultrasound."
+            ],
+            [
+                "3-",
+                "Helical",
+                "computed",
+                "axial",
+                "tomography",
+                "with",
+                "iodinated",
+                "contrast."
+            ],
+            [
+                "4-",
+                "Abdominal",
+                "and",
+                "cerebral",
+                "MRI."
+            ],
+            [
+                "5-",
+                "Periodic",
+                "clinical",
+                "controls."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is:",
+                "2."
+            ],
+            [
+                "Abdomino-pelvic",
+                "ultrasound."
+            ],
+            [
+                "Abdomino-pelvic",
+                "ultrasound",
+                "is",
+                "undoubtedly",
+                "the",
+                "most",
+                "specific",
+                "and",
+                "sensitive",
+                "test",
+                "for",
+                "the",
+                "diagnosis",
+                "of",
+                "polycystic",
+                "kidney",
+                "disease",
+                "and,",
+                "above",
+                "all,",
+                "the",
+                "cheapest",
+                "to",
+                "demonstrate",
+                "whether",
+                "or",
+                "not",
+                "the",
+                "patient's",
+                "sibling",
+                "has",
+                "inherited",
+                "polycystic",
+                "kidney",
+                "disease."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "207_181",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "43-year-old",
+                "woman",
+                "referred",
+                "to",
+                "the",
+                "Hospital's",
+                "Lower",
+                "Genital",
+                "Tract",
+                "Pathology",
+                "Clinic",
+                "for",
+                "presenting",
+                "with",
+                "a",
+                "cervico-vaginal",
+                "cytology",
+                "reported",
+                "as",
+                "\"L-SIL\"",
+                "(Low",
+                "Grade",
+                "Intraepithelial",
+                "Lesion)."
+            ],
+            [
+                "She",
+                "refers",
+                "repeated",
+                "vaginal",
+                "infections",
+                "(Trichomoniasis,...)",
+                "and",
+                "having",
+                "had",
+                "more",
+                "than",
+                "5",
+                "sexual",
+                "partners",
+                "in",
+                "her",
+                "life."
+            ],
+            [
+                "The",
+                "best",
+                "care",
+                "strategy",
+                "for",
+                "this",
+                "woman",
+                "is:"
+            ],
+            [
+                "1-",
+                "Conization",
+                "with",
+                "diathermy",
+                "loop."
+            ],
+            [
+                "2-",
+                "Endocervical",
+                "curettage",
+                "with",
+                "Kevorkian",
+                "curettage."
+            ],
+            [
+                "3-",
+                "Endometrial",
+                "biopsy",
+                "with",
+                "Cornier",
+                "cannula."
+            ],
+            [
+                "4-",
+                "Hysterectomy",
+                "without",
+                "adnexectomy."
+            ],
+            [
+                "5-",
+                "Advise",
+                "her",
+                "to",
+                "stop",
+                "smoking",
+                "and",
+                "contraceptives",
+                "and",
+                "to",
+                "have",
+                "a",
+                "control",
+                "in",
+                "6",
+                "months."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "The",
+                "best",
+                "answer",
+                "to",
+                "this",
+                "question",
+                "is",
+                "number",
+                "5."
+            ],
+            [
+                "Most",
+                "of",
+                "the",
+                "lesions",
+                "identified",
+                "as",
+                "L-SIL",
+                "are",
+                "associated",
+                "with",
+                "HPV",
+                "infection:",
+                "for",
+                "this",
+                "reason,",
+                "it",
+                "is",
+                "advisable",
+                "to",
+                "stop",
+                "smoking,",
+                "as",
+                "this",
+                "is",
+                "a",
+                "factor",
+                "in",
+                "the",
+                "progression",
+                "of",
+                "the",
+                "said",
+                "infection."
+            ],
+            [
+                "On",
+                "the",
+                "other",
+                "hand,",
+                "according",
+                "to",
+                "the",
+                "latest",
+                "studies,",
+                "70%",
+                "of",
+                "the",
+                "cytologies",
+                "reported",
+                "as",
+                "LSIL",
+                "will",
+                "remit,",
+                "15%",
+                "will",
+                "persist",
+                "and",
+                "another",
+                "15%",
+                "will",
+                "show",
+                "a",
+                "more",
+                "severe",
+                "cytology,",
+                "without",
+                "being",
+                "able",
+                "to",
+                "differentiate",
+                "whether",
+                "it",
+                "is",
+                "a",
+                "biological",
+                "progression",
+                "or",
+                "a",
+                "lesion",
+                "hidden",
+                "in",
+                "the",
+                "initial",
+                "cytology."
+            ],
+            [
+                "Because",
+                "of",
+                "this,",
+                "it",
+                "is",
+                "best",
+                "to",
+                "return",
+                "for",
+                "a",
+                "follow-up",
+                "at",
+                "6",
+                "months."
+            ],
+            [
+                "Given",
+                "the",
+                "woman's",
+                "personal",
+                "history",
+                "(more",
+                "than",
+                "5",
+                "sexual",
+                "partners",
+                "and",
+                "repeat",
+                "infections)",
+                "and",
+                "her",
+                "age,",
+                "a",
+                "referral",
+                "for",
+                "colposcopy",
+                "would",
+                "be",
+                "ideal."
+            ],
+            [
+                "However,",
+                "answer",
+                "5",
+                "says",
+                "control",
+                "in",
+                "6",
+                "months,",
+                "but",
+                "does",
+                "not",
+                "specify",
+                "which",
+                "control",
+                "(it",
+                "could",
+                "be",
+                "a",
+                "colposcopy",
+                "or",
+                "cytology)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-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",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "584_73",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "OBSTETRICS",
+                "AND",
+                "GYNECOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "51-year-old",
+                "woman,",
+                "menopausal",
+                "for",
+                "a",
+                "year",
+                "and",
+                "a",
+                "half,",
+                "who",
+                "consults",
+                "for",
+                "vaginal",
+                "spotting",
+                "of",
+                "2",
+                "weeks'",
+                "evolution."
+            ],
+            [
+                "She",
+                "reports",
+                "that",
+                "the",
+                "spotting",
+                "is",
+                "less",
+                "than",
+                "a",
+                "menstrual",
+                "period."
+            ],
+            [
+                "The",
+                "ultrasound",
+                "shows",
+                "a",
+                "7",
+                "mm",
+                "endometrium."
+            ],
+            [
+                "Mark",
+                "the",
+                "correct",
+                "option:"
+            ],
+            [
+                "1-",
+                "The",
+                "endometrium",
+                "is",
+                "thickened",
+                "and",
+                "in",
+                "view",
+                "of",
+                "the",
+                "patient's",
+                "symptoms,",
+                "an",
+                "endometrial",
+                "biopsy",
+                "is",
+                "taken",
+                "with",
+                "a",
+                "Cornier",
+                "cannula."
+            ],
+            [
+                "2-",
+                "The",
+                "endometrium",
+                "is",
+                "not",
+                "thickened",
+                "so",
+                "she",
+                "is",
+                "prescribed",
+                "tranexamic",
+                "acid",
+                "and",
+                "ambulatory",
+                "follow-up."
+            ],
+            [
+                "3-",
+                "Indications",
+                "for",
+                "diagnostic",
+                "hysteroscopy",
+                "without",
+                "the",
+                "need",
+                "for",
+                "endometrial",
+                "biopsy."
+            ],
+            [
+                "4-",
+                "The",
+                "endometrium",
+                "is",
+                "not",
+                "thickened,",
+                "but",
+                "since",
+                "she",
+                "has",
+                "clinical",
+                "signs",
+                "of",
+                "metrorrhagia,",
+                "an",
+                "endometrial",
+                "biopsy",
+                "is",
+                "indicated."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "The",
+                "endometrium",
+                "is",
+                "thickened",
+                "for",
+                "a",
+                "menopausal",
+                "woman",
+                "(some",
+                "guidelines",
+                "put",
+                "the",
+                "limit",
+                "at",
+                "5",
+                "and",
+                "others",
+                "at",
+                "3mm)."
+            ],
+            [
+                "And",
+                "the",
+                "first",
+                "complementary",
+                "test",
+                "to",
+                "perform",
+                "would",
+                "be",
+                "an",
+                "endometrial",
+                "biopsy."
+            ],
+            [
+                "If",
+                "this",
+                "is",
+                "not",
+                "decisive,",
+                "hysteroscopy",
+                "will",
+                "be",
+                "considered",
+                "as",
+                "a",
+                "second",
+                "option."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "138_165",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "OTORHINOLARYNGOLOGY",
+                "AND",
+                "MAXILLOFACIAL",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "child",
+                "who",
+                "comes",
+                "to",
+                "the",
+                "outpatient",
+                "clinic",
+                "because",
+                "he",
+                "brings",
+                "his",
+                "hand",
+                "to",
+                "his",
+                "ear,",
+                "without",
+                "fever",
+                "or",
+                "acute",
+                "inflammatory",
+                "signs",
+                "and",
+                "who",
+                "on",
+                "examination",
+                "shows",
+                "a",
+                "pinkish/amber",
+                "eardrum."
+            ],
+            [
+                "As",
+                "history",
+                "he",
+                "refers",
+                "that",
+                "one",
+                "month",
+                "ago",
+                "he",
+                "presented",
+                "an",
+                "episode",
+                "of",
+                "otalgia,",
+                "fever",
+                "accompanied",
+                "by",
+                "irritability",
+                "and",
+                "that",
+                "he",
+                "was",
+                "treated",
+                "with",
+                "amoxicillin",
+                "40",
+                "mg/kg/day."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "probable",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Recurrent",
+                "acute",
+                "otitis",
+                "media."
+            ],
+            [
+                "2-",
+                "Serous",
+                "otitis",
+                "media."
+            ],
+            [
+                "3-",
+                "Simple",
+                "chronic",
+                "otitis",
+                "media."
+            ],
+            [
+                "4-",
+                "Chronic",
+                "cholesteatomatous",
+                "otitis",
+                "media."
+            ],
+            [
+                "5-",
+                "Mastoiditis."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Reading",
+                "the",
+                "case,",
+                "we",
+                "are",
+                "discarding",
+                "options:",
+                "child",
+                "with",
+                "otalgia,",
+                "but",
+                "without",
+                "fever",
+                "or",
+                "acute",
+                "inflammatory",
+                "signs:",
+                "it",
+                "is",
+                "neither",
+                "1",
+                "(recurrent",
+                "acute",
+                "otitis",
+                "media)",
+                "nor",
+                "5",
+                "(mastoiditis)."
+            ],
+            [
+                "On",
+                "otoscopy,",
+                "a",
+                "pinkish",
+                "and",
+                "amber",
+                "eardrum",
+                "is",
+                "observed:",
+                "there",
+                "are",
+                "no",
+                "scales,",
+                "so",
+                "it",
+                "is",
+                "not",
+                "4",
+                "(cholesteatomatous",
+                "chronic",
+                "otitis",
+                "media);",
+                "nor",
+                "perforations",
+                "or",
+                "adhesions,",
+                "so",
+                "it",
+                "is",
+                "not",
+                "3",
+                "(simple",
+                "chronic",
+                "otitis",
+                "media)."
+            ],
+            [
+                "Otoscopy",
+                "is",
+                "characteristic",
+                "of",
+                "serous",
+                "otitis",
+                "media",
+                "(answer",
+                "2",
+                "correct)."
+            ],
+            [
+                "It",
+                "is",
+                "known",
+                "by",
+                "ENT,",
+                "pediatricians",
+                "and",
+                "family",
+                "physicians",
+                "that",
+                "in",
+                "the",
+                "month",
+                "following",
+                "an",
+                "acute",
+                "otitis",
+                "media,",
+                "the",
+                "middle",
+                "ear",
+                "is",
+                "occupied",
+                "by",
+                "a",
+                "mucous",
+                "content",
+                "whose",
+                "evolution",
+                "should",
+                "be",
+                "monitored."
+            ],
+            [
+                "I",
+                "do",
+                "not",
+                "think",
+                "that",
+                "this",
+                "is",
+                "a",
+                "contestable",
+                "issue",
+                "either."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "136_132",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ONCOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "60-year-old",
+                "man",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "for",
+                "a",
+                "coma",
+                "crisis."
+            ],
+            [
+                "Ex-smoker",
+                "for",
+                "3",
+                "years,",
+                "with",
+                "no",
+                "other",
+                "history",
+                "of",
+                "interest."
+            ],
+            [
+                "A",
+                "CT",
+                "scan",
+                "shows",
+                "multiple",
+                "metastases."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "probable",
+                "origin?"
+            ],
+            [
+                "1-",
+                "Head",
+                "and",
+                "neck",
+                "cancer."
+            ],
+            [
+                "2-",
+                "Lung",
+                "cancer."
+            ],
+            [
+                "3-",
+                "Urinary",
+                "bladder",
+                "cancer."
+            ],
+            [
+                "4-",
+                "Colon",
+                "cancer."
+            ],
+            [
+                "5-",
+                "Pancreatic",
+                "cancer."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Pretty",
+                "easy,",
+                "isn't",
+                "it?"
+            ],
+            [
+                "Lung",
+                "cancer",
+                "is",
+                "the",
+                "most",
+                "frequent",
+                "cause",
+                "of",
+                "brain",
+                "metastases",
+                "and",
+                "in",
+                "20-30%",
+                "of",
+                "cases",
+                "it",
+                "is",
+                "as",
+                "a",
+                "result",
+                "of",
+                "them",
+                "that",
+                "the",
+                "primary",
+                "tumor",
+                "is",
+                "diagnosed",
+                "(as",
+                "here)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "518_105",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CRITICAL",
+                "AND",
+                "EMERGENCY",
+                "CARE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "24-year-old",
+                "woman",
+                "with",
+                "a",
+                "history",
+                "of",
+                "migraine,",
+                "on",
+                "propranolol",
+                "and",
+                "oral",
+                "contraceptives,",
+                "presents",
+                "with",
+                "severe",
+                "dyspnea,",
+                "hoarseness,",
+                "rash,",
+                "nausea",
+                "and",
+                "vomiting",
+                "30",
+                "minutes",
+                "after",
+                "taking",
+                "metamizole."
+            ],
+            [
+                "His",
+                "blood",
+                "pressure",
+                "is",
+                "90/40",
+                "mmHg",
+                "and",
+                "SatO2",
+                "is",
+                "90%."
+            ],
+            [
+                "The",
+                "most",
+                "correct",
+                "initial",
+                "treatment",
+                "would",
+                "be",
+                "to",
+                "administer:"
+            ],
+            [
+                "1-",
+                "Adrenaline."
+            ],
+            [
+                "2-",
+                "Adrenaline",
+                "and",
+                "dexchlorpheniramine."
+            ],
+            [
+                "3-",
+                "Adrenaline,",
+                "dexchlorpheniramine",
+                "and",
+                "methylprednisolone."
+            ],
+            [
+                "4-",
+                "Adrenaline,",
+                "dexchlorpheniramine",
+                "and",
+                "glucagon."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "We",
+                "are",
+                "faced",
+                "with",
+                "an",
+                "anaphylactic",
+                "reaction",
+                "to",
+                "metamizole,",
+                "in",
+                "which",
+                "it",
+                "is",
+                "necessary",
+                "to",
+                "act",
+                "quickly",
+                "or",
+                "the",
+                "patient",
+                "could",
+                "progress",
+                "to",
+                "cardiac",
+                "arrest."
+            ],
+            [
+                "It",
+                "is",
+                "important",
+                "to",
+                "assess",
+                "the",
+                "severity",
+                "of",
+                "the",
+                "allergic",
+                "reactions,",
+                "since,",
+                "in",
+                "this",
+                "case,",
+                "early",
+                "treatment",
+                "is",
+                "essential",
+                "to",
+                "prevent",
+                "high",
+                "mortality",
+                "if",
+                "not",
+                "applied."
+            ],
+            [
+                "The",
+                "treatment",
+                "of",
+                "choice",
+                "is",
+                "IM",
+                "adrenaline",
+                "(only",
+                "switch",
+                "to",
+                "IV",
+                "if",
+                "anaphylaxis",
+                "is",
+                "refractory),",
+                "which",
+                "has",
+                "been",
+                "shown",
+                "to",
+                "increase",
+                "survival,",
+                "and",
+                "administration",
+                "can",
+                "be",
+                "repeated",
+                "every",
+                "5-15",
+                "minutes",
+                "if",
+                "symptoms",
+                "do",
+                "not",
+                "subside."
+            ],
+            [
+                "As",
+                "adjuvant",
+                "treatment,",
+                "dexchlorpheniramine",
+                "could",
+                "be",
+                "administered."
+            ],
+            [
+                "In",
+                "this",
+                "particular",
+                "case,",
+                "since",
+                "the",
+                "patient",
+                "was",
+                "previously",
+                "treated",
+                "with",
+                "propranolol,",
+                "this",
+                "indicates",
+                "that",
+                "the",
+                "correct",
+                "answer",
+                "is",
+                "4,",
+                "which",
+                "includes",
+                "the",
+                "administration",
+                "of",
+                "glucagon,",
+                "which",
+                "is",
+                "administered",
+                "because",
+                "patients",
+                "taking",
+                "beta-blockers",
+                "can",
+                "be",
+                "resistant",
+                "to",
+                "treatment",
+                "with",
+                "adrenaline",
+                "and",
+                "develop",
+                "refractory",
+                "hypotension",
+                "and",
+                "prolonged",
+                "bradycardia."
+            ],
+            [
+                "The",
+                "dose",
+                "in",
+                "adults",
+                "is",
+                "1",
+                "to",
+                "2mg,",
+                "IV",
+                "or",
+                "IM,",
+                "which",
+                "can",
+                "be",
+                "repeated",
+                "in",
+                "5",
+                "minutes",
+                "or",
+                "followed",
+                "by",
+                "an",
+                "infusion",
+                "at",
+                "5-15mcg/min."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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-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",
+                "O",
+                "O",
+                "O",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "581_205",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "543_39",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ALLERGOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "35-year-old",
+                "patient",
+                "consults",
+                "to",
+                "confirm",
+                "a",
+                "suspected",
+                "allergy",
+                "to",
+                "Anisakis",
+                "simplex."
+            ],
+            [
+                "She",
+                "has",
+                "previously",
+                "suffered",
+                "a",
+                "clinical",
+                "picture",
+                "of",
+                "gastrointestinal",
+                "anisakiasis",
+                "after",
+                "eating",
+                "fish."
+            ],
+            [
+                "The",
+                "tests",
+                "performed",
+                "show",
+                "specific",
+                "IgE",
+                "levels",
+                "of",
+                "10",
+                "KU/l",
+                "against",
+                "Anisakis",
+                "simplex."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "would",
+                "be",
+                "the",
+                "dietary",
+                "recommendation",
+                "for",
+                "this",
+                "patient?"
+            ],
+            [
+                "1-",
+                "He",
+                "cannot",
+                "eat",
+                "any",
+                "fish,",
+                "crustaceans,",
+                "mollusks",
+                "or",
+                "cephalopods."
+            ],
+            [
+                "2-",
+                "He",
+                "can",
+                "eat",
+                "fresh",
+                "fish",
+                "cooked",
+                "on",
+                "the",
+                "grill."
+            ],
+            [
+                "3-",
+                "May",
+                "eat",
+                "commercially",
+                "flash-frozen",
+                "fish."
+            ],
+            [
+                "4-",
+                "You",
+                "can",
+                "eat",
+                "fresh",
+                "marinated",
+                "or",
+                "cold",
+                "smoked",
+                "fish."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Anisakis",
+                "simplex",
+                "is",
+                "a",
+                "parasite",
+                "frequently",
+                "found",
+                "in",
+                "fish."
+            ],
+            [
+                "To",
+                "avoid",
+                "reactions",
+                "with",
+                "this",
+                "parasite,",
+                "a",
+                "diet",
+                "free",
+                "of",
+                "fresh",
+                "and",
+                "raw",
+                "fish",
+                "(anchovies",
+                "in",
+                "vinegar,",
+                "smoked,",
+                "salted",
+                "fish,",
+                "sushi,",
+                "etc.)",
+                "should",
+                "be",
+                "followed."
+            ],
+            [
+                "Deep-frozen",
+                "fish",
+                "or",
+                "fresh",
+                "fish",
+                "previously",
+                "frozen",
+                "at",
+                "-20\u00baC",
+                "for",
+                "at",
+                "least",
+                "5",
+                "days",
+                "before",
+                "cooking",
+                "can",
+                "be",
+                "consumed,",
+                "as",
+                "long",
+                "as",
+                "it",
+                "is",
+                "cooked",
+                "at",
+                "high",
+                "temperatures",
+                ">60\u00baC",
+                "(roasted,",
+                "fried,",
+                "etc.),",
+                "avoiding",
+                "raw,",
+                "grilled",
+                "or",
+                "microwaved",
+                "preparations."
+            ],
+            [
+                "It",
+                "is",
+                "recommended",
+                "to",
+                "consume",
+                "preferably",
+                "the",
+                "tails",
+                "because",
+                "the",
+                "larvae",
+                "of",
+                "the",
+                "parasite",
+                "are",
+                "usually",
+                "close",
+                "to",
+                "the",
+                "viscera",
+                "of",
+                "the",
+                "head."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "2_36",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DIGESTIVE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "87-year-old",
+                "patient",
+                "with",
+                "a",
+                "history",
+                "of",
+                "chronic",
+                "bronchitis",
+                "and",
+                "heart",
+                "failure",
+                "has",
+                "been",
+                "diagnosed",
+                "with",
+                "acute",
+                "calculous",
+                "cholecystitis."
+            ],
+            [
+                "After",
+                "4",
+                "days",
+                "of",
+                "hospitalization",
+                "and",
+                "treatment",
+                "with",
+                "absolute",
+                "diet,",
+                "piperacillin-tazobactam",
+                "serum",
+                "therapy,",
+                "the",
+                "patient",
+                "continues",
+                "with",
+                "fever,",
+                "persistent",
+                "abdominal",
+                "pain",
+                "and",
+                "leukocytosis."
+            ],
+            [
+                "The",
+                "most",
+                "appropriate",
+                "attitude",
+                "at",
+                "this",
+                "time",
+                "would",
+                "be:"
+            ],
+            [
+                "1-",
+                "Urgent",
+                "surgical",
+                "treatment."
+            ],
+            [
+                "2-",
+                "Biliary",
+                "drainage",
+                "by",
+                "percutaneous",
+                "cholecystostomy."
+            ],
+            [
+                "3-",
+                "Replace",
+                "piperacillin-tazobactam",
+                "with",
+                "metronidazole-cefotaxime."
+            ],
+            [
+                "4-",
+                "Replace",
+                "piperacillin-tazobactam",
+                "with",
+                "amikacin-clindamycin."
+            ],
+            [
+                "5-",
+                "Add",
+                "an",
+                "aminoglycoside",
+                "such",
+                "as",
+                "gentamicin",
+                "to",
+                "the",
+                "treatment."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "In",
+                "this",
+                "question,",
+                "they",
+                "insist",
+                "on",
+                "the",
+                "age",
+                "and",
+                "comorbidity",
+                "of",
+                "the",
+                "patient,",
+                "as",
+                "well",
+                "as",
+                "the",
+                "time",
+                "of",
+                "evolution,",
+                "so",
+                "the",
+                "answer",
+                "will",
+                "probably",
+                "not",
+                "be",
+                "1."
+            ],
+            [
+                "In",
+                "any",
+                "case,",
+                "the",
+                "ideal",
+                "would",
+                "be",
+                "to",
+                "drain",
+                "the",
+                "gallbladder",
+                "that",
+                "has",
+                "not",
+                "gone",
+                "up",
+                "again,",
+                "so",
+                "the",
+                "answer",
+                "I",
+                "would",
+                "give",
+                "would",
+                "be",
+                "2."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "122_119",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "MICROBIOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "17-year-old",
+                "woman",
+                "came",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "with",
+                "acute",
+                "symptoms",
+                "of",
+                "high",
+                "fever,",
+                "pharyngeal",
+                "pain",
+                "and",
+                "cervical",
+                "lymphadenopathy."
+            ],
+            [
+                "She",
+                "had",
+                "previously",
+                "been",
+                "diagnosed",
+                "with",
+                "acute",
+                "pharyngitis",
+                "and",
+                "was",
+                "treated",
+                "with",
+                "amoxicillin,",
+                "and",
+                "later",
+                "presented",
+                "with",
+                "a",
+                "generalized",
+                "macular",
+                "skin",
+                "rash."
+            ],
+            [
+                "Laboratory",
+                "tests",
+                "showed",
+                "slight",
+                "leukocytosis",
+                "and",
+                "presence",
+                "of",
+                "activated",
+                "leukocytes,",
+                "slight",
+                "thrombopenia",
+                "and",
+                "slightly",
+                "increased",
+                "transaminases."
+            ],
+            [
+                "What",
+                "would",
+                "be",
+                "the",
+                "most",
+                "likely",
+                "diagnosis",
+                "of",
+                "this",
+                "clinical",
+                "picture?"
+            ],
+            [
+                "1-",
+                "It",
+                "is",
+                "a",
+                "typical",
+                "picture",
+                "of",
+                "infectious",
+                "mononucleosis."
+            ],
+            [
+                "2-",
+                "Varicella",
+                "zoster",
+                "infection."
+            ],
+            [
+                "3-",
+                "Acute",
+                "toxoplasmosis."
+            ],
+            [
+                "4-",
+                "Lyme",
+                "disease."
+            ],
+            [
+                "5-",
+                "Infection",
+                "by",
+                "herpes",
+                "virus",
+                "8."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "the",
+                "first",
+                "one."
+            ],
+            [
+                "It",
+                "is",
+                "a",
+                "typical",
+                "picture",
+                "of",
+                "infectious",
+                "mononucleosis."
+            ],
+            [
+                "Although",
+                "a",
+                "similar",
+                "picture",
+                "may",
+                "occur",
+                "in",
+                "acute",
+                "toxoplasmosis,",
+                "less",
+                "than",
+                "1%",
+                "of",
+                "acute",
+                "toxoplasma",
+                "infections",
+                "present",
+                "as",
+                "mononucleosis."
+            ],
+            [
+                "Characteristic",
+                "of",
+                "Epstein-Barr",
+                "infectious",
+                "mononucleosis",
+                "is",
+                "the",
+                "appearance",
+                "of",
+                "macular",
+                "rash",
+                "after",
+                "treatment",
+                "with",
+                "amoxicillin."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "36_130",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY",
+                "AND",
+                "NEUROSURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "85-year-old",
+                "woman",
+                "consults",
+                "for",
+                "fatigue",
+                "and",
+                "weakness",
+                "especially",
+                "in",
+                "the",
+                "mornings."
+            ],
+            [
+                "She",
+                "is",
+                "sometimes",
+                "unsteady",
+                "when",
+                "walking",
+                "and",
+                "has",
+                "to",
+                "sit",
+                "down",
+                "to",
+                "regain",
+                "her",
+                "balance."
+            ],
+            [
+                "On",
+                "two",
+                "occasions",
+                "she",
+                "has",
+                "had",
+                "to",
+                "sit",
+                "down",
+                "to",
+                "keep",
+                "from",
+                "falling",
+                "but",
+                "denies",
+                "symptoms",
+                "of",
+                "dizziness."
+            ],
+            [
+                "She",
+                "has",
+                "arterial",
+                "hypertension,",
+                "urinary",
+                "incontinence",
+                "and",
+                "osteoarthritis."
+            ],
+            [
+                "Her",
+                "treatment",
+                "is",
+                "hydrochlorothiazide",
+                "(25",
+                "mg/d),",
+                "oxybutynin",
+                "(10",
+                "mg/d),",
+                "lisinopril",
+                "(10",
+                "mg/d),",
+                "calcium",
+                "(1500",
+                "mg/d)",
+                "and",
+                "paracetamol",
+                "(3",
+                "g/d)."
+            ],
+            [
+                "On",
+                "examination",
+                "he",
+                "has",
+                "a",
+                "blood",
+                "pressure",
+                "of",
+                "115/70",
+                "mm",
+                "Hg,",
+                "pulse",
+                "80",
+                "bpm."
+            ],
+            [
+                "His",
+                "movements",
+                "are",
+                "slow."
+            ],
+            [
+                "He",
+                "has",
+                "a",
+                "moderate",
+                "hand",
+                "tremor."
+            ],
+            [
+                "She",
+                "can",
+                "get",
+                "up",
+                "from",
+                "the",
+                "chair",
+                "slowly",
+                "but",
+                "without",
+                "needing",
+                "to",
+                "lean",
+                "on",
+                "her",
+                "arms."
+            ],
+            [
+                "She",
+                "walks",
+                "slightly",
+                "leaning",
+                "forward",
+                "with",
+                "little",
+                "swinging",
+                "of",
+                "the",
+                "arms."
+            ],
+            [
+                "Turns",
+                "slowly",
+                "but",
+                "without",
+                "losing",
+                "balance."
+            ],
+            [
+                "She",
+                "is",
+                "unable",
+                "to",
+                "stand",
+                "on",
+                "one",
+                "foot."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "possible",
+                "actions",
+                "would",
+                "you",
+                "perform",
+                "first?"
+            ],
+            [
+                "1-",
+                "Assess",
+                "visual",
+                "acuity."
+            ],
+            [
+                "2-",
+                "Perform",
+                "an",
+                "MRI."
+            ],
+            [
+                "3-",
+                "Tilt",
+                "table",
+                "study."
+            ],
+            [
+                "4-",
+                "Measure",
+                "blood",
+                "pressure",
+                "lying",
+                "down",
+                "and",
+                "standing",
+                "up."
+            ],
+            [
+                "5-",
+                "Therapeutic",
+                "attempt",
+                "with",
+                "L-dopa."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "to",
+                "initiate",
+                "treatment",
+                "with",
+                "L-dopa,",
+                "since",
+                "the",
+                "clinical",
+                "picture",
+                "described",
+                "is",
+                "of",
+                "a",
+                "parkinsonism",
+                "whose",
+                "diagnosis",
+                "is",
+                "exclusively",
+                "clinical."
+            ],
+            [
+                "The",
+                "rest",
+                "of",
+                "the",
+                "answers",
+                "can",
+                "be",
+                "made",
+                "for",
+                "differential",
+                "diagnosis,",
+                "but",
+                "the",
+                "performance",
+                "of",
+                "complementary",
+                "tests",
+                "does",
+                "not",
+                "justify",
+                "delaying",
+                "the",
+                "initiation",
+                "of",
+                "treatment."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-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"
+            ],
+            [
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "338_31",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "20-year-old",
+                "woman",
+                "with",
+                "ovarian",
+                "tumor",
+                "of",
+                "15",
+                "cm,",
+                "solid-cystic,",
+                "detected",
+                "by",
+                "ultrasound",
+                "after",
+                "presenting",
+                "with",
+                "unspecific",
+                "abdominal",
+                "symptoms."
+            ],
+            [
+                "In",
+                "the",
+                "histopathological",
+                "study",
+                "of",
+                "the",
+                "corresponding",
+                "specimen,",
+                "teeth,",
+                "hairs,",
+                "areas",
+                "of",
+                "intestinal",
+                "epithelium,",
+                "areas",
+                "of",
+                "squamous",
+                "epithelium",
+                "(15%)",
+                "and",
+                "bronchial",
+                "epithelium,",
+                "as",
+                "well",
+                "as",
+                "neuroectodermal",
+                "and",
+                "embryonic",
+                "elements",
+                "are",
+                "found",
+                "in",
+                "several",
+                "of",
+                "the",
+                "histological",
+                "preparations."
+            ],
+            [
+                "In",
+                "reference",
+                "to",
+                "this",
+                "case,",
+                "point",
+                "out",
+                "the",
+                "correct",
+                "diagnosis:"
+            ],
+            [
+                "1-",
+                "Teratocarcinoma."
+            ],
+            [
+                "2-",
+                "Immature",
+                "teratoma."
+            ],
+            [
+                "3-",
+                "Mature",
+                "cystic",
+                "teratoma."
+            ],
+            [
+                "4-",
+                "Dysgerminoma."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Mature",
+                "cystic",
+                "teratoma",
+                "(common",
+                "in",
+                "the",
+                "ovary",
+                "of",
+                "the",
+                "adult",
+                "female)."
+            ],
+            [
+                "Mass",
+                "with",
+                "a",
+                "large",
+                "cyst",
+                "occupying",
+                "most",
+                "of",
+                "it;",
+                "in",
+                "its",
+                "cavity",
+                "there",
+                "is",
+                "sebaceous",
+                "material",
+                "and",
+                "hairs."
+            ],
+            [
+                "The",
+                "wall,",
+                "generally",
+                "a",
+                "few",
+                "millimeters",
+                "thick,",
+                "has",
+                "the",
+                "structure",
+                "of",
+                "skin,",
+                "with",
+                "its",
+                "epidermal",
+                "surface",
+                "towards",
+                "the",
+                "cavity."
+            ],
+            [
+                "Because",
+                "of",
+                "this",
+                "preponderant",
+                "development",
+                "of",
+                "cutaneous",
+                "structures",
+                "it",
+                "is",
+                "usually",
+                "called",
+                "dermoid",
+                "cyst."
+            ],
+            [
+                "The",
+                "tissues",
+                "that",
+                "compose",
+                "the",
+                "tumor",
+                "are",
+                "well",
+                "differentiated",
+                "(mature",
+                "or",
+                "adult",
+                "type);",
+                "apart",
+                "from",
+                "skin",
+                "structures",
+                "many",
+                "other",
+                "tissues",
+                "can",
+                "be",
+                "observed,",
+                "particularly",
+                "in",
+                "a",
+                "thickening",
+                "or",
+                "spur",
+                "that",
+                "eminences",
+                "into",
+                "the",
+                "cavity,",
+                "in",
+                "which",
+                "there",
+                "are",
+                "often",
+                "teeth,",
+                "cartilage",
+                "and",
+                "bone."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "432_117",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTIOUS",
+                "DISEASES",
+                "AND",
+                "MICROBIOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "85-year-old",
+                "man",
+                "with",
+                "a",
+                "peripheral",
+                "venous",
+                "catheter",
+                "who,",
+                "one",
+                "week",
+                "after",
+                "being",
+                "hospitalized",
+                "for",
+                "a",
+                "stroke,",
+                "begins",
+                "with",
+                "shivering",
+                "and",
+                "fever."
+            ],
+            [
+                "Blood",
+                "cultures",
+                "are",
+                "performed",
+                "and",
+                "microbiology",
+                "reports",
+                "that",
+                "gram-positive",
+                "cocci",
+                "are",
+                "growing",
+                "in",
+                "clusters."
+            ],
+            [
+                "Pending",
+                "the",
+                "antibiogram,",
+                "what",
+                "is",
+                "the",
+                "most",
+                "appropriate",
+                "antibiotic",
+                "treatment?"
+            ],
+            [
+                "1-",
+                "Cefazolin."
+            ],
+            [
+                "2-",
+                "Cloxacillin."
+            ],
+            [
+                "3-",
+                "Vancomycin."
+            ],
+            [
+                "4-",
+                "Linezolid."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "The",
+                "most",
+                "frequent",
+                "cause",
+                "of",
+                "catheter",
+                "infection",
+                "is",
+                "a",
+                "bacterium",
+                "that",
+                "colonizes",
+                "the",
+                "skin."
+            ],
+            [
+                "The",
+                "Gram",
+                "stain",
+                "tells",
+                "us",
+                "that",
+                "it",
+                "is",
+                "a",
+                "staphylococcus,",
+                "most",
+                "of",
+                "the",
+                "species",
+                "of",
+                "this",
+                "genus",
+                "acquired",
+                "in-hospital",
+                "are",
+                "methicillin",
+                "resistant,",
+                "so",
+                "they",
+                "are",
+                "considered",
+                "resistant",
+                "to",
+                "Cloxacillin,",
+                "Cefazolin",
+                "and",
+                "there",
+                "are",
+                "no",
+                "clinical",
+                "data",
+                "about",
+                "the",
+                "efficacy",
+                "of",
+                "linezolid",
+                "for",
+                "the",
+                "treatment",
+                "of",
+                "systemic",
+                "infection",
+                "related",
+                "to",
+                "catheter."
+            ],
+            [
+                "This,",
+                "plus",
+                "the",
+                "experience",
+                "with",
+                "vancomycin",
+                "use",
+                "in",
+                "this",
+                "setting",
+                "is",
+                "considered",
+                "the",
+                "empirical",
+                "choice",
+                "for",
+                "vancomycin."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "513_38",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CRITICAL",
+                "AND",
+                "EMERGENCY",
+                "CARE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "72-year-old",
+                "patient",
+                "presents",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "with",
+                "severe",
+                "lingual",
+                "angioedema."
+            ],
+            [
+                "She",
+                "has",
+                "no",
+                "associated",
+                "urticaria",
+                "and",
+                "no",
+                "history",
+                "of",
+                "drug",
+                "or",
+                "food",
+                "allergy."
+            ],
+            [
+                "His",
+                "personal",
+                "history",
+                "includes",
+                "type",
+                "2",
+                "diabetes",
+                "mellitus,",
+                "dyslipidemia,",
+                "hypertension,",
+                "hypothyroidism",
+                "and",
+                "Parkinson's",
+                "disease."
+            ],
+            [
+                "In",
+                "regular",
+                "treatment",
+                "with",
+                "metformin,",
+                "simvastatin,",
+                "enalapril,",
+                "thyroxine",
+                "and",
+                "levodopa."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "drugs",
+                "is",
+                "most",
+                "likely",
+                "the",
+                "causal",
+                "drug",
+                "of",
+                "the",
+                "clinical",
+                "picture",
+                "described?"
+            ],
+            [
+                "1-",
+                "Enalapril."
+            ],
+            [
+                "2-",
+                "Simvastatin."
+            ],
+            [
+                "3-",
+                "Metformin",
+                "or",
+                "levodopa",
+                "equally."
+            ],
+            [
+                "4-",
+                "Levodopa."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Of",
+                "the",
+                "proposed",
+                "drugs,",
+                "the",
+                "least",
+                "likely",
+                "options",
+                "would",
+                "be",
+                "3,",
+                "since",
+                "metformin",
+                "very",
+                "rarely",
+                "causes",
+                "lingual",
+                "angioedema",
+                "(in",
+                "March",
+                "2020",
+                "there",
+                "was",
+                "only",
+                "one",
+                "case",
+                "described",
+                "worldwide)",
+                "and",
+                "4,",
+                "since,",
+                "among",
+                "the",
+                "adverse",
+                "reactions",
+                "of",
+                "levodopa,",
+                "angioedema",
+                "is",
+                "classified",
+                "among",
+                "the",
+                "very",
+                "rare",
+                "ones",
+                "(frequency",
+                "less",
+                "than",
+                "0.1%)."
+            ],
+            [
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+                "the",
+                "two",
+                "remaining",
+                "options,",
+                "the",
+                "drugs",
+                "most",
+                "frequently",
+                "and",
+                "classically",
+                "associated",
+                "with",
+                "lingual",
+                "angioedema",
+                "are",
+                "ACE",
+                "inhibitors",
+                "(frequency",
+                "around",
+                "0.2%),",
+                "and",
+                "their",
+                "association",
+                "with",
+                "simvastatin",
+                "is",
+                "also",
+                "less",
+                "than",
+                "0.1%."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-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",
+                "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",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "580_198",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "35-year-old",
+                "woman",
+                "referred",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "for",
+                "head",
+                "trauma",
+                "due",
+                "to",
+                "a",
+                "fall",
+                "on",
+                "a",
+                "scooter,",
+                "with",
+                "no",
+                "loss",
+                "of",
+                "consciousness",
+                "or",
+                "amnesia."
+            ],
+            [
+                "The",
+                "examination",
+                "shows",
+                "a",
+                "closed",
+                "head",
+                "injury",
+                "with",
+                "concussion",
+                "and",
+                "mild",
+                "headache",
+                "without",
+                "nausea",
+                "and",
+                "vomiting."
+            ],
+            [
+                "The",
+                "neurological",
+                "examination",
+                "is",
+                "normal",
+                "and",
+                "the",
+                "Glasgow",
+                "index",
+                "is",
+                "15."
+            ],
+            [
+                "In",
+                "this",
+                "situation,",
+                "which",
+                "imaging",
+                "test",
+                "is",
+                "indicated",
+                "first?"
+            ],
+            [
+                "1-",
+                "Cranial",
+                "CT",
+                "scan",
+                "without",
+                "contrast."
+            ],
+            [
+                "2-",
+                "Cranial",
+                "CT",
+                "with",
+                "contrast."
+            ],
+            [
+                "3-",
+                "No",
+                "imaging",
+                "test."
+            ],
+            [
+                "4-",
+                "Simple",
+                "skull",
+                "radiography."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "After",
+                "a",
+                "TBI",
+                "in",
+                "a",
+                "patient",
+                "who",
+                "is",
+                "not",
+                "anticoagulated",
+                "or",
+                "antiplatelet,",
+                "with",
+                "no",
+                "known",
+                "risk",
+                "factors",
+                "for",
+                "hemorrhage,",
+                "and",
+                "who",
+                "does",
+                "not",
+                "present",
+                "alarming",
+                "data",
+                "in",
+                "the",
+                "anamnesis",
+                "or",
+                "physical",
+                "examination,",
+                "it",
+                "is",
+                "not",
+                "necessary",
+                "to",
+                "perform",
+                "a",
+                "cranial",
+                "imaging",
+                "test."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "248_118",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTIOUS",
+                "DISEASES"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "34-year-old",
+                "man",
+                "consults",
+                "for",
+                "fever",
+                "and",
+                "malaise."
+            ],
+            [
+                "The",
+                "medical",
+                "history",
+                "includes",
+                "a",
+                "history",
+                "of",
+                "homosexual",
+                "relations",
+                "for",
+                "the",
+                "last",
+                "4",
+                "months",
+                "with",
+                "a",
+                "new",
+                "partner."
+            ],
+            [
+                "2",
+                "months",
+                "before",
+                "the",
+                "current",
+                "consultation",
+                "he",
+                "had",
+                "a",
+                "painless",
+                "ulcerative",
+                "lesion",
+                "on",
+                "the",
+                "glans",
+                "penis",
+                "with",
+                "bilateral",
+                "inguinal",
+                "lymphadenopathy,",
+                "all",
+                "self-limited."
+            ],
+            [
+                "Serological",
+                "studies",
+                "were",
+                "requested",
+                "with",
+                "the",
+                "following",
+                "results:",
+                "HIV",
+                "negative,",
+                "RPR",
+                "1/320,",
+                "HAART",
+                "1/128."
+            ],
+            [
+                "What",
+                "treatment",
+                "would",
+                "you",
+                "indicate",
+                "for",
+                "this",
+                "patient?"
+            ],
+            [
+                "1-",
+                "None."
+            ],
+            [
+                "2-",
+                "Intravenous",
+                "penicillin",
+                "G,",
+                "24",
+                "MU",
+                "every",
+                "day",
+                "for",
+                "14",
+                "days."
+            ],
+            [
+                "3-",
+                "Benzathine",
+                "penicillin",
+                "2.4",
+                "MU",
+                "intramuscular,",
+                "3",
+                "doses",
+                "in",
+                "three",
+                "consecutive",
+                "weeks."
+            ],
+            [
+                "4-",
+                "Ceftriaxone",
+                "2",
+                "grams",
+                "intramuscular",
+                "in",
+                "a",
+                "single",
+                "dose."
+            ],
+            [
+                "5-",
+                "Benzathine",
+                "penicillin",
+                "2.4",
+                "MU",
+                "intramuscularly",
+                "in",
+                "a",
+                "single",
+                "dose."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "Direct",
+                "response",
+                "question."
+            ],
+            [
+                "This",
+                "is",
+                "syphilis",
+                "(both",
+                "by",
+                "antecendent",
+                "and",
+                "serology)",
+                "in",
+                "the",
+                "secondary",
+                "stage,",
+                "so",
+                "treatment",
+                "is",
+                "with",
+                "Benzathine",
+                "Penicillin",
+                "2.4",
+                "MU",
+                "in",
+                "a",
+                "single",
+                "dose."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "222_197",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "EPIDEMIOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "30-year-old",
+                "HIV",
+                "(+)",
+                "homosexual",
+                "male",
+                "who",
+                "participates",
+                "as",
+                "a",
+                "volunteer",
+                "in",
+                "an",
+                "AIDS",
+                "patient",
+                "support",
+                "center."
+            ],
+            [
+                "According",
+                "to",
+                "his",
+                "medical",
+                "history",
+                "he",
+                "received",
+                "diphtheria",
+                "toxoid",
+                "(Td)",
+                "6",
+                "years",
+                "ago,",
+                "MMR",
+                "vaccine",
+                "in",
+                "childhood",
+                "and",
+                "adolescence,",
+                "and",
+                "hepatitis",
+                "B",
+                "3",
+                "years",
+                "ago."
+            ],
+            [
+                "He",
+                "is",
+                "currently",
+                "asymptomatic",
+                "with",
+                "a",
+                "CD4",
+                "count",
+                "above",
+                "200",
+                "cls/microliter."
+            ],
+            [
+                "Which",
+                "vaccines",
+                "should",
+                "we",
+                "recommend?"
+            ],
+            [
+                "1-",
+                "Seasonal",
+                "influenza,",
+                "pneumococcal,",
+                "tetravalent",
+                "meningitis",
+                "and",
+                "hepatitis",
+                "A."
+            ],
+            [
+                "2-",
+                "Seasonal",
+                "influenza,",
+                "Td,",
+                "pneumococcal",
+                "and",
+                "tetravalent",
+                "meningitis."
+            ],
+            [
+                "3-",
+                "Tetravalent",
+                "meningitis,",
+                "pneumococcal",
+                "and",
+                "seasonal",
+                "flu."
+            ],
+            [
+                "4-",
+                "Td,",
+                "tetravalent",
+                "meningitis,",
+                "pneumococcal."
+            ],
+            [
+                "5-",
+                "Triple",
+                "viral,",
+                "seasonal",
+                "flu,",
+                "pneumococcal."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Vaccination",
+                "recommendations",
+                "for",
+                "HIV+",
+                "adults",
+                "include",
+                "hepatitis",
+                "B,",
+                "influenza,",
+                "MMR,",
+                "pneumococcal,",
+                "Td",
+                "and",
+                "Tdap,",
+                "and",
+                "for",
+                "some",
+                "adults,",
+                "hepatitis",
+                "A,",
+                "or",
+                "combined",
+                "A",
+                "and",
+                "B,",
+                "bacterial",
+                "meningitis,",
+                "HPV",
+                "and",
+                "meningococcal",
+                "(Source",
+                "[1])."
+            ],
+            [
+                "Considering",
+                "that",
+                "the",
+                "individual",
+                "has",
+                "received",
+                "some",
+                "vaccines,",
+                "has",
+                "a",
+                "CD4",
+                "count",
+                ">100",
+                "(if",
+                "lower",
+                "there",
+                "would",
+                "be",
+                "a",
+                "contraindication)",
+                "and",
+                "works",
+                "in",
+                "a",
+                "center",
+                "that",
+                "helps",
+                "AIDS",
+                "patients",
+                "(he",
+                "is",
+                "equated",
+                "to",
+                "\"health",
+                "personnel\")",
+                "answers",
+                "2,",
+                "4",
+                "and",
+                "5",
+                "are",
+                "wrong."
+            ],
+            [
+                "All",
+                "four",
+                "vaccines",
+                "in",
+                "option",
+                "1",
+                "are",
+                "administrable."
+            ],
+            [
+                "In",
+                "a",
+                "little",
+                "more",
+                "detail:",
+                "Vaccine",
+                "against",
+                "tetanus",
+                "and",
+                "diphtheria:",
+                "all",
+                "persons",
+                "should",
+                "be",
+                "vaccinated",
+                "against",
+                "these",
+                "two",
+                "diseases."
+            ],
+            [
+                "Hepatitis",
+                "B",
+                "vaccine:",
+                "hepatitis",
+                "B",
+                "and",
+                "HIV",
+                "viruses",
+                "share",
+                "the",
+                "same",
+                "routes",
+                "of",
+                "transmission,",
+                "so",
+                "it",
+                "is",
+                "common",
+                "for",
+                "HIV-infected",
+                "patients",
+                "to",
+                "also",
+                "be",
+                "infected",
+                "with",
+                "hepatitis",
+                "B",
+                "virus."
+            ],
+            [
+                "It",
+                "is",
+                "therefore",
+                "important",
+                "to",
+                "know",
+                "whether",
+                "the",
+                "HIV-infected",
+                "person",
+                "has",
+                "markers",
+                "of",
+                "hepatitis",
+                "B",
+                "infection",
+                "and",
+                "to",
+                "proceed",
+                "with",
+                "vaccination",
+                "if",
+                "he/she",
+                "does",
+                "not",
+                "have",
+                "them."
+            ],
+            [
+                "Vaccination",
+                "against",
+                "hepatitis",
+                "A:",
+                "Hepatitis",
+                "A",
+                "in",
+                "a",
+                "person",
+                "with",
+                "hepatitis",
+                "B,",
+                "hepatitis",
+                "C",
+                "or",
+                "other",
+                "liver",
+                "disease",
+                "can",
+                "be",
+                "very",
+                "serious."
+            ],
+            [
+                "Since",
+                "these",
+                "infections",
+                "are",
+                "more",
+                "frequent",
+                "in",
+                "HIV-infected",
+                "patients,",
+                "vaccination",
+                "against",
+                "hepatitis",
+                "A",
+                "is",
+                "recommended."
+            ],
+            [
+                "Vaccination",
+                "against",
+                "influenza:",
+                "influenza",
+                "in",
+                "a",
+                "patient",
+                "with",
+                "a",
+                "lack",
+                "of",
+                "immune",
+                "response",
+                "is",
+                "more",
+                "serious",
+                "and",
+                "presents",
+                "a",
+                "greater",
+                "risk",
+                "of",
+                "complications,",
+                "so",
+                "annual",
+                "vaccination",
+                "against",
+                "this",
+                "disease",
+                "is",
+                "indicated."
+            ],
+            [
+                "If",
+                "the",
+                "patient's",
+                "immune",
+                "status",
+                "is",
+                "very",
+                "deteriorated,",
+                "the",
+                "response",
+                "to",
+                "vaccination",
+                "is",
+                "diminished."
+            ],
+            [
+                "In",
+                "this",
+                "case,",
+                "it",
+                "is",
+                "essential",
+                "to",
+                "vaccinate",
+                "all",
+                "the",
+                "people",
+                "living",
+                "with",
+                "the",
+                "HIV-infected",
+                "person",
+                "to",
+                "prevent",
+                "them",
+                "from",
+                "transmitting",
+                "the",
+                "disease."
+            ],
+            [
+                "Pneumococcal",
+                "vaccine:",
+                "pneumococcal",
+                "infections",
+                "(especially",
+                "pneumonia)",
+                "are",
+                "up",
+                "to",
+                "10",
+                "times",
+                "more",
+                "frequent",
+                "in",
+                "HIV-infected",
+                "persons",
+                "than",
+                "in",
+                "HIV-uninfected",
+                "adults,",
+                "so",
+                "vaccination",
+                "is",
+                "recommended,",
+                "although",
+                "in",
+                "patients",
+                "with",
+                "counts",
+                "below",
+                "200/mm3",
+                "the",
+                "protective",
+                "response",
+                "is",
+                "usually",
+                "not",
+                "sufficient."
+            ],
+            [
+                "They",
+                "should",
+                "receive",
+                "a",
+                "second",
+                "dose",
+                "at",
+                "3-5",
+                "years",
+                "of",
+                "age."
+            ],
+            [
+                "HIV-infected",
+                "children",
+                "should",
+                "be",
+                "vaccinated",
+                "with",
+                "pneumococcal",
+                "conjugate",
+                "vaccine",
+                "with",
+                "the",
+                "corresponding",
+                "number",
+                "of",
+                "doses",
+                "according",
+                "to",
+                "age."
+            ],
+            [
+                "Vaccination",
+                "against",
+                "Haemophilus",
+                "Influenzae",
+                "type",
+                "b:",
+                "this",
+                "bacterium",
+                "causes",
+                "pneumonia",
+                "and",
+                "meningitis,",
+                "especially",
+                "in",
+                "children."
+            ],
+            [
+                "Although",
+                "in",
+                "HIV-infected",
+                "adults",
+                "it",
+                "represents",
+                "a",
+                "small",
+                "number",
+                "of",
+                "the",
+                "causes",
+                "of",
+                "infection,",
+                "vaccination",
+                "is",
+                "recommended."
+            ],
+            [
+                "Vaccination",
+                "against",
+                "measles,",
+                "rubella",
+                "and",
+                "mumps",
+                "(MMR):",
+                "all",
+                "three",
+                "diseases",
+                "can",
+                "become",
+                "more",
+                "serious",
+                "in",
+                "HIV-infected",
+                "patients,",
+                "especially",
+                "measles,",
+                "so",
+                "all",
+                "of",
+                "them",
+                "should",
+                "be",
+                "vaccinated,",
+                "provided",
+                "that",
+                "immunosuppression",
+                "is",
+                "not",
+                "severe",
+                "(count",
+                "less",
+                "than",
+                "200/mm3)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "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",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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"
+            ]
+        ]
+    },
+    {
+        "id": "244_114",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTIOUS",
+                "DISEASES"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "16-year-old",
+                "boy",
+                "consults",
+                "for",
+                "presenting",
+                "with",
+                "pustular",
+                "tonsillitis,",
+                "fever",
+                "up",
+                "to",
+                "38.5\u00b0C,",
+                "painful",
+                "cervical",
+                "lymphadenopathy,",
+                "non-pruritic",
+                "macular",
+                "rash",
+                "on",
+                "the",
+                "chest",
+                "and",
+                "mild",
+                "hepatosplenomegaly,",
+                "of",
+                "4-5",
+                "days",
+                "of",
+                "evolution."
+            ],
+            [
+                "Paul-Bunnell",
+                "test",
+                "and",
+                "Ig",
+                "M",
+                "for",
+                "Epstein-Barr",
+                "virus",
+                "are",
+                "positive."
+            ],
+            [
+                "During",
+                "his",
+                "admission",
+                "he",
+                "developed",
+                "continuous",
+                "fever",
+                "up",
+                "to",
+                "40\u00baC,",
+                "pancytopenia,",
+                "icteric",
+                "hepatitis",
+                "and",
+                "coagulopathy",
+                "of",
+                "progressive",
+                "intensity."
+            ],
+            [
+                "One",
+                "week",
+                "after",
+                "admission,",
+                "he",
+                "was",
+                "transferred",
+                "to",
+                "the",
+                "ICU",
+                "due",
+                "to",
+                "confusion",
+                "and",
+                "respiratory",
+                "failure."
+            ],
+            [
+                "Blood",
+                "cultures",
+                "and",
+                "a",
+                "urine",
+                "culture",
+                "were",
+                "negative,",
+                "CSF",
+                "was",
+                "normal",
+                "and",
+                "the",
+                "chest",
+                "x-ray",
+                "showed",
+                "no",
+                "infiltrates."
+            ],
+            [
+                "Procalcitonin",
+                "is",
+                "normal,",
+                "but",
+                "CRP",
+                "and",
+                "ferritin",
+                "are",
+                "very",
+                "elevated."
+            ],
+            [
+                "Of",
+                "the",
+                "following",
+                "statements,",
+                "which",
+                "would",
+                "be",
+                "the",
+                "most",
+                "correct",
+                "diagnostic",
+                "and",
+                "therapeutic",
+                "approach?"
+            ],
+            [
+                "1-",
+                "She",
+                "has",
+                "a",
+                "bacterial",
+                "sepsis",
+                "of",
+                "undetermined",
+                "origin",
+                "and",
+                "should",
+                "be",
+                "given",
+                "ceftriaxone",
+                "and",
+                "supportive",
+                "care."
+            ],
+            [
+                "2-",
+                "She",
+                "has",
+                "bacterial",
+                "sepsis",
+                "of",
+                "undetermined",
+                "origin",
+                "and",
+                "should",
+                "be",
+                "given",
+                "vancomycin,",
+                "ceftacidime",
+                "and",
+                "supportive",
+                "care."
+            ],
+            [
+                "3-",
+                "This",
+                "is",
+                "infectious",
+                "mononucleosis",
+                "with",
+                "a",
+                "severe",
+                "course",
+                "and",
+                "glucocorticoids",
+                "should",
+                "be",
+                "administered."
+            ],
+            [
+                "4-",
+                "This",
+                "is",
+                "an",
+                "infectious",
+                "mononucleosis",
+                "of",
+                "severe",
+                "course",
+                "and",
+                "treatment",
+                "with",
+                "Acyclovir",
+                "should",
+                "be",
+                "initiated."
+            ],
+            [
+                "5-",
+                "I",
+                "would",
+                "perform",
+                "a",
+                "bone",
+                "marrow",
+                "biopsy/aspirate",
+                "and,",
+                "if",
+                "hemophagocytosis",
+                "is",
+                "confirmed,",
+                "initiate",
+                "treatment",
+                "with",
+                "immunosuppressants."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "Difficult",
+                "question",
+                "in",
+                "which",
+                "the",
+                "correct",
+                "answer",
+                "could",
+                "give",
+                "rise",
+                "to",
+                "discussion."
+            ],
+            [
+                "The",
+                "patient",
+                "is",
+                "a",
+                "16-year-old",
+                "male",
+                "who",
+                "is",
+                "admitted",
+                "for",
+                "a",
+                "fairly",
+                "clear",
+                "case",
+                "of",
+                "mononucleosis",
+                "due",
+                "to",
+                "EBV",
+                "infection",
+                "that",
+                "becomes",
+                "complicated",
+                "during",
+                "admission."
+            ],
+            [
+                "The",
+                "data",
+                "available",
+                "to",
+                "us",
+                "are:",
+                "-",
+                "Pancytopenia.",
+                "-",
+                "Hepatopathy.",
+                "-",
+                "Coagulopathy."
+            ],
+            [
+                "-",
+                "Absence",
+                "of",
+                "infectious",
+                "focus:",
+                "negative",
+                "blood",
+                "cultures,",
+                "negative",
+                "urine",
+                "cultures,",
+                "normal",
+                "X-ray,",
+                "normal",
+                "CSF."
+            ],
+            [
+                "-",
+                "CRP",
+                "and",
+                "Ferritin",
+                "elevated",
+                "/",
+                "normal",
+                "Procalcitonin."
+            ],
+            [
+                "The",
+                "possible",
+                "complications",
+                "that",
+                "could",
+                "have",
+                "occurred",
+                "(and",
+                "that",
+                "are",
+                "considered",
+                "in",
+                "the",
+                "answers)",
+                "are",
+                "sepsis",
+                "or",
+                "a",
+                "bad",
+                "evolution",
+                "of",
+                "mononucleosis."
+            ],
+            [
+                "The",
+                "clinical",
+                "data",
+                "could",
+                "be",
+                "consistent",
+                "with",
+                "a",
+                "septic",
+                "process,",
+                "however,",
+                "the",
+                "main",
+                "infectious",
+                "foci",
+                "have",
+                "been",
+                "reasonably",
+                "ruled",
+                "out",
+                "and",
+                "one",
+                "of",
+                "the",
+                "most",
+                "sensitive",
+                "and",
+                "specific",
+                "markers",
+                "of",
+                "bacteremia",
+                "(procalcitonin)",
+                "is",
+                "in",
+                "the",
+                "normal",
+                "range,",
+                "which",
+                "should",
+                "draw",
+                "our",
+                "attention."
+            ],
+            [
+                "On",
+                "the",
+                "other",
+                "hand,",
+                "a",
+                "complication",
+                "of",
+                "the",
+                "EBV",
+                "mononucleosis",
+                "suffered",
+                "by",
+                "our",
+                "patient",
+                "should",
+                "be",
+                "evaluated,",
+                "among",
+                "the",
+                "possible",
+                "complications",
+                "are",
+                "hemolytic",
+                "anemia,",
+                "meningoecephalitis",
+                "(normal",
+                "CSF)",
+                "or",
+                "Guillain-Barr\u00e9",
+                "sd.",
+                "Guillain-Barr\u00e9",
+                "syndrome,",
+                "which",
+                "are",
+                "not",
+                "very",
+                "consistent",
+                "with",
+                "the",
+                "clinical",
+                "picture",
+                "presented",
+                "to",
+                "us."
+            ],
+            [
+                "Another",
+                "possible",
+                "complication",
+                "of",
+                "exceptional",
+                "severity",
+                "would",
+                "be",
+                "hemophagocytic",
+                "syndrome;",
+                "this",
+                "is",
+                "a",
+                "rare",
+                "entity",
+                "that",
+                "occurs",
+                "in",
+                "certain",
+                "predisposed",
+                "subjects",
+                "and",
+                "is",
+                "characterized",
+                "by",
+                "an",
+                "uncontrolled",
+                "activation",
+                "and",
+                "proliferation",
+                "of",
+                "histiocytes",
+                "and",
+                "T",
+                "lymphocytes,",
+                "which",
+                "produces",
+                "a",
+                "state",
+                "of",
+                "hypercytokinemia."
+            ],
+            [
+                "The",
+                "diagnostic",
+                "criteria,",
+                "revised",
+                "in",
+                "2004,",
+                "include",
+                "persistent",
+                "high",
+                "fever,",
+                "hepatosplenomegaly,",
+                "cytopenias,",
+                "hypertriglyceridemia,",
+                "hyperferritinemia,",
+                "and",
+                "hypofibrinogenemia."
+            ],
+            [
+                "Hyperferritinemia",
+                ">3000",
+                "in",
+                "a",
+                "suggestive",
+                "clinical",
+                "context",
+                "necessitates",
+                "treatment",
+                "of",
+                "the",
+                "patient",
+                "(mainly",
+                "with",
+                "immunosuppressants",
+                "and",
+                "corticosteroids)",
+                "since",
+                "mortality",
+                "is",
+                "very",
+                "high",
+                "and",
+                "early",
+                "treatment",
+                "is",
+                "essential."
+            ],
+            [
+                "The",
+                "definitive",
+                "diagnosis",
+                "is",
+                "made",
+                "by",
+                "microscopic",
+                "study",
+                "of",
+                "an",
+                "OM",
+                "biopsy."
+            ],
+            [
+                "Although",
+                "in",
+                "this",
+                "question",
+                "they",
+                "do",
+                "not",
+                "quantify",
+                "the",
+                "value",
+                "of",
+                "ferritinemia,",
+                "it",
+                "is",
+                "a",
+                "remarkable",
+                "data",
+                "and",
+                "given",
+                "that",
+                "the",
+                "clinical",
+                "picture",
+                "is",
+                "suggestive,",
+                "meeting",
+                "the",
+                "diagnostic",
+                "criteria,",
+                "it",
+                "seems",
+                "to",
+                "me",
+                "that",
+                "answer",
+                "5",
+                "would",
+                "be",
+                "the",
+                "most",
+                "accurate."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Marker",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-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-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "420_78",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GENERAL",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "52-year-old",
+                "man",
+                "was",
+                "referred",
+                "to",
+                "the",
+                "gastroenterology",
+                "department",
+                "for",
+                "hematochezia,",
+                "tenesmus",
+                "and",
+                "reduction",
+                "of",
+                "stool",
+                "diameter."
+            ],
+            [
+                "A",
+                "series",
+                "of",
+                "tests",
+                "were",
+                "performed",
+                "and",
+                "a",
+                "diagnosis",
+                "of",
+                "adenocarcinoma",
+                "of",
+                "the",
+                "sigma",
+                "without",
+                "distant",
+                "metastasis",
+                "was",
+                "made."
+            ],
+            [
+                "The",
+                "patient",
+                "underwent",
+                "surgery",
+                "and",
+                "was",
+                "referred",
+                "to",
+                "the",
+                "medical",
+                "oncology",
+                "department",
+                "for",
+                "evaluation",
+                "of",
+                "complementary",
+                "chemotherapy",
+                "treatment."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "is",
+                "a",
+                "poor",
+                "prognostic",
+                "factor",
+                "after",
+                "surgical",
+                "resection",
+                "and",
+                "should",
+                "be",
+                "taken",
+                "into",
+                "account",
+                "when",
+                "planning",
+                "chemotherapy",
+                "treatment?"
+            ],
+            [
+                "1-",
+                "The",
+                "presence",
+                "of",
+                "anemia",
+                "at",
+                "diagnosis."
+            ],
+            [
+                "2-",
+                "The",
+                "existence",
+                "of",
+                "a",
+                "family",
+                "history",
+                "of",
+                "colorectal",
+                "cancer."
+            ],
+            [
+                "3-",
+                "The",
+                "size",
+                "of",
+                "the",
+                "primary",
+                "lesion",
+                "and",
+                "histological",
+                "differentiation."
+            ],
+            [
+                "4-",
+                "Perforation",
+                "or",
+                "adhesion",
+                "of",
+                "the",
+                "tumor",
+                "to",
+                "adjacent",
+                "organs."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "They",
+                "are",
+                "not",
+                "asking",
+                "about",
+                "factors",
+                "that",
+                "affect",
+                "oncologic",
+                "prognosis",
+                "and",
+                "therefore",
+                "imply",
+                "a",
+                "change",
+                "in",
+                "QT",
+                "strategy."
+            ],
+            [
+                "This",
+                "question",
+                "is",
+                "straightforward."
+            ],
+            [
+                "Option",
+                "4",
+                "is",
+                "describing",
+                "to",
+                "us",
+                "a",
+                "T4",
+                "stage,",
+                "either",
+                "by",
+                "invasion",
+                "of",
+                "adjacent",
+                "organs",
+                "or",
+                "perforation."
+            ],
+            [
+                "The",
+                "T4s",
+                "carry",
+                "a",
+                "much",
+                "higher",
+                "chance",
+                "of",
+                "recurrence,",
+                "in",
+                "fact",
+                "there",
+                "are",
+                "ongoing",
+                "studies",
+                "that",
+                "propose",
+                "prophylactic",
+                "HIPEC",
+                "in",
+                "T4",
+                "and",
+                "second",
+                "look",
+                "surgery",
+                "+",
+                "HIPEC",
+                "in",
+                "perforated",
+                "colon",
+                "tumors."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "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",
+                "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",
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "321_144",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "RHEUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "50-year-old",
+                "man",
+                "diagnosed",
+                "with",
+                "polyangiitis",
+                "with",
+                "granulomatosis",
+                "10",
+                "years",
+                "earlier",
+                "and",
+                "untreated",
+                "for",
+                "the",
+                "past",
+                "5",
+                "years",
+                "is",
+                "asymptomatic",
+                "at",
+                "a",
+                "scheduled",
+                "check-up."
+            ],
+            [
+                "Chest",
+                "X-ray,",
+                "blood",
+                "tests",
+                "and",
+                "urine",
+                "sediment",
+                "are",
+                "normal",
+                "except",
+                "for",
+                "positive",
+                "anti-neutrophil",
+                "cytoplasmic",
+                "antibodies",
+                "(ANCA)",
+                "at",
+                "titer",
+                "1/320,",
+                "with",
+                "anti-proteinase",
+                "3",
+                "specificity,",
+                "which",
+                "had",
+                "previously",
+                "been",
+                "negative."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "advisable",
+                "therapeutic",
+                "approach?"
+            ],
+            [
+                "1-",
+                "Start",
+                "treatment",
+                "with",
+                "corticosteroids."
+            ],
+            [
+                "2-",
+                "Initiate",
+                "treatment",
+                "with",
+                "cyclophosphamide."
+            ],
+            [
+                "3-",
+                "Initiate",
+                "treatment",
+                "with",
+                "mycophenolate",
+                "mofetil."
+            ],
+            [
+                "4-",
+                "Watchful",
+                "waiting."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "In",
+                "ANCA",
+                "vasculitis,",
+                "whatever",
+                "it",
+                "is,",
+                "these",
+                "antibodies",
+                "have",
+                "been",
+                "shown",
+                "to",
+                "be",
+                "related",
+                "to",
+                "the",
+                "activity",
+                "of",
+                "the",
+                "disease,",
+                "but",
+                "at",
+                "no",
+                "time",
+                "are",
+                "changes",
+                "in",
+                "treatment",
+                "obligatory",
+                "due",
+                "to",
+                "their",
+                "levels."
+            ],
+            [
+                "In",
+                "this",
+                "case,",
+                "with",
+                "the",
+                "patient",
+                "being",
+                "asymptomatic",
+                "and",
+                "with",
+                "objective",
+                "evidence",
+                "of",
+                "lack",
+                "of",
+                "activity,",
+                "close",
+                "follow-up",
+                "should",
+                "be",
+                "performed",
+                "without",
+                "restarting",
+                "or",
+                "modifying",
+                "treatment."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "516_103",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CRITICAL",
+                "AND",
+                "EMERGENCY",
+                "CARE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "56-year-old",
+                "patient",
+                "is",
+                "found",
+                "comatose",
+                "at",
+                "home."
+            ],
+            [
+                "He",
+                "has",
+                "a",
+                "history",
+                "of",
+                "arterial",
+                "hypertension",
+                "and",
+                "diabetes",
+                "mellitus."
+            ],
+            [
+                "He",
+                "has",
+                "no",
+                "toxic",
+                "habits",
+                "or",
+                "any",
+                "other",
+                "chronic",
+                "disease."
+            ],
+            [
+                "He",
+                "is",
+                "on",
+                "treatment",
+                "with",
+                "irbesartan",
+                "and",
+                "empaglifozin."
+            ],
+            [
+                "He",
+                "shows",
+                "no",
+                "signs",
+                "of",
+                "malnutrition."
+            ],
+            [
+                "His",
+                "blood",
+                "pressure",
+                "is",
+                "110/60",
+                "mmHg,",
+                "heart",
+                "rate",
+                "110",
+                "bpm,",
+                "90%",
+                "SatO2,",
+                "capillary",
+                "glucose",
+                "120",
+                "mg/dl",
+                "and",
+                "respiratory",
+                "rate",
+                "7",
+                "rpm."
+            ],
+            [
+                "Which",
+                "initial",
+                "therapeutic",
+                "approach",
+                "do",
+                "you",
+                "think",
+                "is",
+                "the",
+                "most",
+                "correct?"
+            ],
+            [
+                "1-",
+                "Administer",
+                "naloxone,",
+                "flumazenil",
+                "and",
+                "thiamine."
+            ],
+            [
+                "2-",
+                "Administer",
+                "naloxone,",
+                "flumazenil",
+                "and",
+                "hypertonic",
+                "glucose."
+            ],
+            [
+                "3-",
+                "Administer",
+                "naloxone",
+                "and",
+                "flumazenil."
+            ],
+            [
+                "4-",
+                "Administer",
+                "thiamine",
+                "and",
+                "hypertonic",
+                "glucose."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "We",
+                "find",
+                "a",
+                "patient",
+                "with",
+                "hypoventilation."
+            ],
+            [
+                "Glycemia",
+                "is",
+                "correct",
+                "(we",
+                "rule",
+                "out",
+                "hyperosmolar",
+                "coma",
+                "and",
+                "hypoglycemia,",
+                "option",
+                "2",
+                "and",
+                "4),",
+                "so,",
+                "although",
+                "there",
+                "is",
+                "no",
+                "history",
+                "of",
+                "intoxication,",
+                "we",
+                "have",
+                "to",
+                "go",
+                "to",
+                "the",
+                "most",
+                "frequent",
+                "and",
+                "that",
+                "we",
+                "can",
+                "antagonize",
+                "with",
+                "antidotes:",
+                "benzodiazepines",
+                "(flumazenil)",
+                "and",
+                "opiates",
+                "(naloxone)."
+            ],
+            [
+                "If",
+                "we",
+                "suspect",
+                "ethylene",
+                "glycol",
+                "intoxication,",
+                "we",
+                "would",
+                "administer",
+                "thiamine,",
+                "but",
+                "there",
+                "are",
+                "no",
+                "data",
+                "to",
+                "make",
+                "us",
+                "suspect."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ]
+        ]
+    },
+    {
+        "id": "44_153",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "Child",
+                "28",
+                "days",
+                "old,",
+                "born",
+                "at",
+                "term."
+            ],
+            [
+                "History",
+                "of",
+                "normal",
+                "pregnancy",
+                "and",
+                "delivery."
+            ],
+            [
+                "He",
+                "has",
+                "been",
+                "breastfed",
+                "since",
+                "birth."
+            ],
+            [
+                "He",
+                "consults",
+                "because",
+                "8",
+                "days",
+                "ago",
+                "he",
+                "started",
+                "vomiting,",
+                "initially",
+                "sporadically",
+                "and",
+                "since",
+                "5",
+                "days",
+                "ago,",
+                "after",
+                "all",
+                "feedings."
+            ],
+            [
+                "He",
+                "is",
+                "permanently",
+                "hungry."
+            ],
+            [
+                "The",
+                "vomiting",
+                "is",
+                "of",
+                "\"squirting\"",
+                "food",
+                "content."
+            ],
+            [
+                "On",
+                "palpation,",
+                "the",
+                "abdomen",
+                "is",
+                "soft",
+                "and",
+                "depressible,",
+                "without",
+                "visceromegaly."
+            ],
+            [
+                "The",
+                "blood",
+                "gas",
+                "analysis",
+                "showed",
+                "pH",
+                "7.49,",
+                "bicarbonate",
+                "30",
+                "mEq/l,",
+                "pCO2",
+                "53",
+                "mmHg,",
+                "base",
+                "excess",
+                "+8",
+                "mEq/l."
+            ],
+            [
+                "Ions:",
+                "Na",
+                "137",
+                "mEq/l,",
+                "K",
+                "3.1",
+                "mEq/l,",
+                "Cl",
+                "94",
+                "mEq/l."
+            ],
+            [
+                "Taking",
+                "into",
+                "account",
+                "the",
+                "most",
+                "probable",
+                "diagnosis",
+                "in",
+                "the",
+                "clinical",
+                "picture",
+                "described,",
+                "what",
+                "is",
+                "the",
+                "complementary",
+                "test",
+                "of",
+                "choice",
+                "to",
+                "confirm",
+                "this",
+                "clinical",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Simple",
+                "abdominal",
+                "X-ray."
+            ],
+            [
+                "2-",
+                "pHmetry."
+            ],
+            [
+                "3-",
+                "Abdominal",
+                "ultrasound."
+            ],
+            [
+                "4-",
+                "Determination",
+                "of",
+                "electrolytes",
+                "in",
+                "sweat."
+            ],
+            [
+                "5-",
+                "Esophagogastroscopy."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "3."
+            ],
+            [
+                "Easy",
+                "question",
+                "if",
+                "pathology",
+                "is",
+                "suspected,",
+                "which",
+                "I",
+                "also",
+                "think",
+                "is",
+                "simple",
+                "because",
+                "the",
+                "clinical",
+                "description",
+                "is",
+                "textbook",
+                "hypertrophic",
+                "pyloric",
+                "stenosis."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "54_72",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "22-year-old",
+                "female",
+                "student",
+                "with",
+                "no",
+                "history",
+                "of",
+                "pathology",
+                "or",
+                "use",
+                "of",
+                "medications",
+                "except",
+                "anovulatory",
+                "drugs",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "for",
+                "deterioration",
+                "of",
+                "general",
+                "condition",
+                "and",
+                "need",
+                "to",
+                "take",
+                "deep",
+                "breaths."
+            ],
+            [
+                "She",
+                "reports",
+                "weight",
+                "loss",
+                "in",
+                "the",
+                "last",
+                "2-3",
+                "days,",
+                "polydipsia,",
+                "polyuria",
+                "and",
+                "nausea."
+            ],
+            [
+                "No",
+                "cough",
+                "or",
+                "febrile",
+                "sensation."
+            ],
+            [
+                "Examination:",
+                "appearance",
+                "of",
+                "gravity,",
+                "blood",
+                "pressure",
+                "100/60",
+                "mmHg,",
+                "deep",
+                "and",
+                "rapid",
+                "breathing",
+                "(28rpm),",
+                "level",
+                "of",
+                "consciousness",
+                "preserved,",
+                "dry",
+                "mucous",
+                "membranes."
+            ],
+            [
+                "No",
+                "fever."
+            ],
+            [
+                "CBC:",
+                "blood",
+                "glucose",
+                "420",
+                "mg/dL,",
+                "Na+",
+                "131",
+                "mEq/L,",
+                "K+",
+                "normal,",
+                "pH",
+                "7.08,",
+                "bicarbonate",
+                "8",
+                "mEq/L",
+                "and",
+                "ketonuria",
+                "(+++)",
+                "Which",
+                "answer",
+                "do",
+                "you",
+                "think",
+                "is",
+                "more",
+                "correct?"
+            ],
+            [
+                "1-",
+                "Debut",
+                "of",
+                "type",
+                "2",
+                "diabetes",
+                "mellitus,",
+                "with",
+                "dyspnea",
+                "probably",
+                "due",
+                "to",
+                "pneumonia",
+                "or",
+                "thromboembolism,",
+                "since",
+                "she",
+                "is",
+                "taking",
+                "anovulatory",
+                "drugs."
+            ],
+            [
+                "2-",
+                "It",
+                "is",
+                "a",
+                "diabetic",
+                "ketoacidosis.",
+                "It",
+                "must",
+                "be",
+                "treated",
+                "with",
+                "intravenous",
+                "insulin,",
+                "serum",
+                "therapy,",
+                "general",
+                "measures",
+                "and",
+                "search",
+                "for",
+                "precipitating",
+                "cause."
+            ],
+            [
+                "3-",
+                "Debut",
+                "of",
+                "type",
+                "1",
+                "diabetes",
+                "with",
+                "ketoacidosis.",
+                "Treat",
+                "with",
+                "bicarbonate",
+                "and",
+                "after",
+                "correction",
+                "of",
+                "acidosis,",
+                "add",
+                "intravenous",
+                "insulin."
+            ],
+            [
+                "4-",
+                "It",
+                "looks",
+                "like",
+                "diabetic",
+                "ketoacidosis,",
+                "but",
+                "it",
+                "could",
+                "be",
+                "alcoholic.",
+                "BAC",
+                "should",
+                "be",
+                "determined",
+                "before",
+                "starting",
+                "insulin",
+                "therapy."
+            ],
+            [
+                "5-",
+                "Treat",
+                "with",
+                "rapid",
+                "subcutaneous",
+                "insulin,",
+                "serum",
+                "therapy",
+                "and",
+                "ask",
+                "him",
+                "to",
+                "drink",
+                "plenty",
+                "of",
+                "fluids."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Debut",
+                "of",
+                "DM",
+                "with",
+                "ketoacidosis."
+            ],
+            [
+                "Priority",
+                "is",
+                "iv",
+                "insulin",
+                "administration",
+                "and",
+                "serum",
+                "therapy."
+            ],
+            [
+                "Bicarbonate",
+                "if",
+                "pH",
+                "<",
+                "7."
+            ],
+            [
+                "Insulin",
+                "administration",
+                "should",
+                "never",
+                "be",
+                "delayed."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-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",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "553_177",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DERMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "33-year-old",
+                "patient,",
+                "resident",
+                "of",
+                "Valencia,",
+                "who",
+                "consults",
+                "for",
+                "presenting",
+                "on",
+                "the",
+                "right",
+                "cheek",
+                "an",
+                "erythematous-orange",
+                "plaque",
+                "after",
+                "an",
+                "insect",
+                "bite",
+                "that",
+                "has",
+                "been",
+                "growing",
+                "slowly",
+                "until",
+                "reaching",
+                "1.5",
+                "cm",
+                "and",
+                "that",
+                "in",
+                "the",
+                "last",
+                "weeks",
+                "has",
+                "ulcerated",
+                "and",
+                "covered",
+                "with",
+                "a",
+                "scammocostra."
+            ],
+            [
+                "The",
+                "lesion",
+                "only",
+                "causes",
+                "discrete",
+                "discomfort",
+                "if",
+                "scratched."
+            ],
+            [
+                "The",
+                "patient",
+                "has",
+                "a",
+                "history",
+                "of",
+                "plaque",
+                "psoriasis",
+                "treated",
+                "with",
+                "subcutaneous",
+                "adalimumab."
+            ],
+            [
+                "She",
+                "is",
+                "in",
+                "good",
+                "general",
+                "condition",
+                "and",
+                "does",
+                "not",
+                "take",
+                "any",
+                "other",
+                "drugs",
+                "and",
+                "does",
+                "not",
+                "report",
+                "any",
+                "drug",
+                "allergies."
+            ],
+            [
+                "Indicate",
+                "the",
+                "treatment",
+                "you",
+                "would",
+                "use:"
+            ],
+            [
+                "1-",
+                "Oral",
+                "isotretinoin."
+            ],
+            [
+                "2-",
+                "Intralesional",
+                "meglumine",
+                "antimoniate."
+            ],
+            [
+                "3-",
+                "Systemic",
+                "corticosteroids."
+            ],
+            [
+                "4-",
+                "Oral",
+                "amoxicillin."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "The",
+                "fact",
+                "that",
+                "the",
+                "place",
+                "of",
+                "residence",
+                "is",
+                "mentioned",
+                "already",
+                "gives",
+                "us",
+                "many",
+                "clues."
+            ],
+            [
+                "A",
+                "\"bite\"",
+                "that",
+                "transforms",
+                "into",
+                "a",
+                "lesion",
+                "in",
+                "an",
+                "uncovered",
+                "area",
+                "with",
+                "a",
+                "crusty",
+                "surface",
+                "and",
+                "that",
+                "bothers",
+                "little",
+                "or",
+                "nothing...",
+                "in",
+                "the",
+                "Mediterranean",
+                "basin",
+                "this",
+                "is",
+                "cutaneous",
+                "leishmaniasis",
+                "or",
+                "oriental",
+                "button."
+            ],
+            [
+                "And",
+                "while",
+                "it",
+                "is",
+                "true",
+                "that",
+                "the",
+                "lesion",
+                "is",
+                "<",
+                "4",
+                "cm",
+                "and",
+                "unique,",
+                "we",
+                "are",
+                "told",
+                "that",
+                "the",
+                "patient",
+                "is",
+                "being",
+                "treated",
+                "with",
+                "adalimumab,",
+                "an",
+                "anti-TNF",
+                "monoclonal",
+                "antibody."
+            ],
+            [
+                "With",
+                "the",
+                "exception",
+                "of",
+                "meglumine",
+                "antimoniate,",
+                "none",
+                "of",
+                "the",
+                "other",
+                "treatments",
+                "proposed",
+                "in",
+                "the",
+                "different",
+                "options",
+                "are",
+                "indicated",
+                "in",
+                "leishmaniasis,",
+                "so",
+                "it",
+                "is",
+                "clear."
+            ],
+            [
+                "The",
+                "only",
+                "thing",
+                "that",
+                "is",
+                "more",
+                "debatable",
+                "is",
+                "that,",
+                "as",
+                "this",
+                "is",
+                "an",
+                "immunosuppressed",
+                "patient,",
+                "systemic",
+                "treatment",
+                "would",
+                "probably",
+                "be",
+                "more",
+                "appropriate."
+            ],
+            [
+                "I",
+                "don't",
+                "know",
+                "if",
+                "for",
+                "that",
+                "reason",
+                "contestable,",
+                "but",
+                "at",
+                "least,",
+                "debatable."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
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+            ],
+            [
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+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "608_115",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "TRAUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
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+                "male,",
+                "a",
+                "regular",
+                "athlete,",
+                "refers",
+                "pain",
+                "in",
+                "the",
+                "right",
+                "leg",
+                "after",
+                "continuous",
+                "running."
+            ],
+            [
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+                "visited",
+                "a",
+                "physiotherapist",
+                "on",
+                "several",
+                "occasions",
+                "and",
+                "has",
+                "been",
+                "diagnosed",
+                "with",
+                "calf",
+                "overload."
+            ],
+            [
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+                "months",
+                "have",
+                "passed,",
+                "he",
+                "has",
+                "not",
+                "improved",
+                "and",
+                "refers",
+                "intense",
+                "pain",
+                "after",
+                "physical",
+                "activity",
+                "that",
+                "subsides",
+                "with",
+                "rest",
+                "in",
+                "the",
+                "following",
+                "hours",
+                "of",
+                "exercise."
+            ],
+            [
+                "What",
+                "test",
+                "can",
+                "help",
+                "in",
+                "the",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Positron",
+                "emission",
+                "tomography",
+                "with",
+                "18",
+                "FDG."
+            ],
+            [
+                "2-",
+                "Determination",
+                "of",
+                "posterior",
+                "compartment",
+                "pressure",
+                "immediately",
+                "after",
+                "activity."
+            ],
+            [
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+                "Doppler",
+                "ultrasound",
+                "to",
+                "rule",
+                "out",
+                "a",
+                "circulatory",
+                "disorder",
+                "of",
+                "the",
+                "lower",
+                "extremity."
+            ],
+            [
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+                "Spectrometry",
+                "by",
+                "magnetic",
+                "resonance."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
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+                "present",
+                "a",
+                "case",
+                "of",
+                "chronic",
+                "compartment",
+                "syndrome."
+            ],
+            [
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+                "diagnosis",
+                "it",
+                "is",
+                "necessary",
+                "to",
+                "measure",
+                "the",
+                "pressure",
+                "of",
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+                "affected",
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+                "at",
+                "rest",
+                "and",
+                "after",
+                "activity",
+                "(answer",
+                "2",
+                "correct)."
+            ]
+        ],
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+            ],
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+            ],
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+                "O",
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+                "O",
+                "O"
+            ],
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
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+            [
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+            ],
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+                "O"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "294_44",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GENETICS",
+                "AND",
+                "IMMUNOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "Amalia",
+                "is",
+                "a",
+                "3-year-old",
+                "girl",
+                "who",
+                "has",
+                "undergone",
+                "surgery",
+                "for",
+                "tetralogy",
+                "of",
+                "Fallot."
+            ],
+            [
+                "She",
+                "also",
+                "presented",
+                "thymic",
+                "dysfunction",
+                "in",
+                "the",
+                "neonatal",
+                "period",
+                "and",
+                "hypocalcemia",
+                "as",
+                "well",
+                "as",
+                "a",
+                "nasal",
+                "voice",
+                "and",
+                "psychomotor",
+                "retardation."
+            ],
+            [
+                "Which",
+                "genetic",
+                "test",
+                "do",
+                "you",
+                "consider",
+                "most",
+                "appropriate",
+                "to",
+                "reach",
+                "an",
+                "etiological",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "22q11",
+                "deletion",
+                "study",
+                "(Di",
+                "George",
+                "or",
+                "Velo-cardio-facial",
+                "syndrome)."
+            ],
+            [
+                "2-",
+                "Study",
+                "of",
+                "FMR1",
+                "gene",
+                "expansion,",
+                "responsible",
+                "for",
+                "Fragile",
+                "X",
+                "syndrome."
+            ],
+            [
+                "3-",
+                "Sequencing",
+                "of",
+                "genes",
+                "related",
+                "to",
+                "HRAS",
+                "(Noonan",
+                "syndrome)."
+            ],
+            [
+                "4-",
+                "Genetic",
+                "study",
+                "of",
+                "Williams",
+                "Beuren",
+                "syndrome."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Question",
+                "in",
+                "which",
+                "the",
+                "clinical",
+                "picture",
+                "must",
+                "be",
+                "recognized:",
+                "cardiovascular",
+                "anomalies",
+                "-",
+                "Tetralogy",
+                "of",
+                "Fallot",
+                "-;",
+                "thymic",
+                "aplasia/hypoplasia",
+                "-",
+                "leading",
+                "to",
+                "primary",
+                "T-cell",
+                "immunodeficiency;",
+                "parathyroid",
+                "aplasia/hypoplasia",
+                "-",
+                "hence",
+                "hypocalcemia",
+                "-;",
+                "palatal",
+                "anomalies",
+                "-",
+                "nasal",
+                "voice;",
+                "psychomotor",
+                "retardation."
+            ],
+            [
+                "In",
+                "my",
+                "opinion,",
+                "just",
+                "with",
+                "the",
+                "words",
+                "\"thymic",
+                "dysfunction\",",
+                "hypocalcemia",
+                "and",
+                "cardiopathy,",
+                "we",
+                "would",
+                "have",
+                "to",
+                "go",
+                "straight",
+                "to",
+                "DiGeorge",
+                "syndrome."
+            ],
+            [
+                "Indeed,",
+                "the",
+                "genetic",
+                "defect",
+                "is",
+                "a",
+                "22q11.2",
+                "deletion",
+                "(which",
+                "if",
+                "we",
+                "know",
+                "it,",
+                "the",
+                "better,",
+                "but",
+                "with",
+                "the",
+                "clinic",
+                "it",
+                "would",
+                "be",
+                "enough",
+                "for",
+                "us)."
+            ],
+            [
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+                "which",
+                "there",
+                "could",
+                "be",
+                "doubt",
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+                "with",
+                "cardiopathy,",
+                "but",
+                "above",
+                "all",
+                "it",
+                "is",
+                "characterized",
+                "by",
+                "short",
+                "stature,",
+                "cardiopathy",
+                "and",
+                "bone",
+                "alterations;",
+                "moreover,",
+                "in",
+                "most",
+                "cases",
+                "it",
+                "is",
+                "caused",
+                "by",
+                "an",
+                "alteration",
+                "in",
+                "the",
+                "PTPN11",
+                "gene,",
+                "not",
+                "in",
+                "those",
+                "mentioned",
+                "in",
+                "the",
+                "question."
+            ]
+        ],
+        "labels": [
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+                "O",
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+            ],
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+            ],
+            [
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
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+                "O",
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+                "O",
+                "O"
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+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "156_230",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "RHEUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
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+                "40-year-old",
+                "patient",
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+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "room",
+                "with",
+                "aphthous",
+                "stomatitis,",
+                "conjunctivitis,",
+                "urethritis,",
+                "balanitis",
+                "and",
+                "joint",
+                "pain."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "diagnoses",
+                "is",
+                "the",
+                "most",
+                "likely?"
+            ],
+            [
+                "1-",
+                "Beh\u00e7et's",
+                "disease."
+            ],
+            [
+                "2-",
+                "Reactive",
+                "arthritis",
+                "syndrome."
+            ],
+            [
+                "3-",
+                "Sweet's",
+                "syndrome."
+            ],
+            [
+                "4-",
+                "Vitamin",
+                "A",
+                "deficiency."
+            ],
+            [
+                "5-",
+                "Gonococcal",
+                "infection."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
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+                "and",
+                "without",
+                "having",
+                "complementary",
+                "tests",
+                "available,",
+                "the",
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+                "likely",
+                "diagnosis",
+                "is",
+                "reactive",
+                "arthritis."
+            ],
+            [
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+                "speaks",
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+                "pain",
+                "and",
+                "not",
+                "arthritis..."
+            ],
+            [
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+                "(triad",
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+            ],
+            [
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+                "oral",
+                "and",
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+                "may",
+                "occur",
+                "but",
+                "urethritis",
+                "is",
+                "not",
+                "a",
+                "feature."
+            ],
+            [
+                "And",
+                "the",
+                "characteristic",
+                "ocular",
+                "condition",
+                "is",
+                "uveitis."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Premise",
+                "B-Premise",
+                "B-Premise",
+                "O",
+                "B-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "82_45",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CARDIOLOGY",
+                "AND",
+                "VASCULAR",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "60-year-old",
+                "man",
+                "reports",
+                "precordial",
+                "pain",
+                "after",
+                "medium",
+                "exertion."
+            ],
+            [
+                "Coronary",
+                "angiography",
+                "shows",
+                "significant",
+                "stenosis",
+                "in",
+                "the",
+                "proximal",
+                "segments",
+                "of",
+                "the",
+                "three",
+                "main",
+                "vessels",
+                "with",
+                "good",
+                "distal",
+                "bed."
+            ],
+            [
+                "Ventricular",
+                "function",
+                "is",
+                "depressed",
+                "(<30%)."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "best",
+                "therapeutic",
+                "option?"
+            ],
+            [
+                "1-",
+                "Percutaneous",
+                "revascularization."
+            ],
+            [
+                "2-",
+                "Medical",
+                "treatment."
+            ],
+            [
+                "3-",
+                "Myocardial",
+                "revascularization",
+                "surgery."
+            ],
+            [
+                "4-",
+                "Implantation",
+                "of",
+                "balloon",
+                "counterpulsation."
+            ],
+            [
+                "5-",
+                "Cardiac",
+                "transplantation."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "We",
+                "are",
+                "talking",
+                "about",
+                "a",
+                "patient",
+                "with",
+                "3-vessel",
+                "coronary",
+                "artery",
+                "disease",
+                "and,",
+                "very",
+                "importantly,",
+                "with",
+                "severe",
+                "ventricular",
+                "dysfunction."
+            ],
+            [
+                "Under",
+                "these",
+                "conditions,",
+                "the",
+                "treatment",
+                "of",
+                "choice",
+                "would",
+                "be",
+                "surgical",
+                "(myocardial",
+                "revascularization",
+                "surgery",
+                "or",
+                "by-pass)."
+            ],
+            [
+                "In",
+                "the",
+                "case",
+                "of",
+                "a",
+                "patient",
+                "with",
+                "preserved",
+                "LV",
+                "function,",
+                "the",
+                "choice",
+                "of",
+                "surgical",
+                "vs.",
+                "percutaneous",
+                "treatment",
+                "would",
+                "be",
+                "more",
+                "questionable,",
+                "since",
+                "today,",
+                "thanks",
+                "to",
+                "drug-eluting",
+                "stents,",
+                "the",
+                "differences",
+                "in",
+                "terms",
+                "of",
+                "morbidity",
+                "and",
+                "mortality",
+                "between",
+                "by-pass",
+                "surgery",
+                "and",
+                "angioplasty",
+                "are",
+                "minimal."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "485_49",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DERMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "60-year-old",
+                "man",
+                "on",
+                "carbamazepine",
+                "treatment",
+                "for",
+                "epilepsy",
+                "presenting",
+                "with",
+                "fever",
+                "(38.8\u00b0C),",
+                "odynophagia,",
+                "conjunctivitis,",
+                "brownish",
+                "skin",
+                "lesions",
+                "spread",
+                "over",
+                "a",
+                "large",
+                "body",
+                "surface,",
+                "target-like",
+                "in",
+                "appearance",
+                "and",
+                "accompanied",
+                "by",
+                "epidermal",
+                "detachment",
+                "(greater",
+                "than",
+                "30%)",
+                "at",
+                "the",
+                "slightest",
+                "friction."
+            ],
+            [
+                "It",
+                "is",
+                "very",
+                "likely",
+                "that",
+                "she",
+                "is",
+                "presenting",
+                "a",
+                "clinical",
+                "picture",
+                "of:"
+            ],
+            [
+                "1-",
+                "Acute",
+                "urticaria",
+                "of",
+                "pharmacological",
+                "cause."
+            ],
+            [
+                "2-",
+                "Erythema",
+                "minor",
+                "exudative",
+                "secondary",
+                "to",
+                "drugs."
+            ],
+            [
+                "3-",
+                "Pharmacological",
+                "Stevens-Johnson",
+                "syndrome."
+            ],
+            [
+                "4-",
+                "Epidermal",
+                "toxic",
+                "necrolysis."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "We",
+                "are",
+                "dealing",
+                "with",
+                "a",
+                "severe",
+                "patient,",
+                "with",
+                "target",
+                "lesions",
+                "and",
+                "Nikolsky's",
+                "sign",
+                "in",
+                ">",
+                "30%",
+                "of",
+                "the",
+                "body",
+                "surface",
+                "area."
+            ],
+            [
+                "Together",
+                "with",
+                "the",
+                "history",
+                "of",
+                "treatment",
+                "with",
+                "carbamazepine,",
+                "the",
+                "suspicion",
+                "will",
+                "be",
+                "of",
+                "toxic",
+                "epidermal",
+                "necrolysis",
+                "(answer",
+                "4)."
+            ],
+            [
+                "If",
+                "the",
+                "epidermal",
+                "detachment",
+                "is",
+                "less",
+                "than",
+                "10%",
+                "then",
+                "we",
+                "would",
+                "be",
+                "dealing",
+                "with",
+                "Stevens-Johnson",
+                "(and",
+                "intermediate",
+                "cases",
+                "are",
+                "referred",
+                "to",
+                "as",
+                "overlap,",
+                "since",
+                "it",
+                "is",
+                "a",
+                "whole",
+                "spectrum)."
+            ],
+            [
+                "Incidentally,",
+                "we",
+                "would",
+                "recommend",
+                "immediate",
+                "admission",
+                "to",
+                "a",
+                "major",
+                "burn",
+                "unit."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "219_124",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "578_107",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "55-year-old",
+                "male",
+                "who",
+                "suffers",
+                "a",
+                "subarachnoid",
+                "hemorrhage",
+                "due",
+                "to",
+                "a",
+                "ruptured",
+                "middle",
+                "cerebral",
+                "artery",
+                "aneurysm."
+            ],
+            [
+                "He",
+                "is",
+                "treated",
+                "surgically."
+            ],
+            [
+                "After",
+                "a",
+                "good",
+                "evolution",
+                "in",
+                "which",
+                "he",
+                "recovers",
+                "the",
+                "ability",
+                "to",
+                "walk,",
+                "one",
+                "month",
+                "after",
+                "suffering",
+                "the",
+                "hemorrhage,",
+                "he",
+                "presents",
+                "a",
+                "progressive",
+                "deterioration,",
+                "becoming",
+                "cloudy",
+                "and",
+                "with",
+                "difficulty",
+                "to",
+                "obey",
+                "orders."
+            ],
+            [
+                "Mark",
+                "the",
+                "correct",
+                "statement:"
+            ],
+            [
+                "1-",
+                "She",
+                "is",
+                "in",
+                "the",
+                "moment",
+                "of",
+                "evolution",
+                "in",
+                "which",
+                "vasospasm",
+                "is",
+                "more",
+                "frequent."
+            ],
+            [
+                "2-",
+                "This",
+                "progressive",
+                "deterioration",
+                "is",
+                "probably",
+                "secondary",
+                "to",
+                "aneurysm",
+                "rebleeding."
+            ],
+            [
+                "3-",
+                "Subacute",
+                "deterioration",
+                "is",
+                "most",
+                "likely",
+                "due",
+                "to",
+                "hydrocephalus."
+            ],
+            [
+                "4-",
+                "The",
+                "diagnostic",
+                "technique",
+                "of",
+                "choice",
+                "is",
+                "cerebral",
+                "angiography."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Vasospasm",
+                "as",
+                "a",
+                "complication",
+                "of",
+                "subarachnoid",
+                "hemorrhage",
+                "usually",
+                "occurs",
+                "early,",
+                "in",
+                "the",
+                "week",
+                "after",
+                "the",
+                "hemorrhage."
+            ],
+            [
+                "The",
+                "progressive",
+                "deterioration",
+                "with",
+                "alteration",
+                "of",
+                "the",
+                "level",
+                "of",
+                "consciousness",
+                "makes",
+                "us",
+                "suspect",
+                "one",
+                "of",
+                "the",
+                "complications",
+                "that",
+                "can",
+                "occur",
+                "in",
+                "this",
+                "condition:",
+                "hydrocephalus."
+            ],
+            [
+                "The",
+                "diagnostic",
+                "technique",
+                "of",
+                "choice",
+                "in",
+                "this",
+                "case",
+                "is",
+                "neuroimaging",
+                "with",
+                "cranial",
+                "CT."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "199_74",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "In",
+                "a",
+                "patient",
+                "presenting",
+                "in",
+                "the",
+                "second",
+                "decade",
+                "of",
+                "life",
+                "with",
+                "a",
+                "progressive",
+                "picture",
+                "of",
+                "parkinsonism,",
+                "tremor,",
+                "dystonia",
+                "and",
+                "behavioral",
+                "alteration,",
+                "you",
+                "should",
+                "always",
+                "perform",
+                "a",
+                "study",
+                "to",
+                "rule",
+                "out",
+                "the",
+                "presence",
+                "of",
+                "a",
+                "disease",
+                "whose",
+                "appropriate",
+                "treatment",
+                "can",
+                "improve",
+                "neurological",
+                "symptoms",
+                "and",
+                "stop",
+                "the",
+                "clinical",
+                "course."
+            ],
+            [
+                "What",
+                "disease",
+                "is",
+                "it?"
+            ],
+            [
+                "1-",
+                "Huntington's",
+                "disease."
+            ],
+            [
+                "2-",
+                "Wilson's",
+                "disease."
+            ],
+            [
+                "3-",
+                "Tourette's",
+                "syndrome."
+            ],
+            [
+                "4-",
+                "Sydenham's",
+                "chorea."
+            ],
+            [
+                "5-",
+                "Juvenile-onset",
+                "Parkinson's",
+                "disease."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "The",
+                "key",
+                "in",
+                "the",
+                "question",
+                "is",
+                "\"stopping",
+                "the",
+                "clinical",
+                "course\",",
+                "as",
+                "Hungtinton's",
+                "disease,",
+                "Tourette's",
+                "and",
+                "Parkinson's",
+                "disease",
+                "do",
+                "not",
+                "have",
+                "treatments",
+                "that",
+                "can",
+                "stop",
+                "the",
+                "clinical",
+                "course."
+            ],
+            [
+                "Sydenham's",
+                "chorea",
+                "is",
+                "typical",
+                "of",
+                "younger",
+                "children",
+                "with",
+                "a",
+                "history",
+                "of",
+                "streptococcal",
+                "infection",
+                "and",
+                "resolution",
+                "is",
+                "usually",
+                "spontaneous."
+            ],
+            [
+                "On",
+                "the",
+                "other",
+                "hand,",
+                "in",
+                "clinical",
+                "cases",
+                "it",
+                "is",
+                "recommended",
+                "to",
+                "rule",
+                "out",
+                "Wilson's",
+                "disease",
+                "in",
+                "young",
+                "patients",
+                "with",
+                "movement",
+                "and",
+                "neuropsychiatric",
+                "disorders."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Disease",
+                "I-Disease",
+                "I-Disease"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "331_87",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "In",
+                "a",
+                "hospitalized",
+                "patient",
+                "who",
+                "is",
+                "unable",
+                "to",
+                "feed",
+                "orally",
+                "for",
+                "more",
+                "than",
+                "6",
+                "days,",
+                "in",
+                "which",
+                "of",
+                "the",
+                "following",
+                "clinical",
+                "situations",
+                "are",
+                "we",
+                "necessarily",
+                "to",
+                "use",
+                "parenteral",
+                "nutrition?"
+            ],
+            [
+                "1-",
+                "Cardioembolic",
+                "stroke",
+                "with",
+                "complete",
+                "neurologic",
+                "dysphagia."
+            ],
+            [
+                "2-",
+                "Cachexia",
+                "due",
+                "to",
+                "chronic",
+                "empyema",
+                "in",
+                "immunocompromised",
+                "patient."
+            ],
+            [
+                "3-",
+                "Prolonged",
+                "paralytic",
+                "syndrome."
+            ],
+            [
+                "4-",
+                "Advanced",
+                "Alzheimer's",
+                "disease",
+                "with",
+                "severe",
+                "risk",
+                "of",
+                "bronchial",
+                "aspiration."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Paralytic",
+                "ileus",
+                "is",
+                "a",
+                "failure",
+                "of",
+                "intestinal",
+                "propulsion",
+                "that",
+                "appears",
+                "acutely",
+                "in",
+                "the",
+                "absence",
+                "of",
+                "mechanical",
+                "obstruction;",
+                "it",
+                "is",
+                "secondary",
+                "to",
+                "various",
+                "causes",
+                "and",
+                "affects",
+                "intestinal",
+                "contractility."
+            ],
+            [
+                "Therefore,",
+                "parenteral",
+                "administration",
+                "is",
+                "necessary."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "205_214",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DERMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "24-year-old",
+                "young",
+                "man",
+                "who",
+                "3",
+                "days",
+                "after",
+                "a",
+                "risky",
+                "sexual",
+                "contact",
+                "presents",
+                "numerous",
+                "pustular",
+                "lesions,",
+                "small,",
+                "very",
+                "pruritic",
+                "and",
+                "evolving",
+                "to",
+                "tiny",
+                "erosions",
+                "affecting",
+                "the",
+                "entire",
+                "glans",
+                "and",
+                "the",
+                "inner",
+                "face",
+                "of",
+                "the",
+                "foreskin."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnostic",
+                "approach?"
+            ],
+            [
+                "1-",
+                "Genital",
+                "candidiasis."
+            ],
+            [
+                "2-",
+                "Chancroid."
+            ],
+            [
+                "3-",
+                "Secondary",
+                "syphilis."
+            ],
+            [
+                "4-",
+                "Trichomonas",
+                "balanitis."
+            ],
+            [
+                "5-",
+                "Dermatophyte",
+                "fungal",
+                "infection."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Chancroid",
+                "is",
+                "a",
+                "solitary",
+                "lesion."
+            ],
+            [
+                "Secondary",
+                "syphilis",
+                "usually",
+                "occurs",
+                "as",
+                "a",
+                "generalized",
+                "rash",
+                "or",
+                "as",
+                "characteristic",
+                "lesions",
+                "on",
+                "palms",
+                "and",
+                "soles",
+                "(syphilitic",
+                "nails)",
+                "with",
+                "a",
+                "longer",
+                "latency",
+                "period."
+            ],
+            [
+                "Trichomonas",
+                "balanitis",
+                "is",
+                "always",
+                "associated",
+                "with",
+                "urethritis,",
+                "which",
+                "is",
+                "not",
+                "referred",
+                "to",
+                "in",
+                "the",
+                "question."
+            ],
+            [
+                "Therefore,",
+                "the",
+                "answer",
+                "is",
+                "1."
+            ],
+            [
+                "However,",
+                "the",
+                "clinical",
+                "picture",
+                "suggests",
+                "herpes",
+                "simplex",
+                "rather",
+                "than",
+                "candidiasis",
+                "and",
+                "5",
+                "also",
+                "refers",
+                "to",
+                "fungi",
+                "(although",
+                "dermatophytes",
+                "do",
+                "not",
+                "cause",
+                "balanitis)....",
+                "from",
+                "our",
+                "point",
+                "of",
+                "view,",
+                "even",
+                "if",
+                "we",
+                "consider",
+                "1",
+                "to",
+                "be",
+                "correct,",
+                "the",
+                "question",
+                "is",
+                "misleading",
+                "and",
+                "could",
+                "be",
+                "open",
+                "to",
+                "challenge."
+            ],
+            [
+                "Moreover,",
+                "genital",
+                "candidiasis",
+                "is",
+                "not",
+                "necessarily",
+                "sexually",
+                "transmitted."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
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+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
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+            [
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+            [
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+                "I-Claim"
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+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim"
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+            [
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+                "O",
+                "O"
+            ],
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+            ],
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+            ],
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+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "441_98",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "302_111",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEPHROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "In",
+                "a",
+                "patient",
+                "with",
+                "rheumatoid",
+                "arthritis",
+                "treated",
+                "with",
+                "methotrexate,",
+                "prednisone",
+                "and",
+                "indomethacin",
+                "who",
+                "acutely",
+                "presents",
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+                "and",
+                "increased",
+                "plasma",
+                "creatinine",
+                "with",
+                "a",
+                "poorly",
+                "expressive",
+                "urine",
+                "sediment",
+                "and",
+                "proteinuria",
+                "less",
+                "than",
+                "100",
+                "mg/24",
+                "h",
+                "the",
+                "most",
+                "likely",
+                "cause",
+                "is:"
+            ],
+            [
+                "1-",
+                "Renal",
+                "amyloidosis."
+            ],
+            [
+                "2-",
+                "Glomerulonephritis",
+                "secondary",
+                "to",
+                "rheumatoid",
+                "arthritis."
+            ],
+            [
+                "3-",
+                "Renal",
+                "failure",
+                "due",
+                "to",
+                "non-steroidal",
+                "anti-inflammatory",
+                "drugs."
+            ],
+            [
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+                "Interstitial",
+                "nephritis",
+                "due",
+                "to",
+                "methotrexate."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Prerenal",
+                "acute",
+                "renal",
+                "failure",
+                "due",
+                "to",
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+                "seems",
+                "the",
+                "most",
+                "plausible",
+                "option",
+                "in",
+                "this",
+                "case."
+            ],
+            [
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+                "due",
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+                "is",
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+                "due",
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+                "rare",
+                "in",
+                "the",
+                "MIR",
+                "usually",
+                "appear."
+            ],
+            [
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+                "and",
+                "renal",
+                "amyloidosis",
+                "are",
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+                "frequent",
+                "in",
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+                "the",
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+                "and",
+                "the",
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+                "of",
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+        ],
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+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
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+                "O"
+            ],
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+                "O",
+                "O"
+            ],
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "517_104",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CRITICAL",
+                "AND",
+                "EMERGENCY",
+                "CARE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "34-year-old",
+                "male",
+                "is",
+                "involved",
+                "in",
+                "a",
+                "traffic",
+                "accident",
+                "and",
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+                "attended",
+                "at",
+                "the",
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+            ],
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+                "observe",
+                "that",
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+                "a",
+                "thready",
+                "pulse",
+                "with",
+                "a",
+                "blood",
+                "pressure",
+                "of",
+                "90/50",
+                "mmHg,",
+                "a",
+                "heart",
+                "rate",
+                "of",
+                "127",
+                "bpm,",
+                "a",
+                "respiratory",
+                "rate",
+                "of",
+                "28",
+                "rpm",
+                "and",
+                "an",
+                "oxygen",
+                "saturation",
+                "of",
+                "92%."
+            ],
+            [
+                "He",
+                "was",
+                "infused",
+                "with",
+                "20",
+                "ml/kg",
+                "of",
+                "crystalloids."
+            ],
+            [
+                "During",
+                "his",
+                "transfer",
+                "to",
+                "the",
+                "hospital",
+                "his",
+                "vital",
+                "signs",
+                "improve",
+                "transiently",
+                "and",
+                "then",
+                "deteriorate",
+                "on",
+                "arrival",
+                "at",
+                "the",
+                "hospital."
+            ],
+            [
+                "Point",
+                "out",
+                "the",
+                "correct",
+                "answer:"
+            ],
+            [
+                "1-",
+                "Type-specific",
+                "blood",
+                "transfusion",
+                "required."
+            ],
+            [
+                "2-",
+                "Requires",
+                "emergency",
+                "blood",
+                "transfusion",
+                "(O",
+                "Rh",
+                "negative)."
+            ],
+            [
+                "3-",
+                "A",
+                "possible",
+                "blood",
+                "transfusion",
+                "with",
+                "crossmatching",
+                "tests",
+                "should",
+                "be",
+                "prepared."
+            ],
+            [
+                "4-",
+                "Try",
+                "again",
+                "infusion",
+                "of",
+                "another",
+                "20",
+                "ml/kg",
+                "of",
+                "crystalloids."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
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+                "a",
+                "polytraumatized",
+                "patient,",
+                "the",
+                "first",
+                "cause",
+                "of",
+                "shock",
+                "is",
+                "blood",
+                "loss",
+                "(hemorrhagic",
+                "shock)."
+            ],
+            [
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+                "to",
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+                "should",
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+                "contemplate",
+                "the",
+                "replenishment",
+                "of",
+                "blood",
+                "volume",
+                "(if",
+                "possible,",
+                "with",
+                "blood",
+                "products",
+                "as",
+                "early",
+                "as",
+                "possible)",
+                "and",
+                "control",
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+                "indication",
+                "is",
+                "emergency",
+                "blood",
+                "transfusion",
+                "(O",
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+            ]
+        ],
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+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise"
+            ],
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
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+            [
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+                "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"
+            ],
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
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+            ],
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
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+            [
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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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "520_38",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DERMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
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+                "72-year-old",
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+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "for",
+                "presenting",
+                "with",
+                "severe",
+                "and",
+                "significant",
+                "lingual",
+                "angioedema."
+            ],
+            [
+                "She",
+                "does",
+                "not",
+                "present",
+                "associated",
+                "urticaria",
+                "and",
+                "has",
+                "no",
+                "history",
+                "of",
+                "drug",
+                "or",
+                "food",
+                "allergy."
+            ],
+            [
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+                "personal",
+                "history",
+                "includes",
+                "type",
+                "2",
+                "diabetes",
+                "mellitus,",
+                "dyslipidemia,",
+                "hypertension,",
+                "hypothyroidism",
+                "and",
+                "Parkinson's",
+                "disease."
+            ],
+            [
+                "She",
+                "is",
+                "on",
+                "regular",
+                "treatment",
+                "with",
+                "metformin,",
+                "simvastatin,",
+                "enalapril,",
+                "thyroxine",
+                "and",
+                "levodopa."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "drugs",
+                "is",
+                "most",
+                "likely",
+                "the",
+                "causal",
+                "drug",
+                "of",
+                "the",
+                "clinical",
+                "picture",
+                "described?"
+            ],
+            [
+                "1-",
+                "Enalapril."
+            ],
+            [
+                "2-",
+                "Simvastatin."
+            ],
+            [
+                "3-",
+                "Metformin",
+                "or",
+                "levodopa",
+                "equally."
+            ],
+            [
+                "4-",
+                "Levodopa."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Angioedema",
+                "is",
+                "a",
+                "type",
+                "of",
+                "profound",
+                "urticaria",
+                "that",
+                "can",
+                "be",
+                "of",
+                "drug",
+                "etiology",
+                "(not",
+                "IgE-mediated)",
+                "and",
+                "in",
+                "this",
+                "case,",
+                "ACEIs",
+                "(such",
+                "as",
+                "enalapril)",
+                "are",
+                "considered",
+                "the",
+                "most",
+                "frequent",
+                "pharmacological",
+                "cause,",
+                "so",
+                "in",
+                "this",
+                "case",
+                "it",
+                "would",
+                "be",
+                "the",
+                "correct",
+                "answer",
+                "(if",
+                "we",
+                "speak",
+                "in",
+                "probabilistic",
+                "terms)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-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",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "379_133",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "20-year-old",
+                "girl",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "because",
+                "she",
+                "has",
+                "noticed",
+                "after",
+                "getting",
+                "up,",
+                "when",
+                "looking",
+                "in",
+                "the",
+                "mirror,",
+                "weakness",
+                "in",
+                "the",
+                "right",
+                "half",
+                "of",
+                "the",
+                "face",
+                "(including",
+                "the",
+                "forehead,",
+                "closing",
+                "the",
+                "eyelid",
+                "and",
+                "smiling)."
+            ],
+            [
+                "She",
+                "is",
+                "accompanied",
+                "by",
+                "dysgeusia,",
+                "with",
+                "a",
+                "sensation",
+                "of",
+                "metallic",
+                "taste",
+                "of",
+                "food",
+                "as",
+                "well",
+                "as",
+                "hyperacusis",
+                "and",
+                "ipsilateral",
+                "mastoid",
+                "pain."
+            ],
+            [
+                "On",
+                "examination",
+                "there",
+                "is",
+                "no",
+                "evidence",
+                "of",
+                "strength",
+                "deficits",
+                "or",
+                "sensory",
+                "deficits",
+                "in",
+                "the",
+                "extremities",
+                "or",
+                "speech",
+                "or",
+                "language",
+                "disorders."
+            ],
+            [
+                "In",
+                "this",
+                "case,",
+                "which",
+                "of",
+                "the",
+                "following",
+                "statements",
+                "is",
+                "correct?"
+            ],
+            [
+                "1-",
+                "The",
+                "most",
+                "probable",
+                "diagnosis",
+                "is",
+                "a",
+                "demyelinating",
+                "plaque",
+                "in",
+                "the",
+                "contralateral",
+                "hemiprotuberance,",
+                "the",
+                "most",
+                "necessary",
+                "complementary",
+                "exploration",
+                "would",
+                "be",
+                "a",
+                "cranial",
+                "MRI."
+            ],
+            [
+                "2-",
+                "Oral",
+                "corticosteroids",
+                "are",
+                "the",
+                "treatment",
+                "of",
+                "choice",
+                "for",
+                "the",
+                "patient."
+            ],
+            [
+                "3-",
+                "Intravenous",
+                "fibrinolysis",
+                "should",
+                "be",
+                "considered",
+                "if",
+                "the",
+                "evolution",
+                "time",
+                "is",
+                "less",
+                "than",
+                "3h."
+            ],
+            [
+                "4-",
+                "Most",
+                "likely",
+                "the",
+                "picture",
+                "is",
+                "irreversible."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "We",
+                "describe",
+                "a",
+                "picture",
+                "of",
+                "typical",
+                "peripheral",
+                "facial",
+                "paralysis,",
+                "with",
+                "dysgeusia,",
+                "hyperacusis",
+                "and",
+                "mastoid",
+                "pain."
+            ],
+            [
+                "In",
+                "this",
+                "case",
+                "the",
+                "treatment",
+                "is",
+                "corticoid."
+            ],
+            [
+                "The",
+                "first",
+                "one",
+                "would",
+                "not",
+                "be",
+                "correct",
+                "because",
+                "although",
+                "within",
+                "the",
+                "age",
+                "range",
+                "of",
+                "multiple",
+                "sclerosis",
+                "debut,",
+                "the",
+                "presentation",
+                "is",
+                "usually",
+                "gradual",
+                "over",
+                "days",
+                "and",
+                "the",
+                "nuclear",
+                "involvement",
+                "of",
+                "the",
+                "VII",
+                "cranial",
+                "nerve",
+                "(which",
+                "could",
+                "simulate",
+                "a",
+                "peripheral",
+                "facial)",
+                "would",
+                "not",
+                "cause",
+                "dysgeusia,",
+                "hyperacusis",
+                "or",
+                "mastoid",
+                "pain."
+            ],
+            [
+                "In",
+                "the",
+                "third",
+                "answer",
+                "they",
+                "propose",
+                "us",
+                "that",
+                "it",
+                "is",
+                "a",
+                "vascular",
+                "picture",
+                "and",
+                "therefore",
+                "that",
+                "the",
+                "facial",
+                "paralysis",
+                "is",
+                "central,",
+                "so",
+                "it",
+                "is",
+                "discarded",
+                "and",
+                "the",
+                "last",
+                "one",
+                "is",
+                "not",
+                "correct",
+                "because",
+                "most",
+                "of",
+                "the",
+                "idiopathic",
+                "peripheral",
+                "facial",
+                "paralysis",
+                "(Bell's",
+                "palsy)",
+                "heal",
+                "without",
+                "sequelae."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "600_184",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "RHEUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "70-year-old",
+                "woman",
+                "who",
+                "has",
+                "been",
+                "complaining",
+                "for",
+                "1",
+                "month",
+                "of",
+                "pain",
+                "and",
+                "stiffness",
+                "in",
+                "the",
+                "shoulder",
+                "girdle",
+                "and",
+                "pelvic",
+                "girdle,",
+                "which",
+                "predominates",
+                "when",
+                "she",
+                "gets",
+                "up",
+                "and",
+                "improves",
+                "with",
+                "mobilization,",
+                "without",
+                "fever,",
+                "headache",
+                "or",
+                "general",
+                "condition."
+            ],
+            [
+                "Physical",
+                "examination",
+                "showed",
+                "stiffness",
+                "and",
+                "pain",
+                "on",
+                "mobilization",
+                "of",
+                "the",
+                "shoulders",
+                "and",
+                "hips."
+            ],
+            [
+                "Laboratory",
+                "tests",
+                "show",
+                "elevated",
+                "ESR",
+                "and",
+                "C-reactive",
+                "protein."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis",
+                "and",
+                "what",
+                "treatment",
+                "would",
+                "you",
+                "prescribe?"
+            ],
+            [
+                "1-",
+                "Rheumatoid",
+                "arthritis,",
+                "would",
+                "initiate",
+                "treatment",
+                "with",
+                "methotrexate."
+            ],
+            [
+                "2-",
+                "Fibromyalgia,",
+                "would",
+                "initiate",
+                "treatment",
+                "with",
+                "duloxetine."
+            ],
+            [
+                "3-",
+                "Polymyalgia",
+                "rheumatica,",
+                "would",
+                "initiate",
+                "treatment",
+                "with",
+                "corticosteroids."
+            ],
+            [
+                "4-",
+                "Ankylosing",
+                "spondylitis,",
+                "I",
+                "would",
+                "initiate",
+                "treatment",
+                "with",
+                "non-steroidal",
+                "anti-inflammatory",
+                "drugs."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "In",
+                "this",
+                "case,",
+                "he",
+                "is",
+                "describing",
+                "the",
+                "cardinal",
+                "symptoms",
+                "of",
+                "polymyalgia",
+                "rheumatica."
+            ],
+            [
+                "Older",
+                "patient,",
+                "over",
+                "50",
+                "years",
+                "of",
+                "age,",
+                "presenting",
+                "with",
+                "pain",
+                "and",
+                "stiffness",
+                "in",
+                "both",
+                "girdles,",
+                "associated",
+                "with",
+                "an",
+                "elevation",
+                "of",
+                "acute",
+                "phase",
+                "reactants."
+            ],
+            [
+                "He",
+                "presents",
+                "all",
+                "the",
+                "indispensable",
+                "criteria:",
+                "age",
+                "equal",
+                "to",
+                "or",
+                "greater",
+                "than",
+                "50",
+                "years,",
+                "bilateral",
+                "omalgia",
+                "and",
+                "increased",
+                "acute",
+                "phase",
+                "reactants."
+            ],
+            [
+                "Of",
+                "the",
+                "optional",
+                "criteria,",
+                "he",
+                "presents",
+                "stiffness,",
+                "pain",
+                "or",
+                "limitation",
+                "in",
+                "the",
+                "hip."
+            ],
+            [
+                "Initial",
+                "treatment",
+                "is",
+                "corticosteroids",
+                "at",
+                "medium",
+                "doses."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-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"
+            ]
+        ]
+    },
+    {
+        "id": "415_72",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CARDIOLOGY",
+                "AND",
+                "CARDIOVASCULAR",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "45-year-old",
+                "man",
+                "with",
+                "a",
+                "history",
+                "of",
+                "febrile",
+                "illness",
+                "and",
+                "chest",
+                "pain",
+                "comes",
+                "to",
+                "the",
+                "hospital",
+                "with",
+                "dyspnea",
+                "and",
+                "tachypnea."
+            ],
+            [
+                "On",
+                "physical",
+                "examination",
+                "his",
+                "blood",
+                "pressure",
+                "is",
+                "low,",
+                "jugular",
+                "venous",
+                "pressure",
+                "is",
+                "elevated",
+                "with",
+                "a",
+                "prominent",
+                "descending",
+                "sinus",
+                "x",
+                "and",
+                "he",
+                "has",
+                "a",
+                "paradoxical",
+                "pulse."
+            ],
+            [
+                "What",
+                "diagnosis",
+                "would",
+                "you",
+                "suspect?"
+            ],
+            [
+                "1-",
+                "Dilated",
+                "cardiomyopathy."
+            ],
+            [
+                "2-",
+                "Pericardial",
+                "effusion",
+                "with",
+                "cardiac",
+                "tamponade."
+            ],
+            [
+                "3-",
+                "Constrictive",
+                "pericarditis."
+            ],
+            [
+                "4-",
+                "Ischemic",
+                "heart",
+                "disease."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "It",
+                "is",
+                "the",
+                "classic",
+                "exploration:",
+                "he",
+                "had",
+                "a",
+                "fever",
+                "and",
+                "pain,",
+                "he",
+                "had",
+                "pericarditis",
+                "with",
+                "effusion,",
+                "and",
+                "now",
+                "this",
+                "is",
+                "causing",
+                "tamponade."
+            ],
+            [
+                "Hence",
+                "the",
+                "hypotension",
+                "(his",
+                "heart",
+                "cannot",
+                "fill",
+                "well",
+                "with",
+                "blood",
+                "and",
+                "pump),",
+                "jugular",
+                "engorgement",
+                "and",
+                "dependence",
+                "on",
+                "respiration",
+                "to",
+                "achieve",
+                "preload",
+                "and",
+                "cardiac",
+                "output",
+                "(i.e.",
+                "paradoxical",
+                "pulse)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-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-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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"
+            ]
+        ]
+    },
+    {
+        "id": "560_180",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "HEMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "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",
+                "tests",
+                "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"
+            ],
+            [
+                "They",
+                "give",
+                "to",
+                "know",
+                "of",
+                "a",
+                "patient",
+                "with",
+                "SLE",
+                "in",
+                "treatment",
+                "with",
+                "Hydroxychloroquine."
+            ],
+            [
+                "She",
+                "has",
+                "a",
+                "hb",
+                "of",
+                "7.4",
+                "and",
+                "a",
+                "MCV",
+                "over",
+                "100,",
+                "adding",
+                "pallor",
+                "and",
+                "weakness,",
+                "we",
+                "would",
+                "be",
+                "dealing",
+                "with",
+                "a",
+                "macrocytic",
+                "anemia."
+            ],
+            [
+                "In",
+                "my",
+                "opinion,",
+                "the",
+                "most",
+                "suitable",
+                "would",
+                "be",
+                "alternative",
+                "2,",
+                "since",
+                "hydroxyloroquine",
+                "has",
+                "been",
+                "reported",
+                "to",
+                "decrease",
+                "the",
+                "absorption",
+                "of",
+                "folic",
+                "acid,",
+                "and",
+                "since",
+                "she",
+                "has",
+                "a",
+                "complication",
+                "of",
+                "SLE,",
+                "in",
+                "this",
+                "case,",
+                "we",
+                "could",
+                "be",
+                "dealing",
+                "with",
+                "an",
+                "autoimmune",
+                "hemolytic",
+                "anemia",
+                "with",
+                "folic",
+                "acid",
+                "consumption."
+            ],
+            [
+                "And",
+                "for",
+                "this",
+                "it",
+                "would",
+                "be",
+                "first",
+                "to",
+                "determine",
+                "with",
+                "the",
+                "direct",
+                "coombs."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "358_232",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "24-year-old",
+                "woman",
+                "consults",
+                "after",
+                "noticing",
+                "inguinal",
+                "lymphadenopathies."
+            ],
+            [
+                "The",
+                "interrogation",
+                "does",
+                "not",
+                "show",
+                "any",
+                "local",
+                "discomfort",
+                "or",
+                "data",
+                "suggestive",
+                "of",
+                "sexually",
+                "transmitted",
+                "infection."
+            ],
+            [
+                "The",
+                "examination",
+                "revealed",
+                "two",
+                "lymphadenopathies,",
+                "one",
+                "in",
+                "each",
+                "groin,",
+                "1",
+                "cm",
+                "in",
+                "diameter,",
+                "soft,",
+                "mobile,",
+                "non-painful."
+            ],
+            [
+                "No",
+                "skin",
+                "lesions",
+                "are",
+                "seen",
+                "on",
+                "the",
+                "lower",
+                "limbs,",
+                "anus",
+                "or",
+                "perineum."
+            ],
+            [
+                "Which",
+                "test",
+                "do",
+                "you",
+                "consider",
+                "essential?"
+            ],
+            [
+                "1-",
+                "A",
+                "lupus",
+                "serology",
+                "since",
+                "it",
+                "is",
+                "most",
+                "likely",
+                "a",
+                "Treponema",
+                "pallidum",
+                "infection."
+            ],
+            [
+                "2-",
+                "A",
+                "gynecological",
+                "examination",
+                "to",
+                "rule",
+                "out",
+                "ovarian",
+                "cancer."
+            ],
+            [
+                "3-",
+                "From",
+                "the",
+                "clinical",
+                "features",
+                "it",
+                "seems",
+                "to",
+                "be",
+                "normal",
+                "lymph",
+                "nodes",
+                "and",
+                "complementary",
+                "explorations",
+                "should",
+                "not",
+                "be",
+                "performed."
+            ],
+            [
+                "4-",
+                "A",
+                "Paul-Bunell",
+                "test",
+                "should",
+                "be",
+                "performed",
+                "to",
+                "rule",
+                "out",
+                "infectious",
+                "mononucleosis."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "3."
+            ],
+            [
+                "In",
+                "the",
+                "inguinal",
+                "region,",
+                "the",
+                "lymph",
+                "nodes",
+                "can",
+                "acquire",
+                "a",
+                "size",
+                "of",
+                "up",
+                "to",
+                "1.5",
+                "cm",
+                "being",
+                "normal."
+            ],
+            [
+                "In",
+                "addition,",
+                "the",
+                "rest",
+                "of",
+                "the",
+                "data",
+                "of",
+                "the",
+                "inguinal",
+                "exploration",
+                "(no",
+                "pain,",
+                "mobile,",
+                "soft,",
+                "etc.)",
+                "corroborates",
+                "this."
+            ],
+            [
+                "On",
+                "the",
+                "other",
+                "hand,",
+                "there",
+                "are",
+                "no",
+                "signs",
+                "or",
+                "symptoms",
+                "that",
+                "make",
+                "us",
+                "think",
+                "of",
+                "a",
+                "sexually",
+                "transmitted",
+                "infection."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "414_71",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "131_221",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY",
+                "AND",
+                "NEUROSURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "individual",
+                "presents",
+                "with",
+                "\"muscle",
+                "weakness\"",
+                "(spastic",
+                "hemiparesis)",
+                "of",
+                "both",
+                "right",
+                "extremities,",
+                "with",
+                "hyperreflexia",
+                "and",
+                "Babinski's",
+                "sign,",
+                "along",
+                "with",
+                "a",
+                "\"facial",
+                "flaccid",
+                "paralysis\"",
+                "of",
+                "the",
+                "left",
+                "hemiface,",
+                "with",
+                "inability",
+                "to",
+                "close",
+                "the",
+                "left",
+                "eye",
+                "or",
+                "retract",
+                "the",
+                "left",
+                "side",
+                "of",
+                "the",
+                "mouth,",
+                "in",
+                "addition",
+                "to",
+                "other",
+                "alterations."
+            ],
+            [
+                "From",
+                "the",
+                "data",
+                "described,",
+                "it",
+                "is",
+                "an",
+                "alteration",
+                "that",
+                "affects,",
+                "among",
+                "other",
+                "elements,",
+                "the",
+                "motor",
+                "fascicles:",
+                "cortico-spinal",
+                "and",
+                "cortico-nuclear,",
+                "but",
+                "at",
+                "what",
+                "level",
+                "of",
+                "the",
+                "neuroaxis",
+                "would",
+                "the",
+                "lesion",
+                "be",
+                "located?"
+            ],
+            [
+                "1-",
+                "At",
+                "the",
+                "level",
+                "of",
+                "the",
+                "area",
+                "4",
+                "of",
+                "Brodmann",
+                "of",
+                "the",
+                "cerebral",
+                "cortex",
+                "of",
+                "the",
+                "right",
+                "side."
+            ],
+            [
+                "2-",
+                "In",
+                "the",
+                "internal",
+                "capsule,",
+                "posterior",
+                "arm",
+                "on",
+                "the",
+                "right",
+                "side."
+            ],
+            [
+                "3-",
+                "In",
+                "the",
+                "left",
+                "cerebral",
+                "peduncle."
+            ],
+            [
+                "4-",
+                "In",
+                "the",
+                "medial",
+                "portion",
+                "of",
+                "the",
+                "caudal",
+                "protuberance",
+                "of",
+                "the",
+                "left",
+                "side."
+            ],
+            [
+                "5-",
+                "In",
+                "the",
+                "medulla",
+                "oblongata",
+                "before",
+                "decussation",
+                "of",
+                "the",
+                "right",
+                "cortico-spinal",
+                "fascicle."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Question",
+                "always",
+                "involves",
+                "the",
+                "brainstem."
+            ],
+            [
+                "We",
+                "have",
+                "a",
+                "right",
+                "hemiparesis",
+                "and",
+                "involvement",
+                "of",
+                "the",
+                "left",
+                "facial",
+                "nucleus,",
+                "since",
+                "it",
+                "has",
+                "affected",
+                "the",
+                "upper",
+                "and",
+                "lower",
+                "facial;",
+                "therefore",
+                "we",
+                "have",
+                "a",
+                "crossed",
+                "clinical",
+                "picture,",
+                "having",
+                "to",
+                "think",
+                "about",
+                "brainstem",
+                "involvement."
+            ],
+            [
+                "If",
+                "we",
+                "have",
+                "in",
+                "a",
+                "quick",
+                "diagram",
+                "where",
+                "the",
+                "nuclei",
+                "of",
+                "the",
+                "cranial",
+                "pairs",
+                "start",
+                "from:",
+                "the",
+                "first",
+                "4",
+                "above",
+                "the",
+                "pons,",
+                "the",
+                "next",
+                "4",
+                "in",
+                "the",
+                "pons,",
+                "and",
+                "the",
+                "last",
+                "4",
+                "below",
+                "the",
+                "pons,",
+                "we",
+                "have",
+                "that",
+                "the",
+                "facial",
+                "nucleus",
+                "is",
+                "in",
+                "the",
+                "middle",
+                "4."
+            ],
+            [
+                "That",
+                "is,",
+                "left",
+                "facial",
+                "nucleus,",
+                "left",
+                "pons,",
+                "so",
+                "answer",
+                "4."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "70_127",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ANESTHESIOLOGY,",
+                "CRITICAL",
+                "CARE",
+                "AND",
+                "EMERGENCY",
+                "MEDICINE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "30-year-old",
+                "woman",
+                "with",
+                "a",
+                "drug",
+                "addiction",
+                "PD",
+                "in",
+                "a",
+                "current",
+                "detoxification",
+                "period",
+                "is",
+                "brought",
+                "to",
+                "the",
+                "ED",
+                "with",
+                "profound",
+                "somnolence,",
+                "with",
+                "no",
+                "other",
+                "symptoms."
+            ],
+            [
+                "We",
+                "find",
+                "out",
+                "that",
+                "her",
+                "treatment",
+                "includes",
+                "olanzapine",
+                "and",
+                "benzodiazepines."
+            ],
+            [
+                "What",
+                "should",
+                "we",
+                "do",
+                "first?"
+            ],
+            [
+                "1-",
+                "Proceed",
+                "to",
+                "IOT."
+            ],
+            [
+                "2-",
+                "Perform",
+                "a",
+                "skull",
+                "X-ray."
+            ],
+            [
+                "3-",
+                "Administer",
+                "flumazenil."
+            ],
+            [
+                "4-",
+                "Administer",
+                "naloxone."
+            ],
+            [
+                "5-",
+                "Wait",
+                "until",
+                "he",
+                "wakes",
+                "up."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Overuse",
+                "of",
+                "the",
+                "drugs",
+                "he",
+                "is",
+                "taking",
+                "should",
+                "be",
+                "suspected."
+            ],
+            [
+                "Olanzapine",
+                "has",
+                "no",
+                "antidote,",
+                "so,",
+                "in",
+                "principle,",
+                "we",
+                "should",
+                "antagonize",
+                "the",
+                "effect",
+                "of",
+                "benzodiazepines."
+            ],
+            [
+                "If",
+                "the",
+                "patient",
+                "continues",
+                "to",
+                "be",
+                "drowsy",
+                "and",
+                "does",
+                "not",
+                "respond",
+                "to",
+                "stimuli,",
+                "we",
+                "should",
+                "proceed",
+                "to",
+                "intubate",
+                "to",
+                "secure",
+                "the",
+                "airway."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "463_71",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CRITICAL",
+                "CARE",
+                "AND",
+                "EMERGENCY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "Woman",
+                "with",
+                "hypotension",
+                "and",
+                "tissue",
+                "hypoperfusion",
+                "in",
+                "whom",
+                "the",
+                "following",
+                "parameters",
+                "are",
+                "objectified",
+                "after",
+                "insertion",
+                "of",
+                "a",
+                "Swan-Ganz",
+                "catheter:",
+                "cardiac",
+                "index",
+                "1.4",
+                "L/min/m2,",
+                "pulmonary",
+                "capillary",
+                "wedge",
+                "pressure",
+                "25",
+                "mmHg",
+                "and",
+                "systemic",
+                "vascular",
+                "resistances",
+                "2000",
+                "dynes/m2."
+            ],
+            [
+                "The",
+                "type",
+                "of",
+                "shock",
+                "presented",
+                "by",
+                "the",
+                "patient",
+                "is:"
+            ],
+            [
+                "1-",
+                "Cardiogenic."
+            ],
+            [
+                "2-",
+                "Septic."
+            ],
+            [
+                "3-",
+                "Hypovolemic."
+            ],
+            [
+                "4-",
+                "Anaphylactic."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "We",
+                "are",
+                "not",
+                "given",
+                "any",
+                "further",
+                "data",
+                "on",
+                "the",
+                "patient",
+                "except",
+                "that",
+                "she",
+                "is",
+                "in",
+                "shock",
+                "(tissue",
+                "hypoperfusion)",
+                "and",
+                "on",
+                "introducing",
+                "a",
+                "Swan-Ganz",
+                "catheter",
+                "we",
+                "find",
+                "a",
+                "low",
+                "cardiac",
+                "index",
+                "(<2),",
+                "elevated",
+                "PCP",
+                "(25mmHg)",
+                "and",
+                "elevated",
+                "systemic",
+                "resistances",
+                "(normal:",
+                "600-1200",
+                "dyne/m2)."
+            ],
+            [
+                "These",
+                "data",
+                "are",
+                "compatible",
+                "with",
+                "cardiogenic",
+                "origin",
+                "of",
+                "shock."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-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",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "476_93",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CRITICAL",
+                "CARE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "58-year-old",
+                "hypertensive",
+                "man",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "for",
+                "a",
+                "30-second",
+                "syncope",
+                "while",
+                "jogging,",
+                "with",
+                "spontaneous",
+                "recovery",
+                "and",
+                "no",
+                "sequelae."
+            ],
+            [
+                "Blood",
+                "pressure",
+                "is",
+                "135/65",
+                "mmHg."
+            ],
+            [
+                "Cardiac",
+                "auscultation",
+                "shows",
+                "a",
+                "loud,",
+                "intense",
+                "systolic",
+                "murmur,",
+                "which",
+                "is",
+                "reduced",
+                "with",
+                "Valsalva",
+                "maneuvers",
+                "and",
+                "an",
+                "attenuated",
+                "second",
+                "tone."
+            ],
+            [
+                "The",
+                "ECG",
+                "shows",
+                "sinus",
+                "rhythm",
+                "at",
+                "72",
+                "bpm,",
+                "with",
+                "criteria",
+                "of",
+                "left",
+                "ventricular",
+                "hypertrophy",
+                "and",
+                "inverted",
+                "T",
+                "waves",
+                "in",
+                "anterior",
+                "face."
+            ],
+            [
+                "Point",
+                "out",
+                "the",
+                "correct",
+                "statement:"
+            ],
+            [
+                "1-",
+                "The",
+                "clinical",
+                "picture",
+                "suggests",
+                "pulmonary",
+                "thromboembolism."
+            ],
+            [
+                "2-",
+                "The",
+                "data",
+                "provided",
+                "indicate",
+                "hypertrophic",
+                "cardiomyopathy",
+                "with",
+                "severe",
+                "obstruction",
+                "of",
+                "the",
+                "left",
+                "ventricular",
+                "outflow",
+                "tract."
+            ],
+            [
+                "3-",
+                "These",
+                "data",
+                "correspond",
+                "to",
+                "severe",
+                "aortic",
+                "stenosis."
+            ],
+            [
+                "4-",
+                "Aortic",
+                "dissection",
+                "should",
+                "be",
+                "excluded",
+                "by",
+                "contrast-enhanced",
+                "computed",
+                "tomography."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "The",
+                "data",
+                "provided",
+                "on",
+                "the",
+                "characteristics",
+                "of",
+                "the",
+                "murmur",
+                "(it",
+                "DECREASES",
+                "with",
+                "Valsalva)",
+                "and",
+                "the",
+                "data",
+                "on",
+                "left",
+                "ventricular",
+                "hypertrophy,",
+                "lead",
+                "us",
+                "to",
+                "the",
+                "diagnosis",
+                "of",
+                "severe",
+                "aortic",
+                "stenosis."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "546_124",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "313_177",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ONCOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "57-year-old",
+                "patient",
+                "diagnosed",
+                "with",
+                "stage",
+                "T3N1M0",
+                "adenocarcinoma",
+                "of",
+                "the",
+                "colon."
+            ],
+            [
+                "He",
+                "was",
+                "treated",
+                "with",
+                "resection",
+                "followed",
+                "by",
+                "postoperative",
+                "FOLFOX",
+                "chemotherapy",
+                "(fluorouracil,",
+                "leucovorin",
+                "and",
+                "oxaliplatin)",
+                "for",
+                "6",
+                "months."
+            ],
+            [
+                "In",
+                "a",
+                "routine",
+                "control,",
+                "two",
+                "years",
+                "later,",
+                "carcinoembryonic",
+                "antigen",
+                "(CEA)",
+                "elevation",
+                "to",
+                "30",
+                "ng/mL",
+                "(previously",
+                "less",
+                "than",
+                "2",
+                "ng/mL)",
+                "was",
+                "detected."
+            ],
+            [
+                "She",
+                "has",
+                "no",
+                "symptoms,",
+                "physical",
+                "examination",
+                "is",
+                "unremarkable,",
+                "chest",
+                "X-ray",
+                "is",
+                "normal."
+            ],
+            [
+                "CT",
+                "scan",
+                "shows",
+                "a",
+                "3",
+                "cm",
+                "mass",
+                "in",
+                "the",
+                "right",
+                "hepatic",
+                "lobe",
+                "that",
+                "is",
+                "captured",
+                "on",
+                "PET."
+            ],
+            [
+                "No",
+                "other",
+                "alterations",
+                "are",
+                "observed",
+                "in",
+                "CT",
+                "or",
+                "PET."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "correct",
+                "approach?"
+            ],
+            [
+                "1-",
+                "Chemotherapy",
+                "with",
+                "FOLFIRI",
+                "(fluorouracil,",
+                "leucovorin",
+                "and",
+                "irinotecan)",
+                "plus",
+                "bevacizumab."
+            ],
+            [
+                "2-",
+                "Monochemotherapy",
+                "with",
+                "capecitabine."
+            ],
+            [
+                "3-",
+                "Assessment",
+                "for",
+                "surgical",
+                "resection",
+                "of",
+                "the",
+                "hepatic",
+                "lesion."
+            ],
+            [
+                "4-",
+                "Hepatic",
+                "radiotherapy."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "We",
+                "are",
+                "faced",
+                "with",
+                "a",
+                "situation",
+                "of",
+                "probable",
+                "liver",
+                "metastasis",
+                "from",
+                "a",
+                "localized",
+                "colon",
+                "adenocarcinoma",
+                "treated",
+                "2",
+                "years",
+                "ago."
+            ],
+            [
+                "Probable",
+                "because",
+                "we",
+                "do",
+                "not",
+                "have",
+                "histological",
+                "confirmation,",
+                "although",
+                "as",
+                "it",
+                "usually",
+                "happens,",
+                "what",
+                "else",
+                "could",
+                "it",
+                "be?"
+            ],
+            [
+                "As",
+                "this",
+                "is",
+                "a",
+                "situation",
+                "of",
+                "oligometastasis",
+                "and",
+                "the",
+                "treatments",
+                "for",
+                "advanced",
+                "colon",
+                "adenocarcinoma",
+                "allow",
+                "prolonged",
+                "survival",
+                "with",
+                "good",
+                "quality",
+                "of",
+                "life",
+                "in",
+                "these",
+                "patients,",
+                "if",
+                "there",
+                "is",
+                "nothing",
+                "to",
+                "contraindicate",
+                "surgery,",
+                "this",
+                "should",
+                "be",
+                "the",
+                "first",
+                "option",
+                "(correct",
+                "answer",
+                "3)."
+            ],
+            [
+                "I",
+                "attach",
+                "the",
+                "algorithm",
+                "proposed",
+                "by",
+                "the",
+                "NCCN",
+                "in",
+                "situations",
+                "of",
+                "recurrence",
+                "(http://www.nccn.org/professionals/physician_gls/pdf/colon.pdf)."
+            ],
+            [
+                "In",
+                "case",
+                "of",
+                "an",
+                "unresectable",
+                "situation,",
+                "chemotherapy",
+                "treatment",
+                "would",
+                "be",
+                "considered",
+                "with",
+                "the",
+                "intention",
+                "of",
+                "converting",
+                "the",
+                "single",
+                "metastatic",
+                "lesion",
+                "into",
+                "a",
+                "resectable",
+                "one."
+            ],
+            [
+                "Since",
+                "more",
+                "than",
+                "12",
+                "months",
+                "have",
+                "passed",
+                "since",
+                "FOLFOX",
+                "treatment,",
+                "the",
+                "same",
+                "scheme",
+                "could",
+                "be",
+                "used,",
+                "although",
+                "FOLFIRI+bevacizumab",
+                "would",
+                "also",
+                "be",
+                "useful."
+            ],
+            [
+                "Capecitabine",
+                "monotherapy,",
+                "in",
+                "the",
+                "patient's",
+                "current",
+                "situation,",
+                "would",
+                "also",
+                "not",
+                "be",
+                "a",
+                "good",
+                "starting",
+                "option,",
+                "since",
+                "the",
+                "responses",
+                "are",
+                "lower",
+                "compared",
+                "to",
+                "FOLFOX",
+                "or",
+                "FOLFIRI",
+                "plus",
+                "antiangiogenic",
+                "combinations."
+            ],
+            [
+                "Hepatic",
+                "radiotherapy",
+                "could",
+                "be",
+                "considered,",
+                "since",
+                "there",
+                "are",
+                "SBRT",
+                "techniques",
+                "that",
+                "achieve",
+                "very",
+                "good",
+                "results,",
+                "but",
+                "in",
+                "this",
+                "case",
+                "it",
+                "is",
+                "best",
+                "to",
+                "start",
+                "by",
+                "asking",
+                "for",
+                "an",
+                "assessment",
+                "by",
+                "the",
+                "surgeons",
+                "and",
+                "if",
+                "they",
+                "rule",
+                "out",
+                "surgery",
+                "we",
+                "would",
+                "consider",
+                "RT."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "482_173",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CRITICAL",
+                "CARE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "patient",
+                "is",
+                "brought",
+                "to",
+                "the",
+                "ED",
+                "from",
+                "a",
+                "fire",
+                "occurring",
+                "inside",
+                "an",
+                "enclosed",
+                "building",
+                "where",
+                "polyurethane",
+                "foams",
+                "were",
+                "present."
+            ],
+            [
+                "He",
+                "is",
+                "conscious,",
+                "but",
+                "presents",
+                "with",
+                "increasing",
+                "mental",
+                "dullness,",
+                "headache,",
+                "and",
+                "severe",
+                "dyspnea."
+            ],
+            [
+                "Oxygen",
+                "saturation",
+                "by",
+                "pulse",
+                "oximetry",
+                "is",
+                "92%",
+                "and",
+                "capillary",
+                "lactic",
+                "acid",
+                "is",
+                "8",
+                "mEq/l."
+            ],
+            [
+                "What",
+                "specific",
+                "treatment",
+                "do",
+                "you",
+                "consider",
+                "most",
+                "appropriate?"
+            ],
+            [
+                "1-",
+                "Administration",
+                "of",
+                "oxygen",
+                "by",
+                "means",
+                "of",
+                "a",
+                "50%",
+                "Venturi",
+                "type",
+                "mask."
+            ],
+            [
+                "2-",
+                "Administration",
+                "of",
+                "intravenous",
+                "hydroxycobalamin."
+            ],
+            [
+                "3-",
+                "Ventilation",
+                "with",
+                "hyperbaric",
+                "chamber."
+            ],
+            [
+                "4-",
+                "Fluid",
+                "therapy",
+                "with",
+                "infusion",
+                "of",
+                "physiological",
+                "saline",
+                "solution",
+                "at",
+                "21",
+                "ml/h."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "The",
+                "first",
+                "thing",
+                "we",
+                "need",
+                "to",
+                "know",
+                "is",
+                "that",
+                "combustion",
+                "of",
+                "polyurethane",
+                "at",
+                "high",
+                "temperature",
+                "results",
+                "in",
+                "the",
+                "release",
+                "of",
+                "cyanide",
+                "(very",
+                "intuitive,",
+                "yes)."
+            ],
+            [
+                "Knowing",
+                "this,",
+                "and",
+                "that",
+                "we",
+                "are",
+                "dealing",
+                "with",
+                "cyanide",
+                "poisoning,",
+                "it",
+                "is",
+                "easier",
+                "to",
+                "answer",
+                "the",
+                "question."
+            ],
+            [
+                "Among",
+                "the",
+                "basic",
+                "initial",
+                "treatment",
+                "measures",
+                "would",
+                "be",
+                "the",
+                "administration",
+                "of",
+                "oxygen",
+                "therapy",
+                "with",
+                "FiO2",
+                "1",
+                "(not",
+                "0.5",
+                "as",
+                "stated",
+                "in",
+                "option",
+                "1),",
+                "and",
+                "an",
+                "antidote,",
+                "in",
+                "this",
+                "case",
+                "hydroxycobalamin",
+                "(this",
+                "was",
+                "asked",
+                "similarly",
+                "last",
+                "year)."
+            ],
+            [
+                "Ventilation",
+                "with",
+                "hyperbaric",
+                "chamber",
+                "would",
+                "only",
+                "be",
+                "indicated",
+                "in",
+                "case",
+                "of",
+                "coexistence",
+                "of",
+                "carbon",
+                "monoxide",
+                "(CO)",
+                "poisoning."
+            ],
+            [
+                "What",
+                "is",
+                "stated",
+                "in",
+                "option",
+                "4",
+                "about",
+                "fluid",
+                "therapy",
+                "is",
+                "not",
+                "indicated;",
+                "in",
+                "case",
+                "of",
+                "associated",
+                "shock,",
+                "volume",
+                "would",
+                "be",
+                "administered,",
+                "but",
+                "in",
+                "any",
+                "case",
+                "not",
+                "at",
+                "that",
+                "rate,",
+                "but",
+                "in",
+                "rapid",
+                "boluses."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "105_233",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "73_62",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ANESTHESIOLOGY,",
+                "CRITICAL",
+                "CARE",
+                "AND",
+                "EMERGENCIES"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "37-year-old",
+                "man",
+                "with",
+                "no",
+                "past",
+                "history",
+                "of",
+                "interest",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "for",
+                "syncope",
+                "while",
+                "walking."
+            ],
+            [
+                "He",
+                "had",
+                "started",
+                "two",
+                "days",
+                "earlier",
+                "with",
+                "dyspnea",
+                "on",
+                "exertion."
+            ],
+            [
+                "Examination:",
+                "weight",
+                "75",
+                "kg,",
+                "BP",
+                "75/50",
+                "mm",
+                "Hg."
+            ],
+            [
+                "SatO2",
+                "89%."
+            ],
+            [
+                "Pulmonary",
+                "auscultation",
+                "was",
+                "normal."
+            ],
+            [
+                "Cardiac",
+                "auscultation:",
+                "rhythmic",
+                "tachycardic",
+                "tones",
+                "at",
+                "130",
+                "bpm."
+            ],
+            [
+                "Abdomen",
+                "normal."
+            ],
+            [
+                "Extremities:",
+                "no",
+                "alterations."
+            ],
+            [
+                "Normal",
+                "hemogram."
+            ],
+            [
+                "Troponin",
+                "1.2",
+                "ng",
+                "/",
+                "ml."
+            ],
+            [
+                "ECG:",
+                "Sensual",
+                "tachycardia",
+                "at",
+                "130",
+                "bpm."
+            ],
+            [
+                "Inverted",
+                "T",
+                "in",
+                "V1-V4."
+            ],
+            [
+                "Thoracic",
+                "CT",
+                "angiography:",
+                "repletion",
+                "defect",
+                "in",
+                "both",
+                "main",
+                "pulmonary",
+                "arteries."
+            ],
+            [
+                "One",
+                "hour",
+                "after",
+                "arrival",
+                "at",
+                "the",
+                "emergency",
+                "room,",
+                "BP",
+                "70/55",
+                "mm",
+                "Hg",
+                "persists."
+            ],
+            [
+                "What",
+                "would",
+                "be",
+                "the",
+                "most",
+                "appropriate",
+                "initial",
+                "treatment?"
+            ],
+            [
+                "1-",
+                "Unfractionated",
+                "heparin,",
+                "10,000U",
+                "iv",
+                "on",
+                "clinical",
+                "suspicion.",
+                "Fibrinolysis",
+                "with",
+                "tPA",
+                "100",
+                "mg",
+                "iv",
+                "once",
+                "the",
+                "diagnosis",
+                "is",
+                "confirmed."
+            ],
+            [
+                "2-",
+                "Enoxaparin:",
+                "80",
+                "mg",
+                "sc",
+                "every",
+                "12",
+                "hours,",
+                "starting",
+                "upon",
+                "diagnostic",
+                "suspicion."
+            ],
+            [
+                "3-",
+                "Enoxaparin;",
+                "80",
+                "mg",
+                "sc",
+                "every",
+                "12",
+                "hours,",
+                "starting",
+                "upon",
+                "diagnostic",
+                "confirmation."
+            ],
+            [
+                "4-",
+                "Fondaparinux:",
+                "7.5",
+                "mg",
+                "sc",
+                "daily."
+            ],
+            [
+                "5-",
+                "Emergency",
+                "pulmonary",
+                "thromboendarterectomy."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "The",
+                "clinical",
+                "case",
+                "is",
+                "a",
+                "typical",
+                "pulmonary",
+                "thromboembolism."
+            ],
+            [
+                "In",
+                "this",
+                "case",
+                "it",
+                "is",
+                "associated",
+                "with",
+                "persistent",
+                "arterial",
+                "hypotension."
+            ],
+            [
+                "Option",
+                "2",
+                "would",
+                "be",
+                "correct",
+                "if",
+                "the",
+                "patient",
+                "were",
+                "not",
+                "hypotensive."
+            ],
+            [
+                "Option",
+                "3",
+                "is",
+                "not",
+                "correct",
+                "since",
+                "diagnostic",
+                "confirmation",
+                "is",
+                "not",
+                "necessary",
+                "to",
+                "initiate",
+                "anticoagulant",
+                "therapy",
+                "in",
+                "case",
+                "of",
+                "PTE",
+                "without",
+                "hypotension."
+            ],
+            [
+                "Option",
+                "4",
+                "is",
+                "not",
+                "indicated."
+            ],
+            [
+                "Option",
+                "5",
+                "would",
+                "be",
+                "correct",
+                "only",
+                "if",
+                "the",
+                "patient",
+                "had",
+                "a",
+                "contraindication",
+                "to",
+                "fibrinolysis."
+            ],
+            [
+                "Persistent",
+                "hypotension",
+                "in",
+                "PTE",
+                "is",
+                "the",
+                "most",
+                "widely",
+                "accepted",
+                "indication",
+                "for",
+                "fibrinolysis,",
+                "so",
+                "the",
+                "correct",
+                "option",
+                "is",
+                "1."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise"
+            ],
+            [
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+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
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+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "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"
+            ],
+            [
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "O",
+                "O"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "538_2",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "139_166",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "OTORHINOLARYNGOLOGY",
+                "AND",
+                "MAXILLOFACIAL",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "64-year-old",
+                "smoker",
+                "and",
+                "heavy",
+                "drinker",
+                "with",
+                "no",
+                "other",
+                "history",
+                "of",
+                "interest."
+            ],
+            [
+                "The",
+                "picture",
+                "he",
+                "explains",
+                "is",
+                "odynodysphagia",
+                "of",
+                "3",
+                "months",
+                "of",
+                "evolution",
+                "and",
+                "left",
+                "otalgia."
+            ],
+            [
+                "He",
+                "provides",
+                "a",
+                "dentist's",
+                "report",
+                "that",
+                "rules",
+                "out",
+                "a",
+                "dental",
+                "cause."
+            ],
+            [
+                "He",
+                "also",
+                "refers",
+                "to",
+                "having",
+                "been",
+                "visited",
+                "by",
+                "different",
+                "specialists",
+                "and",
+                "provides",
+                "a",
+                "head",
+                "and",
+                "neck",
+                "CAT",
+                "scan",
+                "(without",
+                "iodine",
+                "contrast)",
+                "which",
+                "is",
+                "reported",
+                "as",
+                "normal."
+            ],
+            [
+                "On",
+                "examination",
+                "there",
+                "was",
+                "a",
+                "decrease",
+                "in",
+                "the",
+                "propulsive",
+                "capacity",
+                "of",
+                "the",
+                "tongue;",
+                "palpation",
+                "of",
+                "the",
+                "base",
+                "of",
+                "the",
+                "left",
+                "tongue",
+                "showed",
+                "an",
+                "induration",
+                "of",
+                "stony",
+                "consistency",
+                "of",
+                "approximately",
+                "3cm",
+                "and",
+                "with",
+                "indirect",
+                "laryngoscopy",
+                "no",
+                "ulceration",
+                "of",
+                "the",
+                "mucosa",
+                "was",
+                "observed."
+            ],
+            [
+                "Cervical",
+                "palpation",
+                "is",
+                "negative",
+                "for",
+                "lymphadenopathy."
+            ],
+            [
+                "What",
+                "is",
+                "your",
+                "presumptive",
+                "diagnosis",
+                "and",
+                "course",
+                "of",
+                "action?"
+            ],
+            [
+                "1-",
+                "Dental",
+                "cause",
+                "/",
+                "reevaluation",
+                "by",
+                "the",
+                "dentist."
+            ],
+            [
+                "2-",
+                "Abscess",
+                "of",
+                "the",
+                "base",
+                "of",
+                "the",
+                "tongue",
+                "/",
+                "debridement."
+            ],
+            [
+                "3-",
+                "Ankyloglossia",
+                "/",
+                "surgical",
+                "release",
+                "of",
+                "the",
+                "same."
+            ],
+            [
+                "4-",
+                "Malignant",
+                "process",
+                "of",
+                "oropharynx",
+                "/",
+                "repeat",
+                "CT",
+                "scan",
+                "and",
+                "biopsy."
+            ],
+            [
+                "5-",
+                "Nonspecific",
+                "inflammation",
+                "/",
+                "corticosteroid",
+                "treatment."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "We",
+                "are",
+                "presented",
+                "with",
+                "a",
+                "patient",
+                "with",
+                "risk",
+                "factors",
+                "for",
+                "oropharyngeal",
+                "cancer,",
+                "but",
+                "in",
+                "whom",
+                "the",
+                "examination",
+                "and",
+                "tests",
+                "are",
+                "normal."
+            ],
+            [
+                "What",
+                "is",
+                "going",
+                "on",
+                "here?"
+            ],
+            [
+                "This",
+                "question",
+                "is",
+                "reverse",
+                "psychology:",
+                "what",
+                "did",
+                "the",
+                "questioner",
+                "want",
+                "me",
+                "to",
+                "know?"
+            ],
+            [
+                "This",
+                "question",
+                "was",
+                "asked",
+                "by",
+                "an",
+                "otolaryngologist."
+            ],
+            [
+                "He",
+                "already",
+                "tells",
+                "you",
+                "that",
+                "the",
+                "dentist",
+                "\"didn't",
+                "see",
+                "anything\",",
+                "so",
+                "he",
+                "rules",
+                "out",
+                "1."
+            ],
+            [
+                "It",
+                "is",
+                "not",
+                "an",
+                "abscess",
+                "of",
+                "the",
+                "base",
+                "of",
+                "the",
+                "tongue",
+                "either,",
+                "because",
+                "in",
+                "three",
+                "months",
+                "it",
+                "would",
+                "have",
+                "killed",
+                "him:",
+                "neither",
+                "is",
+                "2."
+            ],
+            [
+                "So",
+                "we",
+                "are",
+                "left",
+                "with",
+                "ankyloglossia,",
+                "tongue",
+                "base",
+                "cancer",
+                "and",
+                "non-specific",
+                "inflammation."
+            ],
+            [
+                "When",
+                "there",
+                "is",
+                "doubt",
+                "that",
+                "it",
+                "could",
+                "be",
+                "cancer,",
+                "we",
+                "should",
+                "not",
+                "fool",
+                "around",
+                "and",
+                "order",
+                "a",
+                "new",
+                "CT",
+                "scan",
+                "and",
+                "biopsy."
+            ],
+            [
+                "Tongue",
+                "base",
+                "cancers",
+                "are",
+                "very",
+                "treacherous",
+                "and",
+                "it",
+                "is",
+                "one",
+                "of",
+                "the",
+                "fears",
+                "of",
+                "any",
+                "otolaryngologist",
+                "when",
+                "he",
+                "suspects",
+                "a",
+                "neoplasm."
+            ],
+            [
+                "It",
+                "is",
+                "not",
+                "uncommon",
+                "for",
+                "them",
+                "to",
+                "arise",
+                "without",
+                "exophytic",
+                "masses",
+                "or",
+                "ulcerations",
+                "of",
+                "the",
+                "tongue",
+                "mucosa",
+                "and",
+                "they",
+                "are",
+                "difficult",
+                "to",
+                "detect",
+                "on",
+                "CT",
+                "when",
+                "contrast",
+                "is",
+                "not",
+                "used."
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "4",
+                "and",
+                "I",
+                "do",
+                "not",
+                "think",
+                "it",
+                "can",
+                "be",
+                "challenged."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "446_130",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEPHROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "28-year-old",
+                "man",
+                "comes",
+                "to",
+                "the",
+                "hospital",
+                "emergency",
+                "room",
+                "with",
+                "gross",
+                "hematuria."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "urinalysis",
+                "abnormalities",
+                "would",
+                "support",
+                "a",
+                "diagnosis",
+                "of",
+                "glomerulonephritis?"
+            ],
+            [
+                "1-",
+                "Dysmorphic",
+                "red",
+                "blood",
+                "cells",
+                "and/or",
+                "hematic",
+                "casts."
+            ],
+            [
+                "2-",
+                "Proteinuria",
+                "of",
+                "1",
+                "g/day,",
+                "with",
+                "negative",
+                "test",
+                "strip",
+                "result",
+                "and",
+                "with",
+                "microalbuminuria",
+                "greater",
+                "than",
+                "300",
+                "mg/24",
+                "hours."
+            ],
+            [
+                "3-",
+                "Coexistence",
+                "of",
+                "hematuria",
+                "with",
+                "pyuria",
+                "without",
+                "bacteriuria."
+            ],
+            [
+                "4-",
+                "Clots",
+                "in",
+                "the",
+                "urine",
+                "with",
+                "the",
+                "naked",
+                "eye."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Glomerulonephritis",
+                "is",
+                "typically",
+                "associated",
+                "with",
+                "dysmorphic",
+                "red",
+                "blood",
+                "cells",
+                "and",
+                "hematic",
+                "casts",
+                "in",
+                "the",
+                "sediment",
+                "(option",
+                "1",
+                "correct)."
+            ],
+            [
+                "Proteinuria",
+                "can",
+                "also",
+                "appear",
+                "in",
+                "variable",
+                "range,",
+                "although",
+                "it",
+                "is",
+                "not",
+                "usual",
+                "in",
+                "the",
+                "form",
+                "of",
+                "isolated",
+                "microalbuminuria",
+                "(incorrect",
+                "option",
+                "2),",
+                "and",
+                "hematuria",
+                "with",
+                "pyuria",
+                "although",
+                "it",
+                "is",
+                "not",
+                "characteristic",
+                "(incorrect",
+                "option",
+                "3)."
+            ],
+            [
+                "Clots",
+                "usually",
+                "appear",
+                "in",
+                "the",
+                "context",
+                "of",
+                "alterations",
+                "of",
+                "the",
+                "lower",
+                "urinary",
+                "tract",
+                "(option",
+                "4",
+                "incorrect)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "B-Disease"
+            ],
+            [
+                "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"
+            ],
+            [
+                "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",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "551_130",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "383_150",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "12-month-old",
+                "boy,",
+                "who",
+                "in",
+                "the",
+                "health",
+                "examinations",
+                "performed",
+                "since",
+                "birth",
+                "presents",
+                "right",
+                "testicle",
+                "in",
+                "the",
+                "inguinal",
+                "canal",
+                "that",
+                "is",
+                "not",
+                "possible",
+                "to",
+                "descend",
+                "to",
+                "the",
+                "scrotum."
+            ],
+            [
+                "Mark",
+                "the",
+                "correct",
+                "answer:"
+            ],
+            [
+                "1-",
+                "The",
+                "most",
+                "probable",
+                "diagnosis",
+                "is",
+                "retractile",
+                "testicle."
+            ],
+            [
+                "2-",
+                "Wait",
+                "until",
+                "two",
+                "years",
+                "of",
+                "age",
+                "for",
+                "its",
+                "spontaneous",
+                "decrease."
+            ],
+            [
+                "3-",
+                "Human",
+                "chorionic",
+                "gonadotropin",
+                "is",
+                "the",
+                "treatment",
+                "of",
+                "first",
+                "choice."
+            ],
+            [
+                "4-",
+                "The",
+                "indication",
+                "for",
+                "orchidopexy",
+                "should",
+                "not",
+                "be",
+                "deferred."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "The",
+                "retractile",
+                "testicle",
+                "is",
+                "characterized",
+                "by",
+                "the",
+                "testicle",
+                "being",
+                "permanently",
+                "outside",
+                "the",
+                "scrotal",
+                "sac,",
+                "being",
+                "possible",
+                "to",
+                "descend",
+                "it",
+                "manually",
+                "(although",
+                "when",
+                "it",
+                "is",
+                "released",
+                "it",
+                "automatically",
+                "returns",
+                "to",
+                "its",
+                "initial",
+                "location)."
+            ],
+            [
+                "It",
+                "is",
+                "usually",
+                "due",
+                "to",
+                "a",
+                "short",
+                "pedicle."
+            ],
+            [
+                "In",
+                "this",
+                "case",
+                "we",
+                "are",
+                "being",
+                "told",
+                "that",
+                "the",
+                "teste",
+                "is",
+                "always",
+                "in",
+                "the",
+                "inguinal",
+                "canal",
+                "(cryptorchidism)",
+                "so",
+                "we",
+                "can",
+                "discard",
+                "option",
+                "1."
+            ],
+            [
+                "Hormonal",
+                "treatment",
+                "with",
+                "HCG",
+                "has",
+                "already",
+                "fallen",
+                "into",
+                "disuse,",
+                "due",
+                "to",
+                "its",
+                "low",
+                "efficacy,",
+                "possibility",
+                "of",
+                "reascension",
+                "and",
+                "because",
+                "apoptotic",
+                "and",
+                "inflammatory",
+                "phenomena",
+                "have",
+                "been",
+                "described",
+                "in",
+                "the",
+                "teste",
+                "associated",
+                "with",
+                "its",
+                "use",
+                "(we",
+                "discard",
+                "option",
+                "3)."
+            ],
+            [
+                "Orchidopexy",
+                "is",
+                "the",
+                "treatment",
+                "of",
+                "choice",
+                "when",
+                "we",
+                "are",
+                "faced",
+                "with",
+                "cryptorchidism,",
+                "being",
+                "desirable",
+                "to",
+                "perform",
+                "it",
+                "between",
+                "6",
+                "months",
+                "and",
+                "one",
+                "year",
+                "of",
+                "age,",
+                "and",
+                "should",
+                "not",
+                "be",
+                "deferred",
+                "beyond",
+                "two",
+                "years",
+                "of",
+                "age."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "614_118",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "TRAUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "41-year-old",
+                "male",
+                "consults",
+                "for",
+                "gonalgia",
+                "of",
+                "several",
+                "days'",
+                "evolution."
+            ],
+            [
+                "During",
+                "the",
+                "examination,",
+                "the",
+                "Thessaly",
+                "test",
+                "(pain",
+                "with",
+                "internal",
+                "and",
+                "external",
+                "rotation",
+                "movements",
+                "with",
+                "the",
+                "knee",
+                "flexed)",
+                "is",
+                "positive."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "lesions",
+                "is",
+                "most",
+                "likely",
+                "to",
+                "occur?"
+            ],
+            [
+                "1-",
+                "Meniscal",
+                "injury."
+            ],
+            [
+                "2-",
+                "Injury",
+                "by",
+                "rupture",
+                "of",
+                "the",
+                "anterior",
+                "cruciate",
+                "ligament."
+            ],
+            [
+                "3-",
+                "Injury",
+                "by",
+                "rupture",
+                "of",
+                "the",
+                "posterior",
+                "cruciate",
+                "ligament."
+            ],
+            [
+                "4-",
+                "Degenerative",
+                "arthropathy",
+                "injury."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "The",
+                "Thessaly",
+                "maneuver",
+                "consists",
+                "of",
+                "the",
+                "patient,",
+                "using",
+                "monopodal",
+                "support",
+                "and",
+                "knee",
+                "flexion",
+                "of",
+                "5\u00ba",
+                "and",
+                "then",
+                "20\u00ba,",
+                "performing",
+                "internal",
+                "and",
+                "external",
+                "rotations",
+                "of",
+                "the",
+                "leg."
+            ],
+            [
+                "In",
+                "case",
+                "this",
+                "reproduces",
+                "the",
+                "pain",
+                "that",
+                "the",
+                "patient",
+                "refers,",
+                "the",
+                "test",
+                "will",
+                "be",
+                "considered",
+                "as",
+                "positive."
+            ],
+            [
+                "It",
+                "is",
+                "a",
+                "test",
+                "used",
+                "for",
+                "the",
+                "diagnosis",
+                "of",
+                "meniscal",
+                "pathology",
+                "(sensitivity",
+                "greater",
+                "than",
+                "90%",
+                "and",
+                "specificity",
+                "greater",
+                "than",
+                "95%)",
+                "(Answer",
+                "1",
+                "correct)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "499_182",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "613_118",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "TRAUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "41-year-old",
+                "male",
+                "consults",
+                "for",
+                "gonalgia",
+                "of",
+                "several",
+                "days'",
+                "evolution."
+            ],
+            [
+                "On",
+                "examination,",
+                "the",
+                "Thessaly",
+                "test",
+                "(pain",
+                "with",
+                "internal",
+                "and",
+                "external",
+                "rotation",
+                "movements",
+                "with",
+                "the",
+                "knee",
+                "flexed)",
+                "is",
+                "positive."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "injuries",
+                "is",
+                "more",
+                "likely?"
+            ],
+            [
+                "1-",
+                "Meniscal",
+                "injury."
+            ],
+            [
+                "2-",
+                "Injury",
+                "due",
+                "to",
+                "rupture",
+                "of",
+                "the",
+                "anterior",
+                "cruciate",
+                "ligament."
+            ],
+            [
+                "3-",
+                "Injury",
+                "by",
+                "rupture",
+                "of",
+                "the",
+                "posterior",
+                "cruciate",
+                "ligament."
+            ],
+            [
+                "4-",
+                "Degenerative",
+                "arthropathy",
+                "injury."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Thessaly",
+                "test.",
+                "Provocation",
+                "test",
+                "performed",
+                "in",
+                "suspected",
+                "meniscal",
+                "injury."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "247_117",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTIOUS",
+                "DISEASES"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "54-year-old",
+                "man",
+                "diagnosed",
+                "with",
+                "type",
+                "2",
+                "diabetes",
+                "mellitus",
+                "comes",
+                "to",
+                "our",
+                "office."
+            ],
+            [
+                "He",
+                "reported",
+                "a",
+                "fever",
+                "of",
+                "40\u00baC",
+                "with",
+                "chills",
+                "and",
+                "shivering,",
+                "arthromyalgia",
+                "and",
+                "headache,",
+                "for",
+                "which",
+                "he",
+                "started",
+                "treatment",
+                "with",
+                "paracetamol."
+            ],
+            [
+                "The",
+                "symptoms",
+                "started",
+                "24",
+                "hours",
+                "before",
+                "his",
+                "return",
+                "to",
+                "Spain."
+            ],
+            [
+                "Three",
+                "days",
+                "later",
+                "she",
+                "presented",
+                "a",
+                "generalized",
+                "maculopapular",
+                "rash",
+                "that",
+                "evolved",
+                "into",
+                "more",
+                "intense",
+                "petechiae",
+                "on",
+                "the",
+                "lower",
+                "limbs."
+            ],
+            [
+                "She",
+                "presented",
+                "blood",
+                "tests",
+                "with",
+                "leukopenia",
+                "with",
+                "3,200/mm3",
+                "and",
+                "platelets",
+                "91,000/mm3",
+                "and",
+                "severe",
+                "elevation",
+                "of",
+                "aminotransferases."
+            ],
+            [
+                "The",
+                "thick",
+                "blood",
+                "drop,",
+                "peripheral",
+                "blood",
+                "smear,",
+                "PCR",
+                "and",
+                "malaria",
+                "antigen",
+                "are",
+                "negative."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Coronavirus",
+                "infection."
+            ],
+            [
+                "2-",
+                "Lymphocytic",
+                "choriomeningitis."
+            ],
+            [
+                "3-",
+                "Dengue."
+            ],
+            [
+                "4-",
+                "Chikungunya",
+                "virus",
+                "infection."
+            ],
+            [
+                "5-",
+                "Saint",
+                "Louis",
+                "encephalitis."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "It",
+                "is",
+                "striking",
+                "in",
+                "this",
+                "question",
+                "that",
+                "we",
+                "are",
+                "told",
+                "that",
+                "our",
+                "patient",
+                "has",
+                "returned",
+                "to",
+                "Spain,",
+                "but",
+                "not",
+                "from",
+                "where",
+                "(which",
+                "could",
+                "help",
+                "us",
+                "to",
+                "make",
+                "digressions",
+                "about",
+                "the",
+                "possible",
+                "cause)."
+            ],
+            [
+                "However,",
+                "the",
+                "description",
+                "of",
+                "the",
+                "picture",
+                "is",
+                "very",
+                "exhaustive",
+                "as",
+                "well",
+                "as",
+                "typical,",
+                "so",
+                "the",
+                "question",
+                "is",
+                "easy."
+            ],
+            [
+                "It",
+                "is",
+                "a",
+                "disease",
+                "that",
+                "produces",
+                "fever,",
+                "arthralgias",
+                "and",
+                "a",
+                "generalized",
+                "exanthema",
+                "with",
+                "petechiae",
+                "on",
+                "the",
+                "lower",
+                "limbs."
+            ],
+            [
+                "The",
+                "CBC",
+                "shows",
+                "leukopenia",
+                "accompanied",
+                "by",
+                "plateletopenia",
+                "and",
+                "elevated",
+                "transaminases."
+            ],
+            [
+                "Malaria",
+                "has",
+                "been",
+                "ruled",
+                "out",
+                "as",
+                "a",
+                "possible",
+                "cause."
+            ],
+            [
+                "All",
+                "the",
+                "data",
+                "are",
+                "highly",
+                "suggestive",
+                "of",
+                "Dengue,",
+                "especially",
+                "the",
+                "plateletopenia",
+                "and",
+                "petechiae",
+                "(suggestive",
+                "of",
+                "capillary",
+                "fragility),",
+                "answer",
+                "3",
+                "correct."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "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",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "88_56",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CARDIOLOGY",
+                "AND",
+                "VASCULAR",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "78-year-old",
+                "woman",
+                "with",
+                "a",
+                "history",
+                "of",
+                "hypertension",
+                "treated",
+                "with",
+                "amlodipine",
+                "was",
+                "admitted",
+                "3",
+                "months",
+                "ago",
+                "for",
+                "heart",
+                "failure",
+                "and",
+                "atrial",
+                "fibrillation."
+            ],
+            [
+                "She",
+                "came",
+                "to",
+                "your",
+                "office",
+                "for",
+                "a",
+                "cardiological",
+                "check-up."
+            ],
+            [
+                "The",
+                "discharge",
+                "report",
+                "shows",
+                "the",
+                "result",
+                "of",
+                "the",
+                "echocardiogram",
+                "showing",
+                "moderate",
+                "left",
+                "ventricular",
+                "dysfunction",
+                "and",
+                "the",
+                "discharge",
+                "treatment:",
+                "amlodipine",
+                "was",
+                "discontinued",
+                "and",
+                "furosemide",
+                "and",
+                "enalapril",
+                "were",
+                "started."
+            ],
+            [
+                "The",
+                "patient",
+                "reports",
+                "feeling",
+                "better,",
+                "without",
+                "fatigue",
+                "and",
+                "with",
+                "less",
+                "leg",
+                "edema,",
+                "but",
+                "she",
+                "is",
+                "still",
+                "not",
+                "completely",
+                "well."
+            ],
+            [
+                "Physical",
+                "examination",
+                "showed",
+                "no",
+                "signs",
+                "of",
+                "heart",
+                "failure,",
+                "but",
+                "her",
+                "blood",
+                "pressure",
+                "and",
+                "heart",
+                "rate",
+                "were",
+                "150/90",
+                "mmHg",
+                "and",
+                "120",
+                "bpm,",
+                "respectively."
+            ],
+            [
+                "The",
+                "ECG",
+                "shows",
+                "atrial",
+                "fibrillation",
+                "at",
+                "110-120",
+                "bpm."
+            ],
+            [
+                "Which",
+                "treatment",
+                "is",
+                "most",
+                "likely",
+                "to",
+                "improve",
+                "symptoms",
+                "and",
+                "reduce",
+                "mortality",
+                "from",
+                "cardiovascular",
+                "events?"
+            ],
+            [
+                "1-",
+                "Digoxin",
+                "and",
+                "acetylsalicylic",
+                "acid."
+            ],
+            [
+                "2-",
+                "Atenolol",
+                "and",
+                "acetylsalicylic",
+                "acid."
+            ],
+            [
+                "3-",
+                "Verapamil",
+                "and",
+                "acenocoumarol."
+            ],
+            [
+                "4-",
+                "Carvedilol",
+                "and",
+                "acenocoumarol."
+            ],
+            [
+                "5-",
+                "Carvedilol",
+                "and",
+                "clopidogrel."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Typical",
+                "very",
+                "long",
+                "and",
+                "rambling",
+                "question",
+                "but",
+                "not",
+                "really",
+                "too",
+                "complicated..."
+            ],
+            [
+                "The",
+                "patient",
+                "is",
+                "in",
+                "heart",
+                "failure",
+                "with",
+                "moderate",
+                "ventricular",
+                "dysfunction",
+                "and",
+                "also",
+                "presents",
+                "atrial",
+                "fibrillation;",
+                "she",
+                "has",
+                "criteria",
+                "for",
+                "anticoagulation,",
+                "and",
+                "between",
+                "the",
+                "two",
+                "options",
+                "that",
+                "include",
+                "acenocoumarol",
+                "we",
+                "are",
+                "inclined",
+                "to",
+                "choose",
+                "option",
+                "4,",
+                "since",
+                "it",
+                "includes",
+                "carvedilol,",
+                "a",
+                "drug",
+                "that",
+                "has",
+                "been",
+                "shown",
+                "to",
+                "increase",
+                "survival",
+                "in",
+                "heart",
+                "failure."
+            ],
+            [
+                "Verapamil",
+                "(and",
+                "calcium",
+                "antagonists",
+                "in",
+                "general)",
+                "are",
+                "contraindicated",
+                "in",
+                "systolic",
+                "heart",
+                "failure:",
+                "they",
+                "do",
+                "not",
+                "increase",
+                "survival",
+                "(they",
+                "even",
+                "increase",
+                "morbidity",
+                "and",
+                "mortality)",
+                "and",
+                "specifically",
+                "the",
+                "non-dihydropyridines",
+                "(verapamil",
+                "and",
+                "diltiazem)",
+                "should",
+                "not",
+                "be",
+                "associated",
+                "with",
+                "beta-blockers",
+                "due",
+                "to",
+                "the",
+                "increased",
+                "risk",
+                "of",
+                "conduction",
+                "system",
+                "blockade."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Marker",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "B-Marker",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "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",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "536_122",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "RHEUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "75-year-old",
+                "male,",
+                "hypertensive",
+                "on",
+                "treatment",
+                "with",
+                "enalapril",
+                "(20",
+                "mg/day),",
+                "who",
+                "consults",
+                "for",
+                "deterioration",
+                "of",
+                "general",
+                "condition,",
+                "bitemporal",
+                "headache",
+                "and",
+                "mandibular",
+                "claudication",
+                "of",
+                "3",
+                "weeks",
+                "of",
+                "evolution."
+            ],
+            [
+                "In",
+                "addition,",
+                "in",
+                "the",
+                "last",
+                "hours,",
+                "he",
+                "refers",
+                "two",
+                "episodes",
+                "of",
+                "amaurosis",
+                "fugax",
+                "of",
+                "the",
+                "left",
+                "eye."
+            ],
+            [
+                "Physical",
+                "examination",
+                "revealed",
+                "thickening",
+                "and",
+                "absence",
+                "of",
+                "pulse",
+                "in",
+                "the",
+                "left",
+                "temporal",
+                "artery."
+            ],
+            [
+                "Analysis:",
+                "CRP",
+                "6",
+                "mg/dl",
+                "(VN",
+                "<1);",
+                "hemoglobin",
+                "10.5",
+                "g/dl;",
+                "ESR",
+                "92",
+                "mm."
+            ],
+            [
+                "Chest",
+                "X-ray",
+                "normal."
+            ],
+            [
+                "Considering",
+                "the",
+                "most",
+                "likely",
+                "diagnosis,",
+                "check",
+                "the",
+                "correct",
+                "option",
+                "regarding",
+                "treatment:"
+            ],
+            [
+                "1-",
+                "Rituximab",
+                "should",
+                "be",
+                "administered,",
+                "since",
+                "glucocorticoids",
+                "have",
+                "been",
+                "relegated",
+                "to",
+                "second-line",
+                "treatment",
+                "due",
+                "to",
+                "their",
+                "side",
+                "effects."
+            ],
+            [
+                "2-",
+                "Tocilizumab",
+                "has",
+                "been",
+                "shown",
+                "to",
+                "be",
+                "effective",
+                "in",
+                "reducing",
+                "recurrences",
+                "and",
+                "cumulative",
+                "prednisone",
+                "dose",
+                "in",
+                "more",
+                "than",
+                "50%",
+                "of",
+                "patients."
+            ],
+            [
+                "3-",
+                "In",
+                "the",
+                "presence",
+                "of",
+                "ischemic",
+                "symptoms,",
+                "and",
+                "in",
+                "order",
+                "not",
+                "to",
+                "worsen",
+                "the",
+                "vascular",
+                "risk",
+                "of",
+                "the",
+                "patient,",
+                "the",
+                "use",
+                "of",
+                "glucocorticoids",
+                "at",
+                "doses",
+                "higher",
+                "than",
+                "30",
+                "mg/day",
+                "should",
+                "be",
+                "avoided."
+            ],
+            [
+                "4-",
+                "In",
+                "conjunction",
+                "with",
+                "glucocorticoid",
+                "boluses",
+                "of",
+                "1",
+                "g/day,",
+                "infliximab",
+                "should",
+                "be",
+                "used",
+                "as",
+                "a",
+                "first-line",
+                "drug",
+                "for",
+                "remission",
+                "induction."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Clinical",
+                "case",
+                "of",
+                "giant",
+                "cell",
+                "arteritis."
+            ],
+            [
+                "Corticosteroid",
+                "therapy",
+                "remains",
+                "the",
+                "first",
+                "choice",
+                "(answer",
+                "1",
+                "incorrect),",
+                "to",
+                "be",
+                "administered",
+                "as",
+                "pulses",
+                "(doses",
+                "differ",
+                "according",
+                "to",
+                "the",
+                "literature,",
+                "but",
+                "at",
+                "least",
+                "125",
+                "mg/d)",
+                "in",
+                "case",
+                "of",
+                "ocular",
+                "involvement",
+                "(answer",
+                "3",
+                "incorrect)."
+            ],
+            [
+                "The",
+                "current",
+                "treatment",
+                "of",
+                "choice",
+                "for",
+                "corticosteroid",
+                "sparing",
+                "is",
+                "Tocilizumab",
+                "(answer",
+                "4",
+                "incorrect),",
+                "which",
+                "has",
+                "also",
+                "been",
+                "shown",
+                "to",
+                "reduce",
+                "recurrences",
+                "(answer",
+                "2",
+                "correct)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "492_107",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "HEMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "18-year-old",
+                "patient",
+                "who",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "with",
+                "epistaxis",
+                "of",
+                "several",
+                "days'",
+                "evolution,",
+                "with",
+                "no",
+                "personal",
+                "or",
+                "family",
+                "history",
+                "of",
+                "interest."
+            ],
+            [
+                "On",
+                "examination",
+                "he",
+                "is",
+                "afebrile,",
+                "multiple",
+                "ecchymoses",
+                "are",
+                "observed,",
+                "no",
+                "splenomegaly",
+                "is",
+                "palpable."
+            ],
+            [
+                "Laboratory",
+                "tests:",
+                "leukocytes",
+                "7.2",
+                "x103/\u03bcL,",
+                "Hb",
+                "12.3",
+                "g/dL,",
+                "platelets",
+                "6.0",
+                "x103/\u03bcL."
+            ],
+            [
+                "Thrombocytopenia",
+                "is",
+                "confirmed",
+                "in",
+                "the",
+                "smear,",
+                "where",
+                "platelets",
+                "of",
+                "increased",
+                "size",
+                "are",
+                "observed."
+            ],
+            [
+                "Coagulation",
+                "and",
+                "biochemistry",
+                "studies",
+                "are",
+                "normal."
+            ],
+            [
+                "What",
+                "do",
+                "you",
+                "consider",
+                "the",
+                "most",
+                "likely",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Thrombotic",
+                "thrombocytopenic",
+                "purpura."
+            ],
+            [
+                "2-",
+                "Disseminated",
+                "intravascular",
+                "coagulation."
+            ],
+            [
+                "3-",
+                "Thrombocytopenia",
+                "induced",
+                "by",
+                "infection."
+            ],
+            [
+                "4-",
+                "Primary",
+                "immune",
+                "thrombocytopenia."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "This",
+                "is",
+                "an",
+                "easy",
+                "clinical",
+                "case",
+                "only",
+                "presenting",
+                "thrombopenia",
+                "with",
+                "clinic,",
+                "petechiae",
+                "and",
+                "epistaxis."
+            ],
+            [
+                "1",
+                "is",
+                "false,",
+                "there",
+                "would",
+                "be",
+                "fever,",
+                "hemolysis",
+                "data,",
+                "neurological",
+                "symptoms,",
+                "in",
+                "the",
+                "smear",
+                "there",
+                "would",
+                "be",
+                "schistocytes."
+            ],
+            [
+                "In",
+                "2",
+                "the",
+                "coagulation",
+                "must",
+                "be",
+                "altered",
+                "and",
+                "in",
+                "this",
+                "case",
+                "it",
+                "is",
+                "not",
+                "mentioned."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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-Premise",
+                "I-Premise",
+                "I-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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ]
+        ]
+    },
+    {
+        "id": "599_183",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "RHEUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "45-year-old",
+                "woman",
+                "with",
+                "no",
+                "history",
+                "of",
+                "interest",
+                "consults",
+                "for",
+                "dyspneic",
+                "sensation",
+                "of",
+                "about",
+                "4",
+                "days",
+                "of",
+                "evolution."
+            ],
+            [
+                "Examination",
+                "shows",
+                "rhythmic",
+                "tachycardia,",
+                "without",
+                "murmurs",
+                "and",
+                "pulmonary",
+                "auscultation",
+                "is",
+                "normal."
+            ],
+            [
+                "Arterial",
+                "blood",
+                "gases",
+                "showed",
+                "a",
+                "pO2",
+                "of",
+                "70",
+                "mmHg",
+                "and",
+                "a",
+                "pCO2",
+                "of",
+                "32",
+                "mmHg."
+            ],
+            [
+                "Hemogram,",
+                "renal",
+                "and",
+                "hepatic",
+                "function",
+                "are",
+                "normal."
+            ],
+            [
+                "Prothrombin",
+                "time",
+                "90%,",
+                "activated",
+                "partial",
+                "thromboplastin",
+                "time",
+                "(APTT)",
+                "ratio",
+                "of",
+                "2",
+                "to",
+                "control",
+                "(N",
+                "<1.2)."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Antiphospholipid",
+                "syndrome."
+            ],
+            [
+                "2-",
+                "Factor",
+                "V",
+                "of",
+                "Leiden."
+            ],
+            [
+                "3-",
+                "Hemophilia."
+            ],
+            [
+                "4-",
+                "Acute",
+                "pericarditis."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "In",
+                "this",
+                "clinical",
+                "case,",
+                "we",
+                "are",
+                "presented",
+                "with",
+                "a",
+                "woman",
+                "who",
+                "rapidly",
+                "presents",
+                "dyspnea",
+                "with",
+                "hypoxemia,",
+                "a",
+                "picture",
+                "compatible",
+                "with",
+                "pulmonary",
+                "thromboembolism."
+            ],
+            [
+                "The",
+                "prothrombin",
+                "time",
+                "of",
+                "90%",
+                "and",
+                "the",
+                "aPTT",
+                "with",
+                "a",
+                "ratio",
+                "of",
+                "2,",
+                "is",
+                "translating",
+                "a",
+                "coagulation",
+                "problem;",
+                "and",
+                "antiphospholipid",
+                "antibodies",
+                "can",
+                "be",
+                "detected",
+                "through",
+                "the",
+                "prolongation",
+                "of",
+                "phospholipid-dependent",
+                "coagulation",
+                "tests,",
+                "correct",
+                "answer",
+                "1."
+            ],
+            [
+                "On",
+                "the",
+                "other",
+                "hand,",
+                "although",
+                "factor",
+                "V",
+                "Leiden",
+                "has",
+                "been",
+                "identified",
+                "as",
+                "a",
+                "common",
+                "cause",
+                "of",
+                "familial",
+                "thrombosis,",
+                "it",
+                "would",
+                "not",
+                "alter",
+                "the",
+                "clotting",
+                "time."
+            ],
+            [
+                "In",
+                "the",
+                "case",
+                "of",
+                "hemophilia",
+                "there",
+                "would",
+                "be",
+                "a",
+                "problem",
+                "in",
+                "blood",
+                "coagulation",
+                "but",
+                "it",
+                "is",
+                "not",
+                "a",
+                "frequent",
+                "cause",
+                "of",
+                "thromboembolism."
+            ],
+            [
+                "Finally,",
+                "although",
+                "acute",
+                "pericarditis",
+                "could",
+                "manifest",
+                "itself",
+                "in",
+                "4",
+                "days",
+                "and",
+                "with",
+                "tachycardia,",
+                "the",
+                "rest",
+                "of",
+                "the",
+                "symptoms",
+                "or",
+                "analytical",
+                "parameters",
+                "are",
+                "not",
+                "characteristic."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "O",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "134_169",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "OPHTHALMOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "35-year-old",
+                "man",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "with",
+                "pain",
+                "in",
+                "his",
+                "right",
+                "eye",
+                "of",
+                "3",
+                "days'",
+                "evolution."
+            ],
+            [
+                "Biomicroscopic",
+                "examination",
+                "of",
+                "the",
+                "anterior",
+                "segment",
+                "shows,",
+                "after",
+                "fluorescein",
+                "staining,",
+                "a",
+                "central",
+                "corneal",
+                "ulcer",
+                "in",
+                "the",
+                "form",
+                "of",
+                "a",
+                "dendrite."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Herpetic",
+                "keratitis."
+            ],
+            [
+                "2-",
+                "Corneal",
+                "abrasion."
+            ],
+            [
+                "3-",
+                "Fungal",
+                "keratitis."
+            ],
+            [
+                "4-",
+                "Bacterial",
+                "keratitis."
+            ],
+            [
+                "5-",
+                "Glaucomatocyclic",
+                "crisis."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Dendritic",
+                "corneal",
+                "ulcer",
+                "is",
+                "typical",
+                "of",
+                "herpes",
+                "simplex",
+                "keratitis."
+            ],
+            [
+                "It",
+                "presents",
+                "with",
+                "pain,",
+                "not",
+                "too",
+                "striking,",
+                "and",
+                "scarce",
+                "or",
+                "absent",
+                "red",
+                "eye."
+            ],
+            [
+                "There",
+                "are",
+                "ulcers",
+                "resembling",
+                "dendrites",
+                "that",
+                "may",
+                "confuse",
+                "us",
+                "in",
+                "the",
+                "diagnosis."
+            ],
+            [
+                "These",
+                "pseudodendrites",
+                "are",
+                "found",
+                "in",
+                "herpes",
+                "Zoster",
+                "and",
+                "in",
+                "corneal",
+                "abrasions",
+                "in",
+                "resolution."
+            ],
+            [
+                "Although",
+                "in",
+                "practice",
+                "we",
+                "should",
+                "pay",
+                "attention",
+                "to",
+                "the",
+                "shape",
+                "of",
+                "the",
+                "dendrite",
+                "(the",
+                "true",
+                "dendrite",
+                "is",
+                "deeper",
+                "and",
+                "has",
+                "terminal",
+                "bulbs",
+                "at",
+                "the",
+                "end",
+                "of",
+                "each",
+                "branch),",
+                "and",
+                "pay",
+                "attention",
+                "to",
+                "the",
+                "evolution",
+                "of",
+                "the",
+                "pain",
+                "(in",
+                "the",
+                "pseudodendrite",
+                "after",
+                "abrasion",
+                "the",
+                "pain",
+                "should",
+                "improve),",
+                "when",
+                "answering",
+                "a",
+                "MIR",
+                "question",
+                "it",
+                "is",
+                "simpler:",
+                "if",
+                "it",
+                "is",
+                "a",
+                "dendrite,",
+                "the",
+                "first",
+                "thing",
+                "we",
+                "have",
+                "to",
+                "think",
+                "is",
+                "herpes."
+            ],
+            [
+                "Fungal",
+                "and",
+                "bacterial",
+                "keratitis",
+                "have",
+                "corneal",
+                "infiltrates."
+            ],
+            [
+                "And",
+                "glaucomatocyclitic",
+                "crisis",
+                "(Posner",
+                "Schlossman",
+                "syndrome)",
+                "is",
+                "a",
+                "type",
+                "of",
+                "idiopathic",
+                "hypertensive",
+                "anterior",
+                "uveitis,",
+                "which",
+                "does",
+                "not",
+                "present",
+                "with",
+                "ulceration."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "245_115",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTIOUS",
+                "DISEASES"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "patient",
+                "undergoing",
+                "chemotherapy",
+                "for",
+                "leukemia",
+                "is",
+                "admitted",
+                "for",
+                "pneumonia",
+                "for",
+                "which",
+                "treatment",
+                "with",
+                "cefepime",
+                "has",
+                "been",
+                "prescribed."
+            ],
+            [
+                "A",
+                "chest",
+                "X-ray/CT",
+                "scan",
+                "shows",
+                "an",
+                "infiltrate",
+                "with",
+                "halo",
+                "sign",
+                "and",
+                "crescentic",
+                "meniscus."
+            ],
+            [
+                "The",
+                "lesion",
+                "is",
+                "peripheral",
+                "and",
+                "a",
+                "transthoracic",
+                "puncture",
+                "is",
+                "indicated",
+                "for",
+                "sampling."
+            ],
+            [
+                "Pending",
+                "definitive",
+                "histologic",
+                "and",
+                "microbiologic",
+                "results,",
+                "what",
+                "antimicrobial",
+                "would",
+                "you",
+                "add",
+                "to",
+                "the",
+                "treatment?"
+            ],
+            [
+                "1-",
+                "Ganciclovir."
+            ],
+            [
+                "2-",
+                "Caspofungin."
+            ],
+            [
+                "3-",
+                "Fluconazole."
+            ],
+            [
+                "4-",
+                "Piperacillin-tazobactam."
+            ],
+            [
+                "5-",
+                "Voriconazole."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "Direct",
+                "response",
+                "question."
+            ],
+            [
+                "This",
+                "is",
+                "a",
+                "patient",
+                "undergoing",
+                "chemotherapy",
+                "with",
+                "respiratory",
+                "symptoms",
+                "and",
+                "the",
+                "\"halo",
+                "sign\"",
+                "on",
+                "X-ray,",
+                "very",
+                "suggestive",
+                "of",
+                "invasive",
+                "pulmonary",
+                "aspergillosis."
+            ],
+            [
+                "Treatment",
+                "is",
+                "with",
+                "voriconazole."
+            ],
+            [
+                "Aspergillus",
+                "is",
+                "resistant",
+                "to",
+                "fluconazole,",
+                "so",
+                "it",
+                "would",
+                "not",
+                "be",
+                "a",
+                "valid",
+                "option."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "387_156",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "5-month-old",
+                "infant",
+                "exclusively",
+                "breastfed",
+                "until",
+                "the",
+                "present,",
+                "who",
+                "due",
+                "to",
+                "maternal",
+                "work",
+                "was",
+                "introduced",
+                "a",
+                "bottle",
+                "with",
+                "formula",
+                "and",
+                "a",
+                "few",
+                "days",
+                "ago",
+                "was",
+                "added",
+                "cereals",
+                "with",
+                "and",
+                "without",
+                "gluten."
+            ],
+            [
+                "Family",
+                "history:",
+                "28-year-old",
+                "mother",
+                "with",
+                "asthma,",
+                "32-year-old",
+                "healthy",
+                "father",
+                "and",
+                "5-year-old",
+                "brother",
+                "with",
+                "celiac",
+                "disease",
+                "and",
+                "atopic",
+                "dermatitis."
+            ],
+            [
+                "As",
+                "personal",
+                "history,",
+                "pregnancy",
+                "without",
+                "incidents",
+                "and",
+                "delivery",
+                "by",
+                "cesarean",
+                "section,",
+                "having",
+                "been",
+                "offered",
+                "a",
+                "bottle",
+                "with",
+                "starter",
+                "formula",
+                "on",
+                "the",
+                "first",
+                "day",
+                "of",
+                "life",
+                "in",
+                "the",
+                "maternity",
+                "ward."
+            ],
+            [
+                "Since",
+                "a",
+                "few",
+                "days",
+                "ago",
+                "she",
+                "starts",
+                "with",
+                "abdominal",
+                "distension,",
+                "diarrhea",
+                "stools,",
+                "refusal",
+                "to",
+                "feed,",
+                "peribuccal",
+                "erythema",
+                "with",
+                "longer",
+                "duration",
+                "after",
+                "bottle",
+                "feeding",
+                "and",
+                "lately",
+                "vomiting",
+                "after",
+                "feeding,",
+                "tolerating",
+                "well",
+                "the",
+                "breast."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "probable",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Celiac",
+                "disease."
+            ],
+            [
+                "2-",
+                "Acute",
+                "gastroenteritis."
+            ],
+            [
+                "3-",
+                "Cow's",
+                "milk",
+                "protein",
+                "allergy."
+            ],
+            [
+                "4-",
+                "Bottle",
+                "allergy."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Child",
+                "with",
+                "multiple",
+                "family",
+                "history",
+                "of",
+                "allergy",
+                "(asthma,",
+                "atopy),",
+                "who",
+                "has",
+                "received",
+                "artificial",
+                "milk",
+                "in",
+                "the",
+                "first",
+                "hours",
+                "of",
+                "life",
+                "(sensitization",
+                "to",
+                "cow's",
+                "milk",
+                "protein)",
+                "and",
+                "who,",
+                "coinciding",
+                "with",
+                "the",
+                "intake",
+                "of",
+                "artificial",
+                "milk,",
+                "starts",
+                "digestive",
+                "symptoms",
+                "and",
+                "exanthema",
+                "=",
+                "APLV."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "41_139",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "OTORHINOLARYNGOLOGY",
+                "AND",
+                "MAXILLOFACIAL",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "Given",
+                "a",
+                "patient",
+                "with",
+                "poor",
+                "general",
+                "condition,",
+                "fever",
+                "(axillary",
+                "temperature",
+                "39.5\u00ba),",
+                "bilateral",
+                "submandibular",
+                "swelling",
+                "of",
+                "six",
+                "days'",
+                "evolution,",
+                "mouth",
+                "pain",
+                "and",
+                "trismus,",
+                "which",
+                "of",
+                "the",
+                "following",
+                "statements",
+                "is",
+                "correct?"
+            ],
+            [
+                "1-",
+                "The",
+                "first",
+                "diagnostic",
+                "probability",
+                "is",
+                "carcinoma",
+                "of",
+                "the",
+                "floor",
+                "of",
+                "the",
+                "mouth",
+                "with",
+                "bilateral",
+                "cervical",
+                "metastases."
+            ],
+            [
+                "2-",
+                "The",
+                "therapeutic",
+                "priority",
+                "is",
+                "to",
+                "ensure",
+                "the",
+                "patient's",
+                "nutrition."
+            ],
+            [
+                "3-",
+                "We",
+                "are",
+                "almost",
+                "certainly",
+                "facing",
+                "a",
+                "mediastinitis."
+            ],
+            [
+                "4-",
+                "We",
+                "must",
+                "consider",
+                "as",
+                "a",
+                "priority",
+                "the",
+                "risk",
+                "of",
+                "airway",
+                "obstruction."
+            ],
+            [
+                "5-",
+                "We",
+                "must",
+                "perform",
+                "as",
+                "a",
+                "first",
+                "diagnostic",
+                "measure",
+                "a",
+                "cytology",
+                "by",
+                "fine",
+                "needle",
+                "aspiration",
+                "puncture."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "This",
+                "patient",
+                "is",
+                "in",
+                "serious",
+                "condition."
+            ],
+            [
+                "The",
+                "trismus",
+                "and",
+                "fever",
+                "suggest",
+                "a",
+                "deep",
+                "cervical",
+                "space",
+                "infection",
+                "and",
+                "that",
+                "is",
+                "not",
+                "a",
+                "game",
+                "because",
+                "the",
+                "airway",
+                "can",
+                "become",
+                "obstructed."
+            ],
+            [
+                "Knowing",
+                "this,",
+                "options",
+                "1,",
+                "2",
+                "and",
+                "5",
+                "are",
+                "out",
+                "of",
+                "place",
+                "and",
+                "I",
+                "am",
+                "left",
+                "with",
+                "3",
+                "and",
+                "4."
+            ],
+            [
+                "There",
+                "may",
+                "already",
+                "be",
+                "mediastinitis;",
+                "after",
+                "all,",
+                "that",
+                "is",
+                "the",
+                "natural",
+                "history",
+                "of",
+                "cervical",
+                "deep",
+                "space",
+                "infections,",
+                "but",
+                "answer",
+                "4",
+                "is",
+                "more",
+                "correct",
+                "and",
+                "besides,",
+                "we",
+                "are",
+                "in",
+                "the",
+                "ENT",
+                "block,",
+                "the",
+                "airway",
+                "specialty."
+            ],
+            [
+                "I",
+                "like",
+                "this",
+                "question",
+                "because",
+                "it",
+                "requires",
+                "knowledge",
+                "that",
+                "is",
+                "important",
+                "in",
+                "clinical",
+                "practice."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "B-Marker",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "385_153",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis",
+                "of",
+                "a",
+                "newborn",
+                "with",
+                "microcephaly,",
+                "intrauterine",
+                "growth",
+                "retardation,",
+                "congenital",
+                "heart",
+                "disease,",
+                "vertical",
+                "talus",
+                "foot",
+                "and",
+                "a",
+                "peculiar",
+                "facies",
+                "(microphthalmia,",
+                "small",
+                "palpebral",
+                "fissures,",
+                "micrognathia",
+                "and",
+                "dysplastic",
+                "ears),",
+                "hands",
+                "with",
+                "the",
+                "index",
+                "and",
+                "little",
+                "finger",
+                "above",
+                "the",
+                "middle",
+                "and",
+                "ring",
+                "fingers?"
+            ],
+            [
+                "1-",
+                "Trisomy",
+                "18",
+                "(Edwards'",
+                "syndrome)."
+            ],
+            [
+                "2-",
+                "Trisomy",
+                "13",
+                "(Patau's",
+                "syndrome)."
+            ],
+            [
+                "3-",
+                "Trisomy",
+                "21",
+                "(Down",
+                "syndrome)."
+            ],
+            [
+                "4-",
+                "Trisomy",
+                "9."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "You",
+                "are",
+                "faithfully",
+                "describing",
+                "an",
+                "Edwards'",
+                "syndrome."
+            ],
+            [
+                "Although",
+                "the",
+                "cardiopathies",
+                "and",
+                "the",
+                "alteration",
+                "of",
+                "the",
+                "foot",
+                "that",
+                "he",
+                "describes",
+                "are",
+                "common",
+                "to",
+                "several",
+                "chromosomopathies,",
+                "the",
+                "alteration",
+                "of",
+                "the",
+                "fingers",
+                "and",
+                "toes",
+                "is",
+                "very",
+                "characteristic",
+                "of",
+                "Edwards'",
+                "syndrome."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "194_162",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "3-year-old",
+                "girl",
+                "from",
+                "Bangladesh",
+                "consults",
+                "for",
+                "intermittent",
+                "febrile",
+                "episodes",
+                "of",
+                "3",
+                "weeks'",
+                "duration,",
+                "associated",
+                "with",
+                "weakness",
+                "and",
+                "loss",
+                "of",
+                "appetite."
+            ],
+            [
+                "Physical",
+                "examination",
+                "showed",
+                "marked",
+                "splenomegaly",
+                "and",
+                "mucocutaneous",
+                "pallor."
+            ],
+            [
+                "Complementary",
+                "tests",
+                "include:",
+                "hemoglobin",
+                "8.5",
+                "mg/dL,",
+                "hematocrit",
+                "26%,",
+                "MCV",
+                "86",
+                "fL,",
+                "MCH",
+                "29",
+                "pg,",
+                "leukocytes",
+                "2800/mL",
+                "with",
+                "300",
+                "neutrophils",
+                "/ml,",
+                "platelets",
+                "54000/ml,",
+                "GOT",
+                "85",
+                "U/l,",
+                "GPT92",
+                "U/l",
+                "and",
+                "polyclonal",
+                "hypergammaglobulinemia",
+                "in",
+                "serum",
+                "proteinogram."
+            ],
+            [
+                "Indicate",
+                "the",
+                "most",
+                "probable",
+                "diagnosis",
+                "with",
+                "the",
+                "data",
+                "available",
+                "at",
+                "this",
+                "time:"
+            ],
+            [
+                "1-",
+                "Acute",
+                "lymphoblastic",
+                "leukemia."
+            ],
+            [
+                "2-",
+                "Burkitt's",
+                "lymphoma."
+            ],
+            [
+                "3-",
+                "Visceral",
+                "leishmaniasis."
+            ],
+            [
+                "4-",
+                "Miliary",
+                "tuberculosis."
+            ],
+            [
+                "5-",
+                "Chronic",
+                "malaria."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Data",
+                "such",
+                "as",
+                "pancytopenia",
+                "and",
+                "hypergammaglobulinemia",
+                "are",
+                "very",
+                "characteristic",
+                "of",
+                "kala-azar."
+            ],
+            [
+                "The",
+                "origin",
+                "of",
+                "the",
+                "girl",
+                "is",
+                "also",
+                "indicative",
+                "of",
+                "this",
+                "diagnosis,",
+                "although",
+                "it",
+                "is",
+                "a",
+                "disease",
+                "that",
+                "also",
+                "occurs",
+                "in",
+                "the",
+                "Mediterranean",
+                "area."
+            ],
+            [
+                "In",
+                "the",
+                "differential",
+                "diagnosis,",
+                "it",
+                "is",
+                "important",
+                "to",
+                "keep",
+                "in",
+                "mind",
+                "the",
+                "possibility",
+                "of",
+                "leukosis."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "371_126",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "283_56",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "109_149",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "32-year-old",
+                "asymptomatic",
+                "woman",
+                "goes",
+                "for",
+                "a",
+                "gynecological",
+                "health",
+                "check-up",
+                "because",
+                "she",
+                "wishes",
+                "to",
+                "become",
+                "pregnant."
+            ],
+            [
+                "During",
+                "this",
+                "check-up,",
+                "a",
+                "4cm",
+                "uterine",
+                "myoma",
+                "is",
+                "detected,",
+                "partly",
+                "intramural",
+                "and",
+                "partly",
+                "subserosal,",
+                "located",
+                "on",
+                "the",
+                "anterior",
+                "aspect",
+                "of",
+                "the",
+                "uterus",
+                "and",
+                "which",
+                "does",
+                "not",
+                "deform",
+                "the",
+                "endometrial",
+                "cavity."
+            ],
+            [
+                "What",
+                "approach",
+                "would",
+                "you",
+                "recommend?"
+            ],
+            [
+                "1-",
+                "Laparoscopic",
+                "myomectomy."
+            ],
+            [
+                "2-",
+                "Laparotomic",
+                "myomectomy."
+            ],
+            [
+                "3-",
+                "Myoma",
+                "embolization",
+                "by",
+                "arterial",
+                "catheterization."
+            ],
+            [
+                "4-",
+                "Treatment",
+                "with",
+                "Gn-Rh",
+                "analogues",
+                "for",
+                "three",
+                "months",
+                "before",
+                "attempting",
+                "pregnancy."
+            ],
+            [
+                "5-",
+                "Attempting",
+                "pregnancy",
+                "without",
+                "any",
+                "previous",
+                "treatment."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "5."
+            ],
+            [
+                "An",
+                "asymptomatic",
+                "myoma",
+                "of",
+                "this",
+                "size",
+                "that",
+                "does",
+                "not",
+                "deform",
+                "the",
+                "endometrial",
+                "cavity",
+                "is",
+                "not",
+                "a",
+                "problem",
+                "for",
+                "pregnancy."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Treatment",
+                "I-Treatment"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "92_235",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PALLIATIVE",
+                "CARE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "60-year-old",
+                "patient",
+                "diagnosed",
+                "with",
+                "breast",
+                "neoplasia",
+                "10",
+                "years",
+                "ago."
+            ],
+            [
+                "She",
+                "underwent",
+                "treatment",
+                "with",
+                "radiochemotherapy",
+                "and",
+                "then",
+                "hormonal",
+                "therapy",
+                "for",
+                "5",
+                "years."
+            ],
+            [
+                "A",
+                "bone",
+                "scan",
+                "study",
+                "performed",
+                "for",
+                "polytopic",
+                "bone",
+                "pain",
+                "showed",
+                "the",
+                "presence",
+                "of",
+                "bone",
+                "metastases."
+            ],
+            [
+                "She",
+                "is",
+                "currently",
+                "under",
+                "treatment",
+                "with",
+                "minor",
+                "opioids",
+                "and",
+                "NSAIDs",
+                "with",
+                "good",
+                "pain",
+                "control."
+            ],
+            [
+                "She",
+                "consulted",
+                "for",
+                "headache",
+                "that",
+                "did",
+                "not",
+                "subside",
+                "with",
+                "the",
+                "current",
+                "analgesia",
+                "and",
+                "a",
+                "CT",
+                "scan",
+                "of",
+                "the",
+                "brain",
+                "showed",
+                "images",
+                "compatible",
+                "with",
+                "brain",
+                "metastases."
+            ],
+            [
+                "In",
+                "relation",
+                "to",
+                "the",
+                "treatment",
+                "of",
+                "pain,",
+                "indicate",
+                "the",
+                "CORRECT",
+                "one:"
+            ],
+            [
+                "1-",
+                "Switch",
+                "to",
+                "major",
+                "opioids."
+            ],
+            [
+                "2-",
+                "Extra",
+                "doses",
+                "of",
+                "opioids",
+                "should",
+                "be",
+                "administered",
+                "as",
+                "necessary."
+            ],
+            [
+                "3-",
+                "Corticoids",
+                "should",
+                "be",
+                "added."
+            ],
+            [
+                "4-",
+                "Switch",
+                "to",
+                "a",
+                "major",
+                "opioid",
+                "and",
+                "maintain",
+                "NSAIDs."
+            ],
+            [
+                "5-",
+                "The",
+                "patient",
+                "should",
+                "be",
+                "admitted",
+                "for",
+                "intravenous",
+                "treatment",
+                "with",
+                "major",
+                "opioid."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Brain",
+                "metastases",
+                "produce",
+                "pain",
+                "due",
+                "to",
+                "cranial",
+                "hypertension."
+            ],
+            [
+                "The",
+                "treatment",
+                "of",
+                "choice",
+                "is",
+                "corticosteroids."
+            ],
+            [
+                "Dexamethasone",
+                "in",
+                "oral",
+                "doses",
+                "of",
+                "4",
+                "to",
+                "16",
+                "mg/day",
+                "is",
+                "the",
+                "treatment",
+                "of",
+                "choice."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "342_158",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "24-year-old",
+                "woman,",
+                "primigestation,",
+                "suffers",
+                "a",
+                "spontaneous",
+                "abortion",
+                "at",
+                "7",
+                "weeks",
+                "of",
+                "gestation."
+            ],
+            [
+                "The",
+                "anatomopathological",
+                "study",
+                "of",
+                "the",
+                "abortive",
+                "remains",
+                "indicates",
+                "molar",
+                "disease."
+            ],
+            [
+                "We",
+                "should",
+                "inform",
+                "you",
+                "that:"
+            ],
+            [
+                "1-",
+                "The",
+                "risk",
+                "of",
+                "a",
+                "new",
+                "molar",
+                "gestation",
+                "in",
+                "a",
+                "future",
+                "pregnancy",
+                "is",
+                "50%."
+            ],
+            [
+                "2-",
+                "She",
+                "should",
+                "not",
+                "become",
+                "pregnant",
+                "until",
+                "she",
+                "has",
+                "undergone",
+                "periodic",
+                "controls",
+                "and",
+                "has",
+                "spent",
+                "one",
+                "year",
+                "with",
+                "negative",
+                "BHCG",
+                "levels."
+            ],
+            [
+                "3-",
+                "Subsequent",
+                "controls",
+                "are",
+                "not",
+                "necessary",
+                "if",
+                "the",
+                "evacuation",
+                "of",
+                "the",
+                "trophoblastic",
+                "tissue",
+                "was",
+                "complete."
+            ],
+            [
+                "4-",
+                "It",
+                "is",
+                "necessary",
+                "to",
+                "carry",
+                "out",
+                "periodic",
+                "controls",
+                "since",
+                "40%",
+                "of",
+                "the",
+                "cases",
+                "will",
+                "develop",
+                "a",
+                "gestational",
+                "trophoblastic",
+                "neoplasia."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Gestational",
+                "trophoblastic",
+                "disease",
+                "should",
+                "be",
+                "followed",
+                "up",
+                "(regardless",
+                "of",
+                "whether",
+                "the",
+                "evacuation",
+                "has",
+                "been",
+                "complete",
+                "or",
+                "not)",
+                "and",
+                "the",
+                "patient",
+                "should",
+                "be",
+                "advised",
+                "not",
+                "to",
+                "become",
+                "pregnant",
+                "again",
+                "until",
+                "at",
+                "least",
+                "6",
+                "months",
+                "with",
+                "negative",
+                "BHCG",
+                "titers."
+            ],
+            [
+                "The",
+                "risk",
+                "of",
+                "recurrence",
+                "in",
+                "another",
+                "pregnancy",
+                "is",
+                "low",
+                "(1/55)",
+                "and",
+                "90%",
+                "of",
+                "cases",
+                "progress",
+                "satisfactorily",
+                "without",
+                "developing",
+                "neoplasia."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "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",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "357_232",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "24-year-old",
+                "woman",
+                "consults",
+                "after",
+                "noticing",
+                "inguinal",
+                "lymphadenopathy."
+            ],
+            [
+                "The",
+                "interrogation",
+                "does",
+                "not",
+                "reveal",
+                "any",
+                "local",
+                "discomfort",
+                "or",
+                "data",
+                "suggestive",
+                "of",
+                "sexually",
+                "transmitted",
+                "infection."
+            ],
+            [
+                "The",
+                "examination",
+                "revealed",
+                "two",
+                "lymphadenopathies,",
+                "one",
+                "in",
+                "each",
+                "groin,",
+                "1",
+                "cm",
+                "in",
+                "diameter,",
+                "soft,",
+                "mobile,",
+                "non-painful."
+            ],
+            [
+                "No",
+                "skin",
+                "lesions",
+                "are",
+                "seen",
+                "on",
+                "the",
+                "lower",
+                "limbs,",
+                "anus",
+                "or",
+                "perineum."
+            ],
+            [
+                "Which",
+                "test",
+                "do",
+                "you",
+                "consider",
+                "essential?"
+            ],
+            [
+                "1-",
+                "A",
+                "lues",
+                "serology",
+                "since",
+                "it",
+                "is",
+                "most",
+                "likely",
+                "a",
+                "Treponema",
+                "pallidum",
+                "infection."
+            ],
+            [
+                "2-",
+                "A",
+                "gynecological",
+                "examination",
+                "to",
+                "rule",
+                "out",
+                "ovarian",
+                "cancer."
+            ],
+            [
+                "3-",
+                "By",
+                "the",
+                "clinical",
+                "characteristics",
+                "it",
+                "seems",
+                "to",
+                "be",
+                "normal",
+                "lymph",
+                "nodes",
+                "and",
+                "complementary",
+                "explorations",
+                "should",
+                "not",
+                "be",
+                "done."
+            ],
+            [
+                "4-",
+                "A",
+                "Paul-Bunell",
+                "test",
+                "should",
+                "be",
+                "performed",
+                "to",
+                "rule",
+                "out",
+                "infectious",
+                "mononucleosis."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "The",
+                "presence",
+                "of",
+                "inguinal",
+                "nodes",
+                "up",
+                "to",
+                "1-1.5cm",
+                "may",
+                "be",
+                "normal",
+                "in",
+                "the",
+                "absence",
+                "of",
+                "symptoms."
+            ],
+            [
+                "In",
+                "this",
+                "case,",
+                "they",
+                "are",
+                "very",
+                "nonspecific",
+                "nodes,",
+                "without",
+                "signs",
+                "of",
+                "malignancy",
+                "(mobile,",
+                "soft,",
+                "not",
+                "painful)",
+                "that",
+                "do",
+                "not",
+                "lead",
+                "us",
+                "to",
+                "suspect",
+                "neoplastic",
+                "infiltration",
+                "and",
+                "the",
+                "lack",
+                "of",
+                "other",
+                "clinical",
+                "signs",
+                "also",
+                "leads",
+                "us",
+                "to",
+                "rule",
+                "out",
+                "the",
+                "presence",
+                "of",
+                "STD."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "596_121",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "RHEUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "79-year-old",
+                "woman",
+                "admitted",
+                "for",
+                "an",
+                "osteoporotic",
+                "hip",
+                "fracture."
+            ],
+            [
+                "Regarding",
+                "secondary",
+                "prevention",
+                "of",
+                "fragility",
+                "fractures,",
+                "point",
+                "out",
+                "the",
+                "WRONG",
+                "answer:"
+            ],
+            [
+                "1-",
+                "Low",
+                "adherence",
+                "to",
+                "treatment",
+                "is",
+                "associated",
+                "with",
+                "an",
+                "increased",
+                "risk",
+                "of",
+                "fracture."
+            ],
+            [
+                "2-",
+                "Bone",
+                "remodeling",
+                "markers",
+                "may",
+                "be",
+                "useful",
+                "for",
+                "early",
+                "monitoring",
+                "of",
+                "response",
+                "to",
+                "treatment."
+            ],
+            [
+                "3-",
+                "Vitamin",
+                "D",
+                "monotherapy",
+                "is",
+                "effective",
+                "in",
+                "reducing",
+                "such",
+                "fractures",
+                "in",
+                "non-institutionalized",
+                "elderly."
+            ],
+            [
+                "4-",
+                "Increasing",
+                "dietary",
+                "calcium",
+                "or",
+                "taking",
+                "calcium",
+                "supplements",
+                "alone",
+                "does",
+                "not",
+                "protect",
+                "against",
+                "the",
+                "occurrence",
+                "of",
+                "fractures."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "This",
+                "question",
+                "corresponds",
+                "to",
+                "the",
+                "section",
+                "on",
+                "traumatology;",
+                "however,",
+                "it",
+                "could",
+                "be",
+                "answered",
+                "with",
+                "knowledge",
+                "of",
+                "rheumatology",
+                "and",
+                "with",
+                "the",
+                "osteoporosis",
+                "recommendations",
+                "of",
+                "the",
+                "Spanish",
+                "Society",
+                "of",
+                "Rheumatology."
+            ],
+            [
+                "In",
+                "osteoporosis,",
+                "one",
+                "of",
+                "the",
+                "main",
+                "risks",
+                "associated",
+                "with",
+                "increased",
+                "fracture",
+                "risk",
+                "is",
+                "low",
+                "adherence",
+                "to",
+                "treatment,",
+                "so",
+                "answer",
+                "1",
+                "is",
+                "correct."
+            ],
+            [
+                "Answer",
+                "2",
+                "is",
+                "found",
+                "in",
+                "the",
+                "SER",
+                "guidelines,",
+                "which",
+                "confirm",
+                "that",
+                "some",
+                "studies",
+                "conclude",
+                "that",
+                "bone",
+                "remodeling",
+                "markers",
+                "can",
+                "be",
+                "useful",
+                "for",
+                "early",
+                "monitoring",
+                "of",
+                "adherence",
+                "and",
+                "response",
+                "to",
+                "treatment."
+            ],
+            [
+                "Answer",
+                "4",
+                "is",
+                "correct",
+                "because",
+                "again",
+                "in",
+                "the",
+                "SER",
+                "2019",
+                "guidelines",
+                "they",
+                "quote:",
+                "\"The",
+                "current",
+                "scientific",
+                "evidence",
+                "allows",
+                "us",
+                "to",
+                "affirm",
+                "that",
+                "neither",
+                "increasing",
+                "dietary",
+                "calcium",
+                "nor",
+                "taking",
+                "calcium",
+                "supplements",
+                "alone",
+                "protects",
+                "against",
+                "the",
+                "appearance",
+                "of",
+                "fractures\"."
+            ],
+            [
+                "Therefore,",
+                "the",
+                "correct",
+                "answer",
+                "to",
+                "this",
+                "question",
+                "is",
+                "option",
+                "3."
+            ],
+            [
+                "Patients",
+                "on",
+                "pharmacological",
+                "treatment",
+                "for",
+                "OP",
+                "should",
+                "use",
+                "calcium",
+                "and",
+                "vitamin",
+                "D",
+                "supplements",
+                "because",
+                "practically",
+                "all",
+                "clinical",
+                "trials",
+                "that",
+                "have",
+                "demonstrated",
+                "efficacy",
+                "of",
+                "antiosteoporotic",
+                "drugs",
+                "routinely",
+                "include",
+                "calcium",
+                "supplements",
+                "and",
+                "cholecalciferol",
+                "(vitamin",
+                "D3),",
+                "but",
+                "not",
+                "in",
+                "monotherapy."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "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",
+                "O",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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-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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "334_82",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PHARMACOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "woman",
+                "diagnosed",
+                "with",
+                "type",
+                "1",
+                "diabetes",
+                "mellitus",
+                "for",
+                "24",
+                "years."
+            ],
+            [
+                "She",
+                "comes",
+                "to",
+                "the",
+                "office",
+                "with",
+                "3",
+                "months",
+                "of",
+                "clinical",
+                "evolution",
+                "of",
+                "tingling",
+                "in",
+                "both",
+                "feet,",
+                "with",
+                "distribution",
+                "in",
+                "sock,",
+                "with",
+                "paresthetic",
+                "pain",
+                "and",
+                "sensation",
+                "of",
+                "hot",
+                "feet",
+                "predominantly",
+                "at",
+                "night,",
+                "which",
+                "significantly",
+                "interferes",
+                "with",
+                "sleep."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "drugs",
+                "would",
+                "you",
+                "use",
+                "in",
+                "the",
+                "first",
+                "line",
+                "for",
+                "the",
+                "treatment",
+                "of",
+                "her",
+                "pathology?"
+            ],
+            [
+                "1-",
+                "Ibuprofen."
+            ],
+            [
+                "2-",
+                "Oxycodone."
+            ],
+            [
+                "3-",
+                "Duloxetine."
+            ],
+            [
+                "4-",
+                "Paracetamol."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Duloxetine;",
+                "the",
+                "clinical",
+                "picture",
+                "described",
+                "is",
+                "of",
+                "diabetic",
+                "neuropathy."
+            ],
+            [
+                "Of",
+                "the",
+                "drugs",
+                "proposed,",
+                "the",
+                "first",
+                "choice",
+                "would",
+                "be",
+                "a",
+                "dual",
+                "antidepressant",
+                "such",
+                "as",
+                "duloxetine."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-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"
+            ]
+        ]
+    },
+    {
+        "id": "81_44",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "386_154",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "The",
+                "appearance",
+                "of",
+                "a",
+                "high",
+                "fever",
+                "of",
+                "39\u00b0C",
+                "in",
+                "a",
+                "10-month-old",
+                "infant",
+                "that",
+                "abruptly",
+                "subsides",
+                "after",
+                "3-5",
+                "days,",
+                "followed",
+                "by",
+                "a",
+                "cephalocaudal",
+                "morbilliform",
+                "exanthema",
+                "with",
+                "enanthema",
+                "consisting",
+                "of",
+                "reddish",
+                "papules",
+                "on",
+                "the",
+                "palate,",
+                "and",
+                "resolving",
+                "within",
+                "a",
+                "week,",
+                "associated",
+                "with",
+                "good",
+                "general",
+                "condition,",
+                "is",
+                "usually",
+                "caused",
+                "by:"
+            ],
+            [
+                "1-",
+                "Parvovirus",
+                "B19."
+            ],
+            [
+                "2-",
+                "Herpes",
+                "virus",
+                "type",
+                "6."
+            ],
+            [
+                "3-",
+                "Coxackie",
+                "A16",
+                "virus."
+            ],
+            [
+                "4-",
+                "Primoinfection",
+                "by",
+                "Epstein-Barr",
+                "virus."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "The",
+                "question",
+                "of",
+                "exanthematous",
+                "diseases",
+                "that",
+                "pediatricians",
+                "and",
+                "MIR",
+                "exam",
+                "takers",
+                "like",
+                "so",
+                "much."
+            ],
+            [
+                "By",
+                "the",
+                "picture",
+                "of",
+                "high",
+                "fever",
+                "of",
+                "several",
+                "days",
+                "that",
+                "suddenly",
+                "subsides",
+                "with",
+                "the",
+                "appearance",
+                "of",
+                "a",
+                "rash,",
+                "we",
+                "have",
+                "a",
+                "sudden",
+                "exanthem,",
+                "caused",
+                "by",
+                "Herpes",
+                "virus",
+                "type",
+                "6",
+                "(remember",
+                "the",
+                "mnemonic",
+                "rule",
+                "of",
+                "\"sudden",
+                "Hexanthem\")."
+            ],
+            [
+                "Parvovirus",
+                "B19",
+                "is",
+                "the",
+                "cause",
+                "of",
+                "erythema",
+                "infectiosum",
+                "or",
+                "\"fifth",
+                "disease\",",
+                "whose",
+                "characteristic",
+                "rash",
+                "is",
+                "on",
+                "the",
+                "cheeks,",
+                "giving",
+                "the",
+                "appearance",
+                "of",
+                "a",
+                "slapped",
+                "face."
+            ],
+            [
+                "Coxackie",
+                "A16",
+                "causes",
+                "herpangina",
+                "and",
+                "also",
+                "boca-mano-pie",
+                "disease,",
+                "which",
+                "presents",
+                "an",
+                "initially",
+                "macular",
+                "rash,",
+                "which",
+                "does",
+                "not",
+                "respect",
+                "palms",
+                "or",
+                "soles",
+                "and",
+                "evolves",
+                "into",
+                "bursting",
+                "vesicles."
+            ],
+            [
+                "Finally,",
+                "EBV",
+                "infection",
+                "produces",
+                "a",
+                "mononucleosis",
+                "syndrome",
+                "with",
+                "high",
+                "fever",
+                "lasting",
+                "several",
+                "days,",
+                "with",
+                "pharyngeal",
+                "erythema",
+                "and",
+                "grayish",
+                "exudates",
+                "on",
+                "the",
+                "tonsils."
+            ],
+            [
+                "It",
+                "can",
+                "present",
+                "if",
+                "penicillins",
+                "are",
+                "given",
+                "to",
+                "treat",
+                "it",
+                "(when",
+                "confused",
+                "with",
+                "a",
+                "streptococcal",
+                "pharyngotonsillitis)",
+                "a",
+                "generalized",
+                "exanthema."
+            ],
+            [
+                "In",
+                "addition,",
+                "it",
+                "also",
+                "presents",
+                "with",
+                "fatigue,",
+                "hepatic",
+                "inflammation",
+                "with",
+                "increased",
+                "transaminases",
+                "and",
+                "splenomegaly."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
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+                "O"
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+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "O"
+            ],
+            [
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+                "O",
+                "O"
+            ],
+            [
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+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
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+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
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+                "I-Marker",
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+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim"
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+            [
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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"
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+            [
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "239_146",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "80-year-old",
+                "man",
+                "is",
+                "admitted",
+                "for",
+                "a",
+                "sudden",
+                "onset",
+                "of",
+                "aphasia",
+                "and",
+                "right",
+                "hemiparesis."
+            ],
+            [
+                "His",
+                "history",
+                "includes",
+                "hypertension,",
+                "well",
+                "controlled",
+                "with",
+                "diet",
+                "and",
+                "cognitive",
+                "deterioration",
+                "in",
+                "the",
+                "last",
+                "year",
+                "under",
+                "study",
+                "by",
+                "his",
+                "neurologist."
+            ],
+            [
+                "The",
+                "emergency",
+                "cranial",
+                "CT",
+                "scan",
+                "shows",
+                "a",
+                "left",
+                "frontal",
+                "lobar",
+                "hematoma",
+                "without",
+                "contrast",
+                "uptake."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "probable",
+                "cause",
+                "of",
+                "the",
+                "hematoma?"
+            ],
+            [
+                "1-",
+                "Arteriovenous",
+                "malformation",
+                "masked",
+                "by",
+                "acute",
+                "hematoma."
+            ],
+            [
+                "2-",
+                "Chronic",
+                "arterial",
+                "hypertension."
+            ],
+            [
+                "3-",
+                "Isolated",
+                "vasculitis",
+                "of",
+                "the",
+                "nervous",
+                "system."
+            ],
+            [
+                "4-",
+                "Brain",
+                "tumor."
+            ],
+            [
+                "5-",
+                "Cerebral",
+                "amyloid",
+                "angiopathy",
+                "(congophilic",
+                "angiopathy)."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "Amyloid",
+                "angiopathy",
+                "is",
+                "the",
+                "most",
+                "common",
+                "cause",
+                "of",
+                "spontaneous",
+                "non-hypertensive",
+                "hemorrhage",
+                "in",
+                "elderly",
+                "patients,",
+                "and",
+                "is",
+                "usually",
+                "lobar",
+                "in",
+                "location",
+                "(as",
+                "in",
+                "the",
+                "case)."
+            ],
+            [
+                "They",
+                "often",
+                "appear",
+                "in",
+                "association",
+                "with",
+                "Alzheimer's",
+                "disease",
+                "(CTO",
+                "Manual)."
+            ],
+            [
+                "The",
+                "response",
+                "that",
+                "may",
+                "cause",
+                "the",
+                "most",
+                "doubts",
+                "is",
+                "2,",
+                "hypertension,",
+                "but",
+                "the",
+                "most",
+                "frequent",
+                "localizations",
+                "are:",
+                "putamen,",
+                "thalamus,",
+                "pons",
+                "and",
+                "cerebellum."
+            ],
+            [
+                "Therefore,",
+                "most",
+                "of",
+                "the",
+                "time",
+                "these",
+                "are",
+                "deep",
+                "hemorrhages",
+                "(CTO",
+                "Manual)."
+            ],
+            [
+                "In",
+                "addition,",
+                "as",
+                "a",
+                "clue",
+                "it",
+                "tells",
+                "us",
+                "that",
+                "the",
+                "patient",
+                "has",
+                "well-controlled",
+                "hypertension",
+                "without",
+                "drugs,",
+                "although",
+                "this",
+                "data",
+                "would",
+                "not",
+                "serve",
+                "to",
+                "rule",
+                "out",
+                "the",
+                "response."
+            ],
+            [
+                "Answer",
+                "1,",
+                "a",
+                "malformation",
+                "is",
+                "typical",
+                "of",
+                "young",
+                "patients,",
+                "rare",
+                "in",
+                "older",
+                "people."
+            ],
+            [
+                "It",
+                "also",
+                "decreases",
+                "the",
+                "chance",
+                "of",
+                "not",
+                "finding",
+                "a",
+                "malformation",
+                "with",
+                "contrast-enhanced",
+                "CT."
+            ],
+            [
+                "Answer",
+                "4,",
+                "a",
+                "brain",
+                "tumor,",
+                "does",
+                "not",
+                "seem",
+                "likely",
+                "since",
+                "the",
+                "mass",
+                "is",
+                "not",
+                "seen",
+                "on",
+                "CT,",
+                "and",
+                "as",
+                "in",
+                "the",
+                "previous",
+                "case,",
+                "it",
+                "is",
+                "more",
+                "difficult",
+                "not",
+                "to",
+                "find",
+                "such",
+                "a",
+                "lesion",
+                "after",
+                "contrast",
+                "administration."
+            ],
+            [
+                "Answer",
+                "3",
+                "does",
+                "not",
+                "seem",
+                "correct",
+                "since",
+                "vasculitis",
+                "is",
+                "a",
+                "rare",
+                "entity",
+                "and",
+                "more",
+                "so",
+                "in",
+                "older",
+                "people."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
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+                "I-Premise",
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+                "I-Premise"
+            ],
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
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+                "I-Claim",
+                "I-Claim"
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+                "I-Claim",
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+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-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",
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+                "O",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim"
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+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "525_53",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "287_64",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "472_140",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ORTHOPEDIC",
+                "SURGERY",
+                "AND",
+                "TRAUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "65-year-old",
+                "obese",
+                "woman",
+                "who",
+                "suffers",
+                "a",
+                "fall",
+                "on",
+                "her",
+                "hand",
+                "with",
+                "her",
+                "elbow",
+                "in",
+                "extension."
+            ],
+            [
+                "She",
+                "presents",
+                "with",
+                "arm",
+                "pain",
+                "with",
+                "swelling",
+                "and",
+                "functional",
+                "impotence",
+                "of",
+                "the",
+                "arm",
+                "and",
+                "inability",
+                "to",
+                "extend",
+                "the",
+                "wrist",
+                "and",
+                "fingers."
+            ],
+            [
+                "It",
+                "is",
+                "most",
+                "likely",
+                "to",
+                "present:"
+            ],
+            [
+                "1-",
+                "Dislocation",
+                "fracture",
+                "of",
+                "proximal",
+                "humerus."
+            ],
+            [
+                "2-",
+                "Elbow",
+                "dislocation."
+            ],
+            [
+                "3-",
+                "Diaphyseal",
+                "fracture",
+                "of",
+                "the",
+                "humerus",
+                "associated",
+                "with",
+                "double",
+                "forearm",
+                "fracture."
+            ],
+            [
+                "4-",
+                "Diaphyseal",
+                "fracture",
+                "of",
+                "humerus",
+                "with",
+                "radial",
+                "nerve",
+                "injury."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "We",
+                "must",
+                "take",
+                "into",
+                "account",
+                "all",
+                "the",
+                "clinical",
+                "data",
+                "provided:",
+                "after",
+                "trauma",
+                "we",
+                "have",
+                "pain",
+                "in",
+                "the",
+                "arm",
+                "with",
+                "soft",
+                "tissue",
+                "involvement",
+                "and",
+                "the",
+                "impossibility",
+                "of",
+                "extending",
+                "the",
+                "wrist",
+                "and",
+                "fingers."
+            ],
+            [
+                "The",
+                "only",
+                "option",
+                "that",
+                "includes",
+                "all",
+                "the",
+                "data",
+                "is",
+                "4."
+            ],
+            [
+                "Option",
+                "1",
+                "does",
+                "not",
+                "explain",
+                "the",
+                "involvement",
+                "of",
+                "the",
+                "wrist",
+                "and",
+                "fingers."
+            ],
+            [
+                "The",
+                "elbow",
+                "dislocation",
+                "does",
+                "not",
+                "explain",
+                "the",
+                "lack",
+                "of",
+                "finger",
+                "mobility",
+                "as",
+                "well",
+                "as",
+                "the",
+                "diaphyseal",
+                "fracture",
+                "of",
+                "the",
+                "humerus",
+                "and",
+                "double",
+                "forearm."
+            ],
+            [
+                "\"Direct",
+                "mechanism",
+                "is",
+                "possible,",
+                "as",
+                "is",
+                "indirect",
+                "transmission",
+                "of",
+                "forces",
+                "from",
+                "the",
+                "elbow",
+                "and",
+                "hand...radial",
+                "nerve",
+                "involvement",
+                "is",
+                "extremely",
+                "frequent,",
+                "reaching",
+                "an",
+                "incidence",
+                "of",
+                "10-18%",
+                "of",
+                "cases.\"",
+                "Proximal",
+                "humerus",
+                "fracture-dislocation",
+                "would",
+                "have",
+                "greater",
+                "involvement",
+                "at",
+                "the",
+                "shoulder,",
+                "elbow",
+                "dislocation",
+                "at",
+                "the",
+                "elbow,",
+                "and",
+                "there",
+                "is",
+                "no",
+                "data",
+                "to",
+                "suggest",
+                "double",
+                "forearm",
+                "fracture."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "173_51",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PNEUMOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "53-year-old",
+                "woman",
+                "with",
+                "bronchial",
+                "asthma",
+                "comes",
+                "to",
+                "the",
+                "allergy",
+                "clinic",
+                "for",
+                "a",
+                "checkup."
+            ],
+            [
+                "She",
+                "reports",
+                "repeated",
+                "exacerbations",
+                "with",
+                "nocturnal",
+                "symptoms,",
+                "frequent",
+                "use",
+                "of",
+                "rescue",
+                "medication",
+                "and",
+                "dyspnea",
+                "on",
+                "exertion",
+                "when",
+                "walking",
+                "on",
+                "level",
+                "ground."
+            ],
+            [
+                "Spirometry",
+                "shows",
+                "a",
+                "pre-bronchodilator",
+                "FEV1/FVC",
+                "ratio",
+                "of",
+                "60%",
+                "and",
+                "FEV1",
+                "of",
+                "55%."
+            ],
+            [
+                "Skin",
+                "tests",
+                "are",
+                "positive",
+                "for",
+                "mites",
+                "and",
+                "total",
+                "IgE",
+                "of",
+                "150",
+                "IU/ml."
+            ],
+            [
+                "The",
+                "patient",
+                "is",
+                "being",
+                "treated",
+                "with",
+                "a",
+                "combination",
+                "of",
+                "high-dose",
+                "salmeterol/budesonide",
+                "(50/500",
+                "mg:",
+                "2",
+                "puffs",
+                "twice",
+                "daily),",
+                "maintenance",
+                "oral",
+                "prednisone",
+                "(10",
+                "mg/day)",
+                "and",
+                "theophylline."
+            ],
+            [
+                "Of",
+                "the",
+                "following",
+                "options,",
+                "which",
+                "is",
+                "the",
+                "most",
+                "advisable",
+                "therapeutic",
+                "approach?"
+            ],
+            [
+                "1-",
+                "Add",
+                "magnesium",
+                "sulfate."
+            ],
+            [
+                "2-",
+                "Increase",
+                "the",
+                "dose",
+                "of",
+                "prednisone",
+                "to",
+                "30",
+                "mg/day."
+            ],
+            [
+                "3-",
+                "Add",
+                "omalizumab."
+            ],
+            [
+                "4-",
+                "Nebulized",
+                "treatment",
+                "at",
+                "home."
+            ],
+            [
+                "5-",
+                "Switch",
+                "to",
+                "a",
+                "combination",
+                "with",
+                "high",
+                "doses",
+                "of",
+                "budesonide",
+                "and",
+                "formoterol."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "The",
+                "indication",
+                "of",
+                "omalizumab",
+                "in",
+                "a",
+                "patient",
+                "such",
+                "as",
+                "the",
+                "one",
+                "referred",
+                "to",
+                "is",
+                "a",
+                "correct",
+                "indication,",
+                "although",
+                "in",
+                "severe",
+                "asthma",
+                "that",
+                "is",
+                "difficult",
+                "to",
+                "control,",
+                "there",
+                "are",
+                "other",
+                "prior",
+                "measures",
+                "that",
+                "are",
+                "not",
+                "contemplated",
+                "and",
+                "that",
+                "must",
+                "always",
+                "be",
+                "taken",
+                "into",
+                "account",
+                "before",
+                "resorting",
+                "to",
+                "this",
+                "treatment."
+            ],
+            [
+                "It",
+                "is",
+                "mandatory",
+                "to",
+                "ensure",
+                "firstly",
+                "that",
+                "it",
+                "is",
+                "truly",
+                "asthma",
+                "and",
+                "not",
+                "another",
+                "disease",
+                "that",
+                "simulates",
+                "asthma,",
+                "secondly",
+                "that",
+                "there",
+                "are",
+                "no",
+                "complications",
+                "that",
+                "worsen",
+                "the",
+                "evolution",
+                "as",
+                "could",
+                "be",
+                "the",
+                "presence",
+                "of",
+                "gastroesophageal",
+                "reflux,",
+                "bronchiectasis,",
+                "presence",
+                "of",
+                "opportunistic",
+                "germs",
+                "given",
+                "the",
+                "chronic",
+                "treatment",
+                "with",
+                "steroids,",
+                "etc;",
+                "and",
+                "thirdly,",
+                "it",
+                "is",
+                "necessary",
+                "to",
+                "confirm",
+                "that",
+                "the",
+                "patient",
+                "complies",
+                "with",
+                "the",
+                "treatments",
+                "correctly,",
+                "especially",
+                "the",
+                "inhaled",
+                "treatment,",
+                "etc."
+            ],
+            [
+                "Once",
+                "all",
+                "of",
+                "the",
+                "above",
+                "has",
+                "been",
+                "checked,",
+                "it",
+                "would",
+                "be",
+                "time",
+                "to",
+                "start",
+                "a",
+                "trial",
+                "treatment",
+                "with",
+                "omalizumab."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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",
+                "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",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "480_171",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "58_199",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GENETICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "An",
+                "asymptomatic",
+                "31-year-old",
+                "woman",
+                "(Consultant)",
+                "is",
+                "asymptomatic",
+                "and",
+                "has",
+                "a",
+                "10-week",
+                "gestation",
+                "according",
+                "to",
+                "ultrasound",
+                "study",
+                "(primiparous)."
+            ],
+            [
+                "Her",
+                "younger",
+                "brother",
+                "(index",
+                "case)",
+                "aged",
+                "26",
+                "years",
+                "is",
+                "affected",
+                "by",
+                "ataxia",
+                "and",
+                "genetically",
+                "diagnosed",
+                "as",
+                "a",
+                "heterozygous",
+                "carrier",
+                "of",
+                "an",
+                "expansive",
+                "mutation",
+                "of",
+                "70",
+                "CAG",
+                "repeats",
+                "in",
+                "the",
+                "SCA3",
+                "gene",
+                "(chromosome",
+                "14)."
+            ],
+            [
+                "The",
+                "patient",
+                "is",
+                "referred",
+                "to",
+                "the",
+                "genetic",
+                "counseling",
+                "office",
+                "where",
+                "a",
+                "possible",
+                "chorionic",
+                "villus",
+                "biopsy",
+                "to",
+                "study",
+                "the",
+                "fetal",
+                "genotype",
+                "is",
+                "evaluated."
+            ],
+            [
+                "Is",
+                "this",
+                "invasive",
+                "procedure",
+                "indicated",
+                "as",
+                "a",
+                "pre-natal",
+                "diagnosis",
+                "(PND)",
+                "in",
+                "this",
+                "case?"
+            ],
+            [
+                "1-",
+                "It",
+                "is",
+                "indicated",
+                "after",
+                "studying",
+                "the",
+                "Consultant's",
+                "genotype",
+                "and",
+                "only",
+                "if",
+                "it",
+                "is",
+                "heterozygous."
+            ],
+            [
+                "2-",
+                "This",
+                "is",
+                "not",
+                "indicated,",
+                "since",
+                "SCA3",
+                "ataxia",
+                "is",
+                "full",
+                "penetrance",
+                "and",
+                "the",
+                "Consultant",
+                "is",
+                "asymptomatic",
+                "and",
+                "therefore",
+                "has",
+                "not",
+                "inherited",
+                "the",
+                "mutation."
+            ],
+            [
+                "3-",
+                "It",
+                "may",
+                "be",
+                "indicated",
+                "in",
+                "the",
+                "next",
+                "pregnancy,",
+                "after",
+                "studying",
+                "the",
+                "genotype",
+                "of",
+                "the",
+                "first",
+                "child",
+                "and",
+                "detecting",
+                "the",
+                "mutation",
+                "in",
+                "it."
+            ],
+            [
+                "4-",
+                "SCA3",
+                "ataxia",
+                "is",
+                "recessively",
+                "inherited,",
+                "so",
+                "there",
+                "is",
+                "no",
+                "appreciable",
+                "risk",
+                "of",
+                "disease",
+                "transmission",
+                "and",
+                "PND",
+                "is",
+                "not",
+                "indicated."
+            ],
+            [
+                "5-",
+                "This",
+                "is",
+                "indicated",
+                "regardless",
+                "of",
+                "the",
+                "Consultant's",
+                "genotype,",
+                "since",
+                "SCA3",
+                "ataxia",
+                "is",
+                "maternally",
+                "inherited",
+                "(transmitted",
+                "by",
+                "women)."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "SCA3",
+                "is",
+                "Spinocerebellar",
+                "Ataxia",
+                "type",
+                "3",
+                "also",
+                "called",
+                "Machado-Joseph",
+                "disease."
+            ],
+            [
+                "It",
+                "is",
+                "caused",
+                "by",
+                "mutations",
+                "in",
+                "the",
+                "ATXN3",
+                "gene",
+                "by",
+                "the",
+                "CAG",
+                "triplet",
+                "repeat",
+                "expansion",
+                "mechanism."
+            ],
+            [
+                "Affected",
+                "individuals",
+                "have",
+                "between",
+                "52",
+                "and",
+                "86",
+                "CAG",
+                "triplet",
+                "repeats",
+                "in",
+                "heterozygosis",
+                "with",
+                "complete",
+                "penetrance."
+            ],
+            [
+                "The",
+                "heterozygous",
+                "mutation",
+                "carrier",
+                "has",
+                "the",
+                "disease",
+                "as",
+                "its",
+                "inheritance",
+                "pattern",
+                "is",
+                "autosomal",
+                "dominant."
+            ],
+            [
+                "In",
+                "this",
+                "clinical",
+                "case,",
+                "the",
+                "one",
+                "who",
+                "has",
+                "the",
+                "disease",
+                "and",
+                "has",
+                "the",
+                "mutated",
+                "gene",
+                "in",
+                "heterozygosis",
+                "is",
+                "the",
+                "brother",
+                "(26",
+                "years",
+                "old)",
+                "of",
+                "the",
+                "pregnant",
+                "woman."
+            ],
+            [
+                "I",
+                "think",
+                "that",
+                "before",
+                "doing",
+                "the",
+                "chorion",
+                "biopsy,",
+                "the",
+                "pregnant",
+                "woman",
+                "should",
+                "be",
+                "tested",
+                "to",
+                "know",
+                "her",
+                "ATXN3",
+                "gene",
+                "status."
+            ],
+            [
+                "She",
+                "has",
+                "a",
+                "50%",
+                "chance",
+                "of",
+                "carrying",
+                "the",
+                "mutation",
+                "and",
+                "having",
+                "the",
+                "disease,",
+                "but",
+                "since",
+                "she",
+                "is",
+                "31",
+                "years",
+                "old,",
+                "I",
+                "think",
+                "she",
+                "should",
+                "have",
+                "already",
+                "had",
+                "symptoms."
+            ],
+            [
+                "Nevertheless,",
+                "I",
+                "would",
+                "do",
+                "the",
+                "genetic",
+                "test",
+                "on",
+                "the",
+                "pregnant",
+                "woman",
+                "to",
+                "be",
+                "on",
+                "the",
+                "safe",
+                "side."
+            ],
+            [
+                "If",
+                "she",
+                "came",
+                "out",
+                "without",
+                "the",
+                "mutation,",
+                "there",
+                "would",
+                "be",
+                "nothing",
+                "more",
+                "to",
+                "do",
+                "because",
+                "the",
+                "disease",
+                "would",
+                "no",
+                "longer",
+                "be",
+                "transmitted."
+            ],
+            [
+                "If",
+                "she",
+                "came",
+                "out",
+                "with",
+                "the",
+                "mutation,",
+                "then",
+                "I",
+                "would",
+                "do",
+                "a",
+                "chorionic",
+                "villus",
+                "biopsy."
+            ],
+            [
+                "Answers",
+                "1",
+                "and",
+                "2",
+                "are",
+                "both",
+                "true,",
+                "but",
+                "I",
+                "think",
+                "answer",
+                "1",
+                "is",
+                "more",
+                "true",
+                "than",
+                "answer",
+                "2."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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"
+            ],
+            [
+                "B-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "51_230",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PEDIATRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "37-week",
+                "pregnant",
+                "woman",
+                "with",
+                "positive",
+                "hepatitis",
+                "B",
+                "virus",
+                "surface",
+                "antigen."
+            ],
+            [
+                "She",
+                "consults",
+                "about",
+                "the",
+                "guidelines",
+                "to",
+                "be",
+                "followed",
+                "with",
+                "the",
+                "newborn",
+                "and",
+                "whether",
+                "she",
+                "can",
+                "breastfeed."
+            ],
+            [
+                "What",
+                "advice",
+                "do",
+                "you",
+                "think",
+                "is",
+                "most",
+                "appropriate?"
+            ],
+            [
+                "1-",
+                "Administer",
+                "hepatitis",
+                "B",
+                "vaccine",
+                "at",
+                "birth.",
+                "Artificial",
+                "feeding."
+            ],
+            [
+                "2-",
+                "Vaccination",
+                "and",
+                "immunoglobulins",
+                "should",
+                "be",
+                "administered",
+                "at",
+                "birth.",
+                "Breastfeeding",
+                "from",
+                "one",
+                "month",
+                "onwards."
+            ],
+            [
+                "3-",
+                "Immunoglobulins",
+                "at",
+                "birth",
+                "and",
+                "artificial",
+                "breastfeeding."
+            ],
+            [
+                "4-",
+                "Vaccination",
+                "and",
+                "immunoglobulins",
+                "at",
+                "birth.",
+                "Maternal",
+                "feeding."
+            ],
+            [
+                "5-",
+                "Artificial",
+                "feeding",
+                "and",
+                "isolation",
+                "for",
+                "4",
+                "weeks."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is",
+                "4."
+            ],
+            [
+                "Children",
+                "born",
+                "to",
+                "HBV",
+                "carrier",
+                "mothers",
+                "should",
+                "be",
+                "administered",
+                "hepatitis",
+                "B",
+                "vaccine",
+                "and",
+                "immunoglobulin",
+                "at",
+                "different",
+                "puncture",
+                "sites",
+                "within",
+                "the",
+                "first",
+                "24",
+                "hours",
+                "of",
+                "life."
+            ],
+            [
+                "Although",
+                "the",
+                "virus",
+                "is",
+                "excreted",
+                "in",
+                "breast",
+                "milk,",
+                "the",
+                "risk",
+                "of",
+                "infection",
+                "by",
+                "this",
+                "route",
+                "is",
+                "very",
+                "low",
+                "and",
+                "therefore",
+                "it",
+                "is",
+                "not",
+                "currently",
+                "a",
+                "contraindication",
+                "for",
+                "breastfeeding."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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",
+                "O",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "184_65",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "patient",
+                "with",
+                "obesity",
+                "(body",
+                "mass",
+                "index",
+                "38)",
+                "is",
+                "referred",
+                "to",
+                "your",
+                "office."
+            ],
+            [
+                "In",
+                "the",
+                "clinical",
+                "history",
+                "the",
+                "patient",
+                "refers",
+                "that",
+                "he/she",
+                "has",
+                "been",
+                "obese",
+                "since",
+                "the",
+                "age",
+                "of",
+                "17",
+                "(currently",
+                "36",
+                "years",
+                "old),",
+                "having",
+                "been",
+                "on",
+                "multiple",
+                "diets",
+                "with",
+                "weight",
+                "loss",
+                "ranging",
+                "from",
+                "5",
+                "to",
+                "10",
+                "kg",
+                "but",
+                "has",
+                "subsequently",
+                "regained",
+                "weight."
+            ],
+            [
+                "The",
+                "patient",
+                "is",
+                "currently",
+                "on",
+                "a",
+                "1500",
+                "Kcal",
+                "diet",
+                "(self-administered",
+                "and",
+                "not",
+                "restricted",
+                "in",
+                "fat)",
+                "with",
+                "a",
+                "good",
+                "follow-up",
+                "of",
+                "this",
+                "diet,",
+                "performing",
+                "one",
+                "hour",
+                "of",
+                "aerobic",
+                "exercise",
+                "4",
+                "days",
+                "a",
+                "week."
+            ],
+            [
+                "She",
+                "has",
+                "lost",
+                "3",
+                "kg",
+                "but",
+                "needs",
+                "an",
+                "additional",
+                "loss",
+                "of",
+                "7",
+                "kg",
+                "more."
+            ],
+            [
+                "Given",
+                "the",
+                "possibility",
+                "of",
+                "adding",
+                "a",
+                "drug",
+                "against",
+                "obesity,",
+                "which",
+                "one",
+                "would",
+                "you",
+                "use",
+                "to",
+                "reduce",
+                "fat",
+                "absorption?"
+            ],
+            [
+                "1-",
+                "Orlistat."
+            ],
+            [
+                "2-",
+                "Topiramate."
+            ],
+            [
+                "3-",
+                "Sibutramine."
+            ],
+            [
+                "4-",
+                "Liraglutide."
+            ],
+            [
+                "5-",
+                "Metformin."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Orlistat",
+                "acts",
+                "by",
+                "decreasing",
+                "fat",
+                "absorption;",
+                "it",
+                "is",
+                "currently",
+                "the",
+                "only",
+                "drug",
+                "approved",
+                "for",
+                "use",
+                "in",
+                "obesity."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "295_75",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GENETICS",
+                "AND",
+                "IMMUNOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "Indicate",
+                "the",
+                "clinical",
+                "situation",
+                "that,",
+                "in",
+                "relation",
+                "to",
+                "hepatitis",
+                "B",
+                "virus",
+                "infection,",
+                "presents",
+                "a",
+                "5-year-old",
+                "patient",
+                "from",
+                "Nigeria,",
+                "with",
+                "normal",
+                "physical",
+                "examination",
+                "and",
+                "with",
+                "the",
+                "following",
+                "serology",
+                "against",
+                "hepatitis",
+                "B:",
+                "HBsAg",
+                "+",
+                "/",
+                "ANTI-",
+                "HBs",
+                "-",
+                "/",
+                "HBeAg",
+                "-",
+                "/",
+                "ANTI-",
+                "Hbe",
+                "+",
+                "/",
+                "ANTI-",
+                "Hbc",
+                "IgM",
+                "-",
+                "/",
+                "ANTI-",
+                "Hbc",
+                "IgG",
+                "+/",
+                "DNA",
+                "HBV",
+                "+:"
+            ],
+            [
+                "1-",
+                "Acute",
+                "infection."
+            ],
+            [
+                "2-",
+                "Chronic",
+                "infection."
+            ],
+            [
+                "3-",
+                "Vaccinated",
+                "patient."
+            ],
+            [
+                "4-",
+                "Asymptomatic",
+                "carrier."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Question",
+                "in",
+                "which",
+                "having",
+                "a",
+                "table",
+                "in",
+                "the",
+                "head",
+                "comes",
+                "out",
+                "alone",
+                "discarding",
+                "options:",
+                "Option",
+                "1:",
+                "The",
+                "acute",
+                "infection",
+                "would",
+                "be",
+                "HBeAg",
+                "+",
+                "and",
+                "ANTI-HBe",
+                "-",
+                ".",
+                "In",
+                "addition",
+                "the",
+                "ANTI-HBec",
+                "would",
+                "be",
+                "IgM",
+                "type",
+                "(only",
+                "for",
+                "this",
+                "last",
+                "data,",
+                "we",
+                "would",
+                "have",
+                "to",
+                "discard",
+                "it",
+                "in",
+                "a",
+                "direct",
+                "way)."
+            ],
+            [
+                "Option",
+                "2:",
+                "the",
+                "correct",
+                "one."
+            ],
+            [
+                "It",
+                "complies",
+                "with",
+                "all",
+                "the",
+                "characteristics."
+            ],
+            [
+                "Option",
+                "3:",
+                "The",
+                "vaccinated",
+                "patient",
+                "cannot",
+                "have",
+                "DNA",
+                "of",
+                "the",
+                "virus",
+                "(the",
+                "only",
+                "thing",
+                "that",
+                "positivizes",
+                "in",
+                "a",
+                "vaccinated",
+                "patient",
+                "is",
+                "the",
+                "AntiBs.",
+                "IgG",
+                "type)."
+            ],
+            [
+                "Option",
+                "4:",
+                "The",
+                "option",
+                "that",
+                "could",
+                "offer",
+                "more",
+                "doubts."
+            ],
+            [
+                "In",
+                "the",
+                "asymptomatic",
+                "carrier",
+                "(chronic",
+                "carrier",
+                "/",
+                "seroconverted)",
+                "the",
+                "difference",
+                "is",
+                "that",
+                "there",
+                "is",
+                "no",
+                "viral",
+                "DNA."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "B-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-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
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+    },
+    {
+        "id": "559_160",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "HEMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
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+                "woman,",
+                "taking",
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+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "with",
+                "febrile",
+                "syndrome",
+                "and",
+                "paresthesias",
+                "in",
+                "the",
+                "left",
+                "hemibody."
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+            [
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+                "show",
+                "Hb",
+                "7.5",
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+                "platelets",
+                "7,000/microl,",
+                "normal",
+                "leukocytes",
+                "with",
+                "normal",
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+                "count,",
+                "LDH",
+                "1,200",
+                "IU/l,",
+                "reticulocytes",
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+                "(normal",
+                "0.5-2%),",
+                "undetectable",
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+                "and",
+                "peripheral",
+                "blood",
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+                "with",
+                "schistocytes."
+            ],
+            [
+                "Coagulation",
+                "(prothrombin",
+                "time",
+                "and",
+                "APTT)",
+                "normal."
+            ],
+            [
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+                "of",
+                "the",
+                "following",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis:"
+            ],
+            [
+                "1-",
+                "Autoimmune",
+                "hemolytic",
+                "anemia."
+            ],
+            [
+                "2-",
+                "Thrombotic",
+                "thrombocytopenic",
+                "purpura."
+            ],
+            [
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+                "Evans",
+                "syndrome",
+                "(hemolytic",
+                "anemia",
+                "and",
+                "immune",
+                "thrombopenia)."
+            ],
+            [
+                "4-",
+                "Idiopathic",
+                "immune",
+                "thrombocytopenia."
+            ],
+            [
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+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
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+                "fear",
+                "of",
+                "all",
+                "on-call",
+                "hematologists...",
+                "that",
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+                "get",
+                "a",
+                "TTP."
+            ],
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+                "although",
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+                "it",
+                "is",
+                "the",
+                "greatest",
+                "hematologic",
+                "emergency."
+            ],
+            [
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+                "clinical",
+                "case",
+                "is",
+                "fairly",
+                "typical."
+            ],
+            [
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+                "young",
+                "person",
+                "with",
+                "fever",
+                "and",
+                "neurological",
+                "symptoms",
+                "that",
+                "make",
+                "him",
+                "go",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "(he",
+                "is",
+                "on",
+                "the",
+                "run)."
+            ],
+            [
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+                "tests",
+                "show",
+                "anemia",
+                "with",
+                "evidence",
+                "of",
+                "hemolysis",
+                "(increased",
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+                "and",
+                "retis,",
+                "presence",
+                "of",
+                "schistocytes",
+                "in",
+                "peripheral",
+                "blood)",
+                "and",
+                "severe",
+                "thrombopenia."
+            ],
+            [
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+                "addition,",
+                "coagulation",
+                "is",
+                "normal."
+            ],
+            [
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+                "distinguish",
+                "it",
+                "from",
+                "the",
+                "rest",
+                "of",
+                "things",
+                "(although",
+                "you",
+                "should",
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+                "you",
+                "that",
+                "the",
+                "coombs",
+                "is",
+                "negative."
+            ],
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+                "a",
+                "reminder:",
+                "URGENT",
+                "TREATMENT:",
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+                "but",
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+                "value,",
+                "which",
+                "is",
+                "not",
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+                "done",
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+            ],
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+                "as",
+                "we",
+                "all",
+                "know,",
+                "these",
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+                "usually",
+                "come",
+                "at",
+                "night",
+                "and/or",
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+                "to",
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+                "things",
+                "more",
+                "difficult...."
+            ]
+        ],
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+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
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+                "I-Claim",
+                "I-Claim"
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "O"
+            ],
+            [
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+                "O",
+                "O"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
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+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise",
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+                "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",
+                "B-Premise",
+                "I-Premise",
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+                "I-Premise",
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+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
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+            ],
+            [
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+                "O",
+                "O",
+                "O",
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+                "O",
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+            ],
+            [
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+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "558_160",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "HEMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "35-year-old",
+                "woman,",
+                "taking",
+                "contraceptives,",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "with",
+                "febrile",
+                "syndrome",
+                "and",
+                "paresthesias",
+                "in",
+                "the",
+                "left",
+                "hemibody."
+            ],
+            [
+                "Blood",
+                "tests",
+                "showed",
+                "Hb",
+                "7.5",
+                "g/dL,",
+                "platelets",
+                "7,000/microl,",
+                "normal",
+                "leukocytes",
+                "with",
+                "normal",
+                "differential",
+                "count,",
+                "LDH",
+                "1,200",
+                "IU/l,",
+                "reticulocytes",
+                "10%",
+                "(normal",
+                "0.5-2%),",
+                "undetectable",
+                "serum",
+                "haptoglobin,",
+                "negative",
+                "direct",
+                "Coombs'",
+                "test",
+                "and",
+                "peripheral",
+                "blood",
+                "smear",
+                "with",
+                "schistocytes."
+            ],
+            [
+                "Coagulation",
+                "(prothrombin",
+                "time",
+                "and",
+                "APTT)",
+                "normal."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis:"
+            ],
+            [
+                "1-",
+                "Autoimmune",
+                "hemolytic",
+                "anemia."
+            ],
+            [
+                "2-",
+                "Thrombotic",
+                "thrombocytopenic",
+                "purpura."
+            ],
+            [
+                "3-",
+                "Evans",
+                "syndrome",
+                "(hemolytic",
+                "anemia",
+                "and",
+                "immune",
+                "thrombopenia)."
+            ],
+            [
+                "4-",
+                "Idiopathic",
+                "immune",
+                "thrombocytopenia."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "The",
+                "patient",
+                "presents",
+                "criteria",
+                "for",
+                "Thrombotic",
+                "Thrombocytopenic",
+                "Purpura",
+                "(TTP):",
+                "1."
+            ],
+            [
+                "Neurological",
+                "alteration."
+            ],
+            [
+                "2."
+            ],
+            [
+                "Febrile",
+                "syndrome",
+                "(fever)."
+            ],
+            [
+                "3."
+            ],
+            [
+                "Coombs",
+                "negative",
+                "migroangiopathic",
+                "hemolytic",
+                "anemia",
+                "(presence",
+                "of",
+                "schistocytes)."
+            ],
+            [
+                "4."
+            ],
+            [
+                "Thrombopenia."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
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+            [
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
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+                "I-Premise",
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+                "I-Premise",
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+            [
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+                "O",
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+                "I-Claim",
+                "I-Claim"
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+            ],
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+            ],
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
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+                "I-Claim",
+                "O"
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+    },
+    {
+        "id": "227_72",
+        "text": [
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+                "QUESTION",
+                "TYPE:",
+                "CARDIOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
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+                "A",
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+                "history",
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+                "murmur",
+                "detected",
+                "in",
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+                "to",
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+                "easy",
+                "fatigue",
+                "and",
+                "malleolar",
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+                "absence",
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+                "by",
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+                "oximeter",
+                "97%",
+                "BP",
+                "120/80",
+                "mmHg."
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+            [
+                "Irregular",
+                "heart",
+                "rhythm",
+                "at",
+                "100",
+                "bpm."
+            ],
+            [
+                "Ejective",
+                "systolic",
+                "murmur",
+                "(2/6)",
+                "in",
+                "pulmonary",
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+                "unfolded",
+                "noise,",
+                "wide",
+                "and",
+                "fixed."
+            ],
+            [
+                "No",
+                "rales."
+            ],
+            [
+                "Slight",
+                "hepatomeglaia",
+                "(2-3",
+                "cm)."
+            ],
+            [
+                "Slight",
+                "malleolar",
+                "edema."
+            ],
+            [
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+                "complete",
+                "arrhythmia",
+                "due",
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+                "atrial",
+                "fibrillation",
+                "at",
+                "100",
+                "bpm."
+            ],
+            [
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+                "branch",
+                "of",
+                "the",
+                "His",
+                "bundle."
+            ],
+            [
+                "What",
+                "is",
+                "its",
+                "diagnostic",
+                "orientation?"
+            ],
+            [
+                "1-",
+                "Ventricular",
+                "septal",
+                "defect."
+            ],
+            [
+                "2-",
+                "Aortic",
+                "stenosis."
+            ],
+            [
+                "3-",
+                "Mitral",
+                "stenosis."
+            ],
+            [
+                "4-",
+                "Atrial",
+                "septal",
+                "defect."
+            ],
+            [
+                "5-",
+                "Patent",
+                "ductus",
+                "arteriosus."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "If",
+                "he",
+                "has",
+                "a",
+                "pediatric",
+                "murmur,",
+                "I'm",
+                "thinking",
+                "congenital."
+            ],
+            [
+                "Hepatomegaly,",
+                "malleolar",
+                "edema",
+                "and",
+                "BRD,",
+                "something",
+                "that",
+                "overloads",
+                "the",
+                "right",
+                "heart."
+            ],
+            [
+                "So",
+                "we",
+                "rule",
+                "out",
+                "aortic",
+                "and",
+                "mitral",
+                "stenosis."
+            ],
+            [
+                "A",
+                "patent",
+                "ductus",
+                "would",
+                "give",
+                "cyanosis:",
+                "ruled",
+                "out."
+            ],
+            [
+                "VSD",
+                "or",
+                "ASD?"
+            ],
+            [
+                "If",
+                "I",
+                "am",
+                "told",
+                "that",
+                "he",
+                "has",
+                "AF,",
+                "it",
+                "is",
+                "because",
+                "the",
+                "atria",
+                "are",
+                "of",
+                "size",
+                "XL,",
+                "and",
+                "a",
+                "VSD",
+                "does",
+                "not",
+                "produce",
+                "atrial",
+                "dilatation."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "168_86",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CARDIOLOGY",
+                "AND",
+                "CARDIOVASCULAR",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "What",
+                "examination",
+                "would",
+                "you",
+                "advise",
+                "in",
+                "the",
+                "first",
+                "place",
+                "for",
+                "an",
+                "82-year-old",
+                "patient",
+                "with",
+                "exertional",
+                "angina",
+                "and",
+                "a",
+                "systolic",
+                "ejection",
+                "murmur",
+                "of",
+                "intensity",
+                "3/6",
+                "on",
+                "auscultation?"
+            ],
+            [
+                "1-",
+                "A",
+                "stress",
+                "test."
+            ],
+            [
+                "2-",
+                "Coronary",
+                "angiography."
+            ],
+            [
+                "3-",
+                "Exercise",
+                "echocardiogram."
+            ],
+            [
+                "4-",
+                "Coronary",
+                "CT",
+                "scan."
+            ],
+            [
+                "5-",
+                "Doppler",
+                "echocardiogram."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "Ejective",
+                "murmur,",
+                "our",
+                "first",
+                "suspicion",
+                "is",
+                "aortic",
+                "stenosis."
+            ],
+            [
+                "Angina",
+                "may",
+                "be",
+                "due",
+                "to",
+                "the",
+                "stenosis",
+                "itself",
+                "or",
+                "to",
+                "underlying",
+                "coronary",
+                "artery",
+                "disease",
+                "(probable,",
+                "given",
+                "the",
+                "age)."
+            ],
+            [
+                "And",
+                "with",
+                "this",
+                "information,",
+                "we",
+                "cannot",
+                "know",
+                "if",
+                "the",
+                "stenosis",
+                "is",
+                "severe."
+            ],
+            [
+                "Therefore,",
+                "the",
+                "first",
+                "thing",
+                "we",
+                "will",
+                "have",
+                "to",
+                "do",
+                "will",
+                "be",
+                "to",
+                "study",
+                "the",
+                "valve",
+                "disease:",
+                "we",
+                "do",
+                "not",
+                "want",
+                "to",
+                "put",
+                "the",
+                "patient",
+                "to",
+                "run",
+                "or",
+                "overload",
+                "him",
+                "with",
+                "dobuta",
+                "and",
+                "have",
+                "a",
+                "syncope,",
+                "nor",
+                "do",
+                "we",
+                "want",
+                "to",
+                "do",
+                "a",
+                "catheterization",
+                "without",
+                "having",
+                "first",
+                "performed",
+                "another",
+                "noninvasive",
+                "test."
+            ],
+            [
+                "And",
+                "cardioTC,",
+                "in",
+                "someone",
+                "80",
+                "years",
+                "old,",
+                "is",
+                "going",
+                "to",
+                "tell",
+                "us",
+                "what",
+                "we",
+                "already",
+                "know:",
+                "that",
+                "he",
+                "has",
+                "calcium",
+                "up",
+                "to",
+                "his",
+                "eyebrows."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "329_84",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "447_131",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEPHROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "25-year-old",
+                "man",
+                "with",
+                "no",
+                "known",
+                "history",
+                "of",
+                "interest."
+            ],
+            [
+                "He",
+                "has",
+                "been",
+                "presenting",
+                "with",
+                "foamy",
+                "and",
+                "loaded",
+                "urine",
+                "for",
+                "2",
+                "months,",
+                "with",
+                "no",
+                "other",
+                "symptoms."
+            ],
+            [
+                "Physical",
+                "examination",
+                "without",
+                "findings."
+            ],
+            [
+                "Elemental",
+                "urine:",
+                "pH",
+                "5;",
+                "glucose",
+                "negative;",
+                "hemoglobin",
+                "++;",
+                "protein",
+                "++;",
+                "leukocyte",
+                "esterase",
+                "negative;",
+                "proteinuria",
+                "1.5",
+                "g/24",
+                "hours;",
+                "urinary",
+                "Na",
+                "60",
+                "mEq/L;",
+                "urinary",
+                "K",
+                "30",
+                "mEq/L;",
+                "urinary",
+                "Cl",
+                "100",
+                "mEq/L."
+            ],
+            [
+                "Blood",
+                "biochemistry:",
+                "creatinine",
+                "1.6",
+                "mg/dL;",
+                "urea",
+                "80",
+                "mg/dL;",
+                "Na",
+                "140",
+                "mEq/L;",
+                "K",
+                "3.8",
+                "mEq/L."
+            ],
+            [
+                "Immunological",
+                "study:",
+                "antiDNA",
+                "negative;",
+                "ANCA",
+                "negative;",
+                "antiMBG",
+                "negative,",
+                "rheumatoid",
+                "factor",
+                "negative;",
+                "C3",
+                "20",
+                "mg/dL",
+                "(normal",
+                "60-120);",
+                "C4",
+                "10",
+                "mg/dL",
+                "(normal",
+                "20-40)."
+            ],
+            [
+                "A",
+                "renal",
+                "biopsy",
+                "is",
+                "performed."
+            ],
+            [
+                "Which",
+                "of",
+                "these",
+                "diagnoses",
+                "do",
+                "you",
+                "think",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "to",
+                "be",
+                "found",
+                "in",
+                "the",
+                "biopsy?"
+            ],
+            [
+                "1-",
+                "Membranous",
+                "glomerulonephritis."
+            ],
+            [
+                "2-",
+                "Glomerulonephritis",
+                "with",
+                "minimal",
+                "changes."
+            ],
+            [
+                "3-",
+                "Mesangial",
+                "IgA",
+                "glomerulonephritis."
+            ],
+            [
+                "4-",
+                "Membranoproliferative",
+                "glomerulonephritis."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "We",
+                "are",
+                "presented",
+                "with",
+                "a",
+                "lot",
+                "of",
+                "analytical",
+                "data",
+                "but",
+                "we",
+                "only",
+                "have",
+                "to",
+                "look",
+                "at",
+                "two:",
+                "the",
+                "levels",
+                "of",
+                "complement",
+                "fractions",
+                "C3",
+                "and",
+                "C4",
+                "are",
+                "low."
+            ],
+            [
+                "Of",
+                "the",
+                "options",
+                "given,",
+                "only",
+                "membranoproliferative",
+                "glomerulonephritis",
+                "presents",
+                "with",
+                "hypocomplementemia",
+                "(option",
+                "4",
+                "correct)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "72_52",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ANESTHESIOLOGY,",
+                "CRITICAL",
+                "CARE",
+                "AND",
+                "EMERGENCIES"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "72-year-old",
+                "man,",
+                "ex-smoker,",
+                "hypertensive",
+                "and",
+                "diabetic."
+            ],
+            [
+                "History",
+                "of",
+                "stroke",
+                "with",
+                "residual",
+                "paresis",
+                "in",
+                "the",
+                "left",
+                "arm",
+                "4",
+                "months",
+                "ago."
+            ],
+            [
+                "He",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "of",
+                "a",
+                "regional",
+                "hospital",
+                "with",
+                "intense",
+                "precordial",
+                "pain",
+                "of",
+                "2",
+                "hours",
+                "of",
+                "evolution;",
+                "in",
+                "the",
+                "physical",
+                "examination",
+                "he",
+                "presents",
+                "cold",
+                "and",
+                "sweaty",
+                "skin,",
+                "blood",
+                "pressure",
+                "of",
+                "80",
+                "mm",
+                "Hg;",
+                "electrocardiogram",
+                "with",
+                "marked",
+                "ST",
+                "segment",
+                "elevation",
+                "in",
+                "leads",
+                "V1-V6,",
+                "I",
+                "and",
+                "aVL."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "treatments",
+                "of",
+                "coronary",
+                "repercussion",
+                "is",
+                "the",
+                "most",
+                "appropriate?"
+            ],
+            [
+                "1-",
+                "Immediate",
+                "systemic",
+                "fibrinolysis",
+                "at",
+                "the",
+                "regional",
+                "hospital."
+            ],
+            [
+                "2-",
+                "Immediate",
+                "transfer",
+                "to",
+                "a",
+                "tertiary",
+                "center",
+                "for",
+                "treatment",
+                "with",
+                "fibrinolysis."
+            ],
+            [
+                "3-",
+                "Immediate",
+                "transfer",
+                "to",
+                "a",
+                "tertiary",
+                "center",
+                "for",
+                "percutaneous",
+                "coronary",
+                "revascularization",
+                "procedure."
+            ],
+            [
+                "4-",
+                "Hemodynamic",
+                "stabilization",
+                "and",
+                "deferred",
+                "revascularization",
+                "procedure."
+            ],
+            [
+                "5-",
+                "Immediate",
+                "treatment",
+                "with",
+                "fondaparinux",
+                "and",
+                "abciximab."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "This",
+                "question",
+                "combines",
+                "several",
+                "important",
+                "facts."
+            ],
+            [
+                "To",
+                "begin",
+                "with,",
+                "this",
+                "is",
+                "a",
+                "patient",
+                "with",
+                "an",
+                "extensive",
+                "anterior",
+                "and",
+                "lateral",
+                "AMI,",
+                "with",
+                "cardiogenic",
+                "shock."
+            ],
+            [
+                "On",
+                "the",
+                "other",
+                "hand,",
+                "in",
+                "the",
+                "history,",
+                "we",
+                "are",
+                "told",
+                "that",
+                "the",
+                "patient",
+                "had",
+                "a",
+                "stroke",
+                "4",
+                "months",
+                "ago."
+            ],
+            [
+                "It",
+                "is",
+                "evident",
+                "from",
+                "the",
+                "patient's",
+                "clinical",
+                "picture",
+                "that",
+                "an",
+                "urgent",
+                "reperfusion",
+                "strategy",
+                "is",
+                "indicated,",
+                "which",
+                "invalidates",
+                "options",
+                "4",
+                "and",
+                "5."
+            ],
+            [
+                "The",
+                "basic",
+                "question",
+                "is",
+                "whether",
+                "to",
+                "choose",
+                "fibrinolysis",
+                "(which",
+                "can",
+                "be",
+                "done",
+                "in",
+                "a",
+                "regional",
+                "hospital)",
+                "or",
+                "PCI",
+                "(for",
+                "which",
+                "the",
+                "patient",
+                "should",
+                "be",
+                "referred",
+                "to",
+                "a",
+                "tertiary",
+                "center)."
+            ],
+            [
+                "Option",
+                "2",
+                "does",
+                "not",
+                "make",
+                "much",
+                "sense,",
+                "since",
+                "in",
+                "the",
+                "event",
+                "that",
+                "fibrinolysis",
+                "is",
+                "indicated,",
+                "it",
+                "would",
+                "only",
+                "be",
+                "a",
+                "waste",
+                "of",
+                "time",
+                "to",
+                "make",
+                "the",
+                "transfer."
+            ],
+            [
+                "A",
+                "history",
+                "of",
+                "stroke",
+                "(presumably",
+                "ischemic)",
+                "4",
+                "months",
+                "ago",
+                "is",
+                "a",
+                "relative",
+                "contraindication",
+                "for",
+                "fibrinolysis",
+                "(if",
+                "the",
+                "time",
+                "is",
+                "less",
+                "than",
+                "3",
+                "months",
+                "it",
+                "is",
+                "an",
+                "absolute",
+                "contraindication),",
+                "but",
+                "the",
+                "definitive",
+                "factor",
+                "that",
+                "tips",
+                "the",
+                "balance",
+                "towards",
+                "PCI",
+                "is",
+                "the",
+                "extent",
+                "of",
+                "AMI",
+                "and",
+                "the",
+                "presence",
+                "of",
+                "shock,",
+                "which",
+                "are",
+                "indications",
+                "for",
+                "urgent",
+                "PCI."
+            ],
+            [
+                "Therefore,",
+                "the",
+                "correct",
+                "answer",
+                "is",
+                "3."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "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",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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",
+                "B-Marker",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "505_85",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PSYCHIATRY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "79-year-old",
+                "patient",
+                "is",
+                "brought",
+                "to",
+                "the",
+                "ED",
+                "at",
+                "7",
+                "pm",
+                "from",
+                "a",
+                "nursing",
+                "home,",
+                "but",
+                "we",
+                "do",
+                "not",
+                "have",
+                "the",
+                "referral",
+                "report",
+                "and",
+                "therefore",
+                "do",
+                "not",
+                "know",
+                "his",
+                "history."
+            ],
+            [
+                "He",
+                "is",
+                "disoriented",
+                "in",
+                "time",
+                "and",
+                "space."
+            ],
+            [
+                "He",
+                "has",
+                "trouble",
+                "remembering",
+                "simple",
+                "information."
+            ],
+            [
+                "Sometimes",
+                "he",
+                "becomes",
+                "very",
+                "nervous",
+                "and",
+                "agitated,",
+                "because",
+                "he",
+                "sees",
+                "threatening",
+                "people,",
+                "even",
+                "when",
+                "he",
+                "is",
+                "alone."
+            ],
+            [
+                "At",
+                "other",
+                "times",
+                "he",
+                "appears",
+                "drowsy",
+                "and",
+                "inattentive."
+            ],
+            [
+                "The",
+                "main",
+                "data",
+                "supporting",
+                "the",
+                "diagnosis",
+                "of",
+                "delirium",
+                "as",
+                "opposed",
+                "to",
+                "dementia",
+                "is:"
+            ],
+            [
+                "1-",
+                "The",
+                "presence",
+                "of",
+                "visual",
+                "hallucinations."
+            ],
+            [
+                "2-",
+                "Cognitive",
+                "symptoms."
+            ],
+            [
+                "3-",
+                "Psychomotor",
+                "agitation."
+            ],
+            [
+                "4-",
+                "Fluctuation",
+                "of",
+                "the",
+                "alert",
+                "level."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Little",
+                "to",
+                "comment....",
+                "is",
+                "the",
+                "definition",
+                "of",
+                "delirium."
+            ],
+            [
+                "Altered",
+                "state",
+                "of",
+                "consciousness."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "B-Disease",
+                "B-Marker",
+                "I-Marker",
+                "I-Marker",
+                "B-Disease",
+                "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",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "360_93",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "HEMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "46-year-old",
+                "woman",
+                "with",
+                "a",
+                "history",
+                "of",
+                "rheumatic",
+                "valve",
+                "disease,",
+                "requiring",
+                "mitral",
+                "valve",
+                "replacement",
+                "with",
+                "a",
+                "mechanical",
+                "prosthesis."
+            ],
+            [
+                "The",
+                "initial",
+                "postoperative",
+                "evolution",
+                "is",
+                "favorable."
+            ],
+            [
+                "However,",
+                "after",
+                "starting",
+                "treatment",
+                "with",
+                "acenocoumarol,",
+                "she",
+                "develops",
+                "a",
+                "picture",
+                "of",
+                "skin",
+                "necrosis",
+                "affecting",
+                "the",
+                "abdominal",
+                "region",
+                "and",
+                "extremities."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "alterations",
+                "would",
+                "justify",
+                "this",
+                "picture?"
+            ],
+            [
+                "1-",
+                "Antithrombin",
+                "deficiency."
+            ],
+            [
+                "2-",
+                "Factor",
+                "V",
+                "Leiden."
+            ],
+            [
+                "3-",
+                "Hyperhomocysteinemia."
+            ],
+            [
+                "4-",
+                "Protein",
+                "C",
+                "deficiency."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Warfarin-induced",
+                "skin",
+                "necrosis",
+                "is",
+                "a",
+                "rare",
+                "and",
+                "serious",
+                "adverse",
+                "effect",
+                "of",
+                "oral",
+                "anticoagulant",
+                "therapy,",
+                "occurring",
+                "in",
+                "only",
+                "0.01",
+                "to",
+                "0.1%",
+                "of",
+                "patients",
+                "and",
+                "is",
+                "especially",
+                "related",
+                "to",
+                "coagulation",
+                "protein",
+                "C",
+                "and",
+                "S",
+                "deficiency."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "459_173",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "TRAUMATOLOGY",
+                "AND",
+                "ORTHOPEDICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "36-year-old",
+                "man",
+                "with",
+                "no",
+                "past",
+                "history",
+                "of",
+                "interest",
+                "who,",
+                "after",
+                "a",
+                "high-energy",
+                "trauma",
+                "following",
+                "a",
+                "fall",
+                "from",
+                "a",
+                "motorcycle,",
+                "presents",
+                "with",
+                "a",
+                "Gustilo",
+                "grade",
+                "II",
+                "open",
+                "midshaft",
+                "fracture",
+                "of",
+                "the",
+                "tibia."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "maneuvers",
+                "or",
+                "therapies",
+                "is",
+                "most",
+                "effective",
+                "for",
+                "preventing",
+                "infection?"
+            ],
+            [
+                "1-",
+                "Immediate",
+                "intravenous",
+                "broad-spectrum",
+                "antibiotherapy."
+            ],
+            [
+                "2-",
+                "Exhaustive",
+                "debridement-wound",
+                "lavage",
+                "in",
+                "the",
+                "operating",
+                "room",
+                "with",
+                "at",
+                "least",
+                "10",
+                "liters",
+                "of",
+                "saline."
+            ],
+            [
+                "3-",
+                "Urgent",
+                "stabilization",
+                "of",
+                "the",
+                "fracture",
+                "by",
+                "external",
+                "fixation",
+                "and",
+                "early",
+                "wound",
+                "closure."
+            ],
+            [
+                "4-",
+                "Early",
+                "wound",
+                "closure",
+                "with",
+                "antiseptics",
+                "and",
+                "oxygen",
+                "therapy",
+                "at",
+                "two",
+                "liters",
+                "per",
+                "minute."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "I",
+                "believe",
+                "that",
+                "the",
+                "most",
+                "correct",
+                "is",
+                "2,",
+                "since",
+                "Gustilo",
+                "II",
+                "fractures",
+                "are",
+                "mainly",
+                "covered",
+                "with",
+                "Gram",
+                "(+)",
+                "by",
+                "means",
+                "of",
+                "a",
+                "1st",
+                "generation",
+                "Cepha,",
+                "and",
+                "it",
+                "is",
+                "not",
+                "a",
+                "question",
+                "of",
+                "prevention",
+                "but",
+                "of",
+                "treatment",
+                "(it",
+                "is",
+                "considered",
+                "to",
+                "be",
+                "contaminated)."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-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",
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "149_162",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "PSYCHIATRY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "52-year-old",
+                "woman",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "room",
+                "with",
+                "bilateral",
+                "paralysis",
+                "of",
+                "the",
+                "upper",
+                "extremities",
+                "that",
+                "had",
+                "started",
+                "abruptly",
+                "two",
+                "hours",
+                "earlier."
+            ],
+            [
+                "In",
+                "the",
+                "interview",
+                "she",
+                "is",
+                "smiling",
+                "and",
+                "says",
+                "she",
+                "does",
+                "not",
+                "understand",
+                "why",
+                "her",
+                "family",
+                "is",
+                "so",
+                "worried."
+            ],
+            [
+                "The",
+                "family",
+                "refers",
+                "that",
+                "the",
+                "day",
+                "before",
+                "her",
+                "son",
+                "had",
+                "been",
+                "arrested",
+                "by",
+                "the",
+                "police",
+                "for",
+                "drug",
+                "trafficking",
+                "and",
+                "they",
+                "had",
+                "not",
+                "yet",
+                "been",
+                "able",
+                "to",
+                "contact",
+                "him."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Factitious",
+                "disorder."
+            ],
+            [
+                "2-",
+                "Delusional",
+                "disorder."
+            ],
+            [
+                "3-",
+                "Hypochondriasis."
+            ],
+            [
+                "4-",
+                "Major",
+                "depressive",
+                "disorder."
+            ],
+            [
+                "5-",
+                "Conversive",
+                "disorder."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "The",
+                "nice",
+                "word",
+                "to",
+                "describe",
+                "this",
+                "is:",
+                "\"Belle",
+                "indeference\",",
+                "this",
+                "woman",
+                "shows",
+                "herself",
+                "with",
+                "an",
+                "elegant",
+                "indifference",
+                "to",
+                "a",
+                "paralysis."
+            ],
+            [
+                "The",
+                "diagnosis....",
+                "can",
+                "be",
+                "excluded",
+                "2,3,4",
+                "because",
+                "the",
+                "clinical",
+                "does",
+                "not",
+                "match:",
+                "no",
+                "delirium,",
+                "no",
+                "worry,",
+                "no",
+                "sadness."
+            ],
+            [
+                "1",
+                "would",
+                "be",
+                "if",
+                "he",
+                "was",
+                "making",
+                "a",
+                "profit,",
+                "if",
+                "he",
+                "was",
+                "knowingly",
+                "simulating",
+                "and",
+                "to",
+                "make",
+                "a",
+                "profit",
+                "he",
+                "was",
+                "faking",
+                "his",
+                "illness."
+            ],
+            [
+                "This",
+                "is",
+                "not",
+                "the",
+                "case."
+            ],
+            [
+                "Conversive",
+                "would",
+                "be",
+                "if",
+                "the",
+                "symptom",
+                "wanted",
+                "to",
+                "transmit",
+                "something",
+                "to",
+                "us,",
+                "that",
+                "is",
+                "to",
+                "say,",
+                "it",
+                "was",
+                "a",
+                "metaphor",
+                "of",
+                "its",
+                "internal",
+                "world..."
+            ],
+            [
+                "The",
+                "most",
+                "exact",
+                "in",
+                "this",
+                "case:",
+                "5."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "246_116",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTIOUS",
+                "DISEASES"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "patient",
+                "with",
+                "a",
+                "history",
+                "of",
+                "excessive",
+                "alcohol",
+                "consumption",
+                "has",
+                "been",
+                "diagnosed",
+                "with",
+                "pulmonary",
+                "tuberculosis",
+                "due",
+                "to",
+                "cough,",
+                "fever,",
+                "expectoration,",
+                "and",
+                "sputum",
+                "culture",
+                "isolation",
+                "of",
+                "Mycobacterium",
+                "tuberculosis."
+            ],
+            [
+                "The",
+                "patient",
+                "started",
+                "treatment",
+                "with",
+                "isoniazid,",
+                "rifampicin,",
+                "ethambutol",
+                "and",
+                "pyrazinamide,",
+                "with",
+                "adequate",
+                "tolerance."
+            ],
+            [
+                "Twenty",
+                "days",
+                "after",
+                "starting",
+                "treatment,",
+                "a",
+                "report",
+                "of",
+                "rifampicin",
+                "resistance",
+                "of",
+                "M.",
+                "tuberculosis",
+                "isolated",
+                "in",
+                "sputum",
+                "is",
+                "received."
+            ],
+            [
+                "Which",
+                "regimen",
+                "would",
+                "you",
+                "select",
+                "based",
+                "on",
+                "this",
+                "report?"
+            ],
+            [
+                "1-",
+                "Isoniazid,",
+                "ethambutol,",
+                "pyrazinamide",
+                "for",
+                "12",
+                "months."
+            ],
+            [
+                "2-",
+                "Isoniazid,",
+                "ethambutol,",
+                "pyrazinamide",
+                "for",
+                "12",
+                "months",
+                "and",
+                "streptomycin",
+                "for",
+                "two",
+                "months."
+            ],
+            [
+                "3-",
+                "Isoniazid,",
+                "ethambutol,",
+                "pyrazinamide",
+                "for",
+                "12",
+                "months",
+                "and",
+                "a",
+                "quinolone",
+                "for",
+                "two",
+                "months."
+            ],
+            [
+                "4-",
+                "Isoniazid,",
+                "ethambutol,",
+                "pyrazinamide",
+                "and",
+                "a",
+                "quinolone",
+                "for",
+                "18",
+                "months."
+            ],
+            [
+                "5-",
+                "Isoniazid,",
+                "ethambutol,",
+                "pyrazinamide",
+                "for",
+                "18",
+                "months",
+                "and",
+                "streptomycin",
+                "and",
+                "a",
+                "quinolone",
+                "for",
+                "2",
+                "months."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Another",
+                "question",
+                "that",
+                "may",
+                "generate",
+                "discussion."
+            ],
+            [
+                "When",
+                "a",
+                "diagnosis",
+                "of",
+                "active",
+                "tuberculosis",
+                "infection",
+                "is",
+                "made,",
+                "treatment",
+                "is",
+                "initiated",
+                "with",
+                "isoniazid,",
+                "rifampicin",
+                "and",
+                "pyrazinamide",
+                "together",
+                "with",
+                "ethambutol",
+                "in",
+                "case",
+                "of",
+                "suspicion",
+                "of",
+                "strains",
+                "resistant",
+                "to",
+                "any",
+                "of",
+                "the",
+                "drugs."
+            ],
+            [
+                "Once",
+                "the",
+                "existence",
+                "of",
+                "resistance",
+                "has",
+                "been",
+                "ruled",
+                "out,",
+                "ethambutol",
+                "can",
+                "be",
+                "dispensed",
+                "with."
+            ],
+            [
+                "In",
+                "case",
+                "of",
+                "resistance",
+                "to",
+                "rifampicin,",
+                "rifampicin",
+                "is",
+                "withdrawn",
+                "and",
+                "treatment",
+                "is",
+                "completed",
+                "with",
+                "the",
+                "3",
+                "remaining",
+                "drugs",
+                "for",
+                "12",
+                "months."
+            ],
+            [
+                "The",
+                "option",
+                "of",
+                "adding",
+                "a",
+                "quinolone",
+                "during",
+                "the",
+                "first",
+                "two",
+                "months",
+                "of",
+                "treatment",
+                "(moxifloxacin",
+                "or",
+                "levofloxacin)",
+                "is",
+                "considered",
+                "in",
+                "cases",
+                "of",
+                "extensive",
+                "pulmonary",
+                "involvement."
+            ],
+            [
+                "In",
+                "this",
+                "case,",
+                "they",
+                "do",
+                "not",
+                "tell",
+                "us",
+                "anything",
+                "about",
+                "extensive",
+                "pulmonary",
+                "involvement",
+                "but",
+                "they",
+                "give",
+                "us",
+                "a",
+                "data",
+                "\"excessive",
+                "alcohol",
+                "consumption\"."
+            ],
+            [
+                "You",
+                "know",
+                "that",
+                "in",
+                "the",
+                "MIR",
+                "no",
+                "data",
+                "is",
+                "free,",
+                "and",
+                "if",
+                "the",
+                "person",
+                "who",
+                "posted",
+                "this",
+                "question",
+                "wanted",
+                "to",
+                "reflect",
+                "it,",
+                "probably",
+                "his",
+                "intention",
+                "was",
+                "that",
+                "we",
+                "reflect",
+                "on",
+                "it."
+            ],
+            [
+                "Alcohol",
+                "exerts",
+                "a",
+                "direct",
+                "immunosuppressive",
+                "effect,",
+                "moreover,",
+                "alcoholism",
+                "is",
+                "related",
+                "to",
+                "the",
+                "affectation",
+                "of",
+                "immunity",
+                "in",
+                "the",
+                "respiratory",
+                "tract."
+            ],
+            [
+                "The",
+                "social",
+                "context",
+                "that",
+                "usually",
+                "accompanies",
+                "the",
+                "alcoholic",
+                "patient",
+                "does",
+                "not",
+                "help",
+                "either."
+            ],
+            [
+                "All",
+                "the",
+                "factors",
+                "mentioned",
+                "above",
+                "make",
+                "us",
+                "lean",
+                "more",
+                "towards",
+                "answer",
+                "number",
+                "3,",
+                "although",
+                "it",
+                "is",
+                "undeniable",
+                "that",
+                "number",
+                "1",
+                "could",
+                "also",
+                "be",
+                "correct."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "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",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "457_126",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "OTORHINOLARYNGOLOGY",
+                "AND",
+                "MAXILLOFACIAL",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "47-year-old",
+                "man,",
+                "with",
+                "a",
+                "history",
+                "of",
+                "a",
+                "right",
+                "parotid",
+                "pleomorphic",
+                "adenoma,",
+                "treated",
+                "with",
+                "surgery",
+                "(extrafacial",
+                "parotidectomy)",
+                "6",
+                "months",
+                "ago,",
+                "who",
+                "comes",
+                "to",
+                "our",
+                "office",
+                "for",
+                "presenting",
+                "pain",
+                "with",
+                "sweating",
+                "and",
+                "reddening",
+                "of",
+                "the",
+                "skin",
+                "in",
+                "the",
+                "preauricular",
+                "region",
+                "during",
+                "chewing."
+            ],
+            [
+                "Which",
+                "treatment",
+                "would",
+                "be",
+                "the",
+                "treatment",
+                "of",
+                "choice?"
+            ],
+            [
+                "1-",
+                "Extended",
+                "total",
+                "parotidectomy",
+                "on",
+                "suspicion",
+                "of",
+                "tumor",
+                "recurrence."
+            ],
+            [
+                "2-",
+                "Pregabalin."
+            ],
+            [
+                "3-",
+                "Intradermal",
+                "botulinum",
+                "toxin",
+                "injection."
+            ],
+            [
+                "4-",
+                "Broad-spectrum",
+                "antibiotherapy."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "This",
+                "clinical",
+                "picture",
+                "is",
+                "called",
+                "Frey's",
+                "syndrome",
+                "and",
+                "consists",
+                "of",
+                "an",
+                "anomalous",
+                "reinnervation",
+                "of",
+                "regional",
+                "structures",
+                "after",
+                "parotidectomy",
+                "due",
+                "to",
+                "lesion",
+                "of",
+                "the",
+                "auriculotemporal",
+                "nerve,",
+                "so",
+                "that",
+                "during",
+                "mastication,",
+                "erythema",
+                "and",
+                "preauricular",
+                "sweating",
+                "occur."
+            ],
+            [
+                "The",
+                "treatment",
+                "is",
+                "intradermal",
+                "botulinum",
+                "toxin",
+                "injection."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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",
+                "I-Marker",
+                "B-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"
+            ]
+        ]
+    },
+    {
+        "id": "165_229",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEPHROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "58-year-old",
+                "woman,",
+                "weight",
+                "130",
+                "kg,",
+                "height",
+                "155",
+                "cm,",
+                "body",
+                "mass",
+                "index",
+                ">",
+                "30",
+                "with",
+                "mild",
+                "hypertension,",
+                "blood",
+                "glucose",
+                "108",
+                "mg/dL",
+                "and",
+                "absence",
+                "of",
+                "edema",
+                "in",
+                "the",
+                "lower",
+                "limbs."
+            ],
+            [
+                "Blood",
+                "analysis",
+                "showed",
+                "Cr",
+                "2.0",
+                "mg/dL,",
+                "Urea",
+                "86",
+                "mg/dL,",
+                "Alb",
+                "3.8",
+                "g/1,",
+                "Na",
+                "142",
+                "mEq/L,",
+                "K",
+                "4",
+                "mEq/L."
+            ],
+            [
+                "In",
+                "urinalysis:",
+                "sediment",
+                "without",
+                "alterations",
+                "and",
+                "in",
+                "24",
+                "h",
+                "urine",
+                "proteinuria",
+                "of",
+                "6.3",
+                "g/24",
+                "h."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "entities",
+                "is",
+                "more",
+                "likely",
+                "to",
+                "be",
+                "present?"
+            ],
+            [
+                "1-",
+                "Secondary",
+                "membranous",
+                "glomerulonephritis."
+            ],
+            [
+                "2-",
+                "Focal",
+                "and",
+                "segmental",
+                "glomerulonephritis."
+            ],
+            [
+                "3-",
+                "IgA",
+                "nephropathy."
+            ],
+            [
+                "4-",
+                "Rapidly",
+                "progressive",
+                "glomerulonephritis."
+            ],
+            [
+                "5-",
+                "Minimal",
+                "change",
+                "nephropathy."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "The",
+                "correct",
+                "answer",
+                "is:",
+                "2."
+            ],
+            [
+                "Focal",
+                "segmental",
+                "glomerulonephritis."
+            ],
+            [
+                "We",
+                "are",
+                "in",
+                "front",
+                "of",
+                "a",
+                "patient",
+                "with",
+                "renal",
+                "insufficiency",
+                "whose",
+                "manifestation",
+                "is",
+                "a",
+                "proteinuria."
+            ],
+            [
+                "That",
+                "places",
+                "us",
+                "in",
+                "the",
+                "picture",
+                "of",
+                "nonproliferative",
+                "GN",
+                "(membranous,",
+                "focal",
+                "and",
+                "segmental",
+                "and",
+                "minimal",
+                "changes,",
+                "discarding",
+                "the",
+                "other",
+                "two)."
+            ],
+            [
+                "If",
+                "we",
+                "also",
+                "consider",
+                "that",
+                "the",
+                "patient",
+                "was",
+                "obese,",
+                "slightly",
+                "hypertensive,",
+                "the",
+                "most",
+                "probable",
+                "is",
+                "that",
+                "it",
+                "is",
+                "a",
+                "focal",
+                "segmental",
+                "glomerulonephritis."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "157_73",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "TRAUMATOLOGY",
+                "AND",
+                "ORTHOPEDICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "75-year-old",
+                "patient",
+                "with",
+                "significant",
+                "gonarthrosis",
+                "with",
+                "\"Genu",
+                "Varo\"",
+                "that",
+                "causes",
+                "marked",
+                "functional",
+                "impotence,",
+                "limited",
+                "mobility",
+                "and",
+                "continuous",
+                "pain",
+                "that",
+                "requires",
+                "continuous",
+                "antirheumatic,",
+                "anti-inflammatory",
+                "and",
+                "analgesic",
+                "medication."
+            ],
+            [
+                "What",
+                "treatment",
+                "should",
+                "be",
+                "indicated",
+                "in",
+                "this",
+                "case?"
+            ],
+            [
+                "1-",
+                "Arthroscopic",
+                "lavage",
+                "of",
+                "the",
+                "knee."
+            ],
+            [
+                "2-",
+                "Rehabilitation",
+                "of",
+                "the",
+                "affected",
+                "knee."
+            ],
+            [
+                "3-",
+                "Arthroplasty",
+                "of",
+                "the",
+                "affected",
+                "knee."
+            ],
+            [
+                "4-",
+                "Abduction",
+                "supratuberosity",
+                "tibial",
+                "supratuberosity",
+                "tibial",
+                "osteotomy."
+            ],
+            [
+                "5-",
+                "Knee",
+                "synovectomy."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "We",
+                "are",
+                "dealing",
+                "with",
+                "a",
+                "patient",
+                "who",
+                "has",
+                "exhausted",
+                "the",
+                "pharmacological",
+                "route",
+                "given",
+                "that",
+                "he",
+                "takes",
+                "everything",
+                "and",
+                "has",
+                "two",
+                "important",
+                "problems:",
+                "genu",
+                "varum",
+                "and",
+                "an",
+                "important",
+                "gonarthrosis."
+            ],
+            [
+                "This",
+                "means",
+                "that",
+                "we",
+                "can",
+                "do",
+                "nothing",
+                "with",
+                "an",
+                "arthroscopy,",
+                "let",
+                "alone",
+                "a",
+                "synovectomy",
+                "(1",
+                "and",
+                "5",
+                "false)."
+            ],
+            [
+                "The",
+                "genu",
+                "varum",
+                "could",
+                "falsely",
+                "make",
+                "us",
+                "think",
+                "about",
+                "an",
+                "osteotomy,",
+                "however",
+                "even",
+                "if",
+                "we",
+                "did",
+                "it",
+                "and",
+                "corrected",
+                "the",
+                "varus",
+                "now",
+                "the",
+                "damage",
+                "is",
+                "already",
+                "done",
+                "and",
+                "the",
+                "osteoarthrosis",
+                "is",
+                "severe."
+            ],
+            [
+                "Perhaps",
+                "years",
+                "ago",
+                "before",
+                "the",
+                "osteoarthritis",
+                "took",
+                "place",
+                "it",
+                "would",
+                "have",
+                "been",
+                "resolutive",
+                "but",
+                "not",
+                "now",
+                "(4",
+                "false)."
+            ],
+            [
+                "In",
+                "addition,",
+                "in",
+                "order",
+                "to",
+                "consider",
+                "an",
+                "osteotomy,",
+                "we",
+                "should",
+                "be",
+                "given",
+                "more",
+                "data",
+                "to",
+                "know",
+                "which",
+                "bone",
+                "to",
+                "apply",
+                "the",
+                "osteotomy",
+                "on,",
+                "the",
+                "tibia",
+                "or",
+                "the",
+                "femur."
+            ],
+            [
+                "Finally,",
+                "we",
+                "may",
+                "think",
+                "that",
+                "it",
+                "is",
+                "best",
+                "to",
+                "first",
+                "try",
+                "rehabilitation",
+                "before",
+                "considering",
+                "surgery,",
+                "but",
+                "I",
+                "discard",
+                "this",
+                "option",
+                "because",
+                "the",
+                "question",
+                "emphasizes",
+                "that",
+                "we",
+                "have",
+                "exhausted",
+                "pharmacological",
+                "measures",
+                "(although",
+                "it",
+                "could",
+                "be",
+                "considered",
+                "because",
+                "they",
+                "have",
+                "not",
+                "specified",
+                "whether",
+                "it",
+                "has",
+                "been",
+                "tried",
+                "or",
+                "not)."
+            ],
+            [
+                "In",
+                "any",
+                "case",
+                "with",
+                "the",
+                "knee",
+                "prosthesis",
+                "we",
+                "correct",
+                "the",
+                "problem",
+                "of",
+                "osteoarthritis",
+                "pain",
+                "and",
+                "we",
+                "can",
+                "also",
+                "correct",
+                "the",
+                "knee",
+                "varus."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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",
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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"
+            ],
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "382_231",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "33-year-old",
+                "man,",
+                "independent",
+                "in",
+                "all",
+                "activities",
+                "of",
+                "daily",
+                "living,",
+                "with",
+                "a",
+                "history",
+                "of",
+                "well-controlled",
+                "hypertension,",
+                "antiplatelet",
+                "atrial",
+                "fibrillation",
+                "and",
+                "an",
+                "adenocarcinoma",
+                "of",
+                "the",
+                "prostate",
+                "at",
+                "73",
+                "years",
+                "of",
+                "age,",
+                "currently",
+                "free",
+                "of",
+                "disease."
+            ],
+            [
+                "He",
+                "is",
+                "brought",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "for",
+                "clinical",
+                "aphasia",
+                "and",
+                "right",
+                "hemiparesis",
+                "of",
+                "sudden",
+                "onset,",
+                "45",
+                "minutes",
+                "earlier."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "correct",
+                "approach?"
+            ],
+            [
+                "1-",
+                "Perform",
+                "a",
+                "cranial",
+                "CT",
+                "scan",
+                "and",
+                "if",
+                "there",
+                "are",
+                "no",
+                "hemorrhagic",
+                "lesions",
+                "or",
+                "other",
+                "contraindications",
+                "in",
+                "the",
+                "analysis,",
+                "start",
+                "immediate",
+                "intravenous",
+                "thrombolysis."
+            ],
+            [
+                "2-",
+                "Perform",
+                "urgent",
+                "cranial",
+                "CT",
+                "scan",
+                "and",
+                "if",
+                "there",
+                "is",
+                "no",
+                "bleeding,",
+                "start",
+                "anticoagulation."
+            ],
+            [
+                "3-",
+                "Perform",
+                "cranial",
+                "CT",
+                "scan",
+                "and",
+                "admission",
+                "to",
+                "rehabilitation",
+                "center,",
+                "since",
+                "their",
+                "attitude",
+                "will",
+                "not",
+                "differ",
+                "regardless",
+                "of",
+                "whether",
+                "the",
+                "etiology",
+                "is",
+                "ischemic",
+                "or",
+                "hemorrhagic."
+            ],
+            [
+                "4-",
+                "Cranial",
+                "CT",
+                "scan",
+                "is",
+                "not",
+                "necessary,",
+                "although",
+                "I",
+                "would",
+                "withdraw",
+                "the",
+                "antiaggregation."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "The",
+                "patient",
+                "suffers",
+                "an",
+                "abrupt",
+                "neurological",
+                "deficit",
+                "probably",
+                "related",
+                "to",
+                "a",
+                "vascular",
+                "event,",
+                "so",
+                "first",
+                "we",
+                "will",
+                "have",
+                "to",
+                "perform",
+                "a",
+                "cranial",
+                "CT",
+                "scan",
+                "to",
+                "rule",
+                "out",
+                "a",
+                "hemorrhagic",
+                "stroke."
+            ],
+            [
+                "If",
+                "the",
+                "CT",
+                "scan",
+                "does",
+                "not",
+                "show",
+                "bleeding,",
+                "the",
+                "patient",
+                "has",
+                "an",
+                "acute",
+                "ischemic",
+                "stroke,",
+                "probably",
+                "cardioembolic",
+                "due",
+                "to",
+                "his",
+                "cardiac",
+                "pathology,",
+                "not",
+                "anticoagulated."
+            ],
+            [
+                "Given",
+                "that",
+                "his",
+                "tumor",
+                "process",
+                "is",
+                "under",
+                "control,",
+                "there",
+                "are",
+                "no",
+                "contraindications",
+                "for",
+                "the",
+                "administration",
+                "of",
+                "fibrinolysis",
+                "in",
+                "this",
+                "case,",
+                "since",
+                "the",
+                "patient",
+                "is",
+                "in",
+                "a",
+                "good",
+                "baseline",
+                "condition."
+            ],
+            [
+                "Although",
+                "the",
+                "patient",
+                "is",
+                "88",
+                "years",
+                "old,",
+                "age",
+                "is",
+                "no",
+                "longer",
+                "presented",
+                "as",
+                "an",
+                "absolute",
+                "exclusion",
+                "criterion,",
+                "but",
+                "the",
+                "general",
+                "situation",
+                "of",
+                "the",
+                "patient",
+                "must",
+                "be",
+                "taken",
+                "into",
+                "account",
+                "and",
+                "in",
+                "this",
+                "case",
+                "it",
+                "is",
+                "specified",
+                "that",
+                "he",
+                "presents",
+                "a",
+                "good",
+                "baseline",
+                "situation."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ]
+        ]
+    },
+    {
+        "id": "496_71",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "MEDICAL",
+                "ONCOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "40-year-old",
+                "patient,",
+                "with",
+                "normal",
+                "physical",
+                "examination,",
+                "in",
+                "whom",
+                "a",
+                "mediastinal",
+                "mass",
+                "and",
+                "a",
+                "hepatic",
+                "nodule",
+                "have",
+                "been",
+                "evidenced",
+                "in",
+                "the",
+                "CT",
+                "scan,",
+                "and",
+                "in",
+                "the",
+                "CBC",
+                "a",
+                "serum",
+                "elevation",
+                "of",
+                "lactic",
+                "dehydrogenase",
+                "(LDH),",
+                "human",
+                "chorionic",
+                "betagonadotropin",
+                "(beta-HCG)",
+                "and",
+                "alpha-fetoprotein.What",
+                "is",
+                "your",
+                "diagnostic",
+                "suspicion."
+            ],
+            [
+                "What",
+                "is",
+                "your",
+                "diagnostic",
+                "suspicion:"
+            ],
+            [
+                "1-",
+                "Metastatic",
+                "hepatocarcinoma."
+            ],
+            [
+                "2-",
+                "Extragonadal",
+                "metastatic",
+                "seminoma."
+            ],
+            [
+                "3-",
+                "Mediastinal",
+                "lymphoma."
+            ],
+            [
+                "4-",
+                "Metastatic",
+                "extragonadal",
+                "nonseminomatous",
+                "germ",
+                "cell",
+                "cancer."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Very",
+                "typical",
+                "too."
+            ],
+            [
+                "In",
+                "the",
+                "ED",
+                "it",
+                "can",
+                "be",
+                "diagnosed",
+                "with",
+                "a",
+                "pregnancy",
+                "test",
+                "(in",
+                "males),",
+                "because",
+                "it",
+                "detects",
+                "that",
+                "beta",
+                "HCG",
+                "in",
+                "urine."
+            ],
+            [
+                "Hepatocarcinoma",
+                "can",
+                "elevate",
+                "(alone)",
+                "alpha-fetus,",
+                "seminoma",
+                "LDH,",
+                "lymphoma",
+                "also",
+                "LDH."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "14_213",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "41-year-old",
+                "man",
+                "comes",
+                "to",
+                "the",
+                "clinic",
+                "with",
+                "a",
+                "nodule",
+                "in",
+                "the",
+                "right",
+                "thyroid,",
+                "a",
+                "fine",
+                "needle",
+                "aspiration",
+                "is",
+                "performed."
+            ],
+            [
+                "Cytological",
+                "analysis",
+                "will",
+                "allow",
+                "us:"
+            ],
+            [
+                "1-",
+                "Distinguish",
+                "between",
+                "follicular",
+                "adenoma",
+                "or",
+                "minimally",
+                "invasive",
+                "follicular",
+                "carcinoma."
+            ],
+            [
+                "2-",
+                "Identify",
+                "the",
+                "areas",
+                "of",
+                "capsular",
+                "or",
+                "vascular",
+                "invasion",
+                "of",
+                "the",
+                "follicular",
+                "carcinoma."
+            ],
+            [
+                "3-",
+                "Recognize",
+                "G-cell",
+                "hyperplasia",
+                "associated",
+                "with",
+                "familial",
+                "spinal",
+                "cancer."
+            ],
+            [
+                "4-",
+                "Distinguish",
+                "between",
+                "a",
+                "Hurthle",
+                "cell",
+                "tumor",
+                "and",
+                "an",
+                "oxyphilic",
+                "follicular",
+                "adenoma."
+            ],
+            [
+                "5-",
+                "Identify",
+                "the",
+                "typical",
+                "cytologic",
+                "features",
+                "of",
+                "papillary",
+                "carcinoma."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "I",
+                "think",
+                "the",
+                "correct",
+                "answer",
+                "is",
+                "5;",
+                "FNA",
+                "does",
+                "not",
+                "allow",
+                "a",
+                "histological",
+                "study",
+                "but",
+                "a",
+                "cytological",
+                "one,",
+                "therefore",
+                "questions",
+                "1,",
+                "2",
+                "are",
+                "eliminated."
+            ],
+            [
+                "Question",
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+                "seems",
+                "to",
+                "have",
+                "been",
+                "put",
+                "as",
+                "a",
+                "filler",
+                "because",
+                "it",
+                "is",
+                "not",
+                "relevant."
+            ],
+            [
+                "Question",
+                "4",
+                "could",
+                "raise",
+                "doubts",
+                "if",
+                "you",
+                "are",
+                "not",
+                "a",
+                "pathologist",
+                "but",
+                "the",
+                "most",
+                "logical",
+                "answer",
+                "is",
+                "5",
+                "since",
+                "papillary",
+                "carcinoma",
+                "is",
+                "the",
+                "most",
+                "frequent."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "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",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "330_85",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "22-year-old",
+                "boy",
+                "with",
+                "hyposmia",
+                "presents",
+                "with",
+                "lack",
+                "of",
+                "development",
+                "of",
+                "secondary",
+                "sexual",
+                "characteristics",
+                "and",
+                "infertility."
+            ],
+            [
+                "Bilateral",
+                "testicular",
+                "volume",
+                "of",
+                "4",
+                "mL."
+            ],
+            [
+                "Analytically,",
+                "FSH",
+                "1.2",
+                "U/L",
+                "(vn",
+                "5-15);",
+                "LH",
+                "0.6",
+                "U/L",
+                "(vn",
+                "3-15);",
+                "testosterone",
+                "100",
+                "ng/diu",
+                "(vn",
+                "300-1200),",
+                "prolactin",
+                "normal."
+            ],
+            [
+                "Indicate",
+                "the",
+                "treatment",
+                "you",
+                "will",
+                "propose",
+                "to",
+                "achieve",
+                "fertility:"
+            ],
+            [
+                "1-",
+                "Gn_RH",
+                "infusion",
+                "pump."
+            ],
+            [
+                "2-",
+                "Monthly",
+                "intramuscular",
+                "administration",
+                "of",
+                "triptorelin."
+            ],
+            [
+                "3-",
+                "Intramuscular",
+                "administration",
+                "of",
+                "FSH",
+                "and",
+                "LH",
+                "once",
+                "a",
+                "week."
+            ],
+            [
+                "4-",
+                "Treatment",
+                "with",
+                "bromocriptine."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Kallman's",
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+                "or",
+                "Morsier's",
+                "syndrome",
+                "is",
+                "a",
+                "congenital",
+                "insufficiency",
+                "associated",
+                "with",
+                "hypogonadotropic",
+                "hypogonadism",
+                "due",
+                "to",
+                "a",
+                "deficit",
+                "in",
+                "GnRH",
+                "hormone",
+                "production."
+            ],
+            [
+                "Repeated",
+                "injections",
+                "of",
+                "GnRH",
+                "are",
+                "performed",
+                "to",
+                "restore",
+                "fertility."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "181_59",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "type",
+                "1",
+                "diabetic",
+                "who",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "room",
+                "for",
+                "dyspnea",
+                "and",
+                "general",
+                "malaise."
+            ],
+            [
+                "The",
+                "blood",
+                "test",
+                "showed",
+                "blood",
+                "glucose",
+                "450",
+                "mg/dl,",
+                "Na",
+                "142",
+                "mEq/l,",
+                "K",
+                "4",
+                "mEq/l,",
+                "pH",
+                "7.15,",
+                "bicarbonate",
+                "12",
+                "mmol/l."
+            ],
+            [
+                "Which",
+                "treatment",
+                "would",
+                "NOT",
+                "be",
+                "indicated?"
+            ],
+            [
+                "1-",
+                "Fast",
+                "IV",
+                "saline."
+            ],
+            [
+                "2-",
+                "Serum",
+                "glucose",
+                "5%",
+                "iv",
+                "when",
+                "blood",
+                "glucose",
+                "is",
+                "less",
+                "than",
+                "250",
+                "mg/dl."
+            ],
+            [
+                "3-",
+                "Rapid",
+                "human",
+                "insulin",
+                "iv."
+            ],
+            [
+                "4-",
+                "Potassium",
+                "chloride",
+                "100",
+                "mEq",
+                "/",
+                "day",
+                "diluted",
+                "in",
+                "sera."
+            ],
+            [
+                "5-",
+                "Sodium",
+                "bicarbonate",
+                "1M",
+                "100",
+                "cc",
+                "iv",
+                "in",
+                "30",
+                "minutes."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "Easy",
+                "question",
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+                "treatment",
+                "of",
+                "diabetic",
+                "ketoacidosis",
+                "is",
+                "a",
+                "very",
+                "repeated",
+                "topic",
+                "in",
+                "the",
+                "MIR."
+            ],
+            [
+                "Bicarbonate",
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+                "indicated",
+                "at",
+                "pH",
+                "<",
+                "7."
+            ]
+        ],
+        "labels": [
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+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
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+                "O",
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+                "O",
+                "O",
+                "O"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "B-Disease",
+                "I-Disease",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "182_61",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "76-year-old",
+                "woman",
+                "consults",
+                "us",
+                "because",
+                "she",
+                "is",
+                "concerned",
+                "about",
+                "her",
+                "risk",
+                "of",
+                "stroke",
+                "since",
+                "her",
+                "mother",
+                "died",
+                "of",
+                "stroke",
+                "a",
+                "year",
+                "ago."
+            ],
+            [
+                "She",
+                "is",
+                "diagnosed",
+                "with",
+                "arterial",
+                "hypertension",
+                "and",
+                "type",
+                "2",
+                "diabetes",
+                "mellitus",
+                "and",
+                "is",
+                "being",
+                "treated",
+                "with",
+                "glipizide,",
+                "aspirin,",
+                "enalapril",
+                "and",
+                "atorvastatin."
+            ],
+            [
+                "She",
+                "smokes",
+                "20",
+                "cigarettes",
+                "a",
+                "day",
+                "and",
+                "leads",
+                "a",
+                "sedentary",
+                "life."
+            ],
+            [
+                "The",
+                "examination",
+                "revealed",
+                "a",
+                "blood",
+                "pressure",
+                "of",
+                "150/80",
+                "mm",
+                "Hg."
+            ],
+            [
+                "The",
+                "blood",
+                "test",
+                "shows",
+                "a",
+                "hemoglobin",
+                "A1C",
+                "of",
+                "8%",
+                "and",
+                "LDL",
+                "cholesterol",
+                "of",
+                "110",
+                "mg/dl."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "actions",
+                "is",
+                "associated",
+                "with",
+                "a",
+                "greater",
+                "reduction",
+                "in",
+                "the",
+                "risk",
+                "of",
+                "stroke?"
+            ],
+            [
+                "1-",
+                "Achieve",
+                "optimal",
+                "blood",
+                "pressure",
+                "control."
+            ],
+            [
+                "2-",
+                "Achieve",
+                "optimal",
+                "hemoglobin",
+                "A1C",
+                "levels."
+            ],
+            [
+                "3-",
+                "Add",
+                "an",
+                "antioxidant",
+                "to",
+                "the",
+                "treatment."
+            ],
+            [
+                "4-",
+                "Smoking",
+                "cessation."
+            ],
+            [
+                "5-",
+                "Achieve",
+                "LDL",
+                "levels",
+                "below",
+                "100",
+                "mg/dl."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "The",
+                "most",
+                "influential",
+                "cardiovascular",
+                "factor",
+                "for",
+                "stroke",
+                "in",
+                "women",
+                "over",
+                "70",
+                "is",
+                "blood",
+                "pressure."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "21_111",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTIOUS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "32-year-old",
+                "man,",
+                "ADVP",
+                "and",
+                "recently",
+                "released",
+                "from",
+                "prison,",
+                "has",
+                "a",
+                "protein",
+                "derivative",
+                "skin",
+                "test",
+                "(PPD)",
+                "with",
+                "10",
+                "mm",
+                "of",
+                "induration."
+            ],
+            [
+                "One",
+                "year",
+                "ago,",
+                "the",
+                "PPD",
+                "was",
+                "negative,",
+                "he",
+                "is",
+                "currently",
+                "asymptomatic,",
+                "his",
+                "HIV",
+                "serology",
+                "is",
+                "negative,",
+                "and",
+                "his",
+                "Chest",
+                "X-ray",
+                "is",
+                "normal."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "approaches",
+                "do",
+                "you",
+                "think",
+                "is",
+                "most",
+                "appropriate?"
+            ],
+            [
+                "1-",
+                "Do",
+                "not",
+                "perform",
+                "treatment",
+                "and",
+                "annual",
+                "Rx",
+                "control."
+            ],
+            [
+                "2-",
+                "Sputum",
+                "culture",
+                "for",
+                "mycobacteria",
+                "and",
+                "treat",
+                "only",
+                "if",
+                "positive."
+            ],
+            [
+                "3-",
+                "Isoniazid",
+                "for",
+                "9",
+                "months."
+            ],
+            [
+                "4-",
+                "Treatment",
+                "with",
+                "4",
+                "drugs",
+                "4",
+                "months."
+            ],
+            [
+                "5-",
+                "Treatment",
+                "with",
+                "RIF",
+                "and",
+                "PRZ",
+                "for",
+                "2",
+                "months."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "In",
+                "the",
+                "face",
+                "of",
+                "a",
+                "PPD",
+                "conversion",
+                "within",
+                "2",
+                "years,",
+                "and",
+                "ruling",
+                "out",
+                "current",
+                "TB",
+                "disease,",
+                "INH",
+                "chemoprophylaxis",
+                "is",
+                "indicated,",
+                "although",
+                "I",
+                "thought",
+                "it",
+                "was",
+                "for",
+                "6",
+                "months",
+                "and",
+                "not",
+                "9."
+            ],
+            [
+                "The",
+                "rest",
+                "is",
+                "not",
+                "questionable."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "60_59",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ANESTHESIOLOGY",
+                "AND",
+                "CRITICAL",
+                "CARE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "40-year-old",
+                "male,",
+                "foreign",
+                "tourist,",
+                "is",
+                "referred",
+                "to",
+                "the",
+                "ED",
+                "for",
+                "low",
+                "level",
+                "of",
+                "consciousness,",
+                "temperature",
+                "of",
+                "37.7\u00b0C",
+                "and",
+                "dyspnea."
+            ],
+            [
+                "He",
+                "has",
+                "no",
+                "trauma."
+            ],
+            [
+                "Several",
+                "tests",
+                "were",
+                "performed."
+            ],
+            [
+                "The",
+                "most",
+                "immediate",
+                "is",
+                "an",
+                "ABE",
+                "without",
+                "oxygen,",
+                "showing",
+                "PH",
+                "7.33,",
+                "PCO2",
+                "50,",
+                "PO2",
+                "65,",
+                "HCO3",
+                "27:"
+            ],
+            [
+                "1-",
+                "PET",
+                "SCAN."
+            ],
+            [
+                "2-",
+                "Lobar",
+                "pneumonia."
+            ],
+            [
+                "3-",
+                "EAP."
+            ],
+            [
+                "4-",
+                "Alveolar",
+                "hypoventilation."
+            ],
+            [
+                "5-",
+                "Bronchopneumonia."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "Actually,",
+                "it",
+                "can",
+                "be",
+                "all",
+                "of",
+                "them,",
+                "but",
+                "the",
+                "most",
+                "frequent",
+                "cause",
+                "of",
+                "acute",
+                "uncompensated",
+                "respiratory",
+                "acidosis",
+                "in",
+                "a",
+                "young",
+                "person",
+                "is",
+                "bronchopneumonia."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "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",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "455_155",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "In",
+                "a",
+                "70-year-old",
+                "man,",
+                "hypertensive,",
+                "with",
+                "a",
+                "right",
+                "hemiplegia",
+                "of",
+                "sudden",
+                "onset",
+                "with",
+                "mild",
+                "dysarthria,",
+                "without",
+                "alterations",
+                "in",
+                "evocation",
+                "or",
+                "language",
+                "comprehension,",
+                "what",
+                "type",
+                "of",
+                "stroke",
+                "do",
+                "you",
+                "think",
+                "is",
+                "most",
+                "likely",
+                "to",
+                "have",
+                "suffered?"
+            ],
+            [
+                "1-",
+                "Left",
+                "capsular",
+                "lacunar",
+                "lacunar",
+                "infarction."
+            ],
+            [
+                "2-",
+                "A",
+                "cortico-subcortical",
+                "left",
+                "frontotemporal",
+                "sylvian",
+                "infarction."
+            ],
+            [
+                "3-",
+                "Brain",
+                "stem",
+                "infarction."
+            ],
+            [
+                "4-",
+                "A",
+                "left",
+                "lenticular",
+                "hemorrhage."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "The",
+                "closest",
+                "answer",
+                "is",
+                "1."
+            ],
+            [
+                "If",
+                "we",
+                "are",
+                "strict",
+                "we",
+                "would",
+                "be",
+                "talking",
+                "about",
+                "a",
+                "pure",
+                "motor",
+                "lacunar",
+                "infarction",
+                "(with",
+                "mild",
+                "dysarthria)."
+            ],
+            [
+                "Since",
+                "the",
+                "other",
+                "3",
+                "options",
+                "do",
+                "not",
+                "give",
+                "us",
+                "a",
+                "clinical",
+                "picture",
+                "like",
+                "the",
+                "one",
+                "in",
+                "the",
+                "statement."
+            ],
+            [
+                "Both",
+                "options",
+                "2",
+                "and",
+                "3",
+                "give",
+                "us",
+                "a",
+                "much",
+                "more",
+                "florid",
+                "and",
+                "extensive",
+                "clinical",
+                "picture."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "1_35",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DIGESTIVE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "43-year-old",
+                "man",
+                "with",
+                "no",
+                "diseases",
+                "of",
+                "interest",
+                "comes",
+                "to",
+                "the",
+                "emergency",
+                "department",
+                "for",
+                "4",
+                "melaenic",
+                "stools",
+                "in",
+                "the",
+                "last",
+                "12",
+                "hours."
+            ],
+            [
+                "He",
+                "refers",
+                "taking",
+                "NSAIDs",
+                "in",
+                "previous",
+                "days."
+            ],
+            [
+                "Physical",
+                "examination",
+                "revealed",
+                "pale",
+                "skin",
+                "and",
+                "mucous",
+                "membranes."
+            ],
+            [
+                "BP",
+                "95/65",
+                "and",
+                "HR",
+                "110",
+                "bpm."
+            ],
+            [
+                "The",
+                "abdomen",
+                "is",
+                "not",
+                "painful",
+                "and",
+                "rectal",
+                "examination",
+                "shows",
+                "melenic",
+                "stools."
+            ],
+            [
+                "The",
+                "CBC",
+                "shows",
+                "a",
+                "Hb",
+                "of",
+                "8.1",
+                "gr/dl."
+            ],
+            [
+                "After",
+                "infusion",
+                "of",
+                "saline",
+                "and",
+                "the",
+                "start",
+                "of",
+                "red",
+                "blood",
+                "cell",
+                "concentrate",
+                "transfusion,",
+                "the",
+                "BP",
+                "was",
+                "120/85",
+                "and",
+                "HR",
+                "90",
+                "bpm."
+            ],
+            [
+                "An",
+                "endoscopy",
+                "was",
+                "performed",
+                "in",
+                "which",
+                "clots",
+                "were",
+                "found",
+                "in",
+                "the",
+                "stomach",
+                "and",
+                "a",
+                "2",
+                "cm",
+                "ulcer",
+                "in",
+                "the",
+                "gastric",
+                "antrum",
+                "with",
+                "fibrin",
+                "background",
+                "and",
+                "a",
+                "small",
+                "grayish-white",
+                "protrusion",
+                "of",
+                "3",
+                "mm",
+                "in",
+                "the",
+                "center",
+                "of",
+                "the",
+                "ulcer",
+                "(visible",
+                "platelet",
+                "thrombus",
+                "vessel)."
+            ],
+            [
+                "What",
+                "do",
+                "you",
+                "think",
+                "is",
+                "the",
+                "most",
+                "correct",
+                "approach?"
+            ],
+            [
+                "1-",
+                "Since",
+                "the",
+                "patient",
+                "is",
+                "young,",
+                "with",
+                "no",
+                "associated",
+                "diseases",
+                "and",
+                "the",
+                "ulcer",
+                "has",
+                "stopped",
+                "bleeding,",
+                "he",
+                "can",
+                "be",
+                "discharged",
+                "early",
+                "with",
+                "treatment",
+                "with",
+                "a",
+                "PPI",
+                "and",
+                "H.",
+                "Pylori",
+                "eradication."
+            ],
+            [
+                "2-",
+                "Remove",
+                "the",
+                "endoscope,",
+                "place",
+                "nasogastric",
+                "tube",
+                "for",
+                "continuous",
+                "aspiration",
+                "and",
+                "initiate",
+                "treatment",
+                "with",
+                "a",
+                "PPI",
+                "and",
+                "somatostatin."
+            ],
+            [
+                "3-",
+                "Take",
+                "biopsy",
+                "for",
+                "H.",
+                "Pylori,",
+                "remove",
+                "the",
+                "endoscope",
+                "taking",
+                "care",
+                "not",
+                "to",
+                "dislodge",
+                "the",
+                "platelet",
+                "thrombus",
+                "and",
+                "continue",
+                "pharmacological",
+                "treatment",
+                "with",
+                "i.v.",
+                "PPI."
+            ],
+            [
+                "4-",
+                "Consultation",
+                "to",
+                "the",
+                "surgical",
+                "service",
+                "to",
+                "consider",
+                "urgent",
+                "surgical",
+                "treatment."
+            ],
+            [
+                "5-",
+                "Endoscopic",
+                "treatment",
+                "by",
+                "injection",
+                "of",
+                "adrenaline",
+                "into",
+                "the",
+                "ulcer",
+                "and",
+                "placement",
+                "of",
+                "clips",
+                "(metal",
+                "staples)",
+                "followed",
+                "by",
+                "i.v.",
+                "administration",
+                "of",
+                "PPI."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "Question",
+                "about",
+                "non-varicose",
+                "ADH."
+            ],
+            [
+                "Young",
+                "patient,",
+                "with",
+                "no",
+                "previous",
+                "history,",
+                "who",
+                "after",
+                "taking",
+                "NSAIDs",
+                "presents",
+                "bleeding",
+                "with",
+                "hemodynamic",
+                "instability",
+                "requiring",
+                "transfusion."
+            ],
+            [
+                "Answer",
+                "1",
+                "is",
+                "not",
+                "in",
+                "accordance",
+                "with",
+                "what",
+                "has",
+                "been",
+                "said,",
+                "this",
+                "is",
+                "an",
+                "unstable",
+                "patient",
+                "who",
+                "has",
+                "bled",
+                "a",
+                "lot,",
+                "who",
+                "has",
+                "a",
+                "Forrest",
+                "IIa",
+                "ulcer",
+                "with",
+                "a",
+                "high",
+                "risk",
+                "of",
+                "rebleeding."
+            ],
+            [
+                "Answer",
+                "2",
+                "speaks",
+                "of",
+                "somatostatin,",
+                "which",
+                "is",
+                "used",
+                "for",
+                "bleeding",
+                "due",
+                "to",
+                "portal",
+                "hypertension."
+            ],
+            [
+                "4",
+                "will",
+                "only",
+                "be",
+                "considered",
+                "if",
+                "bleeding",
+                "is",
+                "not",
+                "controlled",
+                "endoscopically."
+            ],
+            [
+                "Between",
+                "3",
+                "and",
+                "5,",
+                "since",
+                "there",
+                "is",
+                "a",
+                "high",
+                "risk",
+                "of",
+                "bleeding,",
+                "endoscopic",
+                "therapy",
+                "is",
+                "recommended,",
+                "preferably",
+                "with",
+                "2",
+                "techniques,",
+                "so",
+                "the",
+                "correct",
+                "one",
+                "would",
+                "be",
+                "5."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-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",
+                "O",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-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"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "B-Marker",
+                "B-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-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "66_106",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ANESTHESIOLOGY,",
+                "CRITICAL",
+                "CARE",
+                "AND",
+                "EMERGENCY",
+                "MEDICINE"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "Elderly",
+                "woman",
+                "brought",
+                "to",
+                "the",
+                "ER",
+                "by",
+                "her",
+                "neighbors",
+                "because",
+                "they",
+                "see",
+                "her",
+                "somewhat",
+                "groggy",
+                "and",
+                "with",
+                "stool",
+                "stains",
+                "on",
+                "her",
+                "clothes."
+            ],
+            [
+                "BP",
+                "100/60",
+                "mmHg,",
+                "HR",
+                "100",
+                "bpm,",
+                "sitting",
+                "70/30,",
+                "HR",
+                "105",
+                "bpm."
+            ],
+            [
+                "PVY",
+                "normal."
+            ],
+            [
+                "Kussmaul's",
+                "respiration."
+            ],
+            [
+                "No",
+                "neurological",
+                "focality."
+            ],
+            [
+                "Weight",
+                "50",
+                "kg."
+            ],
+            [
+                "Lab:",
+                "PH",
+                "7.25,",
+                "PCO2",
+                "14,",
+                "Bicarbonate",
+                "5,",
+                "Na",
+                "133,",
+                "K",
+                "2.5,",
+                "Cl",
+                "118,",
+                "Creat",
+                "3.4,",
+                "NUS",
+                "60,",
+                "Prot",
+                "8."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "answers",
+                "is",
+                "correct?"
+            ],
+            [
+                "1-",
+                "The",
+                "presenting",
+                "acid-base",
+                "disorder",
+                "is",
+                "a",
+                "respiratory",
+                "acidosis."
+            ],
+            [
+                "2-",
+                "Compensation",
+                "to",
+                "correct",
+                "the",
+                "acidosis",
+                "is",
+                "inadequate."
+            ],
+            [
+                "3-",
+                "With",
+                "this",
+                "exploration,",
+                "we",
+                "rule",
+                "out",
+                "that",
+                "she",
+                "is",
+                "dehydrated."
+            ],
+            [
+                "4-",
+                "In",
+                "any",
+                "case,",
+                "we",
+                "should",
+                "not",
+                "put",
+                "bicarbonate."
+            ],
+            [
+                "5-",
+                "She",
+                "has",
+                "an",
+                "acute",
+                "renal",
+                "failure",
+                "of",
+                "prerenal",
+                "cause."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "5"
+            ],
+            [
+                "This",
+                "is",
+                "a",
+                "case",
+                "of",
+                "hyperchloremic",
+                "metabolic",
+                "acidosis",
+                "with",
+                "normal",
+                "anion",
+                "gap."
+            ],
+            [
+                "Severe",
+                "metabolic",
+                "acidosis",
+                "causes",
+                "myocardial",
+                "contractile",
+                "depression,",
+                "reduced",
+                "effectiveness",
+                "of",
+                "catecholamines,",
+                "increased",
+                "incidence",
+                "of",
+                "arrhythmias,",
+                "vasodilatation",
+                "and",
+                "increased",
+                "capillary",
+                "permeability,",
+                "with",
+                "the",
+                "consequent",
+                "reduction",
+                "of",
+                "tissue",
+                "flow,",
+                "at",
+                "the",
+                "cerebral",
+                "level",
+                "(leading",
+                "to",
+                "states",
+                "of",
+                "confusion",
+                "and",
+                "even",
+                "coma),",
+                "at",
+                "the",
+                "renal",
+                "level,",
+                "at",
+                "the",
+                "hepatic",
+                "level..."
+            ],
+            [
+                "These",
+                "patients",
+                "frequently",
+                "present",
+                "intense",
+                "tachypnea",
+                "(Kussmaul's",
+                "breathing)",
+                "in",
+                "an",
+                "attempt",
+                "to",
+                "compensate",
+                "for",
+                "MCA",
+                "by",
+                "hyperventilation."
+            ],
+            [
+                "We",
+                "must",
+                "take",
+                "into",
+                "account",
+                "that,",
+                "in",
+                "this",
+                "case,",
+                "potassium",
+                "is",
+                "decreased,",
+                "so",
+                "the",
+                "most",
+                "frequent",
+                "cause",
+                "(supported",
+                "by",
+                "the",
+                "stains",
+                "on",
+                "the",
+                "dress)",
+                "would",
+                "be",
+                "diarrhea,",
+                "so",
+                "it",
+                "is",
+                "most",
+                "likely",
+                "that",
+                "their",
+                "renal",
+                "failure",
+                "(although",
+                "they",
+                "do",
+                "not",
+                "give",
+                "us",
+                "urine",
+                "ion",
+                "data",
+                "to",
+                "confirm",
+                "it)",
+                "is",
+                "of",
+                "prerenal",
+                "type."
+            ],
+            [
+                "The",
+                "treatment",
+                "would",
+                "be",
+                "water",
+                "and",
+                "electrolyte",
+                "replacement",
+                "and,",
+                "in",
+                "principle,",
+                "unless",
+                "the",
+                "patient",
+                "worsens",
+                "and",
+                "the",
+                "pH",
+                "is",
+                "less",
+                "than",
+                "7.10,",
+                "we",
+                "should",
+                "not",
+                "administer",
+                "bicarbonate."
+            ]
+        ],
+        "labels": [
+            [
+                "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"
+            ],
+            [
+                "B-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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "B-Premise",
+                "I-Premise",
+                "B-Premise",
+                "I-Premise",
+                "B-Premise",
+                "I-Premise",
+                "B-Premise",
+                "I-Premise",
+                "B-Premise",
+                "I-Premise",
+                "B-Premise",
+                "I-Premise",
+                "B-Premise",
+                "I-Premise",
+                "B-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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-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",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "O",
+                "B-Premise",
+                "I-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"
+            ]
+        ]
+    },
+    {
+        "id": "521_76",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "DERMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "7-year-old",
+                "girl",
+                "who",
+                "comes",
+                "for",
+                "consultation",
+                "because",
+                "her",
+                "parents",
+                "notice",
+                "her",
+                "red",
+                "face",
+                "since",
+                "the",
+                "previous",
+                "day",
+                "and",
+                "in",
+                "the",
+                "last",
+                "few",
+                "hours",
+                "they",
+                "have",
+                "noticed",
+                "red",
+                "spots",
+                "on",
+                "her",
+                "body."
+            ],
+            [
+                "On",
+                "examination",
+                "she",
+                "is",
+                "afebrile,",
+                "with",
+                "tonsils",
+                "and",
+                "ears",
+                "without",
+                "alterations,",
+                "normal",
+                "cardiopulmonary",
+                "auscultation."
+            ],
+            [
+                "He",
+                "presents",
+                "a",
+                "confluent",
+                "maculo",
+                "papular",
+                "rash",
+                "on",
+                "both",
+                "cheeks,",
+                "respecting",
+                "the",
+                "upper",
+                "lip,",
+                "resembling",
+                "a",
+                "\"slapped\"",
+                "face."
+            ],
+            [
+                "In",
+                "the",
+                "thorax",
+                "she",
+                "presents",
+                "a",
+                "reticular,",
+                "lacy,",
+                "non-pruritic",
+                "exanthem."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "probable",
+                "clinical",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Chickenpox."
+            ],
+            [
+                "2-",
+                "Rubella."
+            ],
+            [
+                "3-",
+                "Erythema",
+                "infectiosum",
+                "or",
+                "5th",
+                "disease."
+            ],
+            [
+                "4-",
+                "Sudden",
+                "exanthema",
+                "or",
+                "6th",
+                "disease."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Although",
+                "this",
+                "question",
+                "straddles",
+                "the",
+                "line",
+                "between",
+                "derma",
+                "and",
+                "pediatrics,",
+                "we",
+                "would",
+                "like",
+                "to",
+                "do",
+                "our",
+                "bit."
+            ],
+            [
+                "We",
+                "are",
+                "being",
+                "told",
+                "about",
+                "erythema",
+                "s\u00fadenita",
+                "or",
+                "fifth",
+                "disease",
+                "(also",
+                "called",
+                "megaloerythema),",
+                "caused",
+                "by",
+                "parvovirus",
+                "B19."
+            ],
+            [
+                "It",
+                "is",
+                "typical",
+                "that",
+                "after",
+                "an",
+                "episode",
+                "of",
+                "high",
+                "fever",
+                "an",
+                "erythema",
+                "appears",
+                "on",
+                "both",
+                "cheeks",
+                "in",
+                "the",
+                "form",
+                "of",
+                "a",
+                "\"slap\"",
+                "that",
+                "usually",
+                "has",
+                "a",
+                "cranial-caudal",
+                "extension",
+                "in",
+                "the",
+                "following",
+                "days."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "20_110",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "INFECTIOUS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "40-year-old",
+                "male",
+                "patient,",
+                "smoker",
+                "since",
+                "he",
+                "was",
+                "18",
+                "years",
+                "old,",
+                "with",
+                "no",
+                "history",
+                "of",
+                "interest."
+            ],
+            [
+                "He",
+                "consults",
+                "for",
+                "symptoms",
+                "of",
+                "24",
+                "hours",
+                "of",
+                "evolution",
+                "of",
+                "chills,",
+                "thermometric",
+                "fever",
+                "of",
+                "39\u00baC",
+                "and",
+                "cough",
+                "with",
+                "expectoration."
+            ],
+            [
+                "Chest",
+                "X-ray",
+                "shows",
+                "an",
+                "increased",
+                "density",
+                "with",
+                "alveolar",
+                "pattern",
+                "in",
+                "the",
+                "LSD",
+                "and",
+                "the",
+                "patient",
+                "is",
+                "diagnosed",
+                "with",
+                "CAP."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "frequent",
+                "etiological",
+                "agent",
+                "and",
+                "therefore",
+                "of",
+                "obligatory",
+                "coverage",
+                "when",
+                "choosing",
+                "empirical",
+                "atb",
+                "treatment?"
+            ],
+            [
+                "1-",
+                "Mycoplasma",
+                "pneumoniae."
+            ],
+            [
+                "2-",
+                "Chlamydia",
+                "pneumoniae."
+            ],
+            [
+                "3-",
+                "Streptococcus",
+                "pneumoniae."
+            ],
+            [
+                "4-",
+                "Legionella",
+                "pneumophila",
+                "serogroup",
+                "1."
+            ],
+            [
+                "5-",
+                "Haemophilus",
+                "influenzae."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "This",
+                "is",
+                "a",
+                "fairly",
+                "easy",
+                "epidemiology",
+                "question,",
+                "in",
+                "adults",
+                "without",
+                "other",
+                "data,",
+                "Pneumococcus",
+                "is",
+                "the",
+                "1st."
+            ]
+        ],
+        "labels": [
+            [
+                "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"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "422_88",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "ENDOCRINOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "treatment",
+                "of",
+                "choice",
+                "for",
+                "a",
+                "38-year-old",
+                "man",
+                "diagnosed",
+                "with",
+                "Cushing's",
+                "disease",
+                "in",
+                "relation",
+                "to",
+                "a",
+                "pituitary",
+                "macroadenoma",
+                "of",
+                "22",
+                "mm",
+                "in",
+                "diameter?"
+            ],
+            [
+                "1-",
+                "Initially",
+                "try",
+                "medical",
+                "treatment",
+                "and,",
+                "if",
+                "not",
+                "effective,",
+                "resort",
+                "to",
+                "surgery."
+            ],
+            [
+                "2-",
+                "Adrenalectomy."
+            ],
+            [
+                "3-",
+                "Selective",
+                "surgical",
+                "resection",
+                "of",
+                "the",
+                "adenoma."
+            ],
+            [
+                "4-",
+                "Radiotherapy",
+                "to",
+                "try",
+                "to",
+                "reduce",
+                "tumor",
+                "size."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "3"
+            ],
+            [
+                "Although",
+                "the",
+                "majority",
+                "of",
+                "ACTH-producing",
+                "adenomas",
+                "recur,",
+                "surgery",
+                "is",
+                "always",
+                "the",
+                "first",
+                "therapeutic",
+                "option."
+            ],
+            [
+                "The",
+                "available",
+                "medications",
+                "(ketoconazole,",
+                "somatostatin",
+                "analogues)",
+                "are",
+                "aimed",
+                "at",
+                "decreasing",
+                "the",
+                "effects",
+                "of",
+                "excess",
+                "cortisol",
+                "or",
+                "decreasing",
+                "ACTH",
+                "release,",
+                "but",
+                "they",
+                "are",
+                "not",
+                "curative."
+            ]
+        ],
+        "labels": [
+            [
+                "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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "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",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "348_160",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "GYNECOLOGY",
+                "AND",
+                "OBSTETRICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "45-year-old",
+                "woman,",
+                "mother",
+                "of",
+                "3",
+                "children,",
+                "attends",
+                "an",
+                "early",
+                "diagnosis",
+                "consultation."
+            ],
+            [
+                "The",
+                "cervicovaginal",
+                "cytology",
+                "is",
+                "compatible",
+                "with",
+                "a",
+                "high-grade",
+                "squamous",
+                "intraepithelial",
+                "lesion."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "options",
+                "would",
+                "you",
+                "choose?"
+            ],
+            [
+                "1-",
+                "Repeat",
+                "cytology",
+                "in",
+                "1",
+                "month."
+            ],
+            [
+                "2-",
+                "Colposcopy",
+                "with",
+                "possible",
+                "biopsy."
+            ],
+            [
+                "3-",
+                "Hysterectomy",
+                "with",
+                "bilateral",
+                "salpinguectomy",
+                "and",
+                "ovarian",
+                "conservation."
+            ],
+            [
+                "4-",
+                "Fractionated",
+                "uterine",
+                "curettage."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Colposcopy",
+                "is",
+                "indicated",
+                "for",
+                "all",
+                "patients",
+                "with",
+                "altered",
+                "cytology",
+                "(intraepithelial",
+                "lesion",
+                "or",
+                "suspicion",
+                "of",
+                "invasive",
+                "cancer",
+                "or",
+                "HPV",
+                "infection),",
+                "as",
+                "a",
+                "second",
+                "level",
+                "of",
+                "screening."
+            ],
+            [
+                "If",
+                "lesions",
+                "are",
+                "observed",
+                "in",
+                "this",
+                "test,",
+                "a",
+                "biopsy",
+                "of",
+                "the",
+                "lesion",
+                "will",
+                "be",
+                "performed."
+            ],
+            [
+                "There",
+                "is",
+                "no",
+                "point",
+                "in",
+                "repeating",
+                "the",
+                "cytology",
+                "(since",
+                "this",
+                "is",
+                "a",
+                "screening",
+                "test,",
+                "not",
+                "a",
+                "diagnostic",
+                "test),",
+                "performing",
+                "a",
+                "hysterectomy",
+                "for",
+                "an",
+                "intraepithelial",
+                "lesion",
+                "that",
+                "has",
+                "not",
+                "been",
+                "confirmed",
+                "by",
+                "biopsy",
+                "is",
+                "not",
+                "indicated",
+                "either,",
+                "and",
+                "performing",
+                "curettage",
+                "of",
+                "the",
+                "endometrial",
+                "cavity",
+                "does",
+                "not",
+                "provide",
+                "information",
+                "since",
+                "the",
+                "lesion",
+                "is",
+                "from",
+                "the",
+                "cervix."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "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",
+                "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"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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",
+                "B-Marker",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ]
+        ]
+    },
+    {
+        "id": "411_52",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "BIOSTATISTICS"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "couple",
+                "with",
+                "a",
+                "first",
+                "male",
+                "child",
+                "(index",
+                "case)",
+                "with",
+                "cystic",
+                "fibrosis",
+                "(mucoviscidosis)",
+                "come",
+                "for",
+                "genetic",
+                "counseling."
+            ],
+            [
+                "Molecular",
+                "diagnosis",
+                "indicates",
+                "that",
+                "the",
+                "index",
+                "case",
+                "is",
+                "homozygous",
+                "for",
+                "the",
+                "F5O8del",
+                "mutation",
+                "and",
+                "his",
+                "parents",
+                "are",
+                "heterozygous",
+                "carriers."
+            ],
+            [
+                "The",
+                "clinical",
+                "geneticist",
+                "will",
+                "inform",
+                "them",
+                "about",
+                "the",
+                "mode",
+                "of",
+                "transmission",
+                "of",
+                "the",
+                "disease."
+            ],
+            [
+                "Which",
+                "statement",
+                "is",
+                "correct?"
+            ],
+            [
+                "1-",
+                "The",
+                "probability",
+                "that",
+                "the",
+                "next",
+                "offspring",
+                "will",
+                "be",
+                "affected",
+                "is",
+                "25%."
+            ],
+            [
+                "2-",
+                "The",
+                "probability",
+                "that",
+                "the",
+                "next",
+                "offspring",
+                "will",
+                "be",
+                "affected",
+                "is",
+                "50%."
+            ],
+            [
+                "3-",
+                "Having",
+                "had",
+                "an",
+                "affected",
+                "child,",
+                "the",
+                "next",
+                "offspring",
+                "will",
+                "also",
+                "be",
+                "affected."
+            ],
+            [
+                "4-",
+                "Having",
+                "had",
+                "a",
+                "homozygous",
+                "F5O8del",
+                "child,",
+                "the",
+                "next",
+                "offspring",
+                "will",
+                "be",
+                "heterozygous",
+                "carriers",
+                "(67%)",
+                "or",
+                "homozygous",
+                "genotype",
+                "without",
+                "the",
+                "mutation",
+                "(33%)."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "Both",
+                "parents",
+                "are",
+                "carriers",
+                "of",
+                "a",
+                "mutation",
+                "(because",
+                "they",
+                "are",
+                "not",
+                "sick",
+                "and",
+                "have",
+                "already",
+                "had",
+                "a",
+                "homozygous",
+                "child),",
+                "and",
+                "the",
+                "next",
+                "offspring",
+                "has",
+                "a",
+                "50%",
+                "chance",
+                "of",
+                "receiving",
+                "the",
+                "mutation",
+                "from",
+                "each",
+                "parent,",
+                "so",
+                "the",
+                "probability",
+                "of",
+                "receiving",
+                "it",
+                "from",
+                "both",
+                "is",
+                "50%x50%=25%."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ],
+            [
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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"
+            ],
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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"
+            ],
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+                "O",
+                "O"
+            ],
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+                "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",
+                "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",
+                "B-Marker",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "590_64",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "OPHTHALMOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "68-year-old",
+                "woman",
+                "who",
+                "uses",
+                "+4.00",
+                "diopter",
+                "glasses",
+                "for",
+                "distance",
+                "vision",
+                "in",
+                "both",
+                "eyes."
+            ],
+            [
+                "She",
+                "consults",
+                "because",
+                "she",
+                "has",
+                "been",
+                "having",
+                "eye",
+                "pain",
+                "with",
+                "headache",
+                "and",
+                "blurred",
+                "vision",
+                "at",
+                "night",
+                "when",
+                "she",
+                "is",
+                "watching",
+                "television",
+                "in",
+                "dim",
+                "light",
+                "for",
+                "a",
+                "few",
+                "weeks."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "pathologies",
+                "is",
+                "she",
+                "most",
+                "likely",
+                "to",
+                "have?"
+            ],
+            [
+                "1-",
+                "Primary",
+                "angular",
+                "closure",
+                "glaucoma."
+            ],
+            [
+                "2-",
+                "Migraine."
+            ],
+            [
+                "3-",
+                "Actinic",
+                "keratitis."
+            ],
+            [
+                "4-",
+                "Dry",
+                "eye",
+                "syndrome."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "1"
+            ],
+            [
+                "We",
+                "are",
+                "presented",
+                "with",
+                "a",
+                "68-year-old",
+                "female",
+                "patient."
+            ],
+            [
+                "At",
+                "that",
+                "age",
+                "the",
+                "crystalline",
+                "lens,",
+                "although",
+                "it",
+                "does",
+                "not",
+                "normally",
+                "have",
+                "a",
+                "cataract",
+                "that",
+                "needs",
+                "surgery,",
+                "it",
+                "usually",
+                "has",
+                "increased",
+                "in",
+                "thickness."
+            ],
+            [
+                "This",
+                "implies",
+                "that",
+                "it",
+                "projects",
+                "the",
+                "iris",
+                "forward",
+                "and",
+                "reduces",
+                "the",
+                "depth",
+                "of",
+                "the",
+                "anterior",
+                "chamber."
+            ],
+            [
+                "In",
+                "an",
+                "eye",
+                "with",
+                "a",
+                "normal",
+                "anterior",
+                "chamber",
+                "depth",
+                "this",
+                "is",
+                "usually",
+                "not",
+                "a",
+                "problem."
+            ],
+            [
+                "But",
+                "farsighted",
+                "people",
+                "already",
+                "have",
+                "a",
+                "narrow",
+                "anterior",
+                "chamber."
+            ],
+            [
+                "This",
+                "is",
+                "the",
+                "usual",
+                "combination",
+                "we",
+                "find",
+                "in",
+                "primary",
+                "angular",
+                "closure:",
+                "farsightedness",
+                "and",
+                "age",
+                "over",
+                "50-60",
+                "years."
+            ],
+            [
+                "Younger",
+                "hyperopes",
+                "usually",
+                "do",
+                "not",
+                "have",
+                "this",
+                "problem",
+                "yet."
+            ],
+            [
+                "And",
+                "neither",
+                "do",
+                "older",
+                "people",
+                "who",
+                "are",
+                "emmetropic,",
+                "myopic",
+                "or",
+                "have",
+                "had",
+                "cataract",
+                "surgery."
+            ],
+            [
+                "With",
+                "this",
+                "narrow",
+                "angle,",
+                "what",
+                "triggers",
+                "angular",
+                "closure",
+                "is",
+                "mydriasis."
+            ],
+            [
+                "That",
+                "is,",
+                "when",
+                "you",
+                "are",
+                "in",
+                "the",
+                "penumbra,",
+                "the",
+                "pupil",
+                "dilates",
+                "and",
+                "the",
+                "iris",
+                "thickens",
+                "in",
+                "the",
+                "peripheral",
+                "part,",
+                "where",
+                "it",
+                "is",
+                "already",
+                "very",
+                "close",
+                "to",
+                "the",
+                "corneal",
+                "endothelium",
+                "in",
+                "the",
+                "case",
+                "of",
+                "a",
+                "narrow",
+                "chamber."
+            ],
+            [
+                "Mydriasis",
+                "then",
+                "triggers",
+                "angular",
+                "closure,",
+                "which",
+                "is",
+                "accompanied",
+                "by",
+                "ocular",
+                "pain",
+                "that",
+                "may",
+                "radiate",
+                "backwards",
+                "(headache)."
+            ],
+            [
+                "And",
+                "increased",
+                "intraocular",
+                "pressure",
+                "produces",
+                "corneal",
+                "edema",
+                "that",
+                "causes",
+                "blurred",
+                "vision."
+            ],
+            [
+                "Therefore,",
+                "option",
+                "1",
+                "is",
+                "correct."
+            ],
+            [
+                "Migraine",
+                "does",
+                "not",
+                "have",
+                "to",
+                "be",
+                "related",
+                "to",
+                "penumbra,",
+                "and",
+                "ocular",
+                "pain",
+                "and",
+                "blurred",
+                "vision",
+                "is",
+                "not",
+                "particularly",
+                "typical."
+            ],
+            [
+                "Actinic",
+                "keratitis",
+                "is",
+                "caused",
+                "by",
+                "exposure",
+                "to",
+                "ultraviolet",
+                "radiation",
+                "(such",
+                "as",
+                "solar",
+                "radiation),",
+                "and",
+                "is",
+                "not",
+                "related",
+                "to",
+                "hyperopia",
+                "or",
+                "to",
+                "being",
+                "in",
+                "penumbra."
+            ],
+            [
+                "In",
+                "addition,",
+                "the",
+                "history",
+                "of",
+                "exposure",
+                "is",
+                "usually",
+                "clear."
+            ],
+            [
+                "And",
+                "finally,",
+                "dry",
+                "eye",
+                "does",
+                "not",
+                "produce",
+                "these",
+                "symptoms",
+                "either:",
+                "it",
+                "is",
+                "more",
+                "a",
+                "question",
+                "of",
+                "burning,",
+                "foreign",
+                "body",
+                "sensation,",
+                "heaviness,",
+                "etc."
+            ],
+            [
+                "And",
+                "it",
+                "is",
+                "also",
+                "unrelated",
+                "to",
+                "the",
+                "other",
+                "elements:",
+                "penumbra,",
+                "hyperopia,",
+                "etc."
+            ],
+            [
+                "As",
+                "a",
+                "minor",
+                "detail,",
+                "I",
+                "would",
+                "have",
+                "worded",
+                "the",
+                "question",
+                "a",
+                "little",
+                "better."
+            ],
+            [
+                "It",
+                "is",
+                "understood",
+                "that",
+                "we",
+                "are",
+                "asked",
+                "which",
+                "pathology",
+                "is",
+                "the",
+                "most",
+                "probable",
+                "in",
+                "relation",
+                "to",
+                "the",
+                "symptoms",
+                "and",
+                "the",
+                "anamnesis."
+            ],
+            [
+                "But",
+                "as",
+                "it",
+                "is",
+                "worded,",
+                "we",
+                "are",
+                "asked",
+                "about",
+                "which",
+                "of",
+                "the",
+                "pathologies",
+                "she",
+                "is",
+                "most",
+                "likely",
+                "to",
+                "present,",
+                "just",
+                "like",
+                "that."
+            ],
+            [
+                "Actually,",
+                "a",
+                "68-year-old",
+                "woman",
+                "is",
+                "very",
+                "likely",
+                "to",
+                "have",
+                "dry",
+                "eye,",
+                "even",
+                "if",
+                "it",
+                "does",
+                "not",
+                "cause",
+                "the",
+                "symptoms",
+                "for",
+                "which",
+                "she",
+                "is",
+                "presenting."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
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+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise"
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+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
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+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
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+                "O",
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+                "O",
+                "O",
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+                "I-Claim",
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+                "I-Claim"
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+            ],
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+                "I-Claim",
+                "O",
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+                "I-Claim",
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+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ]
+        ]
+    },
+    {
+        "id": "86_51",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "CARDIOLOGY",
+                "AND",
+                "VASCULAR",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "26-year-old",
+                "man",
+                "with",
+                "no",
+                "history",
+                "of",
+                "interest,",
+                "asymptomatic,",
+                "presents",
+                "on",
+                "examination",
+                "with",
+                "a",
+                "mesosystolic",
+                "murmur",
+                "in",
+                "the",
+                "aortic",
+                "focus",
+                "and",
+                "left",
+                "parasternal",
+                "border",
+                "that",
+                "increases",
+                "with",
+                "the",
+                "Valsalva",
+                "maneuver."
+            ],
+            [
+                "BP",
+                "and",
+                "peripheral",
+                "pulses",
+                "are",
+                "normal",
+                "and",
+                "the",
+                "ECG",
+                "shows",
+                "signs",
+                "of",
+                "marked",
+                "left",
+                "ventricular",
+                "enlargement",
+                "and",
+                "very",
+                "deep",
+                "negative",
+                "T",
+                "waves",
+                "in",
+                "V3,",
+                "V4,",
+                "V5",
+                "and",
+                "V6."
+            ],
+            [
+                "What",
+                "is",
+                "the",
+                "most",
+                "likely",
+                "diagnosis?"
+            ],
+            [
+                "1-",
+                "Functional",
+                "murmur."
+            ],
+            [
+                "2-",
+                "Aortic",
+                "stenosis."
+            ],
+            [
+                "3-",
+                "Aortic",
+                "insufficiency."
+            ],
+            [
+                "4-",
+                "Hypertrophic",
+                "cardiomyopathy."
+            ],
+            [
+                "5-",
+                "Ventricular",
+                "septal",
+                "defect."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "A",
+                "young",
+                "male",
+                "patient",
+                "with",
+                "an",
+                "aortic",
+                "systolic",
+                "murmur",
+                "that",
+                "increases",
+                "with",
+                "the",
+                "Valsalva",
+                "maneuver",
+                "and",
+                "signs",
+                "of",
+                "left",
+                "ventricular",
+                "enlargement",
+                "is",
+                "practically",
+                "a",
+                "\"portrait\"",
+                "of",
+                "the",
+                "typical",
+                "findings",
+                "that",
+                "can",
+                "be",
+                "found",
+                "in",
+                "hypertrophic",
+                "cardiomyopathy."
+            ],
+            [
+                "Very",
+                "easy",
+                "question."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "O",
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-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",
+                "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",
+                "O",
+                "O"
+            ]
+        ]
+    },
+    {
+        "id": "498_129",
+        "text": "",
+        "labels": ""
+    },
+    {
+        "id": "31_233",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "NEUROLOGY",
+                "AND",
+                "THORACIC",
+                "SURGERY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "A",
+                "patient",
+                "diagnosed",
+                "with",
+                "bronchial",
+                "asthma",
+                "who",
+                "is",
+                "being",
+                "treated",
+                "with",
+                "low-dose",
+                "inhaled",
+                "steroids",
+                "(200",
+                "micrograms",
+                "of",
+                "budesonide",
+                "every",
+                "12",
+                "hours)",
+                "and",
+                "rescue",
+                "medication",
+                "(salbutamol",
+                "on",
+                "demand)",
+                "comes",
+                "for",
+                "periodic",
+                "clinical",
+                "monitoring."
+            ],
+            [
+                "The",
+                "patient",
+                "reports",
+                "that",
+                "in",
+                "the",
+                "last",
+                "3",
+                "months",
+                "he",
+                "has",
+                "had",
+                "no",
+                "exacerbations",
+                "and",
+                "that",
+                "he",
+                "uses",
+                "salbutamol",
+                "once",
+                "a",
+                "day."
+            ],
+            [
+                "He",
+                "only",
+                "has",
+                "dyspnea",
+                "when",
+                "climbing",
+                "stairs",
+                "and",
+                "some",
+                "nights",
+                "he",
+                "sleeps",
+                "irregularly",
+                "due",
+                "to",
+                "coughing."
+            ],
+            [
+                "Which",
+                "of",
+                "the",
+                "following",
+                "therapeutic",
+                "options",
+                "should",
+                "be",
+                "considered",
+                "as",
+                "the",
+                "treatment",
+                "of",
+                "choice?"
+            ],
+            [
+                "1-",
+                "Increase",
+                "the",
+                "dose",
+                "of",
+                "inhaled",
+                "corticosteroids",
+                "to",
+                "800",
+                "micrograms/day."
+            ],
+            [
+                "2-",
+                "Add",
+                "tiotropium."
+            ],
+            [
+                "3-",
+                "Maintain",
+                "the",
+                "same",
+                "pharmacological",
+                "regimen."
+            ],
+            [
+                "4-",
+                "Switch",
+                "to",
+                "ocmbined",
+                "therapy",
+                "with",
+                "low-dose",
+                "inhaled",
+                "corticosteroids",
+                "and",
+                "long-acting",
+                "beta2-adrenergics."
+            ],
+            [
+                "5-",
+                "Add",
+                "leukotrienes."
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "4"
+            ],
+            [
+                "Asthma",
+                "treatment",
+                "algorithm."
+            ],
+            [
+                "We",
+                "rule",
+                "out",
+                "continuing",
+                "with",
+                "the",
+                "same",
+                "treatment",
+                "since",
+                "the",
+                "patient",
+                "is",
+                "symptomatic."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O",
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "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",
+                "I-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"
+            ],
+            [
+                "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"
+            ],
+            [
+                "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"
+            ]
+        ]
+    },
+    {
+        "id": "618_119",
+        "text": [
+            [
+                "QUESTION",
+                "TYPE:",
+                "TRAUMATOLOGY"
+            ],
+            [
+                "CLINICAL",
+                "CASE:"
+            ],
+            [
+                "13-year-old",
+                "female,",
+                "with",
+                "no",
+                "relevant",
+                "history,",
+                "with",
+                "menarche",
+                "3",
+                "months",
+                "ago,",
+                "followed",
+                "since",
+                "the",
+                "age",
+                "of",
+                "10",
+                "years",
+                "for",
+                "idiopathic",
+                "scoliosis",
+                "that",
+                "has",
+                "worsened."
+            ],
+            [
+                "In",
+                "the",
+                "physical",
+                "examination",
+                "she",
+                "presents",
+                "a",
+                "hump",
+                "of",
+                "7",
+                "degrees",
+                "in",
+                "the",
+                "Adams",
+                "test",
+                "and",
+                "in",
+                "the",
+                "scoliogram",
+                "a",
+                "T4-L1",
+                "thoracolumbar",
+                "curve",
+                "of",
+                "35",
+                "degrees",
+                "of",
+                "Cobb",
+                "and",
+                "a",
+                "Risser",
+                "0:"
+            ],
+            [
+                "1-",
+                "Recommend",
+                "swimming",
+                "and",
+                "review",
+                "in",
+                "three",
+                "months."
+            ],
+            [
+                "2-",
+                "Prescribe",
+                "a",
+                "brace-type",
+                "orthosis."
+            ],
+            [
+                "3-",
+                "Refer",
+                "to",
+                "physiotherapy",
+                "for",
+                "spine",
+                "elastification."
+            ],
+            [
+                "4-",
+                "Check",
+                "in",
+                "6",
+                "months",
+                "with",
+                "a",
+                "new",
+                "X-ray."
+            ],
+            [
+                "5-",
+                "nan"
+            ],
+            [
+                "CORRECT",
+                "ANSWER:",
+                "2"
+            ],
+            [
+                "Treatment",
+                "with",
+                "a",
+                "brace",
+                "in",
+                "Risser",
+                "from",
+                "0",
+                "to",
+                "2",
+                "can",
+                "be",
+                "considered",
+                "since",
+                "there",
+                "is",
+                "still",
+                "growth",
+                "to",
+                "occur",
+                "and",
+                "correction",
+                "can",
+                "take",
+                "place."
+            ],
+            [
+                "Its",
+                "use",
+                "is",
+                "considered",
+                "for",
+                "curves",
+                "between",
+                "30-40\u00ba."
+            ]
+        ],
+        "labels": [
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "B-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise",
+                "I-Premise"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim"
+            ],
+            [
+                "O",
+                "O"
+            ],
+            [
+                "O",
+                "O",
+                "O"
+            ],
+            [
+                "B-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "I-Claim",
+                "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"
+            ]
+        ]
+    }
+]
\ No newline at end of file