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tags:
  - sentence-transformers
  - sentence-similarity
  - feature-extraction
  - dense
  - generated_from_trainer
  - dataset_size:492
  - loss:MultipleNegativesRankingLoss
base_model: llm-semantic-router/mmbert-embed-32k-2d-matryoshka
widget:
  - source_sentence: >-
      A 60-year-old man is rushed to the emergency room after he was found
      unconscious in bed that afternoon. The patient’s wife says he has been
      confused and irritable for the past several days. She says he has a
      history of chronic daily alcohol abuse and has been hospitalized multiple
      times with similar symptoms His temperature is 37°C (98.6°F), the blood
      pressure is 110/80 mm Hg, the pulse is 90/min, and the respiratory rate is
      14/min. On physical examination, the patient is minimally responsive to
      painful stimuli. His abdomen is distended with positive shifting dullness.
      Laboratory results are as follows:

      Complete blood count

      Hematocrit 35%

      Platelets 100,000/mm3

      White blood cells 5000/mm3

      Liver function studies

      Serum Albumin 2 g/dL

      Alkaline phosphatase (ALP) 200 IU/L

      Aspartate aminotransferase (AST) 106 IU/L

      Alanine aminotransferase (ALT) 56 IU/L

      The patient is admitted to the hospital and started on the appropriate
      treatment to improve his mental status. Which of the following best
      describes the mechanism of action of the drug that is most likely used to
      treat this patient’s symptoms?
    sentences:
      - >-
        A 60-year-old man is rushed to the emergency room after he was found
        unconscious in bed that afternoon. The patient’s wife says he has been
        confused and irritable for the past several days. She says he has a
        history of chronic daily alcohol abuse and has been hospitalized
        multiple times with similar symptoms His temperature is 37°C (98.6°F),
        the blood pressure is 110/80 mm Hg, the pulse is 90/min, and the
        respiratory rate is 14/min. On physical examination, the patient is
        minimally responsive to painful stimuli. His abdomen is distended with
        positive shifting dullness. Laboratory results are as follows:

        Complete blood count

        Hematocrit 35%

        Platelets 100,000/mm3

        White blood cells 5000/mm3

        Liver function studies

        Serum Albumin 2 g/dL

        Alkaline phosphatase (ALP) 200 IU/L

        Aspartate aminotransferase (AST) 106 IU/L

        Alanine aminotransferase (ALT) 56 IU/L

        The patient is admitted to the hospital and started on the appropriate
        treatment to improve his mental status. Which of the following best
        describes the mechanism of action of the drug that is most likely used
        to treat this patient’s symptoms?


        Answer: Decreases pH in the gastrointestinal lumen
      - >-
        A 65-year-old man is brought to the emergency department after loss of
        consciousness. He is accompanied by his wife. He is started on
        intravenous fluids, and his vital signs are assessed. His blood pressure
        is 85/50 mm Hg, pulse 50/min, and respiratory rate 10/min. He has been
        admitted in the past for a heart condition. His wife is unable to recall
        the name of the condition, but she does know that the doctor recommended
        some medications at that time in case his condition worsened. She has
        brought with her the test reports from previous medical visits over the
        last few months. She says that she has noticed that he often has
        difficulty breathing and requires three pillows to sleep at night to
        avoid being short of breath. He can only walk for a few kilometers
        before he has to stop and rest. His wife also reports that he has had
        occasional severe coughing spells with pinkish sputum production. She
        also mentions that he has been drinking alcohol for the past 30 years.
        Which of the following medications will improve the prognosis of this
        patient?


        Answer: Enalapril
      - >-
        A 71-year-old African American man is brought to the emergency
        department with a worsening productive cough and dyspnea for 2 days. He
        has had generalized bone pain for 2 months. He was admitted for
        pyelonephritis last month. He also received outpatient treatment for
        pneumonia almost 2 months ago. Over the past 2 months, he has been
        taking over-the-counter ibuprofen for pain as needed. He appears
        anxious. The vital signs include: temperature 38.8°C (101.8°F), pulse
        95/min, respiratory rate 20/min, and blood pressure 155/90 mm Hg. The
        conjunctivae are pale. Crackles are heard in the right lower lobe. The
        cardiac examination shows no abnormalities. The laboratory studies show
        the following:

        Hemoglobin 9 g/dL

        Mean corpuscular volume 95 μm3

        Leukocyte count 13,500/mm3

        Segmented neutrophils 75%

        Lymphocytes 25%

        Platelet count 240,000/mm3

        ESR 85 mm/hr

        Serum

        Na+ 135 mEq/L

        K+ 4.2 mEq/L

        Cl− 113 mEq/L

        HCO3− 20 mEq/L

        Ca+ 12.4 mg/dL

        Albumin 4 g/dL

        Urea nitrogen 38 mg/dL

        Creatinine 2.2 mg/dL

        A chest X-ray shows a right lower lobe opacity and blurring of the
        ipsilateral diaphragmatic dome. Skull and pelvic X-rays are performed
        (see image). Which of the following is the most likely underlying cause
        of this patient’s recent infections?


        Answer: Hypogammaglobulinemia
  - source_sentence: >-
      A 35-year-old man presents to the physician with concerns that a “bad flu”
      he has had for the past 10 days is getting worse and causing
      sleeplessness. On presentation today, his sore throat has improved;
      however, fever and chest and body aches persist despite the use of
      ibuprofen. He reports sharp, intermittent chest pain that worsens with
      exertion. He has not traveled outside the United States recently and does
      not have a history of substance abuse or alcohol use. Physical examination
      shows the temperature is 38.3°C (100.9°F), the heart rate is 110/min, the
      blood pressure is 120/60 mm Hg, and the oxygen saturation is 98% on room
      air. There is bilateral pedal edema at the level of the ankle.
      Auscultation reveals normal S1 and S2 and a third early diastolic heart
      sound. Jugular vein distention is observed. An ECG shows sinus tachycardia
      and diffuse ST-segment elevation throughout the precordial leads with
      1.0-mm PR-segment depression in leads I and II.

      Laboratory results

      WBC 14,000/mm3

      Lymphocyte count 70%

      Hematocrit 45%

      CRP 56 mg/dL

      Troponin T 1.15 ng/mL

      Troponin I 0.2 ng/mL

      Ck-MB 22 ng/mL

      Coxsackie type b viral antibody  positive

      A chest x-ray shows clear lung fields bilaterally and a mildly enlarged
      cardiac silhouette. Transthoracic ultrasound reveals a left ventricular
      ejection fraction of 30%. Which of the following is the cause of
      difficulty sleeping for this patient?
    sentences:
      - >-
        A 20-year-old female with type I diabetes mellitus presents to the
        emergency department with altered mental status. Her friend said that
        she has been out late either studying for upcoming tests or attending
        prayer group meetings. As far as the friend can recollect, the patient
        appeared to be in her usual state of health until only two days ago,
        when she was prescribed trimethoprim-sulfamethoxazole for a urinary
        tract infection. The patient complained that the medication was making
        her feel nauseous and bloated. The patient also relies on glargine and
        lispro for glycemic control. Her temperature is 100.5°F (38.1°C), blood
        pressure is 95/55 mmHg, pulse is 130/min, and respirations are 30/min.
        Her pupils are equal and reactive to light bilaterally. The remainder of
        the physical exam is unremarkable. Her basic metabolic panel is
        displayed below:


        Serum:

        Na+: 116 mEq/L

        Cl-: 90 mEq/L

        K+: 5.0 mEq/L

        HCO3-: 2 mEq/L

        BUN: 50 mg/dL

        Glucose: 1,200 mg/dL

        Creatinine: 1.5 mg/dL


        Which of the following is true regarding this patient's presentation?


        Answer: Hyperkalemia is independent of the patient's total body
        potassium stores
      - >-
        A 24-year-old woman, otherwise healthy, presents with a non-productive
        cough, sore throat, and myalgia. The patient reports that her symptoms
        started gradually 2 weeks ago and have not improved. She has no
        significant past medical history and no current medications. She is a
        college student and denies any recent overseas travel. The patient
        received the flu vaccine this year, and her 2-part PPD required for
        school was negative. She does not smoke, drink, or use recreational
        drugs. The patient denies being sexually active. The vital signs
        include: temperature 37.0°C (98.6°F), blood pressure 110/75 mm Hg, pulse
        98/min, respirations 20/min, and oxygen saturation 99% on room air. On
        physical exam, the patient is alert and cooperative. The cardiac exam is
        normal. There are rales present bilaterally over both lung fields. The
        skin and conjunctiva are pale. The laboratory tests are pending. The
        chest X-ray is shown in the image. Which of the following laboratory
        findings would also commonly be found in this patient?


        Answer: Low serum levels of complement
      - >-
        A 35-year-old man presents to the physician with concerns that a “bad
        flu” he has had for the past 10 days is getting worse and causing
        sleeplessness. On presentation today, his sore throat has improved;
        however, fever and chest and body aches persist despite the use of
        ibuprofen. He reports sharp, intermittent chest pain that worsens with
        exertion. He has not traveled outside the United States recently and
        does not have a history of substance abuse or alcohol use. Physical
        examination shows the temperature is 38.3°C (100.9°F), the heart rate is
        110/min, the blood pressure is 120/60 mm Hg, and the oxygen saturation
        is 98% on room air. There is bilateral pedal edema at the level of the
        ankle. Auscultation reveals normal S1 and S2 and a third early diastolic
        heart sound. Jugular vein distention is observed. An ECG shows sinus
        tachycardia and diffuse ST-segment elevation throughout the precordial
        leads with 1.0-mm PR-segment depression in leads I and II.

        Laboratory results

        WBC 14,000/mm3

        Lymphocyte count 70%

        Hematocrit 45%

        CRP 56 mg/dL

        Troponin T 1.15 ng/mL

        Troponin I 0.2 ng/mL

        Ck-MB 22 ng/mL

        Coxsackie type b viral antibody  positive

        A chest x-ray shows clear lung fields bilaterally and a mildly enlarged
        cardiac silhouette. Transthoracic ultrasound reveals a left ventricular
        ejection fraction of 30%. Which of the following is the cause of
        difficulty sleeping for this patient?


        Answer: Decreased cardiac contractility due to cardiac myocyte injury
  - source_sentence: >-
      A 45-year-old Caucasian man is given nitroglycerin for the management of
      his stable angina. Nitroglycerin given for the rapid relief of acute
      angina would most likely be given through what route of administration?
    sentences:
      - >-
        A 43-year-old man is brought to the emergency department because of
        severe retrosternal pain radiating to the back and left shoulder for 4
        hours. The pain began after attending a farewell party for his coworker
        at a local bar. He had 3–4 episodes of nonbilious vomiting before the
        onset of the pain. He has hypertension. His father died of cardiac
        arrest at the age of 55 years. He has smoked one pack of cigarettes
        daily for the last 23 years and drinks 2–3 beers daily. His current
        medications include amlodipine and valsartan. He appears pale. His
        temperature is 37° C (98.6° F), pulse is 115/min, and blood pressure is
        90/60 mm Hg. There are decreased breath sounds over the left base and
        crepitus is palpable over the thorax. Abdominal examination shows
        tenderness to palpation in the epigastric region; bowel sounds are
        normal. Laboratory studies show:

        Hemoglobin 16.5 g/dL

        Leukocyte count 11,100/mm3

        Serum

        Na+ 133 mEq/L

        K+ 3.2 mEq/L

        Cl- 98 mEq/L

        HCO3- 30 mEq/L

        Creatinine 1.4 mg/dL

        An ECG shows sinus tachycardia with left ventricular hypertrophy.
        Intravenous fluid resuscitation and antibiotics are begun. Which of the
        following is the most appropriate test to confirm the diagnosis in this
        patient?"


        Answer: CT scan of the chest
      - >-
        A 45-year-old Caucasian man is given nitroglycerin for the management of
        his stable angina. Nitroglycerin given for the rapid relief of acute
        angina would most likely be given through what route of administration?


        Answer: Sublingual
      - >-
        A 67-year-old man with stable coronary artery disease comes to the
        physician for a follow-up examination. Aside from occasional exertional
        chest pain on mowing the lawn or prolonged jogging, he feels well. He
        goes jogging for 20 minutes once a week and takes a tablet of sublingual
        nitroglycerine prior to his run to prevent anginal chest pain. The
        patient would like to run longer distances and asks the physician
        whether he could increase the dose of the drug prior to running.
        Administration of higher dosages of this drug is most likely to result
        in which of the following?


        Answer: Reflex sympathetic activity
  - source_sentence: >-
      A 42-year-old woman comes to the physician for a routine health
      maintenance examination. She has generalized fatigue and has had
      difficulties doing her household duties for the past 3 months. She has
      eczema and gastroesophageal reflux disease. She has a history of using
      intravenous methamphetamine in her youth but has not used illicit drugs in
      23 years. Her medications include topical clobetasol and pantoprazole. She
      is 160 cm (5 ft 3 in) tall and weighs 105 kg (231 lb); BMI is 42 kg/m2.
      Her temperature is 37°C (98.6°F), pulse is 95/min, and blood pressure is
      145/90 mm Hg. The lungs are clear to auscultation. Cardiac examination
      shows no abnormalities. Pelvic examination shows a normal vagina and
      cervix. Laboratory studies show:

      Hemoglobin 13.1 g/dL

      Leukocyte count 7,800/mm3

      Platelet count 312,000/mm3

      Serum

      Na+ 141 mEq/L

      K+ 4.6 mEq/L

      Cl- 98 mEq/L

      Urea nitrogen 12 mg/dL

      Fasting glucose 110 mg/dL

      Creatinine 0.8 mg/dL

      Total cholesterol 269 mg/dL

      HDL-cholesterol 55 mg/dL

      LDL-cholesterol 160 mg/dL

      Triglycerides 320 mg/dL

      Urinalysis is within normal limits. An x-ray of the chest shows no
      abnormalities. She has not lost any weight over the past year despite
      following supervised weight loss programs, including various diets and
      exercise regimens. Which of the following is the most appropriate next
      step in management of this patient?"
    sentences:
      - >-
        A 17-year-old male with a history of bipolar disorder presents to clinic
        with a rash (Image A) that he noticed one week after starting a
        medication to stabilize his mood. The medication blocks voltage-gated
        sodium channels and can be used to treat partial simple, partial
        complex, and generalized tonic-clonic seizures. Regarding the patient's
        rash, what is the next step in management?


        Answer: Immediately discontinue the drug
      - >-
        A 42-year-old woman comes to the physician for a routine health
        maintenance examination. She has generalized fatigue and has had
        difficulties doing her household duties for the past 3 months. She has
        eczema and gastroesophageal reflux disease. She has a history of using
        intravenous methamphetamine in her youth but has not used illicit drugs
        in 23 years. Her medications include topical clobetasol and
        pantoprazole. She is 160 cm (5 ft 3 in) tall and weighs 105 kg (231 lb);
        BMI is 42 kg/m2. Her temperature is 37°C (98.6°F), pulse is 95/min, and
        blood pressure is 145/90 mm Hg. The lungs are clear to auscultation.
        Cardiac examination shows no abnormalities. Pelvic examination shows a
        normal vagina and cervix. Laboratory studies show:

        Hemoglobin 13.1 g/dL

        Leukocyte count 7,800/mm3

        Platelet count 312,000/mm3

        Serum

        Na+ 141 mEq/L

        K+ 4.6 mEq/L

        Cl- 98 mEq/L

        Urea nitrogen 12 mg/dL

        Fasting glucose 110 mg/dL

        Creatinine 0.8 mg/dL

        Total cholesterol 269 mg/dL

        HDL-cholesterol 55 mg/dL

        LDL-cholesterol 160 mg/dL

        Triglycerides 320 mg/dL

        Urinalysis is within normal limits. An x-ray of the chest shows no
        abnormalities. She has not lost any weight over the past year despite
        following supervised weight loss programs, including various diets and
        exercise regimens. Which of the following is the most appropriate next
        step in management of this patient?"


        Answer: Bariatric surgery
      - >-
        A 43-year-old woman visits her primary care provider complaining of
        fatigue. Although she has had it for several months, her fatigue has
        been worsening over the past few weeks. She has no other symptoms. Past
        medical history is significant for hypertension. She takes
        chlorthalidone, an oral contraceptive pill, and a multivitamin every
        day. Family history is noncontributory. She drinks about 1 bottle of
        wine every day and started taking a shot or two of whisky or vodka every
        morning before work to “clear out the cobwebs”. She was recently fired
        from her job. Today, her heart rate is 90/min, respiratory rate is
        17/min, blood pressure is 110/65 mm Hg, and temperature is 36.7°C
        (98.1°F). On physical exam, she appears malnourished and anxious. Her
        conjunctiva are pale, and glossitis is noted on oral exam. Her heart has
        a regular rate and rhythm and her lungs are clear to auscultation
        bilaterally. She has no gait or balance abnormalities. Lab results show
        a hemoglobin of 10 g/dL, with a mean corpuscular volume (MCV) of 108 fl.
        Elevated level of which of the following will most likely to be found in
        this patient?


        Answer: Homocysteine
  - source_sentence: >-
      A 45-year-old woman, gravida 3, para 2, at 18 weeks' gestation comes to
      the physician for a prenatal visit. Ultrasonography at a previous visit
      when she was at 12 weeks' gestation showed a hypoplastic nasal bone.
      Pelvic examination shows a uterus consistent in size with an 18-week
      gestation. Maternal serum studies show low α-fetoprotein and free estriol
      concentrations, and increased inhibin A and β-hCG concentrations. Physical
      examination of the infant after delivery is most likely to show which of
      the following findings?
    sentences:
      - >-
        A 45-year-old woman, gravida 3, para 2, at 18 weeks' gestation comes to
        the physician for a prenatal visit. Ultrasonography at a previous visit
        when she was at 12 weeks' gestation showed a hypoplastic nasal bone.
        Pelvic examination shows a uterus consistent in size with an 18-week
        gestation. Maternal serum studies show low α-fetoprotein and free
        estriol concentrations, and increased inhibin A and β-hCG
        concentrations. Physical examination of the infant after delivery is
        most likely to show which of the following findings?


        Answer: Single transverse palmar crease
      - >-
        A 35-year-old woman gravida 2, para 1, comes to the physician for her
        first prenatal visit. Pregnancy and delivery of her first child were
        uncomplicated. She is not sure about the date of her last menstrual
        period. Pelvic examination shows a uterus consistent in size with a
        10-week gestation. An ultrasound examination confirms the gestational
        age and shows one fetus with no indication of multiple gestations.
        During counseling on pregnancy risks and possible screening and
        diagnostic tests, the patient states she would like to undergo screening
        for Down syndrome. She would prefer immediate and secure screening with
        a low risk to herself and the fetus. Which of the following is the most
        appropriate next step in management at this time?


        Answer: Cell-free fetal DNA testing
      - >-
        A 6-month-old male presents with a painless, enlarged left scrotum.
        After examining the patient, you suspect this enlargement is secondary
        to serous fluid entering and accumulating in the scrotum through a
        patent processus vaginalis. Which of the following would be the most
        useful next step in confirming the diagnosis of this patient’s
        condition?


        Answer: Transillumination test followed by scrotal ultrasound
pipeline_tag: sentence-similarity
library_name: sentence-transformers

SentenceTransformer based on llm-semantic-router/mmbert-embed-32k-2d-matryoshka

This is a sentence-transformers model finetuned from llm-semantic-router/mmbert-embed-32k-2d-matryoshka. It maps sentences & paragraphs to a 768-dimensional dense vector space and can be used for semantic textual similarity, semantic search, paraphrase mining, text classification, clustering, and more.

Model Details

Model Description

Model Sources

Full Model Architecture

SentenceTransformer(
  (0): Transformer({'max_seq_length': 32768, 'do_lower_case': False, 'architecture': 'ModernBertModel'})
  (1): Pooling({'word_embedding_dimension': 768, 'pooling_mode_cls_token': False, 'pooling_mode_mean_tokens': True, 'pooling_mode_max_tokens': False, 'pooling_mode_mean_sqrt_len_tokens': False, 'pooling_mode_weightedmean_tokens': False, 'pooling_mode_lasttoken': False, 'include_prompt': True})
)

Usage

Direct Usage (Sentence Transformers)

First install the Sentence Transformers library:

pip install -U sentence-transformers

Then you can load this model and run inference.

from sentence_transformers import SentenceTransformer

# Download from the 🤗 Hub
model = SentenceTransformer("sentence_transformers_model_id")
# Run inference
sentences = [
    "A 45-year-old woman, gravida 3, para 2, at 18 weeks' gestation comes to the physician for a prenatal visit. Ultrasonography at a previous visit when she was at 12 weeks' gestation showed a hypoplastic nasal bone. Pelvic examination shows a uterus consistent in size with an 18-week gestation. Maternal serum studies show low α-fetoprotein and free estriol concentrations, and increased inhibin A and β-hCG concentrations. Physical examination of the infant after delivery is most likely to show which of the following findings?",
    "A 45-year-old woman, gravida 3, para 2, at 18 weeks' gestation comes to the physician for a prenatal visit. Ultrasonography at a previous visit when she was at 12 weeks' gestation showed a hypoplastic nasal bone. Pelvic examination shows a uterus consistent in size with an 18-week gestation. Maternal serum studies show low α-fetoprotein and free estriol concentrations, and increased inhibin A and β-hCG concentrations. Physical examination of the infant after delivery is most likely to show which of the following findings?\n\nAnswer: Single transverse palmar crease",
    'A 35-year-old woman gravida 2, para 1, comes to the physician for her first prenatal visit. Pregnancy and delivery of her first child were uncomplicated. She is not sure about the date of her last menstrual period. Pelvic examination shows a uterus consistent in size with a 10-week gestation. An ultrasound examination confirms the gestational age and shows one fetus with no indication of multiple gestations. During counseling on pregnancy risks and possible screening and diagnostic tests, the patient states she would like to undergo screening for Down syndrome. She would prefer immediate and secure screening with a low risk to herself and the fetus. Which of the following is the most appropriate next step in management at this time?\n\nAnswer: Cell-free fetal DNA testing',
]
embeddings = model.encode(sentences)
print(embeddings.shape)
# [3, 768]

# Get the similarity scores for the embeddings
similarities = model.similarity(embeddings, embeddings)
print(similarities)
# tensor([[1.0000, 0.9805, 0.5273],
#         [0.9805, 1.0000, 0.5430],
#         [0.5273, 0.5430, 1.0000]], dtype=torch.bfloat16)

Training Details

Training Dataset

Unnamed Dataset

  • Size: 492 training samples
  • Columns: sentence_0, sentence_1, and sentence_2
  • Approximate statistics based on the first 492 samples:
    sentence_0 sentence_1 sentence_2
    type string string string
    details
    • min: 36 tokens
    • mean: 219.2 tokens
    • max: 791 tokens
    • min: 49 tokens
    • mean: 227.77 tokens
    • max: 819 tokens
    • min: 51 tokens
    • mean: 159.34 tokens
    • max: 430 tokens
  • Samples:
    sentence_0 sentence_1 sentence_2
    A 48-year-old woman presents to the emergency department because of increasingly severe right upper abdominal pain, fever, and non-bloody vomiting for the last 5 hours. The pain is dull, intermittent, and radiates to her right shoulder. During the past 3 months, she has had recurring abdominal discomfort after meals. The patient underwent an appendectomy more than 30 years ago. She has hypertension, diabetes mellitus type 2, and chronic back pain. She takes bisoprolol, metformin, and ibuprofen daily. She is 171 cm (5 ft 6 in) tall and weighs 99 kg (218 lb). Her BMI is 35.2 kg/m2. She appears uncomfortable and is clutching her abdomen. Her temperature is 38.5°C (101.3°F), pulse is 108/min, and blood pressure is 150/82 mm Hg. Abdominal examination shows right upper quadrant abdominal tenderness and guarding. Upon deep palpation of the right upper quadrant, the patient pauses during inspiration. Laboratory studies show the following:
    Blood
    Hemoglobin 13.1 g/dL
    Leukocyte count 10,900/mm3
    P...
    A 48-year-old woman presents to the emergency department because of increasingly severe right upper abdominal pain, fever, and non-bloody vomiting for the last 5 hours. The pain is dull, intermittent, and radiates to her right shoulder. During the past 3 months, she has had recurring abdominal discomfort after meals. The patient underwent an appendectomy more than 30 years ago. She has hypertension, diabetes mellitus type 2, and chronic back pain. She takes bisoprolol, metformin, and ibuprofen daily. She is 171 cm (5 ft 6 in) tall and weighs 99 kg (218 lb). Her BMI is 35.2 kg/m2. She appears uncomfortable and is clutching her abdomen. Her temperature is 38.5°C (101.3°F), pulse is 108/min, and blood pressure is 150/82 mm Hg. Abdominal examination shows right upper quadrant abdominal tenderness and guarding. Upon deep palpation of the right upper quadrant, the patient pauses during inspiration. Laboratory studies show the following:
    Blood
    Hemoglobin 13.1 g/dL
    Leukocyte count 10,900/mm3
    P...
    A 27-year-old woman presents with acute abdominal pain in her right upper quadrant. The pain came on suddenly while she was eating dinner. After this pain she began feeling dizzy and came to the emergency department. In the ED, her blood pressure is 75/40 mmHg, pulse is 100/minute, and she is afebrile. On physical exam, she feels too light-headed to ambulate. She demonstrates normal bowel sounds with tenderness upon palpation in the right upper quadrant. The patient is deemed too unstable for imaging. An abdominal radiograph and CT are reviewed from a recent previous visit to the ED for mild abdominal pain, and are shown in Figures A and B, respectively. Which of the following specific additional findings in her history supports the most likely diagnosis?

    Answer: Use of oral contraceptives (OCPs) for birth control
    A 42-year-old man presents to his primary care provider for abdominal pain. He reports that for several months he has been experiencing a stabbing pain above the umbilicus during meals. He denies associated symptoms of nausea, vomiting, or diarrhea. The patient’s past medical history is significant for hypertension and hyperlipidemia for which he takes amlodipine and atorvastatin. His family history is significant for lung cancer in his father. The patient is a current smoker with a 20 pack-year smoking history and drinks 3-5 beers per week. Initial laboratory testing is as follows:

    Serum:
    Na+: 141 mEq/L
    K+: 4.6 mEq/L
    Cl-: 102 mEq/L
    HCO3-: 25 mEq/L
    Urea nitrogen: 14 mg/dL
    Creatinine: 1.1 mg/dL
    Glucose: 120 mg/dL
    Calcium: 8.4 mg/dL
    Alkaline phosphatase: 66 U/L
    Aspartate aminotransferase (AST): 40 U/L
    Alanine aminotransferase (ALT): 52 U/L
    Gastrin: 96 pg/mL (<100 pg/mL)
    Lipase: 90 U/L (<160 U/L)

    The patient is started on a proton pump inhibitor without symptomatic improvement after 6 w...
    A 42-year-old man presents to his primary care provider for abdominal pain. He reports that for several months he has been experiencing a stabbing pain above the umbilicus during meals. He denies associated symptoms of nausea, vomiting, or diarrhea. The patient’s past medical history is significant for hypertension and hyperlipidemia for which he takes amlodipine and atorvastatin. His family history is significant for lung cancer in his father. The patient is a current smoker with a 20 pack-year smoking history and drinks 3-5 beers per week. Initial laboratory testing is as follows:

    Serum:
    Na+: 141 mEq/L
    K+: 4.6 mEq/L
    Cl-: 102 mEq/L
    HCO3-: 25 mEq/L
    Urea nitrogen: 14 mg/dL
    Creatinine: 1.1 mg/dL
    Glucose: 120 mg/dL
    Calcium: 8.4 mg/dL
    Alkaline phosphatase: 66 U/L
    Aspartate aminotransferase (AST): 40 U/L
    Alanine aminotransferase (ALT): 52 U/L
    Gastrin: 96 pg/mL (<100 pg/mL)
    Lipase: 90 U/L (<160 U/L)

    The patient is started on a proton pump inhibitor without symptomatic improvement after 6 w...
    A 42-year-old man comes to his primary care physician complaining of abdominal pain. He describes intermittent, burning, epigastric pain over the past 4 months. He reports that the pain worsens following meals. He had an upper gastrointestinal endoscopy done 2 months ago that showed a gastric ulcer without evidence of malignancy. The patient was prescribed pantoprazole with minimal improvement in symptoms. He denies nausea, vomiting, diarrhea, or melena. The patient has no other medical problems. He had a total knee replacement 3 years ago following a motor vehicle accident for which he took naproxen for 2 months for pain management. He has smoked 1 pack per day since the age 22 and drinks 1-2 beers several nights a week with dinner. He works as a truck driver, and his diet consists of mostly of fast food. His family history is notable for hypertension in his paternal grandfather and coronary artery disease in his mother. On physical examination, the abdomen is soft, nondistended, and ...
    A 62-year-old woman comes to the physician in June for a routine check-up. She has chronic back pain and underwent an appendectomy at the age of 27. She is married and has two kids. The patient recently got back from a cruise to Mexico where she celebrated her 40th wedding anniversary. Her last mammogram was 6 months ago and showed no abnormalities. Her last Pap smear was 2 years ago and unremarkable. A colonoscopy 5 years ago was normal. Her mother died of breast cancer last year and her father has arterial hypertension. Her immunization records show that she has never received a pneumococcal or a shingles vaccine, her last tetanus booster was 6 years ago, and her last influenza vaccine was 2 years ago. She drinks 1– 2 alcoholic beverages every weekend. She takes a multivitamin daily and uses topical steroids. She regularly attends water aerobic classes and physical therapy for her back pain. She is 168 cm (5 ft 6 in) tall and weighs 72 kg (160 lb); BMI is 26 kg/m2. Her temperature is... A 62-year-old woman comes to the physician in June for a routine check-up. She has chronic back pain and underwent an appendectomy at the age of 27. She is married and has two kids. The patient recently got back from a cruise to Mexico where she celebrated her 40th wedding anniversary. Her last mammogram was 6 months ago and showed no abnormalities. Her last Pap smear was 2 years ago and unremarkable. A colonoscopy 5 years ago was normal. Her mother died of breast cancer last year and her father has arterial hypertension. Her immunization records show that she has never received a pneumococcal or a shingles vaccine, her last tetanus booster was 6 years ago, and her last influenza vaccine was 2 years ago. She drinks 1– 2 alcoholic beverages every weekend. She takes a multivitamin daily and uses topical steroids. She regularly attends water aerobic classes and physical therapy for her back pain. She is 168 cm (5 ft 6 in) tall and weighs 72 kg (160 lb); BMI is 26 kg/m2. Her temperature is... A 66-year-old G3P3 presents with an 8-year-history of back pain, perineal discomfort, difficulty urinating, recurrent malaise, and low-grade fevers. These symptoms have recurred regularly for the past 5–6 years. She also says that there are times when she experiences a feeling of having a foreign body in her vagina. With the onset of symptoms, she was evaluated by a physician who prescribed her medications after a thorough examination and recommended a vaginal pessary, but she was non-compliant. She had 3 vaginal deliveries She has been menopausal since 51 years of age. She does not have a history of malignancies or cardiovascular disease. She has type 2 diabetes mellitus that is controlled with diet and metformin. Her vital signs include: blood pressure 110/60 mm Hg, heart rate 91/min, respiratory rate 13/min, and temperature 37.4℃ (99.3℉). On physical examination, there is bilateral costovertebral angle tenderness. The urinary bladder is non-palpable. The gynecologic examination reve...
  • Loss: MultipleNegativesRankingLoss with these parameters:
    {
        "scale": 20.0,
        "similarity_fct": "cos_sim",
        "gather_across_devices": false
    }
    

Training Hyperparameters

Non-Default Hyperparameters

  • num_train_epochs: 2
  • multi_dataset_batch_sampler: round_robin

All Hyperparameters

Click to expand
  • do_predict: False
  • eval_strategy: no
  • prediction_loss_only: True
  • per_device_train_batch_size: 8
  • per_device_eval_batch_size: 8
  • gradient_accumulation_steps: 1
  • eval_accumulation_steps: None
  • torch_empty_cache_steps: None
  • learning_rate: 5e-05
  • weight_decay: 0.0
  • adam_beta1: 0.9
  • adam_beta2: 0.999
  • adam_epsilon: 1e-08
  • max_grad_norm: 1
  • num_train_epochs: 2
  • max_steps: -1
  • lr_scheduler_type: linear
  • lr_scheduler_kwargs: None
  • warmup_ratio: None
  • warmup_steps: 0
  • log_level: passive
  • log_level_replica: warning
  • log_on_each_node: True
  • logging_nan_inf_filter: True
  • enable_jit_checkpoint: False
  • save_on_each_node: False
  • save_only_model: False
  • restore_callback_states_from_checkpoint: False
  • use_cpu: False
  • seed: 42
  • data_seed: None
  • bf16: False
  • fp16: False
  • bf16_full_eval: False
  • fp16_full_eval: False
  • tf32: None
  • local_rank: -1
  • ddp_backend: None
  • debug: []
  • dataloader_drop_last: False
  • dataloader_num_workers: 0
  • dataloader_prefetch_factor: None
  • disable_tqdm: False
  • remove_unused_columns: True
  • label_names: None
  • load_best_model_at_end: False
  • ignore_data_skip: False
  • fsdp: []
  • fsdp_config: {'min_num_params': 0, 'xla': False, 'xla_fsdp_v2': False, 'xla_fsdp_grad_ckpt': False}
  • accelerator_config: {'split_batches': False, 'dispatch_batches': None, 'even_batches': True, 'use_seedable_sampler': True, 'non_blocking': False, 'gradient_accumulation_kwargs': None}
  • parallelism_config: None
  • deepspeed: None
  • label_smoothing_factor: 0.0
  • optim: adamw_torch
  • optim_args: None
  • group_by_length: False
  • length_column_name: length
  • project: huggingface
  • trackio_space_id: trackio
  • ddp_find_unused_parameters: None
  • ddp_bucket_cap_mb: None
  • ddp_broadcast_buffers: False
  • dataloader_pin_memory: True
  • dataloader_persistent_workers: False
  • skip_memory_metrics: True
  • push_to_hub: False
  • resume_from_checkpoint: None
  • hub_model_id: None
  • hub_strategy: every_save
  • hub_private_repo: None
  • hub_always_push: False
  • hub_revision: None
  • gradient_checkpointing: False
  • gradient_checkpointing_kwargs: None
  • include_for_metrics: []
  • eval_do_concat_batches: True
  • auto_find_batch_size: False
  • full_determinism: False
  • ddp_timeout: 1800
  • torch_compile: False
  • torch_compile_backend: None
  • torch_compile_mode: None
  • include_num_input_tokens_seen: no
  • neftune_noise_alpha: None
  • optim_target_modules: None
  • batch_eval_metrics: False
  • eval_on_start: False
  • use_liger_kernel: False
  • liger_kernel_config: None
  • eval_use_gather_object: False
  • average_tokens_across_devices: True
  • use_cache: False
  • prompts: None
  • batch_sampler: batch_sampler
  • multi_dataset_batch_sampler: round_robin
  • router_mapping: {}
  • learning_rate_mapping: {}

Framework Versions

  • Python: 3.12.10
  • Sentence Transformers: 5.2.2
  • Transformers: 5.0.0
  • PyTorch: 2.7.0+cu128
  • Accelerate: 1.12.0
  • Datasets: 4.5.0
  • Tokenizers: 0.22.2

Citation

BibTeX

Sentence Transformers

@inproceedings{reimers-2019-sentence-bert,
    title = "Sentence-BERT: Sentence Embeddings using Siamese BERT-Networks",
    author = "Reimers, Nils and Gurevych, Iryna",
    booktitle = "Proceedings of the 2019 Conference on Empirical Methods in Natural Language Processing",
    month = "11",
    year = "2019",
    publisher = "Association for Computational Linguistics",
    url = "https://arxiv.org/abs/1908.10084",
}

MultipleNegativesRankingLoss

@misc{henderson2017efficient,
    title={Efficient Natural Language Response Suggestion for Smart Reply},
    author={Matthew Henderson and Rami Al-Rfou and Brian Strope and Yun-hsuan Sung and Laszlo Lukacs and Ruiqi Guo and Sanjiv Kumar and Balint Miklos and Ray Kurzweil},
    year={2017},
    eprint={1705.00652},
    archivePrefix={arXiv},
    primaryClass={cs.CL}
}