id,text,labels
402_183,"[['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', 'Sofia', '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.'], ['Sofia', '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', ""Sofia's"", 'age.'], ['2-', 'Because', 'you', 'consider', 'Sofia', '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.']]","[['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']]"
237_144,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
620_121,,
396_136,,
253_86,"[['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).']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
224_63,"[['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', 'cm².'], ['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', 'cm²)', '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.']]","[['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'], ['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']]"
430_115,"[['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.']]","[['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']]"
588_63,,
11_74,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
535_121,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
452_149,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
55_74,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', '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']]"
281_33,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
310_216,"[['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.""]]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
293_214,"[['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.']]","[['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']]"
132_229,"[['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...']]","[['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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
49_159,,
120_192,"[['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.']]","[['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']]"
304_174,"[['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.']]","[['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']]"
214_228,"[['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°C.'], ['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['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']]"
249_120,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
53_146,"[['QUESTION', 'TYPE:', 'PSYCHIATRY'], ['CLINICAL', 'CASE:'], ['A', '31-year-old', 'man', 'with', 'no', 'psychiatric', 'history', 'comes', 'to', 'the', 'emergency', 'room', 'complaining...¨', '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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
48_158,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
490_106,"[['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/μL,(neutrophils', '41.9%,', 'lymphocytes', '55.8%),platelets', '48.0', 'x103/μL,', 'fibrinogen', '118', 'mg/dL,D-dimer', '20.2', 'μg/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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
416_76,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
45_154,,
336_31,"[['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.']]","[['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']]"
609_115,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
389_235,,
201_76,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
345_159,"[['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.']]","[['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']]"
166_82,"[['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....']]","[['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']]"
481_171,,
612_116,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['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']]"
585_74,"[['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.']]","[['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']]"
3_37,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
439_96,"[['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"".']]","[['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']]"
192_160,"[['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°C.'], ['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['O', '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']]"
261_100,,
289_65,"[['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.']]","[['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', 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'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
366_106,"[['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/µL,', 'leukocytes', '2500/µL', '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.']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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'], ['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', '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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
544_40,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['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']]"
533_179,"[['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).']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['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']]"
80_37,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
394_225,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
229_178,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
198_73,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['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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'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']]"
351_161,"[['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.']]","[['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']]"
69_124,"[['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).']]","[['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']]"
140_134,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
475_89,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
85_50,"[['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.']]","[['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', 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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', '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']]"
527_31,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
407_81,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 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'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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']]"
15_126,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', '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', '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', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['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']]"
322_85,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
610_116,,
391_222,"[['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.'], ['As', 'a', 'psychiatry', 'resident,', 'I', 'wish', 'the', 'MIR', 'questions', 'in', 'my', 'specialty', 'were', 'a', 'bit', 'more', 'thought-provoking', 'and', 'in-depth,', 'although', 'I', 'know', 'that', 'the', 'seconds', 'you', 'will', 'have', 'saved', 'by', 'marking', 'the', 'fourth', 'one', 'directly', 'are', 'very', 'valuable.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
324_55,"[['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', 'frémito.'], ['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.']]","[['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']]"
240_150,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
68_123,"[['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).'], ['3-', 'We', 'will', 'notify', 'the', 'cardiologist', 'on', 'duty', 'to', 'evaluate', 'the', 'patient.'], ['4-', 'From', 'the', 'Triage', 'consultation,', 'the', 'patient', 'will', 'be', 'referred', 'to', 'the', 'Coronary', 'Unit.'], ['5-', 'We', 'will', 'do', 'an', 'ECG', 'in', 'less', 'than', '10', 'minutes.'], ['CORRECT', 'ANSWER:', '5'], ['If', 'the', 'ECG', 'shows', 'ischemic', 'changes,', 'we', 'will', 'obviously', 'treat', '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.']]","[['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'], ['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', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
206_125,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
570_153,"[['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).']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
506_87,"[['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.']]","[['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']]"
619_121,,
161_118,"[['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/mm³,', '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.']]","[['O', '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']]"
269_141,,
18_138,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
250_78,"[['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).']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
5_44,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
359_91,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
108_219,"[['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).']]","[['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']]"
255_94,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', '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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
303_111,"[['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'], ['Amyloidosis', 'presents', 'with', 'proteinuria', 'usually', 'in', 'the', 'nephrotic', 'range,', 'and', 'has', 'a', 'more', 'chronic', 'course.'], ['GMN', 'associated', 'with', 'rheumatoid', 'arthritis', 'characteristically', 'alters', 'the', 'sediment,', 'and', 'renal', 'failure', 'due', 'to', 'NSAIDs', 'has', 'a', 'more', 'chronic', 'course,', 'with', 'papillary', 'necrosis.'], ['Thus,', 'given', 'the', 'course', 'and', 'the', 'alterations', 'described,', 'interstitial', 'nephritis', 'due', 'to', 'methotrexate', 'is', 'more', 'likely,', 'which', 'is', 'more', 'directly', 'toxic', 'than', 'allergic,', 'hence', 'the', 'absence', 'of', 'pyuria,', 'eosinophilia,', 'fever', 'or', 'other', 'hypersensitivity', 'data.']]","[['O', 'O', 'O'], ['O', 'O'], ['O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
539_3,,
408_190,"[['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.'], ['In', '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?'], ['1-', 'Suspend', 'ibuprofen', 'and', 'tramadol', 'and', 'start', 'a', 'major', 'opioid', 'such', 'as', 'morphine', 'or', 'oxycodone.'], ['2-', 'Suspend', 'tramadol,', 'maintain', 'ibuprofen', 'and', 'initiate', 'a', 'major', 'opioid', 'such', 'as', 'morphine', 'and', 'oxycodone.'], ['3-', '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.'], ['4-', 'Suspend', 'tramadol,', 'maintain', 'ibuprofen', 'and', 'initiate', 'a', 'major', 'opioid', 'such', 'as', 'morphine', 'and', 'oxycodone', 'and', 'at', 'the', 'same', 'time', 'treatment', 'for', 'breakthrough', 'pain', 'with', 'sublingual', 'fentanyl.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '4'], ['The', 'correct', '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.'], ['We', '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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', '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', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-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', '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', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise']]"
29_60,"[['QUESTION', 'TYPE:', 'NEUROLOGY', 'AND', 'THORACIC', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '71-year-old', 'patient,', 'smoker', 'of', '2', 'packs', 'of', 'cigarettes/day', 'for', '50', 'years,', 'with', 'good', 'quality', 'of', 'life', 'and', 'no', 'other', 'pathologic', 'history', 'of', 'interest,', 'consults', 'for', 'cough', 'and', 'hemoptotic', 'expectoration.'], ['Physical', 'examination', 'revealed', 'no', 'significant', 'pathological', 'findings.'], ['Chest', 'X-ray', 'showed', 'a', 'mass', 'of', '4x3.4', 'cm', 'lower', 'right,', 'a', '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.']]","[['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']]"
10_37,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
284_57,,
188_230,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
349_160,"[['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).']]","[['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']]"
290_50,"[['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.']]","[['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']]"
305_174,"[['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.']]","[['O', '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']]"
104_91,,
38_232,"[['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', ""Sjögren'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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
376_130,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
163_122,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['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']]"
148_158,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 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'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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'], ['O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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'], ['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O'], ['B-Premise', 'I-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'], ['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']]"
178_94,"[['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″', '(normal', '25-35″)', '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).']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['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', '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']]"
100_85,"[['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', '187μIU/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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
398_140,"[['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.']]","[['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']]"
28_58,,
587_76,,
554_50,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
251_81,"[['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', '38.5ºC,', '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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
128_79,"[['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.']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
0_34,"[['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).']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
256_162,"[['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.'], ['The', 'rest', 'of', 'the', 'entities', 'offered', 'do', 'not', 'present', 'with', 'chylous', 'ascitic', 'fluid.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
604_113,"[['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%.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
362_96,,
410_195,"[['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.'], ['An', 'alternative', '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?'], ['1-', '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.'], ['4-', 'Enrolling', 'the', 'patient', 'in', 'terminal', 'palliative', 'care.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '1'], ['The', 'correct', 'answer', 'is', '1', 'since', '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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['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']]"
361_94,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
172_50,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
83_48,"[['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.']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-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']]"
141_135,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
317_139,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
550_129,,
110_152,"[['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.']]","[['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']]"
419_77,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
37_227,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['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'], ['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'], ['B-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'], ['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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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', 'I-Claim', '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', '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']]"
532_67,,
272_69,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
428_61,"[['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″C', '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.']]","[['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'], 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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'], ['O', 'O'], ['O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-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']]"
393_224,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['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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124_46,"[['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...).']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
405_31,"[['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', 'Ramón,', '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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-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'], ['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']]"
497_127,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
307_207,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['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-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-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', 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'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']]"
589_63,,
350_160,"[['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.']]","[['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']]"
25_116,"[['QUESTION', 'TYPE:', 'INFECTIOUS'], ['CLINICAL', 'CASE:'], ['A', '40-year-old', 'woman', 'is', 'admitted', 'to', 'the', 'Emergency', 'Department', 'with', 'a', 'fever', 'of', '38ºC', '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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
103_89,,
22_112,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['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']]"
488_105,"[['QUESTION', 'TYPE:', 'HEMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '67-year-old', 'patient', 'who', 'in', 'the', 'last', '6', 'months,', 'in', 'two', 'routine', 'analyses,', 'presents', 'progressive', 'lymphocytosis.'], ['In', 'the', 'last', 'one,', 'hemoglobin', '15.4', 'g/dL;', 'leukocytes', '18.5', 'x103/μL', 'with', '82%', 'of', 'mature', 'lymphocytes', 'that', 'by', 'flow', 'cytometry', 'express', 'CD5/CD19/CD23', 'antigens', 'and', 'platelets', '240', 'x103/μL.'], ['What', '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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
111_153,"[['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.']]","[['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']]"
119_119,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
562_183,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
514_97,"[['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.']]","[['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']]"
101_86,"[['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).""']]","[['O', 'O', 'O'], ['O', 'O'], ['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']]"
230_179,"[['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).']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
479_164,"[['QUESTION', 'TYPE:', 'CRITICAL', 'CARE'], ['CLINICAL', 'CASE:'], ['A', '72-year-old', 'man', 'presenting', 'since', '48', 'hours', 'with', 'fever', 'of', '38.7°C,', '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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
515_101,"[['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).']]","[['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'], ['B-Premise', 'I-Premise', 'I-Premise', 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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'], ['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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-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-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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']]"
234_105,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
174_52,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
143_141,"[['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......']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
9_36,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
601_112,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
202_44,"[['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.']]","[['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']]"
259_97,"[['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.']]","[['O', 'O', 'O'], ['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']]"
204_220,"[['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.']]","[['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']]"
4_40,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
372_127,"[['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.']]","[['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']]"
377_131,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
145_143,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
567_150,"[['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).']]","[['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']]"
177_93,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['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']]"
125_105,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
510_151,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
268_140,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
465_116,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
340_33,"[['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.']]","[['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']]"
561_180,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
451_175,"[['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', 'Lasège', 'at', '10º,', '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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['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']]"
399_141,"[['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.']]","[['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']]"
12_92,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 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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'], ['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']]"
605_113,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
443_102,"[['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.']]","[['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']]"
197_71,"[['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).']]","[['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']]"
478_134,"[['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).']]","[['O', 'O', 'O', 'O'], ['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']]"
97_171,"[['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).']]","[['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']]"
426_94,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
262_58,"[['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%.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
346_159,"[['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.']]","[['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']]"
170_89,"[['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.']]","[['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']]"
40_136,"[['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.']]","[['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']]"
126_59,"[['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.']]","[['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']]"
568_151,"[['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', 'ºC,', '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).']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
286_60,,
228_75,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
217_122,"[['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).']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
142_138,"[['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.']]","[['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']]"
267_139,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
99_84,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
380_135,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
341_33,"[['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.']]","[['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']]"
308_215,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
519_176,,
63_200,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['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'], ['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']]"
30_61,"[['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.']]","[['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-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'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-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', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', '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', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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', '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-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
226_71,"[['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!']]","[['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'], ['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'], ['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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
565_148,,
135_38,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
556_55,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
448_148,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
591_64,"[['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).']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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', 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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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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', 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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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim']]"
291_157,"[['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.']]","[['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']]"
213_160,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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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442_100,"[['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.']]","[['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']]"
491_106,"[['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/μL,(neutrophils', '41.9', '%,', 'lymphocytes', '55.8', '%),platelets', '48.0', 'x103/μL,', 'fibrinogen', '118', 'mg/dL,D-dimer', '20.2', 'μg/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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', 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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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
277_226,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['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'], ['O', 'O'], ['O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
155_83,"[['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...).']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
373_86,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
523_124,"[['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/µl', '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/µL.'], ['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).']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
417_76,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-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', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
403_135,"[['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', 'Müller', 'muscle,', 'which', 'is', 'an', 'accessory', 'muscle', 'to', 'the', 'levator', 'of', 'the', 'upper', 'eyelid.'], ['If', 'the', 'Müller', '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', 'alteration', 'of', 'the', '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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['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-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
42_150,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
445_233,"[['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.']]","[['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']]"
511_152,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 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'I-Claim', 'I-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-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']]"
33_65,"[['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.']]","[['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', 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'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']]"
129_81,"[['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.']]","[['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']]"
503_80,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
300_106,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
434_119,"[['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).']]","[['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']]"
563_175,"[['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).']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
89_57,"[['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.']]","[['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']]"
586_75,"[['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.']]","[['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']]"
461_148,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
547_125,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
193_161,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
431_116,"[['QUESTION', 'TYPE:', 'INFECTIOUS', 'DISEASES', 'AND', 'MICROBIOLOGY'], ['CLINICAL', 'CASE:'], ['A', '38-year-old', 'man', 'comes', 'to', 'the', 'emergency', 'department', 'with', 'fever', 'above', '39ºC', '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.']]","[['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']]"
569_152,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
501_76,"[['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.']]","[['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']]"
242_111,"[['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', '38ºC.'], ['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
487_68,"[['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).']]","[['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'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
364_176,"[['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', '≥3', 'nodal', 'areas,', 'each', 'with', 'a', 'diameter', '≥', '3', 'cm.'], ['-', 'Any', 'nodal', 'or', 'extranodal', 'mass', 'with', 'a', 'diameter', '≥', '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).']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['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']]"
90_32,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
528_134,"[['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).']]","[['O', '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']]"
583_70,"[['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).']]","[['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']]"
195_163,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
84_49,"[['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.']]","[['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']]"
427_95,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
462_151,"[['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).']]","[['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']]"
557_168,"[['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', '≥', '126mgr/dl', '(fasting', 'at', 'least', '8h)', 'or', '*', 'Glycemia', 'at', '2h', 'SOG', '≥', '200mgr/dl', '(on', '2', 'occasions)', 'or', '*', 'HbA1C', '≥', '6.5%.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
35_68,"[['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.']]","[['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']]"
271_170,"[['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.']]","[['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'], 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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', 'I-Claim', 'I-Claim', 'I-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']]"
306_207,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
328_83,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
223_62,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
468_122,"[['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).']]","[['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']]"
96_170,"[['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.']]","[['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']]"
603_112,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-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']]"
574_100,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
67_111,"[['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.']]","[['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']]"
77_31,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
440_97,,
203_47,"[['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.']]","[['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']]"
158_133,"[['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.']]","[['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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
46_155,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-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']]"
593_146,,
395_136,,
424_91,"[['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).']]","[['O', 'O', 'O'], ['O', 'O'], ['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']]"
169_87,"[['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.']]","[['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']]"
95_170,"[['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.']]","[['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']]"
537_1,,
363_97,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
339_33,"[['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.']]","[['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']]"
144_142,"[['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', '35ºC,', '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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
356_166,"[['QUESTION', 'TYPE:', 'GYNECOLOGY', 'AND', 'OBSTETRICS'], ['CLINICAL', 'CASE:'], ['A', 'pregnant', 'woman,', '10', 'weeks', 'pregnant,', 'comes', 'to', 'the', 'emergency', 'room', 'with', 'a', 'blood', 'pressure', 'of', '160/105', 'mmHg.'], ['She', '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', 'does', 'she', 'have?'], ['1-', 'Moderate', 'pre-eclampsia.'], ['2-', 'Pregnancy-induced', 'hypertension.'], ['3-', 'Chronic', 'hypertension.'], ['4-', 'Eclampsia.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['Chronic', 'hypertension.'], ['This', 'is', 'hypertension', 'that', 'is', 'detected', 'before', 'pregnancy', 'or', 'before', 'the', '20th', 'week', 'of', 'pregnancy', 'and/or', 'persists', 'at', '12', 'weeks', 'postpartum.']]","[['O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
495_64,"[['QUESTION', 'TYPE:', 'MEDICAL', 'ONCOLOGY'], ['CLINICAL', 'CASE:'], ['65-year-old', 'woman', 'with', 'no', 'comorbidities,', 'undergoing', 'left', 'breast-conserving', 'surgery', 'with', 'selective', 'sentinel', 'lymph', 'node', 'biopsy.'], ['The', 'pathological', 'anatomy', 'of', 'the', 'specimen', 'shows', 'an', 'infiltrating', 'ductal', 'carcinoma', 'grade', 'III', 'of', '11', 'mm,', 'two', 'negative', 'sentinel', 'nodes,', 'estrogen', 'receptors:', '0%,', 'progesterone', 'receptors:', '0%,', 'Ki', '67:', '70%,', 'HER2:', 'negative.'], ['The', 'extension', 'study', 'is', 'negative.'], ['Adjuvant', 'treatment', 'would', 'be:'], ['1-', 'Chemotherapy', 'based', 'on', 'anthracyclines', 'and', 'taxanes,', 'radiotherapy', 'and', 'trastuzumab.'], ['2-', 'Chemotherapy', 'based', 'on', 'anthracyclines', 'and', 'taxanes,', 'radiotherapy', 'and', 'tamoxifen.'], ['3-', 'Chemotherapy', 'based', 'on', 'anthracyclines', 'and', 'taxanes,', 'and', 'radiotherapy.'], ['4-', 'Chemotherapy', 'based', 'on', 'anthracyclines', 'and', 'taxanes,', 'radiotherapy', 'and', 'aromatase', 'inhibitors,', 'since', 'it', 'is', 'postmenopausal.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['Typical', 'question,', 'conservative', 'surgery', 'implies', 'radiate,', 'for', 'sure.'], ['High', 'grade,', 'and', 'no', 'hormone', 'receptors', 'or', 'her2', '(the', 'dreaded', 'triple', 'negative).'], ['I', 'was', 'there', 'when', 'there', 'were', 'no', 'taxanes', 'or', 'herceptin', 'and', 'I', 'was', 'in', 'the', 'trials', 'that', 'showed', 'that', 'more', 'and', 'more', 'are', 'being', 'cured,', 'unfortunately', 'still', 'not', 'all.'], ['That', 'is', 'why', 'today,', 'anthracyclines', '(does', 'not', 'suffer', 'from', 'heart)', 'and', 'taxanes', 'before', 'RT.'], ['My', 'specialty', 'is', 'beautiful,', 'and', 'will', 'be', 'more', 'so', 'in', 'the', 'coming', 'years.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O']]"
355_166,"[['QUESTION', 'TYPE:', 'GYNECOLOGY', 'AND', 'OBSTETRICS'], ['CLINICAL', 'CASE:'], ['A', 'pregnant', 'woman,', '10', 'weeks', 'pregnant,', 'comes', 'to', 'the', 'emergency', 'room', 'with', 'a', 'blood', 'pressure', 'of', '160/105', 'mmHg.'], ['She', '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.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['The', 'correct', 'answer', 'is', '3.'], ['The', 'SEGO', 'in', 'its', '2006', 'protocol', '""Hypertensive', 'disorders', 'of', 'pregnancy""', 'refers', 'that', 'this', 'is', 'chronic', 'hypertension,', 'although', 'diagnosed', 'in', 'pregnancy.'], ['This', 'is', 'because', 'it', 'has', 'been', 'diagnosed', 'at', '10', 'weeks', 'of', 'gestation.'], ['Above', '20', ""weeks'"", 'gestation,', 'we', 'would', 'be', 'talking', 'about', 'preeclampsia', '(if', 'HT', '+', 'proteinuria', 'or', 'uterine', 'artery', 'pulsatility', 'index', 'above', 'the', '95th', 'percentile),', 'pregnancy-induced', 'hypertension', '(only', 'HT)', 'or', 'eclampsia', '(a', 'form', 'of', 'severe', 'preeclampsia).']]","[['O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-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']]"
94_31,"[['QUESTION', 'TYPE:', 'DERMATOLOGY,', 'VENEREOLOGY', 'AND', 'PLASTIC', 'SURGERY'], ['CLINICAL', 'CASE:'], ['A', '17-year-old', 'boy', 'with', ""Crohn's"", 'disease', 'with', 'colonic', 'involvement', 'of', '2', 'years', 'of', 'evolution,', 'in', 'maintenance', 'treatment', 'with', 'azathioprine,', 'consults', 'for', 'the', 'appearance', 'for', '5', 'days', 'of', 'subcutaneous', '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', 'nº1', 'would', 'not', 'be', 'correct.']]","[['O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-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']]"
39_134,"[['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.']]","[['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 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'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']]"
252_83,"[['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.']]","[['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']]"
57_77,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-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']]"
595_88,,
98_171,"[['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.']]","[['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']]"
118_117,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
388_233,,
421_78,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
500_45,"[['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).']]","[['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']]"
611_116,"[['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).']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['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']]"
542_38,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
79_36,"[['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.']]","[['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']]"
524_54,"[['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.']]","[['O', 'O', 'O'], ['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']]"
319_141,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
400_147,"[['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.']]","[['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']]"
196_164,"[['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', 'Schönlein-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.', 'Schönlein-Henoch.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
509_150,"[['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.'], ['He', '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'], ['They', 'refer', 'to', 'a', 'concept', 'that', 'has', 'emerged', 'relatively', 'recently', 'and', 'is', 'not', 'present', 'in', 'all', 'clinical', 'guidelines', 'as', 'uncomplicated', 'symptomatic', 'diverticular', 'disease.'], ['In', 'these', 'cases,', 'the', 'therapeutic', 'trial', 'with', 'rifaximin', 'is', 'recommended,', 'being', 'the', 'true', 'number', '1.'], ['The', 'absence', 'of', 'acute', 'phase', 'reactants', 'in', 'the', 'CBC', 'suggests', 'that', 'she', 'does', 'not', 'have', 'acute', 'diverticulitis', 'at', 'the', 'time', 'of', 'consultation', 'that', 'would', 'lead', 'us', 'to', 'request', 'an', 'imaging', 'test', 'to', 'rule', 'it', 'out.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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'], ['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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
549_128,,
221_48,"[['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.'], ['The', 'Rosenthal', 'fibers', 'may', 'confuse', 'us', 'as', 'they', 'are', 'not', 'very', 'specific,', 'and', 'make', 'us', 'think,', 'for', 'example,', 'of', 'pleomorphic', 'xanthoastrocytoma', 'in', 'which', 'they', 'can', 'also', 'be', 'found,', 'but', 'the', 'cell', 'morphology', 'described', '(long', 'and', 'thin', 'cytoplasmic', 'processes,', '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).']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O', 'O', 'O', 'O', 'O', 'O'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['O'], ['O', 'O'], ['O'], ['O'], ['O', 'O', 'O'], ['O'], ['O']]"
606_113,"[['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'], ['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).']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
436_223,,
220_126,,
483_174,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
113_93,"[['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', 'básico', 'razonado""', 'by', 'Jesús', 'San', 'Miguel.']]","[['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']]"
59_51,"[['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.']]","[['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']]"
412_54,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
347_159,"[['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).']]","[['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']]"
325_56,"[['QUESTION', 'TYPE:', 'CRITICAL,', 'PALLIATIVE', 'AND', 'EMERGENCY', 'CARE'], ['CLINICAL', 'CASE:'], ['A', '54-year-old', 'patient', 'is', 'admitted', 'for', 'thermometric', 'fever', 'of', '38°C', '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.']]","[['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']]"
335_175,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
19_109,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
401_147,"[['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.']]","[['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']]"
607_115,,
453_150,"[['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.']]","[['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']]"
529_166,"[['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.']]","[['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']]"
258_96,"[['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%.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
375_128,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['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']]"
352_161,"[['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.']]","[['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']]"
575_102,"[['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).']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
278_31,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
225_64,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', 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370_125,"[['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.']]","[['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']]"
332_88,,
78_33,"[['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.']]","[['O', 'O', 'O', 'O'], ['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']]"
397_140,"[['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.']]","[['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']]"
275_74,"[['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).']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
418_77,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['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', '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', '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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
200_75,,
469_137,"[['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.'], ['This', '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', 'is', 'why', 'the', 'ideal', 'time', 'to', 'intervene', 'in', 'these', 'patients', 'is', 'after', 'achieving', 'stabilization', 'of', 'their', 'medical', 'pathologies,', 'taking', 'care', 'that', 'this', 'takes', 'place', 'before', '48', 'h', 'have', 'elapsed.""', 'There', 'is', '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.']]","[['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'], ['B-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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-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-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']]"
378_132,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
582_208,"[['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', 'Lasègue', '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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
160_117,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
312_217,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', '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'], ['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']]"
24_115,"[['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...']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
260_99,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
211_87,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
162_121,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
207_181,"[['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).']]","[['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'], 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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'], ['B-Claim', 'I-Claim', 'I-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']]"
584_73,"[['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.']]","[['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']]"
138_165,"[['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.']]","[['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']]"
136_132,"[['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).']]","[['O', 'O', 'O'], ['O', 'O'], ['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']]"
518_105,"[['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.']]","[['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']]"
581_205,,
543_39,"[['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', '-20ºC', 'for', 'at', 'least', '5', 'days', 'before', 'cooking', 'can', 'be', 'consumed,', 'as', 'long', 'as', 'it', 'is', 'cooked', 'at', 'high', 'temperatures', '>60ºC', '(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.']]","[['O', 'O', 'O'], ['O', 'O'], ['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']]"
2_36,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
122_119,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
36_130,"[['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.']]","[['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']]"
338_31,"[['QUESTION', 'TYPE:', 'GYNECOLOGY', 'AND', 'OBSTETRICS'], ['CLINICAL', 'CASE:'], ['20-year-old', 'woman', 'with', 'ovarian', 'tumor', 'of', '15', 'cm,', 'solid-cystic,', 'detected', 'by', 'ultrasound', 'after', 'presenting', 'with', 'unspecific', 'abdominal', 'symptoms.'], ['In', 'the', 'histopathological', 'study', 'of', 'the', 'corresponding', 'specimen,', 'teeth,', 'hairs,', 'areas', 'of', 'intestinal', 'epithelium,', 'areas', 'of', 'squamous', 'epithelium', '(15%)', 'and', 'bronchial', 'epithelium,', 'as', 'well', 'as', 'neuroectodermal', 'and', 'embryonic', 'elements', 'are', 'found', 'in', 'several', 'of', 'the', 'histological', 'preparations.'], ['In', 'reference', 'to', 'this', 'case,', 'point', 'out', 'the', 'correct', 'diagnosis:'], ['1-', 'Teratocarcinoma.'], ['2-', 'Immature', 'teratoma.'], ['3-', 'Mature', 'cystic', 'teratoma.'], ['4-', 'Dysgerminoma.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['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.']]","[['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']]"
432_117,"[['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.']]","[['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']]"
513_38,"[['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%).'], ['Of', '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%.']]","[['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']]"
580_198,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
248_118,"[['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.']]","[['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']]"
222_197,"[['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).']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 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244_114,"[['QUESTION', 'TYPE:', 'INFECTIOUS', 'DISEASES'], ['CLINICAL', 'CASE:'], ['A', '16-year-old', 'boy', 'consults', 'for', 'presenting', 'with', 'pustular', 'tonsillitis,', 'fever', 'up', 'to', '38.5°C,', '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', '40ºC,', '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-Barré', 'sd.', 'Guillain-Barré', '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,', 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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']]"
420_78,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
321_144,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
516_103,"[['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.']]","[['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']]"
44_153,"[['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.']]","[['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']]"
54_72,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
553_177,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O']]"
608_115,"[['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,', '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.'], ['3-', 'Doppler', 'ultrasound', 'to', 'rule', 'out', 'a', 'circulatory', 'disorder', 'of', 'the', 'lower', 'extremity.'], ['4-', 'Spectrometry', 'by', 'magnetic', 'resonance.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '2'], ['We', 'present', 'a', 'case', 'of', 'chronic', 'compartment', 'syndrome.'], ['For', 'its', 'diagnosis', 'it', 'is', 'necessary', 'to', 'measure', 'the', 'pressure', 'of', 'the', 'affected', 'compartments', 'at', 'rest', 'and', 'after', 'activity', '(answer', '2', 'correct).']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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-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', 'B-Claim', 'I-Claim', 'I-Claim']]"
294_44,"[['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).'], ['The', 'only', 'option', 'with', 'which', 'there', 'could', 'be', 'doubt', 'is', 'Noonan', 'syndrome,', 'which', 'can', 'also', 'be', 'associated', '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.']]","[['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', 'I-Premise', 'I-Premise', 'I-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'], ['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'], ['O', 'O'], ['O', 'O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
156_230,"[['QUESTION', 'TYPE:', 'RHEUMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '40-year-old', 'patient', 'who', 'comes', 'to', 'the', 'emergency', 'room', 'with', 'aphthous', 'stomatitis,', 'conjunctivitis,', 'urethritis,', 'balanitis', 'and', 'joint', 'pain.'], ['Which', 'of', 'the', 'following', 'diagnoses', 'is', 'the', 'most', 'likely?'], ['1-', ""Behçet's"", 'disease.'], ['2-', 'Reactive', 'arthritis', 'syndrome.'], ['3-', ""Sweet's"", 'syndrome.'], ['4-', 'Vitamin', 'A', 'deficiency.'], ['5-', 'Gonococcal', 'infection.'], ['CORRECT', 'ANSWER:', '2'], ['Given', 'this', 'clinical', 'picture', 'and', 'without', 'having', 'complementary', 'tests', 'available,', 'the', 'most', 'likely', 'diagnosis', 'is', 'reactive', 'arthritis.'], ['The', 'only', 'problem', 'is', 'that', 'the', 'statement', 'speaks', 'of', 'joint', 'pain', 'and', 'not', 'arthritis...'], [""Reiter's"", 'syndrome', '(triad', 'of', 'conjunctivitis,', 'urethritis', 'and', 'arthritis)', 'is', 'one', 'of', 'the', 'forms', 'in', 'which', 'reactive', 'arthritis', 'can', 'present.'], ['In', ""Behçet's"", 'disease', 'oral', 'and', 'genital', 'aphthous', 'ulcers', 'may', 'occur', 'but', 'urethritis', 'is', 'not', 'a', 'feature.'], ['And', 'the', 'characteristic', 'ocular', 'condition', 'is', 'uveitis.']]","[['O', 'O', 'O'], ['O', 'O'], ['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']]"
82_45,"[['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.']]","[['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']]"
485_49,"[['QUESTION', 'TYPE:', 'DERMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '60-year-old', 'man', 'on', 'carbamazepine', 'treatment', 'for', 'epilepsy', 'presenting', 'with', 'fever', '(38.8°C),', '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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
219_124,,
578_107,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
199_74,"[['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.']]","[['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']]"
331_87,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
205_214,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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'], ['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-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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'], ['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', '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']]"
441_98,,
302_111,"[['QUESTION', 'TYPE:', 'NEPHROLOGY'], ['CLINICAL', 'CASE:'], ['In', 'a', 'patient', 'with', 'rheumatoid', 'arthritis', 'treated', 'with', 'methotrexate,', 'prednisone', 'and', 'indomethacin', 'who', 'acutely', 'presents', 'edema', '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.'], ['4-', 'Interstitial', 'nephritis', 'due', 'to', 'methotrexate.'], ['5-', 'nan'], ['CORRECT', 'ANSWER:', '3'], ['Prerenal', 'acute', 'renal', 'failure', 'due', 'to', 'NSAIDs', 'seems', 'the', 'most', 'plausible', 'option', 'in', 'this', 'case.'], ['Tubulointerstitial', 'nephritis', 'due', 'to', 'methotrexate', 'is', 'less', 'likely', 'due', 'to', 'the', 'absence', 'of', 'rash,', 'fever', 'or', 'eosinophilia,', 'which', 'although', 'rare', 'in', 'the', 'MIR', 'usually', 'appear.'], ['Although', 'GMN', 'and', 'renal', 'amyloidosis', 'are', 'relatively', 'frequent', 'in', 'RA,', 'the', 'anodyne', 'urine', 'sediment', 'and', 'the', 'absence', 'of', 'proteinuria', 'make', 'these', 'options', 'unlikely.']]","[['O', 'O', 'O'], ['O', 'O'], ['O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-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-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
517_104,"[['QUESTION', 'TYPE:', 'CRITICAL', 'AND', 'EMERGENCY', 'CARE'], ['CLINICAL', 'CASE:'], ['A', '34-year-old', 'male', 'is', 'involved', 'in', 'a', 'traffic', 'accident', 'and', 'is', 'attended', 'at', 'the', 'scene', 'of', 'the', 'accident.'], ['The', 'medical', 'personnel', 'observe', 'that', 'he', 'is', 'pale,', 'sweaty,', 'has', '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'], ['In', 'a', 'polytraumatized', 'patient,', 'the', 'first', 'cause', 'of', 'shock', 'is', 'blood', 'loss', '(hemorrhagic', 'shock).'], ['The', 'guidelines', 'to', 'follow', 'should', 'always', 'contemplate', 'the', 'replenishment', 'of', 'blood', 'volume', '(if', 'possible,', 'with', 'blood', 'products', 'as', 'early', 'as', 'possible)', 'and', 'control', 'of', 'the', 'focus.'], ['In', 'this', 'case,', 'given', 'the', 'vital', 'compromise,', 'the', 'need', 'for', 'transfusion', 'is', 'very', 'urgent,', 'so', 'the', 'indication', 'is', 'emergency', 'blood', 'transfusion', '(O', 'Rh', 'negative).']]","[['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', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', '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', 'I-Claim', 'I-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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
520_38,"[['QUESTION', 'TYPE:', 'DERMATOLOGY'], ['CLINICAL', 'CASE:'], ['A', '72-year-old', 'patient', '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.'], ['His', '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).']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['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']]"
379_133,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
600_184,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
415_72,"[['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).']]","[['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']]"
560_180,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
358_232,"[['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.']]","[['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']]"
414_71,,
131_221,"[['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.']]","[['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']]"
70_127,"[['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.']]","[['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']]"
463_71,"[['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.']]","[['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']]"
476_93,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
546_124,,
313_177,"[['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.']]","[['O', 'O', 'O'], ['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']]"
482_173,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-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'], ['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']]"
105_233,,
73_62,"[['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.']]","[['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-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', 'B-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', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise'], ['B-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', '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', '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'], ['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'], ['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'], ['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'], ['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']]"
538_2,,
139_166,"[['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.']]","[['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']]"
446_130,"[['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).']]","[['O', 'O', 'O'], ['O', 'O'], ['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']]"
551_130,,
383_150,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
614_118,"[['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', '5º', 'and', 'then', '20º,', '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).']]","[['O', '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']]"
499_182,,
613_118,"[['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.']]","[['O', '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']]"
247_117,"[['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', '40ºC', '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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
88_56,"[['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.']]","[['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'], ['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-Premise', 'I-Premise', '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']]"
536_122,"[['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).']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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', 'B-Claim', 'I-Claim', 'I-Claim']]"
492_107,"[['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/μL,', 'Hb', '12.3', 'g/dL,', 'platelets', '6.0', 'x103/μL.'], ['Thrombocytopenia', 'is', 'confirmed', 'in', 'the', 'smear,', 'where', 'platelets', 'of', 'increased', 'size', 'are', 'observed.'], ['Coagulation', 'and', 'biochemistry', 'studies', 'are', 'normal.'], ['What', 'do', 'you', 'consider', 'the', 'most', '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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
599_183,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
134_169,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
245_115,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['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']]"
387_156,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
41_139,"[['QUESTION', 'TYPE:', 'OTORHINOLARYNGOLOGY', 'AND', 'MAXILLOFACIAL', 'SURGERY'], ['CLINICAL', 'CASE:'], ['Given', 'a', 'patient', 'with', 'poor', 'general', 'condition,', 'fever', '(axillary', 'temperature', '39.5º),', '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.']]","[['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']]"
385_153,"[['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.']]","[['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']]"
194_162,"[['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.']]","[['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']]"
371_126,,
283_56,,
109_149,"[['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.']]","[['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']]"
92_235,"[['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.']]","[['O', 'O', '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']]"
342_158,"[['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.']]","[['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']]"
357_232,"[['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.']]","[['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']]"
596_121,"[['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.']]","[['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']]"
334_82,"[['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.']]","[['O', 'O', 'O'], ['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']]"
81_44,,
386_154,"[['QUESTION', 'TYPE:', 'PEDIATRICS'], ['CLINICAL', 'CASE:'], ['The', 'appearance', 'of', 'a', 'high', 'fever', 'of', '39°C', '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.']]","[['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', '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'], ['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', 'B-Marker', 'I-Marker', '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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
239_146,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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', '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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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'], ['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-Marker', 'B-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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
525_53,,
287_64,,
472_140,"[['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.']]","[['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']]"
173_51,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['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']]"
480_171,,
58_199,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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']]"
51_230,"[['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.']]","[['O', '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']]"
184_65,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
295_75,"[['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.']]","[['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', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
559_160,"[['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', 'show', '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', 'fear', 'of', 'all', 'on-call', 'hematologists...', 'that', 'you', 'will', 'get', 'a', 'TTP.'], ['Because,', 'although', 'infrequent,', 'it', 'is', 'the', 'greatest', 'hematologic', 'emergency.'], ['The', 'clinical', 'case', 'is', 'fairly', 'typical.'], ['A', 'young', 'person', 'with', 'fever', 'and', 'neurological', 'symptoms', 'that', 'make', 'him', 'go', 'to', 'the', 'emergency', 'department', '(he', 'is', 'on', 'the', 'run).'], ['Laboratory', 'tests', 'show', 'anemia', 'with', 'evidence', 'of', 'hemolysis', '(increased', 'LDH', 'and', 'retis,', 'presence', 'of', 'schistocytes', 'in', 'peripheral', 'blood)', 'and', 'severe', 'thrombopenia.'], ['In', 'addition,', 'coagulation', 'is', 'normal.'], ['To', 'distinguish', 'it', 'from', 'the', 'rest', 'of', 'things', '(although', 'you', 'should', 'not', 'hesitate...)', 'it', 'tells', 'you', 'that', 'the', 'coombs', 'is', 'negative.'], ['As', 'a', 'reminder:', 'URGENT', 'TREATMENT:', 'PLASMATIC', 'REPLACEMENTS.'], ['The', 'diagnostic', 'confirmation', 'is', 'the', 'ADAMTS', '13', 'deficit,', 'but', 'treatment', 'is', 'started', 'before', 'having', 'that', 'value,', 'which', 'is', 'not', 'usually', 'done', 'urgently.'], ['And,', 'as', 'we', 'all', 'know,', 'these', 'things', 'usually', 'come', 'at', 'night', 'and/or', 'weekends,', 'to', 'make', 'things', 'more', 'difficult....']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['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', 'O'], ['O', 'O', 'O'], ['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'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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'], ['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', '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'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O'], ['O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O', 'O']]"
558_160,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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'], ['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', 'O'], ['O', 'O', 'O'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'O'], ['B-Premise', 'I-Premise'], ['O'], ['B-Premise', 'I-Premise', 'I-Premise'], ['O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['O'], ['B-Premise']]"
227_72,"[['QUESTION', 'TYPE:', 'CARDIOLOGY'], ['CLINICAL', 'CASE:'], ['A', '45-year-old', 'woman', 'with', 'a', 'history', 'of', 'heart', 'murmur', 'detected', 'in', 'childhood.'], ['She', 'is', 'admitted', 'to', 'the', 'emergency', 'department', 'for', 'palpitations,', 'easy', 'fatigue', 'and', 'malleolar', 'edema.'], ['Physical', 'examination', 'revealed', 'absence', 'of', 'cyanosis.'], ['Oxygen', 'saturation', 'by', 'pulse', 'oximeter', '97%', 'BP', '120/80', 'mmHg.'], ['Irregular', 'heart', 'rhythm', 'at', '100', 'bpm.'], ['Ejective', 'systolic', 'murmur', '(2/6)', 'in', 'pulmonary', 'focus.'], ['2nd', 'unfolded', 'noise,', 'wide', 'and', 'fixed.'], ['No', 'rales.'], ['Slight', 'hepatomeglaia', '(2-3', 'cm).'], ['Slight', 'malleolar', 'edema.'], ['ECG:', 'complete', 'arrhythmia', 'due', 'to', 'atrial', 'fibrillation', 'at', '100', 'bpm.'], ['QRS', '+120º.'], ['Conduction', 'disorder', 'of', 'the', 'right', 'bundle', '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.']]","[['O', 'O', 'O'], ['O', 'O'], ['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']]"
168_86,"[['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.']]","[['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']]"
329_84,,
447_131,"[['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).']]","[['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']]"
72_52,"[['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.']]","[['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']]"
505_85,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
360_93,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
459_173,"[['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).']]","[['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']]"
149_162,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
246_116,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
457_126,"[['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.']]","[['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']]"
165_229,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
157_73,"[['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.']]","[['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', 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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'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim']]"
382_231,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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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'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']]"
496_71,"[['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.']]","[['O', 'O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
14_213,"[['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', '3', '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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
330_85,"[['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"", 'syndrome', '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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
181_59,"[['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', 'since', 'the', 'treatment', 'of', 'diabetic', 'ketoacidosis', 'is', 'a', 'very', 'repeated', 'topic', 'in', 'the', 'MIR.'], ['Bicarbonate', 'is', 'indicated', 'at', 'pH', '<', '7.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim'], ['O', 'B-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', 'I-Claim', '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']]"
182_61,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
21_111,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
60_59,"[['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°C', '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.']]","[['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']]"
455_155,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['O', 'B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"
1_35,"[['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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
66_106,"[['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.']]","[['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', 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'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']]"
521_76,"[['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', 'súdenita', '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.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', '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']]"
20_110,"[['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', '39ºC', '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.']]","[['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']]"
422_88,"[['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.']]","[['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']]"
348_160,"[['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.']]","[['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']]"
411_52,"[['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%.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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'], ['O', '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'], ['O', 'O'], ['O', 'O', 'O'], ['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', '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']]"
590_64,"[['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', 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86_51,"[['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.']]","[['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']]"
498_129,,
31_233,"[['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.']]","[['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']]"
618_119,"[['QUESTION', 'TYPE:', 'TRAUMATOLOGY'], ['CLINICAL', 'CASE:'], ['13-year-old', 'female,', 'with', 'no', 'relevant', 'history,', 'with', 'menarche', '3', 'months', 'ago,', 'followed', 'since', 'the', 'age', 'of', '10', 'years', 'for', 'idiopathic', 'scoliosis', 'that', 'has', 'worsened.'], ['In', 'the', 'physical', 'examination', 'she', 'presents', 'a', 'hump', 'of', '7', 'degrees', 'in', 'the', 'Adams', 'test', 'and', 'in', 'the', 'scoliogram', 'a', 'T4-L1', 'thoracolumbar', 'curve', 'of', '35', 'degrees', 'of', 'Cobb', 'and', 'a', 'Risser', '0:'], ['1-', 'Recommend', 'swimming', 'and', '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', '30-40º.']]","[['O', 'O', 'O'], ['O', 'O'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise'], ['B-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-Premise', 'I-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']]"