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[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What information is available about Guanfacine?", "role": "user" }, { "content": "Guanfacine also is used in the treatment of migraine headaches and drug withdrawal symptoms. Talk to your doctor about the possible risks of using this drug for your condition.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Can you provide an overview of thrombophilia, please?", "role": "user" }, { "content": "Rudolf Virchow described hypercoagulability in the mid 1800s, however, it was not until 1965 that the first descriptions of inherited thrombophilia were published. Later, in the 1990s, the more common mutations associated with primary hypercoagulable states were identified.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "How does an osteoma appear on an X-ray?", "role": "user" }, { "content": "On x-ray, osteoma demonstrates a dense well circumscribed mass with varying amounts of central lucency. Caldwell and Waters view are the radiographic positions of choice for the evaluation of osteomas.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Can you provide an overview of milk-alkali syndrome?", "role": "user" }, { "content": "The exact incidence and prevalence of milk-alkali syndrome is not known. With the introduction of histamine antagonists and decrease in antacid consumption since the 1970s, the incidence of milk-alkali syndrome has decreased significantly. However, since the 1990s, there has been an increase in milk-alkali syndrome due to increase in calcium and vitamin D consumption in postmenopausal women for osteoporosis prevention. Milk-alkali syndrome is the third most common cause of hypercalcemia in hospitalized patients after primary hyperparathyroidism and malignancies.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What does ACE inhibitor mean?", "role": "user" }, { "content": "ACE inhibitors can be divided into three groups based on their molecular structure:\r\nCaptopril (trade name Capoten), the first ACE inhibitor\r\nThis is the largest group, including:\r\nEnalapril (Vasotec/Renitec) Ramipril (Altace/Tritace/Ramace/Ramiwin) Quinapril (Accupril) Perindopril (Coversyl/Aceon) Lisinopril (Lisodur/Lopril/Novatec/Prinivil/Zestril) Benazepril (Lotensin)\r\nFosinopril (Monopril), the only member\r\nCasokinins and lactokinins are breakdown products of casein and whey that occur naturally after ingestion of milk products, especially cultured milk. Their role in blood pressure control is uncertain.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What information regarding lung cancer is available?", "role": "user" }, { "content": "Lung cancer is a common cancer in the world. It is a leading cause of cancer death in men and women in the United States. Cigarette smoking is the main and most important cause of most lung cancers. Other risk factors include high levels of pollution, radiation and asbestos exposure. According to the pathology, lung cancer can be divided into small cell lung carcinoma and non-small cell lung carcinoma. Usual symptoms include a cough that doesn't go away and gets worse over time, constant chest pain, coughing up blood, shortness of breath, wheezing, hoarseness, repeated problems with pneumonia or bronchitis, swelling of the neck and face, loss of appetite or weight loss and fatigue. Treatments involve surgery, radiation therapy, chemotherapy, targeted therapies, or a combination. The prognosis varies widely. It mainly depends on the stage of the cancer and whether or not the tumor can be removed by surgery.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the strategy to prevent a deficiency in 21-hydroxylase through secondary prevention?", "role": "user" }, { "content": "Continued monitoring of hormone balance and careful adjustment of glucocorticoid dose is helpful in controlling infertility. In general, women with 21-hydroxylase deficiency have a lower fertility rate. \r\nTo prevent adrenal crisis, all patients taking glucocorticoids replacement should take bolus dose of glucocorticoids during severe illness, surgery and severe exhaustion.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What exactly is carcinoid syndrome?", "role": "user" }, { "content": "Gastroenteropancreatic neuroendocrine tumors are classified based on their origin from the embryonic divisions of the alimentary tract into foregut (bronchial, stomach), midgut (small intestine, appendix, cecum) and hindgut (distal colon, rectum, genitourinary) tumours.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the connection between deep vein thrombosis and economy class syndrome?", "role": "user" }, { "content": "About half of people with DVT have no symptoms at all. The following are the most common symptoms of DVT that occur in the affected part of the body (usually the leg or arm): \r\nSwelling of your leg or arm Pain or tenderness that can not be explained Skin that is warm to the touch Redness of the skin\r\nPE can be present without any symptoms of a DVT. Symptoms of a PE can include: \r\nDifficulty breathing Faster than normal or irregular heartbeat Chest pain or discomfort, which usually worsens with a deep breath or coughing Anxiety Coughing up blood Lightheadedness, or fainting", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What information is available on Molluscum contagiosum?", "role": "user" }, { "content": "Avoid direct contact with the skin lesions. Do not share towels with other people. Avoiding sex can also prevent molluscum virus and other STDs. You can also avoid STDs by having a monogamous sexual relationship with a partner known to be disease-free. Male and female condoms cannot fully protect you, as the virus can be on areas not covered by the condom. Nonetheless, condoms should still be used every time the disease status of a sexual partner is unknown. They reduce your chances of getting or spreading STDs. It is advisable to use condoms containing spermicide such as nonoxynol 9.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the physiological mechanism behind junctional tachycardia?", "role": "user" }, { "content": "Normally, the atrioventricular node (AVN) can generate an escape rhythm of 40-60 beats per minute in case the sinoatrial node (SA node) or atrial pacemakers fail (sinus arrest) or slow (sinus bradycardia) or if there is complete heart block. This junctional escape rhythm generates a normal, narrow QRS complex rhythm at a rte below 60 beats per minute (junctional bradycardia) as the electrical impulses once they are generated are conducted with normal velocity down the His-Purkinje system. Retrograde P waves (i.e. upside down) due to retrograde or backward conduction may or may not be present in junctional bradycardia.\r\nIn contrast to a junctional escape rhythm or junctional bradycardia at a rate of 40-60 beats per minute, junctional tachycardia is faster, at a rate > 60 beats per minute. Junctional tachycardia generates a normal, narrow QRS complex rhythm as the electrical impulses are conducted with normal velocity down the His-Purkinje system. Retrograde P waves (i.e. upside down) P waves due to retrograde or backward conduction may or may not be present.\r\nThe cause of the more rapid firing of the atrioventricular node is thought to be due to enhanced automaticity as a result of abnormal Calcium metabolism in the sarcoplastic reticulum.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What kind of injury is classified as an avulsion fracture?", "role": "user" }, { "content": "Immediate stabilization of patients is the first step. Then the radial fracture and the DRUJ stabilization is recommended in these cases. Open forearm fractures considered as a surgical emergency. Humerus fracture occurs in younger patients who are skeletally immature; the normally they treated using a closed reduction and casting. Since closed reduction and cast application have led to unsatisfactory results. Then, Almost always the open reduction are necessary for the Humerus fracture. There are controversies regarding the indications for intramedullary nailing of forearm fractures.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is Subependymoma, and how can it be distinguished from other illnesses?", "role": "user" }, { "content": "Subependymoma must be differentiated from: \r\nNeoplasms of the ventri­cular wall and septum pellucidum Ependymoma Central neurocytoma Subependymal giant cell astrocytoma Neoplasms of the choroid plexus Choroid plexus papilloma and carcinoma Others Intraventricular meningioma Intraventricular metastasis Oligodendroglioma Pilocytic astrocytoma Glioblastoma multiforme Medulloblastoma Intraventricular teratoma", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What does the physical examination entail for Pleural effusion?", "role": "user" }, { "content": "Physical findings for effusions are determined by the volume of pleural fluid and the extent of lung compression. Pleural fluid also interferes with transmission of low-frequency vibrations and results in diminished tactile fremitus, asymmetric chest expansion, decreased or absent fremitus posteriorly and laterally, dullness on percussion, decreased or absent breath sounds, and reduced vocal resonance.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What does a physical examination for a Warthin's tumor involve?", "role": "user" }, { "content": "Patients with Warthin's tumor are usually well-appearing.\r\nMobile non-tender mass which is firm, solitary, and normal in color and appearance On oral examination, redness or bulging may be present", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the mechanism of action that causes Parotitis?", "role": "user" }, { "content": "Viral parotitis is caused by the infiltration of respiratory droplets containing the mumps virus. Mumps virus is a member of the paramyoxoviridae family with a single-strand, negative-sense RNA molecule. The mumps HN and F glycoproteins reach the surface of the infected host cell through the endoplasmic reticulum and Golgi complex. Virions emerge from the infected cells due to the M protein facilitating the localization of the viral ribonucleic proteins onto the host cell membrane. The virus binds with the neighboring host cells via sialic acid through HN glycoprotein. Both HN and F glycoproteins mediate the fusion of virus and host cell, as well as cell and cell - membrane fusion, to perpetuate the spread of the virus throughout the host. The virus replicates in the nasopharynx and regional lymph nodes. Upon replication, viremia occurs for three to five days, spreading to the salivary glands. The parotid gland particularly susceptible to parotitis due to the lower rate of secretion. Salivary flow rate is reduced due to the inflammation response. Reduced saliva flow rate in the parotid gland leads to a reduction in the salivary defense proteins IgA (sIgA) and IgG, increasing vulnerability of the parotid gland to infection. Parotitis results from the inflammatory response to the presence of mumps virus in the parotid salivary gland.\r\nBacterial parotitis is most commonly caused by staphylococcus aureus, a gram-positive coccal bacterium often found in the respiratory tract. Staphylococcus aureus infects the host through skin to skin or skin to surface contact with an infected individual or object.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the explanation for Chigger and its pathophysiology?", "role": "user" }, { "content": "Chiggers do burrow into the skin but do not suck blood. It attaches to its host, injects digestive enzymes into the bite wound, and then sucks up the digested tissue. Warm, rainy days make these parasitic and predatory mites reproduce into large populations. Once the ground temperature is regularly above 60°F, the harvest mite lays eggs, and “chigger season” is underway. This season typically begins in April and ends in the early autumn/first “frost.” Chiggers do not like sunlight or humidity. During the wet season, chiggers are usually found in tall grass and other vegetation. During dry seasons, chiggers are most found underneath brush and shady areas.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What information do you have about Roseola?", "role": "user" }, { "content": "Exanthem subitum; Sixth disease.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Can you provide a summary of eosinophilic esophagitis?", "role": "user" }, { "content": "The incidence Eosinophilic esophagitis (EoE) is approximately 10 per 100,000 individuals worldwide. The prevalence of EoE is approximately 50-100 per 100,000 individuals worldwide. Patients of all age groups may develop EoE. It usually affects individuals of the white race. Males are more commonly affected by EoE than females. EoE is a rare disease that tends to affect people with a history of European ancestry.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Could you provide the current phrasing of the sentence for me to rephrase it?", "role": "user" }, { "content": "The most important risk factor in the development of peritoneal carcinomatosis include:\r\nOvarian cancer Colon cancer Gastric cancer Pancreatic cancer", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the meaning of ichthyosis vulgaris?", "role": "user" }, { "content": "The symptoms of the inherited condition manifest themselves at around four years old. The symptoms will often improve with age, although they may grow more severe again in old age.\r\nThe acquired variant usually becomes evident during adulthood.\r\nThe condition is not life-threatening; the impact on the patient, who has a mild case, is generally restricted to mild itching and the social impact of having skin with an unusual appearance. People afflicted with \"mild\" cases have symptoms which include \" mosaic lines\" or scaly patches on the shins, fine white scales on the forearms and rough palms.\r\nHowever, severe cases, although rare, do exist. Severe cases would entail the build up of scales everywhere, with areas of the body that have a concentration of sweat glands being least affected. Areas where the skin rubs against each other, such as the arm pits, the groin, and the \"folded\" areas of the elbow and knees, would also be less affected. When the build up of scales is bad, the person with a severe case would suffer from \"prickly itch\" when he or she needs to sweat but cannot as a result of the scales.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "In chronic cases, what is the prescribed treatment for stable angina using beta blockers?", "role": "user" }, { "content": "In patients with stable angina, beta blockers are used as a first line of therapy for both, symptomatic relief and the prevention of ischemic events. The physiologic mechanism of benefit of this therapy is a marked reduction in myocardial oxygen consumption by reducing the heart rate and myocardial contractility. Selective beta-1 blockers are preferred to non-selective beta-blockers due to fewer associated side effects. The most commonly used selective beta-1 blockers are metoprolol, atenolol, and bisoprolol.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the underlying abnormal physiological condition that causes hepatopulmonary syndrome?", "role": "user" }, { "content": "Nitric oxide\r\nThe normal physiology of nitric oxide can be understood as follows:\r\nThe endothelium (inner lining) of blood vessels use nitric oxide to signal the surrounding smooth muscle to relax, thus dilating the artery and increasing blood flow. This underlies the action of nitroglycerin, amyl nitrate, \"poppers\" (isobutyl nitrite or similar) and other nitrate derivatives in the treatment of heart disease: The compounds are converted to nitric oxide (by a process that is not completely understood), which in turn dilates the coronary artery (blood vessels around the heart), thereby increasing its blood supply. Nitric oxide also acts on cardiac muscle to decrease contractility and heart rate. The vasodilatory actions of nitric oxide play a key role in renal control of extracellular fluid homeostasis. Nitric oxide also plays a role in erection of the penis. Nitric oxide is also a second messenger in the nervous system and has been associated with neuronal activity and various functions like avoidance learning.\r\nNitric oxide is synthesized by nitric oxide synthase (NOS). There are three isoforms of the NOS enzyme: endothelial (eNOS), neuronal (nNOS), and inducible (iNOS) - each with separate functions. The neuronal enzyme (NOS-1) and the endothelial isoform (NOS-3) are calcium-dependent and produce low levels of gas as a cell-signaling molecule. The inducible isoform (NOS-2) is calcium-independent and produces large amounts of gas which can be cytotoxic.\r\nNitric Oxide (NO) is of critical importance as a mediator of vasorelaxation in blood vessels. Platelet-derived factors, shear stress, angiotensin II, acetylcholine, and cytokines stimulate the production of NO by endothelial nitric oxide synthase (eNOS). eNOS synthesizes NO from the terminal guanidine-nitrogen of L-arginine and oxygen and yields citrulline as a byproduct. NO production by eNOS is dependent on calcium - calmodulin and other cofactors. NO, a highly reactive free radical then diffuses into the smooth muscle cells of the blood vessel and interacts with soluble guanylate cyclase. Nitric oxide stimulates the soluble guanylate cyclase to generate the second messenger cyclic GMP (3’,5’ guanosine monophosphate)from guanosine triphosphate (GTP). The soluble cGMP activates cyclic nucleotide-dependent protein kinase G (PKG or cGKI). PKG is a kinase that phosphorylates a number of proteins that regulate calcium concentrations, calcium sensitization, hyperpolarize cell through potassium channels, actin filament and myosin dynamic alterations that result in smooth muscle relaxation.(see smooth muscle article). .\r\nAngiogenesis\r\nThe underlying mechanisms behind angiogenesis are beginning to be discovered. The process may begin with vasodilatation mediated by nitric oxide followed by an increase in permeability mediated by VEGF. This increased permeability allows for plasma protein extravasation and scaffold formation. Endothelial cell migration is supported by adhesion molecules such as PECAM-1 and cadherins. The vascular smooth muscle cells detaching and loosening signaled by Ang2 enables the migration and sprouting of endothelial cells. The process of angiogenesis is initiated by VEGF by Ang1 and is required to stabilize the endothelial networks and to increase periendothelial cell interactions. Platelet-derived growth factor (PDGF) stimulates inflammatory cells and promotes cell-cell interactions by molecules such as integrin. VEGF has morphogenic effects which allow endothelial cells cords to acquire and enlarge their lumen. Unfortunately, muscularization of the network is poorly understood. The process appears to be tissue-specific. In the coronary arteries, the epicardial layer appears to be the source of smooth muscle cells which migrate under PDGF-BB and VEGF stimulation. TGF-beta and downstream transcription factors Smads promote extracellular matrix production and solidify cell-cell interactions. FGF can help further this process resulting in arteriogenesis. In pathologic conditions such as ischemic myocardium, arteriogenesis can allow for as much as a 20-fold enlargement of collateral network vessels. Chemokines and cytokines are upregulated by increased collateral flow which results in monocyte recruitment. Monocytes produce proteinases which cause medial destruction and further remodeling. Hypoxia-inducible transcription factors (HIF), and their stabilization by peptide regulator 39 help induce and potentiate the neovascularization process. Newer imaging techniques utilize knowledge of molecular mechanisms to help enhance image resolution and improve sensitivity and specificity.\r\nPulmonary microvascular dilation and angiogenesis are two central pathogenic features that drive abnormal pulmonary gas exchange in experimental hepatopulmonary syndrome, and thus might underlie hepatopulmonary syndrome in humans. \r\n\r\nVasodilators\r\nThe exact pathogenesis of the hepatopulmonary syndrome is not completely understood.\r\nIt is thought that hepatopulmonary syndrome is the result of microscopic intrapulmonary arteriovenous dilatations due to either increased liver production or decreased liver clearance of vasodilators, possibly involving nitric oxide. \r\n \r\nThe progression to hepatopulmonary syndrome is believed that involves the nitric oxide metabolism. The dilation of these blood vessels causes overperfusion relative to ventilation, leading to ventilation-perfusion mismatch and hypoxemi a. There is an increased gradient between the partial pressure of oxygen in the alveoli of the lung and adjacent arteries (alveolar-arterial A-a gradient) while breathing room air. Patients with hepatopulmonary syndrome have platypnea - orthodeoxia syndrome (POS); that is, because intrapulmonary vascular dilations (IPVDs) predominate in the bases of the lungs, standing worsens hypoxemia (orthodeoxia)/dyspnea (platypnea) and the supine positio n improves oxygenation as blood is redistributed from the bases to the apices. Additionally, late in cirrhosis, it is common to develop high output failure, which would lead to less time in capillaries per red blood cell, exacerbating the hypoxemia.\r\nAngiogenesis\r\nAs discussed below a variety of angiogenesis-related genes polymorphism has been linked to hepatopulmonary syndrome. An increased levels of endothelin-1 in cirrhotic patients have been correlated with intrapulmonary molecular and gas exchange abnormalities, hypothesizing a probable contribution to the pathogenesis of hepatopulmonary syndrome.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Could you provide me with the given sentence so I can rephrase it for you?", "role": "user" }, { "content": "Marburg hemorrhagic fever must be differentiated from other viral hemorrhagic fevers that may cause fever, abdominal pain,and bleeding such as Ebola, Crimean-Congo hemorrhagic fever (CCHF), Hantavirus Infection, Rift Valley fever, Lujo hemorrhagic fever and Lassa fever. SInce many of the signs and symptoms of marburg hemorrhagic fever are similar to those of other infectious diseases such as malaria or typhoid fever, leptospirosis, marburg hemorrhagic fever must also be differentiated from those infections.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Could you provide me with the text that needs to be rephrased?", "role": "user" }, { "content": "GERD can be classified based on the endoscopic appearance of the esophageal mucosa and the clinical presentation of the disease.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What does secondary prevention for Ascites entail?", "role": "user" }, { "content": "Effective measures for the secondary prevention of ascites include: \r\nWater and sodium intake restriction Diuretic use Antibiotic prophylaxis for spontaneous bacterial peritonitis (SBP).", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Could you please explain what Vein and Overview mean?", "role": "user" }, { "content": "In the circulatory system, a vein is a blood vessel that carries blood toward the heart. The majority of veins in the body carry low-oxygen blood from the tissues back to the heart; the exceptions being the pulmonary and umbilical veins which both carry oxygenated blood.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the historical background or context of cryptococcosis?", "role": "user" }, { "content": "Cryptococci were first identified in 1894 by German pathologist Otto Busse in a patient with chronic periostitis of the tibia. He described the isolated organism as a \" Saccharomyces -like\" pathogen. The infection was referred to as \"Busse-Buschke\" disease named after Busse and his colleague, dermatologist Abraham Buschke. Busse later named the organism Saccharomyces hominis. During the same time period, Francesco Sanfelice reported isolating a similar organism from fermenting peach juice. Because of its unique colony form, he referred to the species as Saccharomyces neoformans. In 1901, Jean Paul Vuillemin, a French mycologist, transferred the yeast-like fungus to the genus Cryptococcus due to the absence of ascospores in its life cycle, a defining feature of Saccharomyces. In the 1950s, four capsule serotypes (A through D) were identified using rabbit antisera. This classification was later improved by DNA sequencing, epidemiology, and pathobiology. Until 1999, Cryptococcus gattii was known as Cryptococcus neoformans var gattii, until it was recognized as separate species with distinct epidemiological patterns and clinical manifestations.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "How cost-effective is therapy for treating rhinosinusitis?", "role": "user" }, { "content": "Current literature suggests that in patients with refractory chronic rhinosinusitis endoscopic sinus surgery(ESS) is superior to continued medical therapy in terms of symptom relief, quality of life and cost effectiveness with reported incremental cost effectiveness ratio (ICER) of five to thirteen thousand dollars per quality adjusted life year (QALY). Medical therapy mostly helps maintain the quality of life and health-state utility of the patients. \r\nBiologic therapies such as mepolizumab, omalizumab and dupilumab are recently introduced as alternative therapies for sever cases of chronic rhinosinusitis. To date, there has been insufficient evidence in the literature regarding their health care, social and economic cost effectiveness. It is suggested that use of biologic agents could prevent recurrence of the disease, and subsequently decrease the direct and indirect costs of the surgery. On the other hand the their high cost and need for multiple visits to the health care provider, should be considered. Thus, it is not easy to determine the cost-effectiveness of biologic agents in treatment of chronic rhinosinusitis and further prospective research with longer follow-up period is required.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What does the term unicornuate uterus mean?", "role": "user" }, { "content": "Patient #1", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the secondary prevention strategy for fungal meningitis?", "role": "user" }, { "content": "There are no known secondary preventive measures of fungal meningitis.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Can you provide a description or summary of heart failure?", "role": "user" }, { "content": "The prevalence of heart failure has been increasing due to the increase in the aging population, the early detection, preventive measures and improvement in the therapy. The prevalence of heart failure in the United States was estimated in 2006 to be 5.8 million people of all ages with an estimated incidence of 10/1000 for individuals older than 65 years of age.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the purpose of constipation?", "role": "user" }, { "content": "† Criteria fulfilled for the past 3 months and symptom onset at least 6 months before diagnosis. \r\nAmerican Gastroenterological Association, however have stopped using the term functional constipation because a subset these patients have slow colonic transit that has been associated with a marked reduction in colonic intrinsic nerves and interstitial cells of Cajal which is against the true definition of functional disorder.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What does iron deficiency anemia mean?", "role": "user" }, { "content": "Iron deficiency anemia was discovered in 1852 by Karl Vierordt and his student H. Welcher. Over the next century, the details of iron regulation were elucidated.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the preferred diagnostic test for detecting Glycogen storage disease type I?", "role": "user" }, { "content": "Glycogen storage disease type 1 is diagnosed by identification of proband by either of the following: \r\nMolecular genetic testing Enzyme activity assay\r\nMolecular genetic testing shows: Biallelic pathogenic variants in G6PC for patients with GSD type 1a Biallelic pathogenic variants in SLC37A4 for patients with GSD type 1b\r\nMolecular genetic testing Genetic testing Analysis performed Serial single-gene testing First sequence analysis of G6PC is done Sequence analysis of SLC37A4 if no G6PC pathogenic variants identified Targeted analysis For G6PC pathogenic variant Ashkenazi Jewish ancestry p.Arg83Cys analysis For G6PD pathogenic variant Old Order Amish ancestry p.Gln347Ter analysis Multigene panel Multiple genes are sequenced at the same time including G6PC, SLC37A4 and other related genes when differential diagnosis is considered Comprehensive genomic testing Exome sequencing Considered if the diagnosis is not confirmed by serial single-gene testing and/or use of a multigene panel in an individual with features of GSD type I Genome sequencing\r\nMolecular genetic testing is preferred over enzyme activity assay due to: Relatively high sensitivity Need for liver biopsy for enzyme activity assay\r\nEnzyme activity assay is performed on frozen liver (ample of 15-20 mg) obtained by percutaneous or open liver biopsy. Transport should be done on dry ice via overnight delivery to the clinical diagnostic laboratory. Enzyme activity assay performed are: Glucose-6-phosphatase (G6Pase) catalytic activity Glucose-6-phosphate exchanger SLC37A4 (transporter) activity", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the historical context or background of Methemoglobinemia?", "role": "user" }, { "content": "It has been reported (Heard & Ashworth 1968 apud Basrani et al. 2007) that, when placed in an aqueous solution, Chlorhexidine Gluconate (antiseptic) slowly hydrolyzes and forms para-chloroaniline (4-Chloroaniline, p-Chloroaniline or PCA). Para-chloroaniline (PCA) has been shown to be toxic. As an aromatic amine, the primary toxic effect is methemogloblin formation. Toxicological studies in rats and mice have shown that the hemopoietic system is the major target for PCA.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Could you provide an explanation and overview of Estriol, please?", "role": "user" }, { "content": "Estriol (also oestriol) is one of the three main estrogens produced by the human body. It is only produced in significant amounts during pregnancy as it is made by the placenta. In pregnant women with multiple sclerosis (MS), estriol reduces the disease's symptoms noticeably, according to researchers at UCLA's Geffen Medical School.\r\nLevels of estriol in non-pregnant women do not change much after menopause, and levels are not significantly different from levels in men.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What are the laboratory results that can be linked to atrial fibrillation?", "role": "user" }, { "content": "Many cases of atrial fibrillation (AF) have no definite cause, it may be the result of various other problems. Nevertheless, thyroid function tests are required, especially for a first episode of atrial fibrillation (AF), when the ventricular rate is difficult to control, or when atrial fibrillation (AF) recurs unexpectedly after cardioversion. Renal function and electrolytes are routinely performed in patients suffering from atrial fibrillation. In addition, in acute-onset atrial fibrillation associated with chest pain, cardiac troponins or other markers of damage to the heart muscle may be ordered.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the definition of myoclonus and how is it categorized?", "role": "user" }, { "content": "In juvenile myoclonic epilepsy, seizures usually involve the neck, shoulders, and upper arms. These seizures typically occur shortly after waking up. They normally begin between puberty and early adulthood. They can usually be controlled with medication, but it must be taken for life. In rare cases, myoclonic seizures can be symptomatic of Lennox-Gastaut syndrome, beginning in early childhood and usually involving the face, neck, shoulders, and upper arms. In these cases, the seizures tend to be strong and difficult to control.Progressive myoclonic epilepsy includes both myoclonic and tonic-clonic seizures. Treatment is not normally successful for any extended period of time.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is osteochondritis, and how can it be diagnosed?", "role": "user" }, { "content": "To determine whether your pains are osteochondritis dissecans, an MRI or X-Ray can be performed to show whether the loose piece of bone is still in place. In specific cases if caught early enough, a harmless dye will be injected into your blood stream to show where the calcium will most likely continue to build up. Doing this makes the removal process much easier..", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the definition of Hydroa vacciniforme-like lymphoma?", "role": "user" }, { "content": "HVLL reports date back to 1986; however, it is not until 2008 that the WHO recognized HVLL as a separate entity from Hydroa vacciniforme and classified it under \"EBV positive T-cell lymphoproliferative disorders of childhood\".", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the underlying pathological mechanism of gliomatosis cerebri?", "role": "user" }, { "content": "Genes involved in pathogenesis of gliomatosis cerebri include: \r\nP53 Isocitrate dehydrogenase (IDH1) OLIG-2 Ki-67 EGFR PTEN VCAM1 VEGF Gene on chromosome 7q Gene on chromosome 10q Gene on chromosome 13q\r\nGliomatosis cerebri may be associated with: \r\nNeurofibromatosis type 1 Pilomatricoma\r\nOn gross pathology, gliomatosis cerebri is characterized by: \r\nDiffuse, usually astrocytic growth pattern Involvement of at least three lobes of the brain Bilateral involvement of the cerebral hemispheres, deep gray matter, brainstem, or cerebellum\r\nCommon intracranial sites involved in gliomatosis cerebri include: \r\nBasal and thalamic nuclei (75%) Corpus callosum (50%) Brainstem and spinal cord (10-15%) Cerebellum (10%) Two or more sites generally affected at the same time\r\nOn microscopic histopathological examination, gliomatosis cerebri is characterized by: \r\nDiffuse proliferation of immature glial elements resembling astrocytes, oligodendroglia, or undifferentiated cells Cytologic and nuclear atypia Calcification Microcysts Mitotic figures No necrosis or microvascular proliferation\r\nAccording to WHO classification of brain tumors, gliomatosis cerebri is classified into grade 2 or grade 3 tumors.\r\nGliomatosis cerebri is demonstrated by positivity to tumor markers such as GFAP, S-100, and Ki-67.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What information is available about gas gangrene?", "role": "user" }, { "content": "Gas gangrene is a potentially deadly form of tissue death (gangrene).", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What constitutes an avulsion fracture?", "role": "user" }, { "content": "The diagnosis of a Distal humerus fracture should be confirmed using a radiographic examination.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What are the natural history, prognosis, and potential complications associated with septic arthritis?", "role": "user" }, { "content": "Complications of septic arthritis mainly depends on the pre existing joint disease and treatment of current infection. Major complications of septic arthritis includes: \r\nJoint degeneration (arthritis): common with non gonococcal arthritis (~ 40%) Bacteremia (5-20%) Osteomyelitis\r\nIn children: As the growth plate is in very close to epiphysis, direct extension of a joint infection to the growth plate can lead to reduced bone growth in children. \r\nEndocarditis Pericarditis Pyomyositis Perihepatitis Meningitis", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Could you explain what the Bispectral index means?", "role": "user" }, { "content": "The BIS is an electroencephalogram-derived multivariant scale that correlates with the metabolic ratio of glucose (Akire M., Anesthesiology 1998). From this metabolic activity the brain obtains its functionality, the ability to capture information from outside and inside the body and integrate that information into conscious perception, with the ability to remember it later. Both loss of consciousness and awakening from anaesthesia are correlated with this scale (Flashion R, et al. Anesthesiology 97).\r\nThe bispectral index has not been proven to measure the level of consciousness, independently of the cause of reduced consciousness (whether this be drugs, metabolic disease, hypothermia, head trauma, hypovolemia, natural sleep and so on). citation needed Not all unconscious patients will have a low BIS value, although the general clinical state may be very different from one to the other, and the prognosis may also differ. citation needed\r\nThe bispectral index is prone to artifacts. Its numbers cannot be relied upon in all situations, including brain death, circulatory arrest or hypothermia: Anesth Analg. 2004 Mar;98(3):706-7. Eur J Anaesthesiol. 2006 Jul;23(7):618-9. Resuscitation. 2006 May;69(2):207-12. Intensive Care Med. 2007 Jan;33(1):133-6\r\nA monitor of the Autonomic Nervous System (such as the ANSiscope) may be more appropriate for purposely assessing the reaction to noxious stimuli during surgery. However, a monitor of the central nervous system may be more appropriate for monitoring consciousness. After the publication of the B-Aware Trial (P. Myles, K. Leslie et al. Lancet 2004) BIS is suggested as a parameter that allows the anaesthetist to reduce the risk of anaesthesia awareness during surgery for a'high risk' group .", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Could you explain the meaning of \"rephrase this to proper english\"? The provided sentence is already in proper English. If you mean to ask how to rephrase the sentence, a possible rephrased version would be: \"Could you explain what an inferior vena cava filter is?\"", "role": "user" }, { "content": "An inferior vena cava filter is a medical device that is implanted into the inferior vena cava to prevent pulmonary emboli (PEs). IVC filters are used in case of contraindication to anticoagulation, failure of anticoagulation or complication to anticoagulation in patients who have a venous thromboembolism disease or as a prophylactic measure for patients with high risk of pulmonary embolism.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Could you explain what ventricular remodeling means?", "role": "user" }, { "content": "Maladaptive remodeling is age dependent and the mortality rate resulting from Myocardial Infarction increases with age.\r\nCoronary artery disease which is the leading cause of heart failure with reduced systolic function occurs more in males than females.However, heart failure with preserved systolic function affects females more than males with a ratio of 2:1", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What are the secondary methods of preventing constipation?", "role": "user" }, { "content": "Effective measures for the secondary prevention of constipation include:\r\nAppropriate dietary modification and addition of fiber Suitable laxative and stool softener therapies The following food should be avoided while constipated: Cheese Chips Fast food Ice cream Meat Prepared foods, such as some frozen meals and snack foods Processed foods, such as hot dogs or some microwavable dinners", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the relationship or interaction between percutaneous coronary intervention using Taxus and cardiac surgery?", "role": "user" }, { "content": "Diagnostic angiograms were assessed by staff at an independent core laboratory who were unaware of treatment status of patients. A SYNTAX Score was designed for scoring of the coronary angiograms according to the complexity and severity of the coronary artery disease. The SYNTAX score was used as a diagnostic tool for comprehensive anatomical assessment of patients with coronary artery disease.Higher scores reflect more complex disease and lower scores less severe.Patients with left main disease with 1 or 2 vessel disease had higher scores as compared to 3-vessel disease.A high score was considered > 33 and a low score was defined as < 22. \r\n1. RCA Proximal: From the ostium to one half the distance to the acute margin of the heart. 2. RCA Mid: From the end of the first segment to acute margin of the heart. 3. RCA Distal: From the acute margin of the heart to the origin of the posterior descending artery 4. Posterior descending artery: Running in the posterior interventricular groove. 16. Posterolateral branch from the RCA: Posterolateral branch originating from the distal coronary artery distal to the crux. 16a. Posterolateral branch from the RCA: First posterolateral branch from segment 16. 16b. Posterolateral branch from the RCA: Second posterolateral branch from the segment 16. 16c. Posterolateral branch from the RCA: Third posterolateral branch from the segment 16. 5. Left main: From the ostium of the LCA through bifurcation into the left anterior descending and left circumflex branches. 6. LAD Proximal: Proximal to and including first major septal branch. 7. LAD Mid: LAD immediately distal to the origin of first septal branch and extending to the point where LAD forms an angle (RAO view). If this angle is not identifiable this segment ends at one half the distance from the first septal to the apex of the heart. 8. LAD Apical: Terminal portion of LAD, beginning at the end of previous sement and extending to or beyond the apex. 9. First Diagonal: The first diagonal originating from segment 6 or 7. 9a. First Diagonal a: Additional first diagonal originating from segment 6 or 7, before segment 8. 10. Second Diagonal: Orginating from segment 8 or the transition between segment 7 and 8. 10a. Second Diagonal a: Additional second diagonal originating from segment 8. 11. Proximal Circumflex: Main stem of circumflex from its origin of left main and including origin of first obtuse marginal branch. 12. Intermediate/anterolateral artery: Branch from trifurcating left main other than proximal LAD or LCX. It belongs to the circumflex territory. 12a. Obtuse marginal a: First side branch of circumflex running in general to the area of obtuse margin of the heart. 12b. Obtuse marginal b: Second additional branch of circumflex running in the same direction as 12. 13. Distal Circumflex artery: The stem of circumflex distal to the origin from the most distal obtuse marginal branch, and running along the posterior left atrioventricular groove. Caliber may be small or artery absent. 14. Left Posterolateral: Running to the posterolateral surface of the left ventricle. May be absent or a division of obtuse marginal branch. 14a. Left Posterolateral a: Distal from 14 and running in the same direction. 14b. Left Posterolateral b: Distal from 14 and 14a and running in the same direction. 15. Posterior descending: Most distal part of dominant left circumflex when present. It gives origin to the septal branches. When this artery is present, segment 4 is usually absent.\r\nAdverse lesions are more specifically scored according to their particular characteristic by either multiplying or adding by a certain factor.\r\nType A lesions are defined as lesions not involving the ostium of side branch, in the main vessel proximal to the ostium of the side branch. Type B lesions are defined as lesions not involving the ostium of side branch, in the main vessel distal to the ostium of the side branch. Type C lesions are defined as lesions not involving the ostium of side branch, in the main vessel both proximal and distal to the ostium of the side branch. Type D lesions are defined as lesions involving the ostium of side branch, in the main vessel proximal and distal to the ostium of the side branch. Type E lesions are defined as lesions involving only the ostium of side branch. Type F lesions are defined as lesions involving only the ostium of side branch,in the main vessel proximal to the ostium of the side branch. Type G lesions are defined as lesions involving only the ostium of side branch,in the main vessel distal to the ostium of the side branch.\r\nTrifurcations are scored for segments 3/4/16/16a, 5/6/11/12, 11/12a/12b/13, 6/7/9/9a and 7/8/10/10a. Bifurcations are scored for segments 5/6/11, 6/7/9, 7/8/10, 11/13/12a, 13/14/14a, 3/4/16 and 13/14/15. Severe tortuosity was defined one or more bends of 90° or more, three or more bends of 45° to 90° proximal of the diseased segment. Aorto-ostial was defined for immediate origin of coronary arteries from the aorta. Diffuse/small vessels disease was defined as diseases involving more then 75% of the of length of the segment of 2 mm vessel diameter. Co-dominance is not used as a option while scoring for dominance.\r\nAdapted from publication Sianos G, Morel MA, Kappetein AP; et al. (2005). \"The SYNTAX Score: an angiographic tool grading the complexity of coronary artery disease\". EuroIntervention: Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 1 (2): 219–27. PMID 19758907. Unknown parameter |month= ignored (help) CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Could you provide me the original statement that needs to be rephrased?", "role": "user" }, { "content": "Under normal circumstances, heme synthesis begins in the mitochondrion, proceeds into the cytoplasm, and finishes back in the mitochondrion. However, without porphobilinogen deaminase, a necessary cytoplasmic enzyme, heme synthesis cannot finish, and the metabolite porphyrin accumulates in the cytoplasm.\r\nAdditional factors must also be present such as hormones, drugs, and dietary changes that trigger the appearance of symptoms. Symptoms of AIP may include abdominal pain, constipation, and muscle weakness.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What information is available about Quinapril?", "role": "user" }, { "content": "Accupril®", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What information is there about cerebral venous sinus thrombosis?", "role": "user" }, { "content": "- Lifelong prophylaxis with anticoagulant is required in patients with recurrent CVT or pro thrombotic conditions.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Can you explain what a splenic abscess is?", "role": "user" }, { "content": "Splenic abscess can result from various sources such as: \r\nPathogenic Mechanism Description Hematogenous Dissemination Hematogenous dissemination or arterial dissemination is the most common mode of infection that results in splenic abscess. It is a metastatic infection through hematologic seeding from distant infections such as infective endocarditis, purulent teeth-related infections and urinary tract infections Most common organism involved is staphylococcs aureus Often results in multiple abscesses Secondary infection of splenic infarction Embolic or thrombotic non-infectious events due to red cell abnormalities such as hemolytic and sickle cell anemia causes ischemia followed by superinfection of emboli which tend to obstruct free blood flow and oxygen delivery to the spleen on the microscopic level. Contiguous spread of bacteria It is a mode of infection spread to the spleen from anatomically neighboring structures such as stomach or large bowel perforation, infected pancreatic cyst, perisplenic or subpleuric abscess. Can cause either solitory or multiple abscesses Trauma or Surgery Secondary infections may developed due to splenic trauma during any intra-abdominal procedures. Trauma leads to hematoma formation. In case of penetrating trauma to the spleen or intraabdominal surgery, direct inoculation of the spleen with pathogens may form a septic focus which, left untreated, may lead to formation of an abscess. Immunodeficiency It is major factor involved in the course of splenic abscess especially if the causative organism is fungi or any other atypical organism.\r\nSolitary splenic abscess\r\nEnlarged spleen with due to large solitary abscesses with thick wall around the abscess to prevent dissemination is seen\r\nMultiple splenic abscess\r\nAt the time of autopsy, spleen present as large and soft, and pus extruded organ from the cut surface.\r\nSolitary splenic abscess\r\nMicroscopically the abscess consist of necrotic tissue with a fibrous wall surrounded by inflammatory cell infiltration.\r\nMultiple splenic abscess\r\nMultiple microscopically visible foci of infection riddled homogeneously throughout the spleen Abscesses are filled with polymorphonuclear leukocytes which were scattered throughout the parenchyma, intermixed with other foci of microinfarction and coagulation necrosis\r\nSplenic abscess is commonly associate with: \r\nParanchymal liver disease Pancreatitis Pleural effusion Renal cysts Ovarian cysts Abdominal lymphadenopathy", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Could you explain what an anti-diabetic drug is?", "role": "user" }, { "content": "Biguanides reduce hepatic glucose output and increase uptake of glucose by the periphery, including skeletal muscle. Metformin should be temporarily discontinued before any radiographic procedure involving intravenous iodinated contrast as patients are at an increased risk of lactic acidosis.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the importance of tumor lysis syndrome in a physical examination?", "role": "user" }, { "content": "Common physical examination findings of tumor lysis syndrome include fever, tachycardia, edema, cardiac arrhythmia, and tetany.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the history of Albinism, and what are its symptoms?", "role": "user" }, { "content": "Patients may present both cutaneous and ocular findings. Cutaneous features include hypopigmented/ white hair, skin, and eyelashes. Ocular features include photophobia, decreased visual acuity, pink eyes, hypopigmentation of iris, and strabismus.\r\nPatients with albinism have positive familial history of as albinism is inherited by genetic mutation Patients with severe cutaneous findings can easier be diagnosed rather than those with only ocular albinism Comparing the cutaneous features of suspected patients with other family members is vital for the diagnosis \r\nCutaneous features include: White or hypo-pigmented hair White or hypo-pigmented eyelashes White or hypo-pigmented skin Ocular findings include: Photophobia Decreased visual acuity Pink eyes Hypopigmentation of iris Strabismus", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "How are hemangiomas and electrocardiograms related?", "role": "user" }, { "content": "There are no other ECG findings associated with hemangioma.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the classification system used for pulmonary hypertension?", "role": "user" }, { "content": "PH is a pathological condition present in different disease states that share similar clinical manifestations and some common histopathological features. Shown below is a table that summarizes the classification of PH based on histopathology findings. \r\nClass Histopathological findings Pulmonary arteriopathy Constrictive lesions in pulmonary arteries: Medial hypertrophy Intimal thickening Adventitial thickening Complex lesions in pulmonary arteries: Plexiform lesions Dilatation lesions Arteritis Pulmonary arteriopathy with venous-venular changes Changes similar to pulmonary arteriopathy PLUS Changes in venules and veins Pulmonary occlusive venopathy (with or without arteriopathy) Changes in venules and veins: Diffuse fibrotic occlusion Intimal thickening Medial thickening Adventitial thickening Changes in the capillaries: Dilatation Congestion Changes in the interstitium Edema Fibrosis Hemosiderosis Pulmonary microvasculopathy (with or without arteriopathy and/on venopathy) Changes in the capillaries: Localized capillary proliferation Changes in the interstitium Edema Fibrosis Hemosiderosis Unclassified Non specific changes", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the surgical procedure for treating neonatal jaundice?", "role": "user" }, { "content": "Surgery is not recommended for the management of neonatal jaundice.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Could you please explain what hereditary multiple exostoses is?", "role": "user" }, { "content": "Hereditary multiple exostoses (HME) is a rare medical condition in which multiple bony spurs or lumps (also known as exostoses, or osteochondromas) develop on the bones of a child. HME is synonymous with Multiple hereditary exostoses and Multiple osteochondromatosis, which is the preferred term used by the World Health Organization.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What does a soy allergy mean?", "role": "user" }, { "content": "It is a hypersensitivity to dietary substances from soy causing an overreaction of the immune system which may lead to severe physical symptoms for millions of people. \r\nMany fast-food restaurants commonly use soy protein in hamburger buns (soy flour) hamburger meat (soy protein) and hydrolyzed vegetable protein (HVP) in sauces. On their respective web sites, McDonald's, Burger King and Wendy's list soy flour as an ingredient in their hamburger buns. U.S. Nutrition Information Multi-grain breads, doughnuts, doughnut mix and pancake mix commonly contain soy flour.\r\nSome products for reasons having to do with national regulation of soy products don't list soy protein or soy flour on their ingredients labels, yet they still contain soy. There are still many latent issues resolving how soy should be regulated.\r\nStudies show that most individuals who are allergic to soy protein may be able to safely consume soybean oil (not cold pressed, expeller pressed, or extruded oil) and soy lecithin, as these products do not normally contain soy protein. \r\nProducts containing soy protein include:\r\nEdamame Miso Natto Shoyu sauce Soy (soy albumin, soy fiber, soy flour, soy grits, soy milk, soy nuts, soy sprouts) Soya Soybean (curd, granules) Soybean butter Soy protein (concentrate, isolate) Soy sauce, tamari Tempeh Textured vegetable protein (TVP) Tofu\r\nThe following food additives may contain soy protein:\r\nHydrolyzed vegetable protein (HVP) Flavoring (including natural and artificial) Canned chicken broth Vegetable broth, gum, and starch Bouillon cubes (beef, chicken, vegetable, etc.)", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the medical treatment for avian influenza?", "role": "user" }, { "content": "Preliminary evidence demonstrates that neuraminidase inhibitor s can reduce the duration of viral replication and improve survival among patients with avian influenza. In cases of suspected avian influenza, one of the following 3 neuraminidase inhibitors should be administered as soon possible, preferably within 48 hours of symptom onset. \r\nThe use of corticosteroids is not recommended. \r\nPhysicians may consider increasing either the recommended daily dose and/or the duration of treatment in cases of severe disease.\r\nThe use of amantadine is not recommended as most H5N1 and H7N9 avian influenza viruses are resistant to it. Supportive care is also an important cornerstone of the care of patients with avian influenza. Considering the severity of the illness and the possible complications, patients may require fluid resuscitation, vasopressors, intubation and ventilation, paracentesis, hemodialysis or hemofiltration, and parentral nutrition.\r\n\r\n1. Preferred regimen: Oseltamivir 75 mg PO qd for a minimum 10 days Note:Patients with severe disease may have diarrhea and may not absorb oseltamivir efficiently 2. Patients with Avian Influenza who have diarrhea and malabsorption Preferred regimen (1): Zanamivir 10 mg inhaled bid for minimum 5 days Preferred regimen (2): Peramivir 600 mg IV as a single dose for 1 day Note(1): Preliminary evidence demonstrates that Neuraminidase inhibitor can reduce the duration of viral replication and improve survival among patients with avian influenza. In cases of suspected avian influenza, one of the following 3 neuraminidase inhibitors should be administered as soon possible, preferably within 48 hours of symptom onset. Note(2): The use of Corticosteroids is not recommended. Note(3): Physicians may consider increasing either the recommended daily dose and/or the duration of treatment in cases of severe disease. Note(4): The use of Amantadine is not recommended as most H5N1 and H7N9 avian influenza viruses are resistant to it. Note(5): Supportive care is also an important cornerstone of the care of patients with avian influenza. Considering the severity of the illness and the possible complications, patients may require fluid resuscitation, vasopressors, intubation and ventilation, paracentesis, hemodialysis or hemofiltration, and parentral nutrition.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the natural progression, potential issues, and outlook for those with subependymal giant cell astrocytoma?", "role": "user" }, { "content": "Subependymal giant cell astrocytoma's generally found in the caudothalamic groove adjacent to the foramen of Monro. It commonly presents in the first two decades of life. It is usually benign and slow growing but can progress to occluding the foramen of monro leading to obstructive hydrocephalus with symptoms of increased intracranial pressure. New tumors hardly arise after 20-25 years of age.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the explanation for palpitation and what is an overview of it?", "role": "user" }, { "content": "Palpitations are a nonspecific symptom that are often defined as a rapid disagreeable sensation / pulsation that may be momentary or sustained and regular or irregular.Patient often present with a flip flopping,fluttering,pounding or thud like sensation in one particular area or all over the precordium. It may or may not be associated with symptoms such as chest pain, dyspnea, presyncope, syncope or haemodynamic compromise. A detailed history, physical examination and 12 lead ECG constitute the initial evaluation necessary. Based on this, a decision regarding investigative modalities such as ambulatory ECG monitoring, laboratory investigations, echocardiography and electrophysiology study may be made. Treatment is directed at treating the underlying cause.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Could you please provide the given sentence that needs to be rephrased for me to help you better?", "role": "user" }, { "content": "An initial assessment to determine the status of the mother and fetus is required. Although mothers used to be treated in the hospital from the first bleeding episode until birth, it is now considered safe to treat placenta praevia on an outpatient basis if the fetus is at less than 37 weeks of gestation, and neither the mother or the fetus are in distress.\r\nImmediate delivery of the fetus may be indicated if the fetus is mature or if the fetus or mother are in distress. Blood volume replacement (to maintain blood pressure) and blood plasma replacement (to maintain fibrinogen levels) may be necessary.\r\nIt is controversial if vaginal delivery or a ceasarean section is the safest method of delivery. In cases of fetal distress a Ceasarean section is indicated. Caesarian section is contraindicated in cases of disseminated intravascular coagulation.\r\nA problem exists in places where a Ceasarean section cannot be performed, due to the lack of a surgeon or equipment. In these cases the infant can be delivered vaginally. There are two ways of doing this with a placenta praevia:\r\nThe baby's head can be brought down to the placental site (if necessary with Willet's forceps or a vulsellum) and a weight attached to his scalp A leg can be brought down and the baby's buttocks used to compress the placental site\r\nThe goal of this type of delivery is to save the mother, and both methods will often kill the baby. These methods were used for many years before Ceasarean section and saved the lives of both mothers and babies with this condition.\r\nThe main risk with a vaginal delivery with a praevia is that as you are trying to bring down the head or a leg, you might separate more of the placenta and increase the bleeding.\r\nPlacenta praevia increases the risk of puerperal sepsis and postpartum haemorrhage because the lower segment to which the placenta was attached contracts less well post-delivery.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What does ciliary dyskinesia surgery entail?", "role": "user" }, { "content": "Increased nasal secretions are common in children with PCD. Nasal polyps are reported frequently with improvement with the use of Saline nasal douches and anticholinergic therapy often to treat symptoms, but again there is no evidence base to support their use. Otolaryngology consult consultation for surgery and polypectomy in refractory cases could be performed to facilitate sinus drainage . It has been suggested that some patients with chronic rhinosinusitis may benefit from long-term macrolide therapy and from endoscopic sinus surgery in recalcitrant disease. Chronic rhinosinusitis (CRS) and bacterial sinusitis are troublesome in patients with primary ciliary dyskinesia (PCD). Pseudomonas aeruginosa is found in most of the cultures in these patients, which can cause serious lung infections. CRS-related symptoms after Endoscopic Sinus Surgery and adjuvant therapy show improvement in symptoms. In selected PCD patients, the suggested regimen may delay chronic lung infection with Psuedomonas aeruginosa and stabilize lung function. Around 85% of the children with PCD have chronic and occasionally severe otitis media with effusion. Hearing problems associated with this usually improve spontaneously in the early teenage years. However, hearing loss and otological problems may also be seen later in adulthood. There is inadequate evidence on the management of otitis media with effusion in PCD patients, otitis media with effusion is usually managed conservatively with hearing aids, as treatment with tympanostomy often results in prolonged and unpleasant otorrhoea.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Can you provide an overview of Pseudomyxoma peritonei?", "role": "user" }, { "content": "The incidence of pseudomyxoma peritonei is approximately 0.1 per 100,000 individuals worldwide. Females are more commonly affected with pseudomyxoma peritonei than males. The median age at diagnosis is 50 years.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Could you provide me with the sentence you want me to rephrase?", "role": "user" }, { "content": "Symptoms of dysplastic nevus include a rapidly growing existing nevus, non-healing skin ulcers, pruritus, and bone pain.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What are the treatments for heart failure and hemodialysis?", "role": "user" }, { "content": "No recommendation was made regarding the initiation or continuation of statin therapy in 2 specific groups :", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Can you explain what carotid sinus hypersensitivity is?", "role": "user" }, { "content": "Persons with CSH may have reproducible signs and symptoms with carotid sinus pressure, and this may be used diagnostically. If patients have audible bruits on exam or known significant carotid atherosclerosis, carotid sinus massage (CSM) is generally not recommended.\r\nThe usual criteria for diagnosis are >3 seconds of ventricular asystole and/or a fall of SBP of >50 mmHg during carotid sinus massage.\r\nThe massage is defined as firm steady pressure to the carotid sinus for ~5 seconds with the neck in the hyperextended position while supine. The carotid sinus can be found along the carotid artery medial to the sternocleidomastoid (SCM) at the level of the thyroid cartilage. Heart rate, blood pressure, EKG and clinical response are monitored for change. The procedure is then repeated on the other side. The procedure may be repeated standing to evaluate carotid sinus vasodepressor hypersensitivity.\r\nPatients may have either a heart rate fall, the cardioinhibitory response, or fall in blood pressure, the vasodepressor response. Weiss and Baker also reported that some patients suffered from syncope without any fall in heart rate or blood pressure, they called the primary cerebral type. \r\nThe test is not all-together sensitive or specific. If normal patients are tested, some will have a fall in blood pressure and heart rate despite no history of syncope. Other patients with history of syncope will have a fall in HR or BP but no reproducible symptoms at the time of the test.\r\nMany patients will give a history of syncope or near-syncope with movement of the neck, wearing of a tight collar, shaving, etc. This history is not necessary, however, to make the diagnosis. Patients are usually upright, often standing, and develop a sudden episode of syncope, often with an associated fall. Small convulsive movements often occur with the loss of consciousness. The loss of consciousness is usually <30 seconds, and patients awake quickly with no clouding of consciousness.\r\nThe syndrome has been described in patients in chronic Afib, in addition to patients in normal sinus rhythm (NSR).\r\nPressing on the eyes can elicit a vagal response, but this is not part of the syndrome.\r\nCaeful examination should be done to assess for carotid bruits and to assure that there is no obvious mass compressing the carotid (such as tumors or lymph nodes).", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Could you provide me with the context of the sentence for me to rephrase properly? Please provide additional information if possible.", "role": "user" }, { "content": "Mastitis is an infection in the tissue of the breast.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What does facilitated percutaneous coronary intervention mean in the context of ST-elevation myocardial infarction?", "role": "user" }, { "content": "Primary PCI is defined as the performance of percutaneous coronary intervention (PCI) (either conventional balloon angioplasty or coronary stent placement) in the setting of ST elevation MI (STEMI) without antecedent treatment with a fibrinolytic agent. The chapter on Primary PCI can be found here.\r\nStated simply, this is performance of a PCI in a closed artery following fibrinolytic therapy. Rescue PCI is defined as the intent to administer a fibrinolytic agent in the setting of STEMI, and the performance of PCI for failure of the fibrinolytic agents is unintended. If there are clinical signs and symptoms of failure of the fibrinolytic agent to achieve reperfusion, then rescue PCI is performed to open the totally occluded artery. The strategy differs from facilitated PCI, a strategy in which the intent is to administer a fibrinolytic agent, and routinely perform PCI in the majority of patients even in the presence of or irrespective of signs and symptoms of successful fibrinolytic reperfusion. The chapter on Rescue PCI can be found here.\r\nStated simply, this is performance of a PCI in an open artery following fibrinolytic therapy. Adjunctive PCI is defined as the intent to administer fibrinolytic agent in the setting of STEMI, and the performance of PCI for partial success of the fibrinolytic agent is unintended. If there are clinical signs and symptoms of incomplete reperfusion, then adjunctive PCI is performed to further open a patent artery (one with TIMI grade 2 or 3 flow). The strategy differs from facilitated PCI in that the intent is to administer a fibrinolytic agent, and the performance of PCI is intended to improve the fibrinolytic results.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What does the term Congenital Herpes Simplex mean?", "role": "user" }, { "content": "The annual incidence of neonatal herpes is estimated to be 10 cases per 100,000 livebirths.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What are the historical background and symptoms of fungal meningitis?", "role": "user" }, { "content": "Commonly, patients with fungal meningitis have a history of one or more of the following: \r\nChronic sinusitis Granulocytopenia Chronic renal failure Diabetes Pregnancy IV drug abuse Prolonged intravenous therapy Exposure history for example: travel to or residence in endemic regions of the pathogen Immune suppression status, such as systemic neoplasia, organ transplantation, Human immunodeficiency virus (HIV) / acquired immunodeficiency syndrome (AIDS), Water aspiration as in a case of Pseudallescheria boydii Traumatic inoculation as in a case of Sporothrix schenckii", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What does the physical examination entail for Plummer-Vinson syndrome?", "role": "user" }, { "content": "Physical examination of patients with Plummer-Vinson syndrome is usually remarkable for glossitis, esophageal webs or strictures, and dysphagia. Other findings on physical examination include pallor, stomatitis, atrophy of lingual papillae, splenomegaly (33%), achlorhydria and koilonychia.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What are the historical and symptomatic details related to deficiency of Vitamin B12?", "role": "user" }, { "content": "Tiredness Decreased mental work capacity Decreased concentration and memory Irritability and depression Sleep disturbances because B12 involved in the regulation of the sleep wake cycle by the pineal gland (through melatonin). \r\nSensory disturbances due to damage to peripheral nerves caused by demyelination and irreversible nerve cell death Numbness Tingling Ataxic gait Subacute combined degeneration of spinal cord mania and psychosis. Bipolar disorder appears to genetically co-segregate with the hereditary B12-deficiency disorder pernicious anemia.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What medical treatment is available for a recurrent corneal erosion?", "role": "user" }, { "content": "Water or saline eye drops tend to be ineffective, as with the eye generally profusely watering, the type of tears being produced have little adhesive property. Rather a better quality of tear is required with higher wetting ability (i.e greater amount of glycoproteins) and so artificial tears (eg viscotears) are applied frequently. Whilst individual episodes may settle within a few hours or days, additional episodes (as the name suggests) will recur at intervals.\r\nPatients with recalcitrant recurrent corneal erosions often show increased levels of matrix metalloproteinase (MMP) enzymes. These enzymes dissolve the basement membrane and fibrils of the hemidesmosomes, which can lead to the separation of the epithelial layer. Treatment with oral tetracycline antibiotics (such as doxycycline or oxytetracycline) together with a topical corticosteroid (such as prednisolone), reduce MMP activity and may rapidly resolve and prevent further episodes in cases unresponsive to conventional therapies.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Can you provide an overview of breast lumps?", "role": "user" }, { "content": "Mammography is the gold standard test for the diagnosis of breast lumps in women aged >40 years old. Ultrasound is the gold standard test for the diagnosis of breast lumps in women aged <40 years old. Management and medical therapy of breast lumps depends on women's age (age> 40 or age <40) and mammography results in women aged > 40 years. In women aged > 40 years; no further evaluation is needed in case of clearly benign mass in mammography; however, ultrasound imaging is required for the rest of the findings mammography. Approach to breast lumps in women >40 years is depended on breast imaging reporting and data systems (BI-RADS) stages. Medical therapy of breast lumps in women< 40 years is depended on ultrasound results and BI-RADS categories.\r\nThe important key to breast lumps diagnosis is history and physical exams. History must be complete and include all details regarding to age, parity, pregnancy, past history of breast diseases, familial history, and drug history. Common symptoms of breast lumps include breast pain, palpable mass, nipple discharge, galactorrhea.\r\nPhysical examination of patients with breast lumps should perform both in sitting position and supine position to examine all 4 quadrants of breast. Careful physical examination may lead to diagnosis. Breast physical exam should include information about, number, size, location, shape, mobility, consistancy of masses, nipple discharge, and axillary lymph nodes.\r\nThere are no diagnostic laboratory findings associated with breast lumps.\r\nThere are no ECG findings associated with breast lumps.\r\nThere are no x-ray findings associated with breast lumps.\r\nBreast ultrasound is the first imaging modality in patients with palpable masses under age 40 years old and is adjunctive modality to mammography for patients older than 40 years. Breast sonography is a type of imaging used to confirm abnormal findings on mammography or MRI. Breast ultrasound improves breast cancer detection rate.\r\nThere are no CT scan findings associated with breast lumps.\r\nMRI is considered as the primary imaging modality in selected patients and may be used when results of other imaging modalities are indeterminate. Breast MRI has some indications and does not use regularly. Breast MRI is not the primary modality for diagnosis of breast lumps and does not provide any additional findings to ultrasound and mammographic results and has both false-positive and false-negetive results.\r\nMammography is considered as the first and mainstay for evaluation of palpable masses in women over the age of 40 years. Diagnostic mammogram contains particular views by focal compression of specific part of breast tissue.There is standard method for reporting mammographic findings which is called breast imaging reporting and database system (BI-RADS) which is classified into 7 categories.\r\nThe only certain method to approve the presence of breast malignancy is breast lump biopsy.The three types of biopsies are core-needle biopsy, open surgical biopsy, and fine needle biopsy. Core-needle biopsy has different types such as ultrasound guided-core needle biopsy, stereotactic-guided core-needle biopsy, MRI-guided core-needle biopsy, and freehand core-needle biopsy. Core-needle biopsy has high sensitivity and specificity. Triple test score is used by surgeons for assessment of palpable breast lumps. Classic type of triple test includes clinical breast examination, FNA, and mammography and modified version includes clinical breast examination, core-needle biopsy and ultrasound.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the medical treatment for neoplastic meningitis?", "role": "user" }, { "content": "The mainstay of therapy for neoplastic meningitis is intrathecal chemotherapy. Radiotherapy may be used in patients with neoplastic meningitis for palliation of symptoms, reduce the bulky tumors, and correction of cerebrospinal fluid flow abnormalities. Supportive care should be directed towards all patients with neoplastic meningitis, regardless of the treatment regimen (anticonvulsants, corticosteroids, and opiates).", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Can you provide a summary of a left ventricular aneurysm?", "role": "user" }, { "content": "The symptoms of left ventricular aneurysm depends on the size of the aneurysm. Small and medium sized aneurysms are usually asymptomatic but large sized aneurysms may present as persistent chest pain and dyspnea despite the proper treatment of the underlying cardiac condition.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is an overview of acute retinal necrosis?", "role": "user" }, { "content": "Acute retinal necrosis may be classified both by staging—acute or late—or by severity: mild or fulminant.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Can you provide information on the history and symptoms of laryngeal papillomatosis?", "role": "user" }, { "content": "In adults, the symptoms of Laryngeal papillomatosis are hoarseness, or a strained or breathy voice. Size and placement of the tumors dictate the change in the person's voice. Breathing difficulties may occur but more commonly are found in children.\r\nIn babies and small children the symptoms include a weak cry, difficulty swallowing, noisy breathing, and chronic cough. Noisy breathing may be a stridor, which can sound like a whistle or a snore, and is a sign that the laryngeal or tracheal parts of the airway are narrowing. The symptoms tend to be more severe in children than in adults.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the underlying physiological mechanism of mast cell leukemia?", "role": "user" }, { "content": "There are no characteristic findings of mast cell leukemia on gross pathology. Gross specimens are not seen typically.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What role does a CT scan play in diagnosing a lipoma?", "role": "user" }, { "content": "On CT, the lipoma is seen as a well-delineated mass with absorption density characteristic of fatty tissue.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is a Wilms' tumor?", "role": "user" }, { "content": "Wilms tumors are the most common pediatric renal mass. The incidence of Wilms tumor is estimated to be 0.71 cases per 10,00,000 children younger than 15 years. There is no significant gender predilection among unilateral cases, but the male to female ratio in bilateral cases is 0.60:1.00. It typically occurs in early childhood with peak incidence between 3 and 4 years of age. Asian individuals are less likely to develop Wilms tumor.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the cause of spotted fevers?", "role": "user" }, { "content": "Traveling or residing within endemic regions will increase chances of infection. Tick activity is generally heightened during certain the spring and summer months. Within endemic regions, tick may choose an animal host, including a domesticated animal such as a dog or cat. Although rare, cases of blood transfusion and organ transplantation have been recorded as methods of transmission. All together, individuals who spend time outdoors and/or have pets that go outdoors in endemic regions are at risk for tick-borne disease.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What information is available on Roseola?", "role": "user" }, { "content": "The viruses that cause roseola are spread either through fecal-oral contact or via airborne droplets. Careful hand washing can help prevent the spread of these viruses.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What are the imaging results associated with hepatitis in autoimmune disorders?", "role": "user" }, { "content": "Cholangiography is other imaging study to differentiate primary sclerosing cholangitis from autoimmune hepatitis.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the primary method of preventing acute viral nasopharyngitis?", "role": "user" }, { "content": "The most effective measures for preventing the common cold include:\r\nAvoiding close contact with people who have a cold. Hand hygiene and avoid touching mouth and face. In 2002, the Centers for Disease Control and Prevention recommended alcohol-based hand gels as an effective method for reducing infectious viruses on the hands of health care workers. As with hand washing with soap and water, alcohol gels provide no residual protection from re-infection. Antibacterial soaps have no effect on the cold virus; it is the mechanical action of hand washing that removes the viral particles. \r\nCommon cold is caused by a large variety of viruses which mutate frequently during reproduction resulting in constant variation in viral strains. Thus, successful immunization is highly improbable.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What are the natural history, prognosis, and potential complications associated with Antithrombin III deficiency?", "role": "user" }, { "content": "Most patients have a good outcome if they stay on anticoagulant medications.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is ketosis and could you give a brief description or summary of it?", "role": "user" }, { "content": "Ketosis (IPA pronunciation: Template:IPA) is a stage in metabolism occurring when the liver converts fat into fatty acids and ketone bodies which can be used by the body for energy.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What role does CMR play in diagnosing cardiac amyloidosis?", "role": "user" }, { "content": "The 4-chamber cine sequence allows for proper visualization of the atria A maximum length is usually taken in an end-systolic frame The right atrium can be measured from the annulus of the tricuspid valve back to the right atrial wall, and similarly, the left atrium can be measured from the annulus of the mitral valve back to the left atrial wall This is particularly useful in cardiac amyloidosis, as the atria are typically enlarged", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What lifestyle changes are recommended for individuals with Congestive Heart Failure?", "role": "user" }, { "content": "The patient should be vaccinated for pneumococcus and influenza.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the spoken information regarding Penicillin V Potassium?", "role": "user" }, { "content": "Penicillin V potassium comes as a tablet and liquid to take by mouth. It is usually taken every 6 hours (four times a day) or every 8 hours (three times a day). Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take penicillin V potassium exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.\r\nShake the liquid well before each use to mix the medication evenly.\r\nThe tablets should be swallowed whole and taken with a full glass of water.\r\nContinue to take penicillin V potassium even if you feel well. Do not stop taking penicillin V potassium without talking to your doctor.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the pathophysiology behind the syndrome?", "role": "user" }, { "content": "IMAGe syndrome is characterized by \r\nIntrauterine growth restriction Metaphyseal dysplasia Adrenal hypoplasia congenita Genital abnormalities", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What are the natural history, prognosis, and potential complications associated with clinical depression?", "role": "user" }, { "content": "People who are depressed are more likely to use alcohol or illegal substances. Other complications of depression include:\r\nIncreased risk of physical health problems Suicide", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What are the possible diagnoses for AV block with paroxysmal symptoms?", "role": "user" }, { "content": "\"ESC Guidelines on Syncope (Diagnosis and Management of)\".", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What information is available about purpura in Henoch-Schönlein syndrome?", "role": "user" }, { "content": "The doctor will examine your body and look at your skin. The physical exam will reveal skin sores (lesions) and joint tenderness. Tests may include:\r\nSkin biopsy Urinalysis", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is Doppler imaging of an atrial septal defect?", "role": "user" }, { "content": "The doppler is an effective imaging modality to show an ASD, as well as other details such as the defect size, the direction of flow, the speed of the flow, and what therapies might be of best use. There are some disadvantages to the use of doppler.", "role": "assistant" } ]