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[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Could you provide me with the current text that needs to be rephrased?", "role": "user" }, { "content": "Pericardial changes are the most common cardiac complications of radiation therapy . Incidence of radiation-induced pericarditis has significantly decreased with the use of lower doses and newer radiotherapy techniques . In a study, incidence decreased from 20% to 2.5% with the changes in methods of RT administration \r\nIn a study among pediatric population with various cancers, radiation therapy with ≥15 GY increased the risk of developing pericarditis by two to six times", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is surgery for Paget's disease of the breast?", "role": "user" }, { "content": "Surgery is the mainstay treatment for Paget's disease of the breast.The indication for surgery depends on: \r\nPresence of palpable breast mass. Stage, clinical, radiological and histopathological features of the underlying breast cancer. Metastatic involvement of lymph nodes. Presence of Invasive breast cancer is and indication for axillary lymph node dissection.\r\n\r\n\r\nMastectomy is considered as the standard therapy for Paget's disease of the breast. However, breast-conserving surgery that includes removal of the nipple areola complex and lumpectomy, followed by whole- breast or moderate-dose radiation therapy to eradicate micro-invasion, is a safe option for people with Paget's disease of the breast who do not have a palpable lump in their breast and whose mammograms do not reveal a tumor. Paget’s disease associated with ductal carcinoma in situ observation without radiation therapy can be considered in patients with negative margins. Immunohistochemical stains for hormone receptor (Estrogen or progesterone receptor) and HER2 receptor should be done as they effect prognosis and treatment. Breast reconstruction should be considered for cosmetic appearance.\r\n\r\nPaget’s disease associated with invasive breast cancer treatment should include complete resection of the underlying disease with excision of the nipple - areola complex and radiation therapy of the remaining breast tissue. Sentinel lymph node biopsy should be offered to all patients to see whether the cancer has spread to the axillary lymph nodes. If cancer cells are histologically found in the sentinel lymph node (s), more extensive axillary lymph node surgery is performed depending on the extent. Immunohistochemical stains for hormone receptor (Estrogen or progesterone receptor) and HER2 receptor should be done for adjuvent treatment. Reconstruction of breast as well as nipple areolar complex should be considered for cosmetic appearance.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the importance of DNA in humans?", "role": "user" }, { "content": "The \"calibration of radiocarbon dates at approximately 2500-2450 BP 2500-2450 b2k is problematic due to a \"plateau\" (known as the \"Hallstatt-plateau\") in the calibration curve ... A decrease in solar activity caused an increase in production of 14 C, and thus a sharp rise in Δ 14 C, beginning at approximately 850 cal (calendar years) BC ... Between approximately 760 and 420 cal BC (corresponding to 2500-2425 BP 2500-2425 b2k), the concentration of 14 C returned to \"normal\" values.\"", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What are the laboratory results for Polyarteritis nodosa?", "role": "user" }, { "content": "There are no specific lab tests for diagnosing polyarteritis nodosa. Diagnosis is generally based upon the physical examination and a few laboratory studies that help to confirm the diagnosis. Laboratory findings helpful in the diagnosis of polyarteritis nodosa include CBC, ESR, C-reactive protein, p-ANCA, Hepatitis B surface antigen and hepatitic C serologies, elevated levels of liver enzymes, elevated creatinine level and hypergammaglobulinemia.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What does the Cardiology Board Review cover on cardiomyopathy?", "role": "user" }, { "content": "Diastolic dysfun in 100% 70% have dynamic obstruction Suendo ischemia MR proportion to gradient Gradient reduces forward CO Sx vary from day to day due to graient, Na intake, temperature. AS sx are constant with constant graient Mitarl vale like your hand hanging out a car and gets pulled back MR anteriorly directed means there may be a primary problemw ith the mitral voalve Sx with reduced pre load and increased contractily", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What does the term acute bronchitis mean?", "role": "user" }, { "content": "Age, season of the year, and the immunization statusare the main determining risk factors for acquiring acute bronchitis.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Could you please provide the current wording of the sentence you would like me to rephrase?", "role": "user" }, { "content": "In mucous membrane pemphigoid, the autoimmune reaction occurs in the skin specifically at the level of the basement membrane, the layer that holds the skin to the underlying tissue. When the condition is active, the basement membrane is dissolved by the antibodies produced, and areas of skin lift away at the base, causing hard blisters which scar if they burst. In other words, this is a desquamating/blistering disease in which the epithelium \"unzips\" from the underlying connective tissue, allowing fluid to gather that subsequently manifest as bullae, or blisters.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What classification does Leptospirosis fall under?", "role": "user" }, { "content": "More common but serious illness is uncommon Most of cases present either subclinical or of very mild severity. Few cases present with a febrile illness of sudden onset. Other symptoms include chills, headache (severe with retro-orbital pain and photophobia), myalgia, abdominal pain, conjunctival suffusion, and skin rash (transient and last < 24 hours) May progress to aseptic meningitis in ≤ 25% of patients and more common in younger age group than the patients with icteric leptospirosis. Mortality is very less when compared to icteric leptospirosis\r\nRapidly progressive and severe form of leptospirosis (Weil's disease) In the severe form of leptospirosis renal failure, hepatic failure and pulmonary hemorrhage can occur and associate with Icterohemorrhagiae. Less common form of leptospirosis with incidence of 5%-10%. Jaundice is not associate with hepatocellular injury, eventually LFT returns to normal after recovery. High mortality rate with a range of 5%-15%.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What information is obtainable regarding bacterial vaginosis?", "role": "user" }, { "content": "Although BV will sometimes clear up without treatment, all women with symptoms of BV should be treated to avoid complications. Male partners generally do not need to be treated. However, BV may spread between female sex partners.\r\nTreatment is especially important for pregnant women. All pregnant women who have ever had a premature delivery or low birth weight baby should be considered for a BV examination, regardless of symptoms, and should be treated if they have BV. All pregnant women who have symptoms of BV should be checked and treated.\r\nSome physicians recommend that all women undergoing a hysterectomy or abortion be treated for BV prior to the procedure, regardless of symptoms, to reduce their risk of developing an infection.\r\nBV is treatable with antibiotics prescribed by a health care provider. Two different antibiotics are recommended as treatment for BV: metronidazole or clindamycin. Either can be used with non-pregnant or pregnant women, but the recommended dosages differ. Women with BV who are HIV-positive should receive the same treatment as those who are HIV-negative.\r\nBV can recur after treatment.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What type of information is available regarding miscarriage?", "role": "user" }, { "content": "When a miscarriage occurs, the tissue passed from the vagina should be examined to determine if it was a normal placenta or a hydatidiform mole.\r\nIt is also important to determine whether any pregnancy tissue remains in the uterus.\r\nIf the pregnancy tissue does not naturally exit the body, the woman may be closely watched for up to 2 weeks. Surgery (D and C) or medication (such as misoprostol) may be needed to remove the remaining contents from the womb.\r\nAfter treatment, the woman usually resumes her normal menstrual cycle within 4 - 6 weeks. Any further vaginal bleeding should be carefully monitored, it is often possible to become pregnant immediately. However, it is recommended that women wait one normal menstrual cycle before trying to become pregnant again.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What medical therapy is utilized for treating malignant peripheral nerve sheath tumors?", "role": "user" }, { "content": "In the setting of localized disease, as is the case with all soft tissue sarcomas, complete surgical extirpation with clear margins is the treatment of choice.The predominant therapy for malignant peripheral nerve sheath tumor is surgical resection.In the setting of advanced or metastatic MPNST, outcomes are generally poor. Doxorubicin and ifosfamide are the most active agents in unselected soft tissue sarcomas, with a Response Evaluation Criteria in Solid Tumors (RECIST) response rate of approximately 25% for the combination. Adjunctive chemotherapy and radiation therapy may be required.Multiple retrospective datasets have shown the negative prognostic impact of involved margins and local recurrence. As in the case with most large (>5 cm) high-grade limb sarcomas, adjuvant radiation is advocated to reduce local recurrence. The risk-benefit profile of adjuvant radiation in patients with NF1 must be carefully discussed with all patients in view of the heightened risk of radiation-induced sarcomas.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the score for Rockall?", "role": "user" }, { "content": "Total score is calculated by simple addition. A score less than 3 carries good prognosis but total score more than 8 carries high risk of mortality .", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Can you explain the connection between polycythemia vera and ultrasound?", "role": "user" }, { "content": "Abdominal and extremities ultrasound may be helpful in the diagnosis of polycythemia vera. Findings on an ultrasound suggestive of polycythemia vera include: \r\nSplenomegaly Hepatomegaly Ascites Deep vein thrombosis", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What does Secondary Amenorrhea mean?", "role": "user" }, { "content": "A physical exam and pelvic exam must be done to rule out pregnancy. A pregnancy test will be done.\r\nBlood tests may be done to check hormone levels, including:\r\nEstradiol levels Follicle stimulating hormone (FSH level) Luteinizing hormone (LH level) Prolactin level Serum hormone levels such as testosterone levels Thyroid stimulating hormone (TSH)\r\nOther tests that may be performed include:\r\nCT scan of the head Endometrial biopsy Genetic testing MRI of the head Ultrasound of the pelvis or hysterosonogram", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "When diagnosing a lung abscess, what information does an MRI provide?", "role": "user" }, { "content": "MRI lung is the least accepted modality in diagnosing lung abscess.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the mechanism by which ovarian cancer develops?", "role": "user" }, { "content": "Shown below is a video of clear cell adenocarcinoma of the vagina.\r\n{{#ev:youtube|qO2w8VLf690}}", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Could you please explain the meaning of the term \"cutaneous abscess\"?", "role": "user" }, { "content": "Alexander Ogston, a scottish surgeon first described the pyogenic abscess in the late 19th century.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Can you provide information on the natural history, potential complications, and prognosis associated with impetigo?", "role": "user" }, { "content": "The prognosis of non-bullous impetigo is very good.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What does humeral shaft fracture mean?", "role": "user" }, { "content": "The injuries of the ball-and-socket shoulder joint considered as the Humeral shaft fracture. It is more common among the elderly population following a low energy trauma such as falling. Meanwhile, A few people experience the axillary nerve damage such as reduced sensation around the middle deltoid and/or axillary artery involvement.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What are the possible causes or conditions that can be mistaken for Marburg hemorrhagic fever?", "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. \r\nVirus Disease Incubation Period Symptoms Laboratory findings Prodromal phase Illness phase Fever Headache Myalgia Abdominal pain Hemorrhage Filoviruses Marburg Hemorrhagic Fever 5-10 + + + + + Clinically indistinguishable Maculopapular rash on the trunk (chest, back, stomach) Multiorgan failure Thrombocytopenia Leukopenia Lymphopenia Ebola 2-21 + + + + + Bunyaviruses Crimean-Congo hemorrhagic fever (CCHF) 13 + + + + + Red eyes, a flushed face, a red throat, and petechiae (red spots) on the palate Changes in mood and sensory perception. Hantavirus Infection 9 -33 + + + - + Flushing of the face Injection of the conjunctiva Prostration Thrombocytopenia Leukocytosis Raised PT and aPTT Elevated hematocrit Rift Valley fever 2-6 + - + - - Most commonly mild disease with recovery in 2 weeks Encephalitis Hemorrhagic fever, which occurs in less than 1% of overall RVF Arenaviruses Lassa fever 7-21 + + + - - Deafness Respiratory distress Repeated vomiting Facial swelling Pain in the chest, back, and abdomen, and shock.encephalitis Hemorrhage only 20% have severe disease Lujo hemorrhagic fever 7-13 + + + + + Morbilliform rash of the face and trunk Face and neck swelling Pharyngitis Diarrhea Lymphocytic choriomeningitis (LCM) 8-13 + + + - - Meningitis, encephalitis, meningoencephalitis Acute hydrocephalus Myocarditis Thrombocytopenia Leukopenia Elevated liver enzymes Flaviviruses Alkhurma hemorrhagic fever (AFD) 2-4 + - + - - Neurologic symptoms Hemorrhagic symptoms only in severe form. Multi-organ failure Thrombocytopenia Leukopenia Elevated liver enzymes Kyasanur Forest Disease (KFD) 3-8 + + + + + Biphasic Complete recovery by 2 week Wave of symptoms in 3 rd week with tremors, and vision deficits. Pancytopenia Omsk hemorrhagic fever 3-8 + + + + + Biphasic Complete recovery by 2 week Wave of symptoms in 3 rd week with encephalitis Pancytopenia\r\n\r\nShown below is a table summarizing the typical findings of the differential diagnoses of MHF.\r\nDisease Incubation period Symptoms Physical signs Lab findings Other findings Fever Cough Rash Joint pain Myalgia Diarrhea Common hemorrhagic symptoms Characterestic physical finding Icterus Plasma Creatine kinase Confirmatory test Marburg hemorrhagic fever 5-10 days + + Maculopapular rash on the trunk (chest, back, stomach) + + + Bloody diarrhea (Melena) Hematemesis Exanthema Petechiae / ecchymoses Mucosal hemorrhage Visceral hemorrhage Fever and upper respiratory symptoms - Normal Viral culture or PCR History of Travel Patients with co-morbid conditions Leptospirosis 2 to 30 days Fever last for 4-7 days, remission for 1-2 days and then relapse + Present over legs hemorrhagic rash + + (Severe myalgia is characteristic of leptospirosis typically localized to the calf and lumbar areas) + Conjunctival hemorrhage, Hemoptysis Conjunctival suffusion + Elevated Microscopic agglutination test of urine History of exposure to soil or watercontaminated by infected rodents Recent history travel to tropical, sub tropical areas, or humid areas Dengue 4 to 10 days Fever last for 1-2 days, remission for 1-2 days, and then relapse for 1-2 days (Biphasic fever pattern) - Pruritic rash over legs and trunk (may be hemorrhagic) + + - Upper gastrointestinal bleeding Painful lymphadenopathy - Normal Serology showing positive IgM or IgG Recent travel to South America, Africa, or Southeast Asia Malaria Plasmodium falciparum: 9-14 days Plasmodium vivax: 12-18 days Plasmodium ovale: 18-40 days Fever present daily or on alternate day or every 3 days depending on Plasmodium sps. - No rash - + - Bloody urine Hepatosplenomegaly + Normal Giemsa stained thick and thin blood smears Recent travel to South America, Africa, or Southeast Asia Ebola 2 to 21 days. + + Maculopapular non-pruritic rash with erythema Centripetal distribution + + + May be bloody in the early phase Epistaxis Mucosal bleeding Sudden onset of high fever with conjunctival injection and early gastrointestinal symptoms - Normal RT-PCR Recent visit to endemic area especially African countries Yellow fever 3 to 6 days + + - - + - Conjunctival hemorrhage, Hemoptysis Relative bradycardia (Faget's sign) + Normal RT-PCR, Nucleic acid amplification test, Immuno-histochemical staining Recent travel to Africa, South and Central America, and the Caribbean Tropical rain forests of south America Typhoid fever 6 to 30 days + - Blanching erythematous maculopapular lesions on the lower chest and abdomen + + + Intestinal bleeding Rose spots - Normal Blood or stool culture showing salmonella typhi sps. Residence in endemic area Recent travel to endemic area\r\n<\\small>", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the physiological explanation for a femoral hernia?", "role": "user" }, { "content": "Ehlers-Danlos syndrome Appendicitis Meckel's diverticulum Intestinal obstruction Intestinal volvulus Intussusception", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What does the physical examination for esthesioneuroblastoma entail?", "role": "user" }, { "content": "Common physical examination findings of esthesioneuroblastoma include a reddish-gray, polypoid mass located in the upper nasal fossa, epistaxis, nasal discharge, nasal pain, facial swelling, trismus, proptosis, diplopia, anosmia, serous otitis media, cervical lymphadenopathy, retropharyngeal lymphadenopathy, decreased visual acuity, extraocular movement paralysis, altered mental status, and frontal headaches.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is a glucagonoma and what are the risk factors linked to it?", "role": "user" }, { "content": "The most common risk factor in the development of glucagonoma is a positive family history of multiple endocrine neoplasia type1 which is characterized by the presence of pituitary adenomas, islet cell tumors of the pancreas, and hyperparathyroidism.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What are zoonoses and which infectious agents cause them? Can you give some examples?", "role": "user" }, { "content": "Zoonoses can be listed according to the infective agent:\r\nParasites which includes protozoa, helminths, cestodes and trematodes Bacteria Viruses Fungi Prions", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the DNA of a human being?", "role": "user" }, { "content": "\"The genome of... the Denisovans that once interbred with us has been sequenced... About 100,000 recent changes in our genome have occurred after the split from the Denisovans.... DNA from fossils unearthed in Denisova Cave in southern Siberia in 2008 revealed a lineage unlike us and closely related to Neanderthals. The precise age of the Denisovan material remains uncertain — anywhere from 30,000 to 80,000 years of age.... The Denisovans lived in a vast range from Siberia to Southeast Asia. The Denisovans share more genes with people from Papua New Guinea than any other modern population studied.\" \r\n\"The picture of her genome the girl from Denisova Cave is as accurate as that of modern day human genomes, and shows she had brown eyes, hair and skin.\" \r\n\"The Denisovans have mysterious origins. They appear to have left little behind for palaeontologists save a tiny finger bone and a wisdom tooth found in Siberia's Denisova cave in 2010.\" \r\n\"This is an extinct genome sequence of unprecedented accuracy.\" \r\n\"For most of the genome we can even determine the differences between the two sets of chromosomes that the Denisovan girl inherited from her mother and father.\" \r\nAbout \"3% of the genes of people living today in Papua New Guinea come from Denisovans, with a trace of their DNA lingering in the Han and Dai people from mainland China.\" \r\nA genetic \"contribution from Denisovans is found exclusively in island Southeast Asia and Oceania (6).\" \r\n\"Assuming 6.5 million years of sequence divergence between humans and chimpanzees, the shortening of the Denisovan branch allows the bone to be tentatively dated to between 74,000 and 82,000 years before present, in general agreement with the archaeological dates (2).\" \r\nLess \"Denisovan allele-sharing occurred with the Dai than with the Han (although nonsignificantly so, Z = –0.9) .... Further analysis shows that if Denisovans contributed any DNA to the Dai, it represents less than 0.1% of their genomes today ....\" \r\n\"Denisovans share more alleles with the three populations from eastern Asia and South America (Dai, Han, and Karitiana) than with the two European populations (French and Sardinian) (Z = 5.3).\" \r\nDef. \"the fraction of nucleotide sites that are different between a person’s maternal and paternal genomes\" is called heterozygosity. \r\n\"The great apes have 24 pairs of chromosomes whereas humans have 23. This difference is caused by a fusion of two acrocentric chromosomes that formed the metacentric human chromosome 2 (25) and resulted in the unique head-to-head joining of the telomeric hexameric repeat GGGGTT. A difference in karyotype would likely have reduced the fertility of any offspring of Denisovans and modern humans. We searched all DNA fragments sequenced from the Denisovan individual and identified 12 fragments containing joined repeats. By contrast, reads from several chimpanzees and bonobos failed to yield any such fragments (8). We conclude that Denisovans and modern humans (and presumably Neandertals) shared the fused chromosome 2.\" \r\n\"In total, we identified 111,812 single-nucleotide changes (SNCs) and 9499 insertions and deletions where modern humans are fixed for the derived state, whereas the Denisovan individual carried the ancestral, i.e., ape-like, variant (8). This is a relatively small number. We identified 260 human-specific SNCs that cause fixed amino acid substitutions in well-defined human genes, 72 fixed SNCs that affect splice sites, and 35 SNCs that affect key positions in well-defined motifs within regulatory regions.\" \r\n\"One way to identify changes that may have functional consequences is to focus on sites that are highly conserved among primates and that have changed on the modern human lineage after separation from Denisovan ancestors. We note that, among the 23 most conserved positions affected by amino acid changes (primate conservation score of ≥0.95), eight affect genes that are associated with brain function or nervous system development (NOVA1, SLITRK1, KATNA1, LUZP1, ARHGAP32, ADSL, HTR2B, and CNTNAP2). Four of these are involved in axonal and dendritic growth (SLITRK1 and KATNA1) and synaptic transmission (ARHGAP32 and HTR2B), and two have been implicated in autism (ADSL and CNTNAP2). CNTNAP2 is also associated with susceptibility to language disorders (27) and is particularly noteworthy as it is one of the few genes known to be regulated by FOXP2, a transcription factor involved in language and speech development as well as synaptic plasticity (28). It is thus tempting to speculate that crucial aspects of synaptic transmission may have changed in modern humans.\" \r\n\"Of the 34 genes with clear associations with human diseases that carry fixed substitutions changing the encoded amino acids in present-day humans, four (HPS5, GGCX, ERCC5, and ZMPSTE24) affect the skin and six (RP1L1, GGCX, FRMD7, ABCA4, VCAN, and CRYBB3) affect the eye. Thus, particular aspects of the physiology of the skin and the eye may have changed recently in human history. Another fixed difference occurs in EVC2, which when mutated causes Ellis–van Creveld syndrome. Among other symptoms, this syndrome includes taurodontism, an enlargement of the dental pulp cavity and fusion of the roots, a trait that is common in teeth of Neandertals and other archaic humans. A Denisovan molar found in the cave has an enlarged pulp cavity but lacks fused roots (2). This suggests that the mutation in EVC2, perhaps in conjunction with mutations in other genes, has caused a change in dental morphology in modern humans.\"", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the explanation for delayed puberty in terms of its pathophysiology?", "role": "user" }, { "content": "Delayed puberty is the result of disturbances in hypothalamus-pituitary-gonadal (HPG) axis. Genetics plays an important role in the development of delayed puberty. In case of constitutional delay of growth and puberty (CDGP), 50-75% of patients have a positive family history of delayed puberty. About 25 various genes, in 3 different group of Kallmann syndrome -related genes, hypothalamus - pituitary - gonadal (HPG) axis related genes, and obesity- related genes play roles in delayed puberty. On gross pathology, lack of testicular enlargement in boys or breast development in girls is the characteristic finding of delayed puberty. Microscopic evaluation of ovaries in a patient with delayed puberty may reveal the presence of normal cuboidal epithelium; the ovary has some dense fibrous tissue, about 0.4 mm thick band, in the cortex. The band is extended under the tunica albuginea, devoid of follicles. Under the fibrous band, there will be numerous small follicles. These follicles consist of primordial (51%), intermediary (42%), and primary (7%) follicles.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the structure of human DNA?", "role": "user" }, { "content": "Heinrich Event 4 \"33-39.93 ka BP\".", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Can you provide a summary of the Bourbon virus infection?", "role": "user" }, { "content": "There is no specific treatment, cure, or vaccine for Bourbon virus infection. Early diagnosis, hospitalization, and supportive therapy are fundamentals of treatment.\r\nSurgical intervention is not recommended for the management of Bourbon virus infection.\r\nThere is no vaccine or drug to prevent Bourbon virus disease. Therefore, preventing bites from ticks and other insects is the best way to prevent infection. \r\nSecondary preventive measures for Bourbon virus infection are similar to primary prevention.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the electrocardiographic manifestation of stable angina in chronic cases?", "role": "user" }, { "content": "Resting electrocardiography to assess risk", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "In cases of Amyloidosis, what information does an X-ray provide?", "role": "user" }, { "content": "An x-ray may be helpful in the diagnosis of secondary amyloidosis. Findings suggestive of amyloid deposition may include nodular densities.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the physical examination conducted to diagnose portal hypertension?", "role": "user" }, { "content": "Patients with portal hypertension are usually asymptomatic at early stages of the disease. Physical examination of patients with portal hypertension is usually remarkable for splenomegaly, caput medusae, and thrombocytopenia. The presence of jaundice on physical examination is highly suggestive of cirrhosis.\r\nPatients with portal hypertension usually appear ill and icteric.\r\nLow-grade fever High-grade fever in spontaneous bacterial peritonitis (SBP) Tachypnea in congestive heart failure (CHF) Bounding pulse Arterial hypotension\r\nJaundice Spider angiomas Pallor in severe internal bleeding Telangiectasis\r\nJugular venous distension in CHF\r\nFlow murmur over the pericardium Mild heave\r\nAbdominal distention in ascites Shifting dullness in ascites Abdominal tenderness in all abdominal quadrants due to SBP Rebound tenderness (positive Blumberg sign) in SBP Guarding may be present in SBP Splenomegaly Dilated veins on abdominal wall, suggestive of umbilical epigastric vein shunts Venous patterns on the flanks, suggestive of parieto-portal shunts Caput medusae, i.e. tortuous paraumbilical collateral veins Paraumblical hernia Gynecomastia Venous hums\r\nRectal hemorrhoids Loss of pubic hair in cirrhosis Testicular atrophy in cirrhosis \r\nHepatic encephalopathy Altered mental status\r\nDupuytrens contracture Muscle wasting in cirrhosis Palmar erythema in cirrhosis Leukonychia in cirrhosis Asterixis in hepatic encephalopathy Cyanosis Pitting edema of the lower extremities", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the explanation for policosanol and the studies conducted on it?", "role": "user" }, { "content": "Published studies have come to conflicting conclusions regarding the efficacy of policosanol in lowering LDL (i.e., \"bad cholesterol\") or raising HDL (i.e., \"good cholesterol\")., despite a number of studies funded by the Cuban government, which produces and markets the drug. Older independent clinical trials found no evidence of the efficacy of policosanol, while more recent studies have found effect.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the guide for residents to survive constipation?", "role": "user" }, { "content": "Constipation is a syndrome that is characterized by either difficulty in passing stool, infrequent bowel movements, hard stool, or a feeling of incomplete evacuation that occurs either in isolation or secondary to another underlying disorder.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What are the different possible diagnoses for hypercalcemia?", "role": "user" }, { "content": "Different causes of hypecalcemia should be differentiated from each other. Common causes of hypercalcemia to be differentiaetd include:\r\nParathyroid related Hyperparathyroidism Primary hyperparathyroidism Secondary hyperparathyroidism Tertiary hyperparathyroidism Familial hypocalciuric hypercalcemia Non-parathyroid related Malignancy Humoral hypercalcemia of malignancy Osteolytic tumors Production of calcitriol by tumors Ectopic parathyroid hormone production Medication-induced Thiazide diuretics Lithium Nutritional Milk-alkali syndrome Vitamin D toxicity Granulomatous disease Sarcoidosis Surgical Immobization\r\n\r\nDifferential diagnosis of hypercalcemia Disorder Mechanism of hypercalcemia Clinical features Laboratory findings Imaging & diagnostic modalities PTH Calcium Phosphate Other findings Hyperparathyroidism Primary hyperparathyroidism Increase in secretion of parathyroid hormone (PTH) from a primary process in parathyroid gland. Parathyroid hormone causes increase in serum calcium. Usually asymptomatic Hypercalcemia detected on routine biochemical panel ↑ ↑ ↓/Normal Normal/↑ calcitriol Findings of bone resorption: X-ray Dual energy X-ray absorptiometry (DXA) Preoperative localization of hyperfunctioning parathyroid gland: Non-Invasive Tc-99m sestamibi scintigraphy Neck ultrasound 4D-CT SPECT (P-SPECT) PET MRI Invasive: Super sensitive venous sampling Selective arteriography Angiography Predicting post-operative success: Intraoperative parathyroid hormone monitoring Secondary hyperparathyroidism Increase in secretion of parathyroid hormone (PTH) from a secondary process. Parathyroid hormone causes increase in serum calcium after long periods. May present with history of: Chronic renal failure Vitamin D deficiency ↑ ↓/Normal ↑ -- Tertiary hyperparathyroidism Continuous elevation of parathyroid hormone (PTH) even after successful treatment of the secondary cause of elevated parathyroid hormone. Parathyroid hormone causes increase in serum calcium. Usually present with history of kidney transplant Usually hyperplasia of all four parathyroid glands ↑ ↑ ↑ -- Familial hypocalciuric hypercalcemia This is a genetic disorder caused my mutation in calcium-sensing receptor gene. A benign condition Does not require treatment Normal/↑ Normal/↑ -- -- Urinary calcium/creatinine clearance ratio Malignancy Humoral hypercalcemia of malignancy Tumor cells secretes parathyroid hormone-related protein (PTHrP) which has similar action as parathyroid hormone. Most common cause of malignancy related hypercalcemia Usually present with solid tumors -- ↑ ↓/Normal ↑ PTHrP Normal/↑ calcitriol Chest X-ray CT scan MRI Osteolytic tumors Multiple myeloma produces osteolysis of bones causing hypercalcemia. Osteolytic metasteses can cause bone resorption causing hypercalcemia. Commonly present in multiple myeloma and breast cancer ↓ ↑ -- -- DXA X-ray Mammography Ultrasound ESR Serum protein electrophoresis Production of calcitirol Some tumors has ectopic activity of 1-alpha-hydroxylase leading to increased production of calcitriol. Calcitriol is active form of vitamin D and causes hypercalcemia. Commonly present in lymphomas and in some ovarian germ cell tumors -- ↑ -- ↑ Calcitriol CT scan MRI Ectopic parathyroid hormone Some tumors leads to ectopic production of parathyroid hormone. In rare instances, small cell carcinoma of lung may produce hypercalcemia by this process ↑ ↑ ↓/Normal Normal/↑ calcitriol Chest X-ray CT scan MRI Medication induced Lithium Lithium lowers urinary calcium and causes hypercalcemia. Lithium has been reported to cause an increase in parathyroid hormone and enlargement if parathyroid gland after weeks to months of therapy. History of mood disorder ↑ ↑ -- -- Lithium levels Thiazide diuretics Thiazide diuretics lowers urinary calcium excretion and causes hypercalcemia. History of cardiac disorder Rarely causes hypercalcemia -- ↑ -- -- -- Nutritional Milk-alkali syndrome Hypercalcemia is be caused by high intake of calcium carbonate. History of High milk intake Excess calcium intake for treating: Osteoporosis Dyspepsia May lead to metabolic alkalosis and renal insufficiency. -- ↑ -- ↓ calcitriol Renal function tests Vitamin D toxicity Excess vitamin D causes increased absorption of calcium from intestine causing hypercalcemia. History of: Excess intake vitamin D Excess milk fortified with vitamin D Topical application of vitamin D analogue calcipotriol -- ↑ -- ↑ Vitamin D (calcidiol and/or calcitriol) -- Granulomatous disease Sarcoidosis Hypercalcemia is causes by endogeous production of calcitriol by disease-activated macrophages. History of: Cough Dyspnea Chest pain Tiredness or weakness Fever Weight loss -- ↑ -- ↑ Calcitriol ↑ ACE levels Chest X-ray Biopsy", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is a survival guide for residents who have short stature?", "role": "user" }, { "content": "Short stature is caused by multiple causes such as Systemic disorders with secondary effects on growth and pathologic short stature whish is Endocrine, Genetic, and Skeletal dysplasia s/ growth plate abnormalities. The incidence of short stature is in the late preterm group was 2.9% which was significantly higher than that in the term group (1.4%). The main symptom of short stature in children is very short compared to other children of the same age and sex so usually the children with short stature grow slowly, get their adult teeth later than normal and have normal proportions (their arm s and leg s match their height).To diagnose short stature we have to do the clinic evaluation to know if its identified as a short stature with dismorphic features or no as well as if the body disproportion or skeletal deformities. Then we can treat the short stature case by the cause of it individually.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Can you provide an overview of Onchocerciasis?", "role": "user" }, { "content": "Infected persons may be without symptoms. Those with symptoms will usually have one or more of the three manifestations: skin rash (usually itchy), eye disease, and nodules under the skin. The most serious manifestation consists of lesions in the eye that can lead to visual impairment and blindness.\r\nThe gold standard test for the diagnosis of onchocerciasis remains the skin snip biopsy. The biopsy is performed using a sclerocorneal biopsy punch or by elevating a small cone of skin (3 mm in diameter) with a needle and shaving it off with a scalpel. There are antibody tests that can assist in the diagnosis of onchocerciasis, though many are not available outside the research setting", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the classification of shock that is categorized as cardiogenic shock?", "role": "user" }, { "content": "Also referred to as pre-shock or compensated shock Patient with relative hypotension (SBP < 90 mm Hg or mean arterial pressure MAP < 60 mm Hg or drop in MAP of > 30 mm Hg from baseline) or tachycardia (pulse > 100 bpm) without hypoperfusion Physical exam findings may include elevated jugular vein distension (JVP), rales in lung fields, warm skin with strong distal pulses, normal mentation Laboratory findings may include normal lactate, minimal renal function impairment, and elevated brain natriuretic peptide (BNP) Hemodynamic findings include relative hypotension, tachycardia, normal cardiac index (≥ 2.2 L/min/m2) and pulmonary arterial (PA) oxygen saturation ≥ 65%.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What are the laboratory results linked to the condition of steatorrhea?", "role": "user" }, { "content": "Quantitative analysis of fat in the stool may be helpful in the diagnosis of steatorrhea. The various tests that may be helpful in the diagnosis are: Acid steatocrit may be helpful in assessing steatorrhea in a stool specimen on the spot. This method is considered to be very sensitive and specific. Near-infrared reflectance analysis (NIRA): NIRA is considered to be most accurate and the test of choice in the evaluation of malabsorption of fat as it consumes less time and can measure carbohydrates, fat and nitrogen levels in fecal fat at the same time. Assessment of fecal fat: Fecal fat excreted in healthy individuals is usually around 6g per day. In conditions such as diarrhea and associated diseases, the amount of fat excreted is on a higher side comparatively and it should not be mistaken as malabsorption. Sudan III stain is a qualitative test which may be helpful in determining the condition steatorrhea in most patients in a very less time compared to the stool collection test.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Can you explain what metabolic syndrome means?", "role": "user" }, { "content": "There is no established system for the classification of metabolic syndrome.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What are the possible changes that can happen to the skin?", "role": "user" }, { "content": "Acne vulgaris Acromegaly Adrenal disease Albinism Alcohol abuse Anemia Atopic Bacterial folliculitis Bullous pemphigoid Carcinoid syndrome Cardiovascular disease Carotene Candidiasis Chronic renal failure Chronic renal disease Cidofovir Cicatricial pemphigoid Cushing's disease Dermatitis herpetiformis Dermatosclerosis Diabetes Drugs Drug side effects: Fluorescein sodium, Sunitinib, Betamethasone dipropionate, Betamethasone valerate Erosive lichen planus Erythema multiforme Fever Fungal folliculitis Hepatopathy Herpes gestationis Hypertension Hypothyroidism Impetigo Keratosis pilaris Linear IgA bollous dermatosis Liver disease Milia Mitral facies Molluscum contagiosum Neurofibromatosis Nevi Pemphigus foliaceus Pemphigus vulgaris Peripheral vascular insufficiency Pituitary disease Polycythemia Porphyria cutanea tarda Pulmonary disease Raynaud's syndrome Resolving hematoma Rosacea Urticaria Viral exanthems Vitiligo", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Could you provide more context to your request? The statement \"What is Congenital CMV?\" is already in proper English.", "role": "user" }, { "content": "There are no screening recommendations for congenital CMV.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Could you please provide me with the exact sentence that you want me to rephrase? It appears to be already in proper English.", "role": "user" }, { "content": "Diabetic retinopathy is the result of microvascular abnormalities of the retina.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Which type of surgery is conducted on people who have Congenital Rubella Syndrome?", "role": "user" }, { "content": "The role of surgery in patients with congenital rubella syndrome consists of treating the several cardiac, ophthalmic, and hearing complications that arise as a result.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "According to Haff, what is a physical examination used for in detecting diseases?", "role": "user" }, { "content": "Physical examination reveals no abnormalities, but there may be muscle tenderness, weakness, as well as myoglobinuria.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the explanation for Bubo and Overview?", "role": "user" }, { "content": "A bubo (Greek boubôn, \"groin\") (plural form= buboes) is a swelling of the lymph nodes, found in an infection such as bubonic plague, gonorrhea, tuberculosis or syphilis.\r\nAccording to historical records they were also characteristic of the pandemic responsible for the Black Death and perhaps other ancient pandemics. It usually appears under the armpit, in the groin or on the neck. Many doctors believed that bursting them was the answer, although in the view of modern medicine this treatment is useless or in fact harmful. There are reports of people using hen feathers in order to burst lymph nodes. When lymph nodes are burst, the puncture site can leave a patient at higher risk for dangerous infection.\r\nBuboes rarely require any form of local care, but instead recede with systemic antibiotic therapy. In fact, for plague patients, incision and drainage poses a risk to others in contact with the patient due to aerosolization of the bubo contents.\r\nNeedle aspiration can be done for diagnostic purposes and may also provide symptomatic relief.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "\"Could you explain what a pancreatic fistula is?\"", "role": "user" }, { "content": "The etiology of pancreatic fistula include iatrogenic and non- iatrogenic insults.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Can you give a brief summary of ectopic pregnancy?", "role": "user" }, { "content": "There are a number of risk factors for ectopic pregnancies. They include: pelvic inflammatory disease, infertility, those who have been exposed to DES, tubal surgery, smoking, previous ectopic pregnancy, multiple sexual partners, current IUD use, tubal ligation, and previous abortion.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What are the possible diagnoses that could be considered in the case of ST-elevation myocardial infarction?", "role": "user" }, { "content": "ST elevation MI is one of several life threatening causes of chest pain that must be distinguished from each other.\r\nAortic dissection Esophageal rupture Myocardial infarction Pulmonary embolism Tension pneumothorax\r\nThe frequency of conditions exclusive of acute myocardial infarction in a decreasing order is: \r\nGastroesophageal disease Ischemic heart disease (angina, not myocardial infarction) Chest wall syndromes\r\nThorough history including: onset, duration, type of pain, location, exacerbating factors, alleviating factors, and radiation. Risk factors for coronary artery disease: family history, smoking, hyperlipidemia, and diabetes.\r\nActinomycosis Acute intermittent porphyria Adenosine Amonafide Anemia Ankylosing spondylitis Aortic valve stenosis Arsenic trioxide Arsenicals Blood transfusion and complications Bornholm disease Bronchogenic cyst Carbon monoxide toxicity Cardiomyopathy Familial hypertrophic cardiomyopathy Cardiopulmonary resuscitation Coronary artery dissection Diffuse esophageal spasm Dissecting aortic aneurysm Dressler syndrome Pleural empyema Esophageal achalasia Esophageal cyst Fabry disease Functional disorders Gastric ulcer Gastroesophageal reflux Gemeprost Glatiramer acetate Glycogenosis type 7 Ischaemic heart disease Kawasaki disease Left ventricular hypertrophy Lymphangiomyomatosis Mediastinitis Mesothelioma Mitral valve prolapse Myocardial infarction Myocarditis Naratriptan Nylidrin Esophageal foreign body Esophageal rupture Esophagitis Pericarditis Pleural effusion Pleural fibroma Pleuritis Pneumonia Pneumothorax Porfimer Prinzmetal angina Pulmonary embolism Pulmonary infarction Quaternary syphilis Recurrent hereditary polyserositis Regadenoson Respiratory alkalosis Rib fracture Rib pain Rizatriptan Rumination disorder SAPHO syndrome Shingles Sickle cell crisis (thrombotic) Sickle cell disease Acute spinal cord injury Subdiaphragmatic abscess Sumatriptan Syndrome X Tabes dorsalis Takotsubo cardiomyopathy Tension pneumothorax Thallium Thyroiditis Tietze costochondritis Trichinella spiralis Unstable angina Varicella-zoster virus Wegener granulomatosis Zolmitriptan", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What does a physical examination to diagnose atrioventricular septal defect typically include?", "role": "user" }, { "content": "Poor physical development\r\nInspection:\r\nHyperinflated thorax Bulging precordium Dominant v wave in the jugular venous pulse\r\nPalpation:\r\nSystolic thrill Palpable impulse in the second and third intercostal space representing a dilated pulmonary artery Prominent heave at the left sternal border\r\nAuscultation:\r\nSingle first heart sound Soft fixed splitting osecond heart sound Sytolic murmur on left lower sternal border Loud Pulmonic component of the second heart sound if pulmonary hypertension develops. A low-pitched early diastolic rumble may be heart at the lower left sternal border and is related to increased tricuspid valve flow.\r\nCyanosis", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Which other diagnostic tests can be performed for thyroid nodules?", "role": "user" }, { "content": "The molecular marker evaluation tests are performed based on samples that are collected during fine needle aspiration using needle washing. The most important indications of the molecular markers study include: \r\nIndeterminate cytological diagnosis To assist narrowing disease management options (medical treatment versus surgical treatment)\r\nThe molecular tests which have the most available data are Afirma Gene-expression Classifier, seven-gene panel of genetic mutations and rearrangements and galectin-3 immunohistochemistry. \r\nA highly sensitive (92%) gene-expression classifier called Afirma evaluates the presence of related gene expression profiles. The low specificity of this technique (a negative predictive value of 93 %, positive predictive value and specificity of 48–53 %) lead to major usage of this technique as a rule out test to identify benign nodules. A benign gene expression classifier result predicts low risk of malignancy but there is still an up to 5% chance of malignancy in the nodules classified as benign.\r\nThe seven gene mutation and rearrangement analysis panel evaluates the following genetic mutations:\r\nPoint mutations BRAF gene NRAS gene HRAS gene KRAS gene Common rearrangements RET / PTC PAX8 /PPARγ\r\nThis technique has a high specificity (86–100 %) and positive predictive value (84–100 %) but poor a sensitivity (reported from 44 to 100 %), thus it is being used to rule in thyroid malignancies, mainly as the second line after gene expression classifier Afirma test.\r\nImmunohistochemistry evaluation of the marker galectin -3 should be performed on representative histological sections of the thyroid neoplasms that are obtained based on FNA or direct surgical biopsy. The samples should then be stained and then the staining can be graded. Specific cytoplasmic staining of more than 5% of the tumor cells, regardless of the intensity, is scored as positive for galectin -3. It has a high sensitivity especially for papillary thyroid carcinoma.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Could you provide me with the original sentence so I can properly rephrase it?", "role": "user" }, { "content": "The villi can also be classified by their relations:\r\nThese villi are found floating freely in the intervillous space. They exhibit a bi-layered epithelium consisting of cytotrophoblasts with overlaying syncytium (syncytiotrophoblast).\r\nThese villi act to stablise mechanical integrity of the placental-maternal interface.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the physiological process underlying B-cell prolymphocytic leukemia?", "role": "user" }, { "content": "B-cell prolymphocytic leukemia cells are positive for B cell markers such as CD19, CD20, CD22. CD23 is negative but CD5 is expressed in one third tumor cells population. Another case was described as CD45 +, CD19 +, CD20 +, CD5 +, HLA-DR +, CD10 -, CD23 +/-, CD38 + and FMC7 Tumor cells express surface IgM proteins.\r\nThe originating cell line for B-cell prolymphocytic leukemia is a mature B-cells and are medium sized cells. More than 50 percent of the circulating cells in the peripheral blood are prolymphocytes. The nucleus is typically round or oval, and the cytoplasm is usually moderately abundant. Leukemic cells can be found in peripheral blood, lymph nodes, bone marrow, spleen, liver, and skin.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Could you provide me with the original text that needs to be rephrased? It appears to already be in proper English.", "role": "user" }, { "content": "Naegleria fowleri causes the disease primary amebic meningoencephalitis (PAM), a brain infection that leads to the destruction of brain tissue. In its early stages, symptoms of PAM may be similar to symptoms of bacterial meningitis.\r\nInitial symptoms of PAM start about 5 days (range 1 to 7 days) after infection. The initial symptoms may include headache, fever, nausea, or vomiting. Later symptoms can include stiff neck, confusion, lack of attention to people and surroundings, loss of balance, seizures, and hallucinations.\r\nIn Naegleria infections, the diagnosis can be made by microscopic examination of cerebrospinal fluid (CSF). A wet mount may detect motile trophozoites, and a Giemsa-stained smear will show trophozoites with typical morphology. Confocal microscopy or cultivation of the causal organism, and its identification by direct immunofluorescent antibody, may also prove useful. An increasing number of PCR -based techniques (conventional and real-time PCR) have been described for detection and identification of free-living amoebic infections in the clinical samples. Such techniques may be available in selected reference diagnostic laboratories.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Can you provide a summary of what endometrial hyperplasia is?", "role": "user" }, { "content": "Progesterone therapy is the preferred drug for the treatment of benign hyperplasia. The management of endometrial hyperplasia depends upon the desire for future childbearing. \r\nTotal hysterectomy is curative for atypical endometrial hyperplasia or endometrial intraepithelial neoplasia.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "How are failure to thrive and echocardiography and ultrasound related?", "role": "user" }, { "content": "Echocardiography and ultrasounds are useful in diagnosing organic causes of failure to thrive. Listing down each organic cause is beyond the scope of this microchapter. Listing down each organic cause is beyond the scope of this microchapter. Echocardiocardiogrpahs may be useful in diagnosing congenital heart disease or cardiac malignancies Ultrasounds are useful in diagnosing obstructions, gastrointestinal malignancies or inflammatory conditions such as inflammatory bowel disease. Low muscle volume,hepatomegaly, increased hepatic echogenicity (as a sign of hepatosteatosis),anechoic intraperitoneal fluid (ascites) are some ultrasound findings in patients with failure to thrive.\r\nAn example of an organic cause diagnosed by an echocardiography is:\r\nVentricular Septal Defect", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What information is currently available on rat-bite fever?", "role": "user" }, { "content": "Rat-bite fever is a rare disease spread by infected rodents.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Can you provide an overview of cancer whose primary origin is unknown?", "role": "user" }, { "content": "Several studies have evaluated the chromosomal and molecular anomalies found in cancers of unknown primary; however, they could not identify unique causes of metastasis of unknown primaries relative to those with known primary origins.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the purpose of an MRI in detecting Pseudomyxoma peritonei?", "role": "user" }, { "content": "Abdominal MRI is helpful in the diagnosis of pseudomyxoma peritonei. On abdominal MRI, pseudomyxoma peritonei is characterized by a mass which is hypointense on T1-weighted MRI and hyperintense on T2-weighted MRI. MRI has better sensitivity in detecting ascitic fluid and mucocele.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the definition of antidiuretic hormone?", "role": "user" }, { "content": "Brenner & Rector's The Kidney, 7th ed., Saunders, 2004. Full Text with MDConsult subscription\r\nCaldwell, H.K. and Young, W.S., III. Oxytocin and Vasopressin: Genetics and Behavioral Implications in Lim, R. (ed.) Handbook of Neurochemistry and Molecular Neurobiology, 3rd edition, Springer, New York, pp. 573-607, 2006. 320kb PDF", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the mechanism behind pulmonic regurgitation?", "role": "user" }, { "content": "Location: Pulmonary valve is located at the junction of the right ventricular outflow tract and pulmonary artery. Pulmonic valve lies anterior and superior to the aortic valve at third intercostal space level. Infundibulum of the right ventricle separates it from tricuspid valve. \r\nStructure: Three equal sized, semilunar cusps or leaflets make up the pulmonary valve. Based on the corresponding aortic valve, the cusps are named right, left and anterior. The three cusps are joined by commissures and the cusps are thinner when compared to the aortic valve, due to a low pressure in the right ventricle. Histologically, the pulmonary valve consists of stratified extracellular matrix compartments. The layers constitute fibrosa, spongiosa and ventricularis. The diameter of pulmonic valve is demonstrated to be closely related to the body size. For adult men (>17 years age) mean pulmonary valve diameter is 26.2 +/- 2.3 mm and 23.9 +/- 2.2 mm for adult women. Physiology: The right ventricle delivers the received blood entirely to the pulmonary circulation every beat, maintaining optimum pressure. Pulmonary valve opens during right ventricular systole allowing the deoxygenated blood to be delivered to the lungs. During the right ventricular diastole the pulmonary valves close completely to prevent regurgitation (back flow) of the blood into the right ventricle. The closure of the pulmonic valve contributes to the P2 component of the second heart sound (S2).\r\nThe pathogenesis of pulmonic regurgitation involves the following mechanisms: \r\nThe diastolic pressure difference between main pulmonary artery (MPA and right ventricle (RV) is usually very small and steers the pulmonic regurgitation. The right ventricular stiffness due to right ventricular hypertrophy (such as in Tetralogy of Fallot and fibrosis) increases the ventricular diastolic pressure. Increased ventricular diastolic pressure decreases the gradient causing regurgitation. A slight increase in the intrathoracic pressure (such as among ventilated patients) can accentuate PR considerably. Along with diastolic pressure difference between right ventricle and pulmonary artery, the degree/ severity/ volume of regurgitant jet is dependent on: Size/ area of the regurgitant orifice Afterload of the right ventricle / capacitance of pulmonary arteries Right ventricle diastolic compliance Duration of right ventricular diastole Torricelli principle sums up some of the factors influencing regurgitant volume: \r\nPR volume = regurgitant orifice area · constant · diastolic time · mean diastolic pressure difference between the MPA and RV.(P2−P1)0.5.\r\nThe most common cause of PR is post repair of TOF to relieve right ventricle outflow tract (RVOT) obstruction. The valvular lesion is thought to be due to the disruption of pulmonary valve's morphological integrity. In a TOF patient even after the RVOT obstruction relief, the right ventricle (RV) is hypertrophied and pulmonary arteries are usually hypoplastic, both demonstrating low compliance. Among children, tachycardia leads to shorter duration diastoles.\r\nRegurgitation is avoided despite large regurgitation orifice due to Torricelli principle. Progressively, an increased size and capacitance of central pulmonary ateries and right ventricular dilatation occurs due to increased RV stroke volume. The changes described progress with age accompanied by a longer duration of diastole and decreased heart rate. This progressively leads to an increase in the degree of PR.\r\nThe development of pulmonic regurgitation due to tophus valvular vegetations has been reported in a case. The patient reported had long-standing cyanotic congenital heart disease and developed hyperuricemia secondary to polycythemia. The possible mechanism of development of the vegetations involved hemodynamic valvular trauma in the setting of sustained hyperuricemia and subsequent dystrophic calcification at primary tophus lesion.\r\nThe exact pathogenesis of dilatation of the pulmonary artery is not fully understood. The demonstration of the disease among pediatric population signals the congenital nature of the etiology. Main pulmonary artery and the origin of its right and left main pulmonary arteries are majorly affected. It is thought that pulmonary artery dilatation is mediated by the unequal division of truncus arteriosus communis. Other proposed mechanisms include maldevelopment of the whole pulmonary tree and the association of hypoplastic aorta with dilated.\r\nA study utilized pulsed doppler echocardiography and cineangiography to identify the significance of pulmonic valve ring dimensions in the development of PR. It reported the ratio of sagittal to the transverse diameter of the pulmonic valve ring to be greater among patients with PR. In patients with PAH the study also demonstrated greater dilatation of the sagittal diameter of the pulmonic valve ring than pulmonary sinus diameter. In the light of the results, the etiology of PR was attributed to the distortion of pulmonic valve ring.\r\nAbsent pulmonary valve syndrome (APVS) is rare and involves developmental abnormality and dysplasia or absolute absence of pulmonary valve cusps. A variable degree of dilatation/ aneurysm of the main pulmonary artery always accompanies the disorder. It is thought that the development of pulmonary artery aneurysm is mediated by either the congenital weakness or cystic medial degeneration of the pulmonary artery walls. An association between cystic medial degeneration and increased hemodynamic forces then leads to aneurysm formation. Pulmonary artery aneurysms have been associated with structural cardiac and vascular abnormalities, vasculitis, and infection (such as syphilis). The pathogenesis of Fallot type (APVS) involves either agenesis of ductus arteriosus or post pulmonary stenotic dilatation due to increased stroke volume. Quuadricuspid pulmonary valve is rare but may cause PR. Thick valvular leaflets with decreased mobility without complete closure during diastole may lead to the development of PR. \r\nPatients with pulmonic regurgitation (PR) develop chronic right ventricular overload resulting in right ventricular remodeling and progressive decline in function. The rate of decline in right ventricular systolic function is also affected by associated conditions such as peripheral pulmonary artery stenosis and pulmonary hypertension which accentuates PR. Among patients with increased pulmonary artery pressure from dysfunction of left ventricle or residual pulmonary artery stenosis the severity of PR is increased. Progressive dilation of the right ventricle results in functional tricuspid regurgitation and increases the risk of developing arrhythmias.\r\nADAMTS19 has been identified as a novel causative gene for autosomal recessive cardiac valve disease. ADAMTS is a disintegrin and metalloproteinase with thrombospondin motifs protein family. All patients demonstrated anomalies of the aortic and/or pulmonary heart valves, such as thickening of valve leaflets, stenosis and insufficiency. Among patients with severe pulmonary regurgitation (PR), the gene expression pattern of GRK2 and β2- adrenoceptor (molecular markers of cardiac dysfunction) has been reported to be altered. The lymphocyte expression of described adrenoceptors and kinases demonstrates neurohumoral changes in heart failure. 25% cases of absent pulmonary valve syndrome (APVS) are associated with chromosomal anomalies such as Trisomy 21, Trisomy 13, chromosome 6 and 7 deletions. 22q11 micro-deletion has been shown to be associated with 25% cases of APVS. \r\nIsolated PR is uncommon and is usually demonstrated with other valvular abnormalities or in certain conditions. The most important conditions/ diseases associated with PR include:\r\nTOF: Surgical repair of pulmonic stenosis associated with TOF may lead to PR. Post TOF repair, PR is a common complication. Marfan syndrome: Dilatation of pulmonary artery root is one of the established diagnostic criteria of Marfan syndrome. Although other valvular regurgitations are common in Marfan syndrome, pulmonic regurgitation is also possible. Rheumatic heart disease: The disease is uncommon among developed countries but developing countries still share the burden of the disease. Syphilis: Although a rare cause, pulmonary artery dilatation and PAH may be caused by tertiary syphilis. Given the prognostic implications and available treatments, early detection of PAH. Being a sexually transmitted disease (STD), it is important to screen the patient for other STDs.\r\nOn gross pathology vegetative lesions on the pulmonic valve leaflets may be observed among patient s with acquired alteration in the valvular leaflet morphology. \r\nOn polarized light microscopy of the material taken from the pulmonic valve, negatively birefringent crystals may be observed in acquired alteration in the valvular leaflet morphology.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What does the physical examination entail for aortic stenosis?", "role": "user" }, { "content": "Aortic stenosis is most often diagnosed when it is asymptomatic and can sometimes be detected during routine examination of the heart and circulatory system. The major signs include pulsus parvus et tardus (a slow-rising, small volume carotid pulse), a lag time between apical and carotid impulses and a distinct systolic ejection murmur.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the process used for screening acute cholecystitis?", "role": "user" }, { "content": "There is insufficient evidence to recommend routine screening for acute cholecystitis.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the role of a farnesyltransferase inhibitor?", "role": "user" }, { "content": "So how to explain the preclinical successes showing that many N- or K-RAS transformed cell lines (and even tumor cell lines that do not harbor RAS mutations) are sensitive to FTase inhibitors? It has been suggested that this is due to inhibition of farnesylation of a number of other proteins (Reuter et al., 2000). Therefore it is hoped that FTIs, whilst not RAS specific, still have potential for cancer therapy.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Can you provide an overview of perianal abscess, please?", "role": "user" }, { "content": "The abscess usually begins when bacteria enters through a tear in the lining of the rectum or anus. Most often, this occurs between the internal and external sphincters (intersphincteric abscess), where the perianal glands are located. As the abscess increases in size, most will follow the plane of least resistance and spread towards the surface, creating a perianal abscess. Occasionally, the infection can spread into the ishiorectal fossa or above the level of the levator muscles, creating ischiorectal and/or supralevator abscesses, respectively. Although supralevator abscesses are difficult to diagnose, perianal and ischiorectal abscesses still seem to account for the majority of the ones encountered.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the explanation for the natural history, complications, and prognosis of meningioma?", "role": "user" }, { "content": "The incidence of meningioma increases with advancing age, with the median age of diagnosis being about 65 years. There are some factors associated with faster progression of the tumor, they include absence of calcification, age 60 or younger, and intial tumor diameter greater than 25mm. Meningiomas can grow in a linear or volumetric fashion. They can grow anywhere in the central nervous system containing arachnoid membrane. If left untreated, patients with meningioma may progress to developing morning headaches, focal neurological deficits, edema surrounding the tumor, cranial nerve palsies, and more. Prognosis is generally good, and the survival rate of patients with meningioma mainly depends on the grade and the extent of resection of the tumor.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What are the epidemiological and demographic characteristics of complex regional pain syndrome?", "role": "user" }, { "content": "CRPS can strike at any age, but is more common between the ages of 40 and 60.The number of reported CRPS cases among adolescents and young adults is increasing.\r\nIt affects both men and women, but is more frequently seen in women.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Are burn treatments considered to be investigational or a possible future development?", "role": "user" }, { "content": "A primarily topical therapy and topical therapy\r\nantibiotics\r\nfluid resuscitation\r\nskin excision and grafting\r\nrespiratory and metabolic care and nutrition.\r\nThe use of systemic antibiotics and topical silver therapy greatly reduced sepsis related mortality.\r\nThis along with the advent of antiseptic surgical techniques, burn depth classification and skin grafting allowed the excision and coverage of full-thickness burns which resulted in greatly improved survival rates. Advancements in the methods of assessing the surface area of burns paved way for more accurate fluid resuscitation, minimizing the effects of shock and avoiding fluid over-loading.\r\nmetabolic care,\r\nnutritional support and care of inhalation injuries further improved the outcome of burn patients.\r\nburn care such as the use of cell and pharma-logical therapies. \r\nYou may need one or more of the following procedures:\r\nBreathing assistance. If you've been burned on the face or neck, your throat may swell shut. If that appears likely, your doctor may insert a tube down your windpipe (trachea) to keep oxygen supplied to your lungs. Feeding tube. People with extensive burns or who are undernourished may need nutritional support. Your doctor may thread a feeding tube through your nose to your stomach. Easing blood flow around the wound. If a burn scab (eschar) goes completely around a limb, it can tighten and cut off the blood circulation. An eschar that goes completely around the chest can make it difficult to breathe. Your doctor may cut the eschar to relieve this pressure. Skin grafts. A skin graft is a surgical procedure in which sections of your own healthy skin are used to replace the scar tissue caused by deep burns. Donor skin from deceased donors or pigs can be used as a temporary solution. Plastic surgery. Plastic surgery (reconstruction) can improve the appearance of burn scars and increase the flexibility of joints affected by scarring.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the natural course of Lesch-Nyhan syndrome?", "role": "user" }, { "content": "Severe, progressive disability if likely. Spasticity Dystonia Choreoathetosis Ophisthotonus Nephrolithiasis Urinary tract infection Gouty arthritis Skin and soft tissue infections Hip dysplasia and subluxation Pneumonia Scoliosis Fractures Atlanto-axial joint subluxation", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the definition of atelectasis and what are the factors that increase the risk of developing it?", "role": "user" }, { "content": "Chest trauma, general anaesthesia, thoracic surgery, cystic fibrosis, prematurity and respiratory distress syndrome are some of the common risk factors that predispose patients to developing atelectasis. Children less than three years of age and adults over sixty years of age are also at increased risk of alveolar collapse and impaired surfactant production in response to pulmonary stressors such as toxins, hyperoxia, hypoxia and ischemia.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Could you provide the original sentence? There isn't any statement here to rephrase.", "role": "user" }, { "content": "Protein-energy malnutrition represents a shift of the body from fed to fasting/starvation state. Starvation leads to a decreased basal plasma insulin concentration and in decrease of glucose -stimulated insulin secretion. Prolonged fasting results in a deficiency in amino acids used for gluconeogenesis. It is thought that kwashiorkor is produced by a deficiency in the adequate consumption of protein- rich foods during the weaning process. However, the associated edema is not fully understood. Several theories have been put forward to explain this finding. Marasmus on the other hand is thought to be due to the total caloric deficiency leading to wasting in a child. Marasmus always results from a negative energy balance.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the meaning of mast cell leukemia?", "role": "user" }, { "content": "Mast cell leukemia may be classified into two categories based on prognosis to leukemic and aleukemic. Also, it can be classified to acute or chronic according to the duration of the symptoms.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is Ileus and what information is currently available on the condition?", "role": "user" }, { "content": "Prevention depends on the cause. Treating some conditions, such as electrolyte abnormalities, thyroid disorders, and diabetes, that can predispose to ileus may reduce your risk.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "\"What is hypogonadotrophic hypogonadism?\" is already in proper English. There is no need for rephrasing.", "role": "user" }, { "content": "Hypogonadotropic hypogonadism should be differentiated from other diseases causing hypogonadism like features. \r\nDiseases Onset Manifestations Diagnosis History and Symptoms Physical examination Laboratory findings Gold standard Imaging Other investigation findings Trumatic delivery Lactation failure Menstrual irregularities Other features Sheehan's syndrome Acute ++ ++ Oligo / amenorrhea Symptoms of: Adrenal insufficiency Hypothyroidism Breast tissue atrophy Decreased axillary and pubic hair growth Pancytopenia Eosinophilia Hyponatremia Low fasting plasma glucose Decreased levels of anterior pituitary hormones in blood Clinical diagnosis Most senitive test: Low baseline prolactin levels w/o response to TRH CT/MRI: Sequential changes of pituitary enlargement followed by: Shrinkage and necrosis leading to decreased sellar volume or empty sella Pituitary hormone stimulation tests (Metoclopramide and clomiphene citrate stimulation tests) Lymphocytic hypophysitis Acute +/- + Oligo / amenorrhea Associated with autoimmune conditions Generalized headache Retro-orbital or Bitemporal pain Mass lesion effect such as visual field defects DI Autoimmune thyroiditis Decreased pituitary hormones(Gonadotropins most common) Hyperprolactinemia (40%) GH excess Pituitary biopsy: lymphocytic infiltration CT & MRI: Features of a pituitary mass Diffuse and homogeneous contrast enhancement Assays for: Anti-TPO Anti-Tg Ab Pituitary apoplexy Acute +/- ++ Oligo / amenorrhea Severe headache Nausea and vomiting Paralysis of eye muscles (diplopia) Changes in vision Visual acuity defects CN palsies (nerves III, IV, V, and VI) Decreased levels of anterior pituitary hormones in blood. MRI CT scan without contrast: Hemorrhage on CT presents as a hyperdense lesion MRI: If inconclusive CT Blood tests may be done to check: PT / INR and aPTT Pituitary hormonal assay Empty sella syndrome Chronic - + Oligo / amenorrhea Erectile dysfunction Headache Low libido Signs of raised intracranial pressure may be present Nipple discharge Decreased levels of pituitary hormones in blood. MRI Empty sella containing CSF Pituitary hormone stimulation tests (Metoclopramide and clomiphene citrate stimulation tests) Simmonds' disease / Pituitary cachexia Chronic +/- + Oligo / amenorrhea Cachexia Premature aging Progressive emaciation Loss of body hair Decreased levels of anterior pituitary hormones in blood. MRI Done to rule out any pituitary cause Pituitary hormone stimulation tests (Metoclopramide and clomiphene citrate stimulation tests) Hypothyroidism Chronic +/- - Oligomenorrhea / menorrhagia Cold intolerance Constipation Dry skin Bradycardia Hair loss Myxedema Delayed relaxation phase of deep tendon reflexes Low T3, T4 Normal/ low TSH Rest of pituitary hormone levels WNL TSH levels Done to rule out any pituitary cause Assays for anti-TPO and anti-Tg Ab FNA biopsy Hypogonadotropic hypogonadism Chronic - - Oligo / amenorrhea Hot flushes Energy and mood changes Decreased libido Breast tissue atrophy Decreased maturation of vaginal mucosa Low estrogen, testosterone High FSH / LH FSH LH Done to rule out any pituitary cause Genetic tests (karyotype) Measurement of total and free testosterone and 17-hydroxyprogesterone concentrations Hypoprolactinemia Chronic - + - Infertility Subfertiliy Puerperal agalactogenesis No workup is necessary Decreased prolactin levels Done to rule out any pituitary cause Prolactin assay in 3rd trimester LH, FSH Thyrotropin and free thyroxine Panhypopituitarism Chronic - + Oligo / amenorrhea Polyuria Polydipsia Features of hypothyroidism and hypoadrenalism Growth failure B/L hemianopsia Papilledema All pituitary hormones decreased MRI Done to rule out any pituitary cause Left hand and wrist radiograph for bone age Primary adrenal insufficiency / Addison's disease Chronic - - - Hypoglycemia Hypotension Dehydration Hyperpigmentation loss of pubic and axillary hair Hyponatremia with/without hyperkalemia Plasma renin activity to aldosterone ratio Abdominal CT Abdominal CT Serum cortisol testing Serum ACTH testing Anti-adrenal Ab testing Menopause Chronic - +/- Oligo / amenorrhea Hot flashes Insomnia Weight gain and bloating Mood changes Vaginal atrophy Loss of pelvic muscle tone ↑ FSH ↓ Estradiol and inhibin FSH > LH Normal Endometrial biopsy\r\n\r\nTreatment of HH may consist of administration of either a GnRH agonist or a gonadotropin formulation in the case of primary HH and treatment of the root cause (e.g., a tumor) of the symptoms in the case of secondary HH. Alternatively, hormone replacement therapy with androgens and estrogens in males and females, respectively, may be employed.\r\nHypogonadism Delayed puberty and infertility Hypothalamus, pituitary gland, and HPG axis Gonads (testicles and ovaries) GnRH and gonadotropins (FSH and LH) Sex hormones (androgens and estrogens)\r\nTemplate:WH Template:WS", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is venography, and what are the potential complications that it may be associated with?", "role": "user" }, { "content": "Thrombophlebits Contrast media extravasation Arrhythmias in patients with pulmonary hypertension General contrast media complications allergic reaction or anaphylaxis Hematoma at site of injection site Pulmonary embolus", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What do intraprocedural thrombotic events mean?", "role": "user" }, { "content": "The overall rate of IPTE is high, currently estimated by several studies to be between 3.5 and 11.4% of all PCI procedures. In 2012, McEntegart et al. performed frame-by-frame analysis for 3,428 patients with NSTEMI}non-ST elevation acute coronary syndrome (NSTEACS) previously enrolled in the ACUITY trial (Acute Catherterization and Urgent Intervention Triage Strategy). The total incidence of IPTE was 3.5% with varying rates of occurrence among specific etiologies of IPTE. 89.3% of all IPTE occurred at the level of a main branch. \r\nSimilarly in 2012, Pride et al. evaluated 1,452 high-risk patients with NSTTEAS enrolled in the EARLY ACS trial (Early Glycoprotein IIb/IIIa in Non-ST-Segment Elevation Acute Coronary Syndrome) who underwent angiographic assessment. Incidence of IPTE was 11.4%. \r\nIn contrast to McEntegart, the study by Pride et al. included high-risk patients only. High-risk criteria were defined by the authors as having at least two of the following: Ischemic changes on electrocardiography (ECG), elevated cardiac enzyme, advanced age ≥ 60 years or age between 50-59 with documented coronary artery disease, cerebrovascular disease, or peripheral vascular disease. It is uncertain whether the inclusion criteria played a role in the increase of IPTE rates in the study as compared to McEntegart’s findings.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What does post-traumatic endophthalmitis mean?", "role": "user" }, { "content": "Post-traumatic bacterial endophthalmitis occurs following penetrating ocular injuries. Post-traumatic endophthalmitis is associated with a large variety of organisms. The most commonly isolated organisms include gram-positive Staphylococcus epidermidis and Streptococcus (as a part of the normal skin flora and regularly contaminate open wounds). Bacillus cereus is second most common. In some cases post-traumatic endophthalmitis is polymicrobial. The risk for developing endophthalmitis after open globe injuries is estimated at about 7% of injured eyes.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the recommended treatment for pericarditis?", "role": "user" }, { "content": "Class I 1. Hospital admission is recommended for high-risk patients with acute pericarditis (at least one risk factor). 2. Outpatient management is recommended for low-risk patients with acute pericarditis. 3. Evaluation of response to anti-inflammatory therapy is recommended after 1 week. (Level of Evidence: B) \r\nClass I 1. Aspirin or NSAIDs are recommended as first-line therapy for acute pericarditis with gastroprotection. 2. Colchicine is recommended as first-line therapy for acute pericarditis as an adjunct to aspirin / NSAID therapy. (Level of Evidence: A) \r\nClass IIa 1. Serum CRP should be considered to guide the treatment length and assess the response to therapy. 2. Low- dose corticosteroids should be considered for acute pericarditis in cases of contraindication / failure of aspirin / NSAIDs and colchicine, and when an infectious cause has been excluded, or when there is a specific indication such as autoimmune disease. 3. Exercise restriction should be considered for non- athletes with acute pericarditis until resolution of symptoms and normalization of CRP, ECG, and echocardiogram. 4. For athletes, the duration of exercise restriction should be considered until resolution of symptoms and normalization of CRP, ECG, and echocardiogram —at least 3 months is recommended. (Level of Evidence: C)\r\nClass I 1. Aspirin and NSAIDs are mainstays of treatment and are recommended at full doses, if tolerated, until complete symptom resolution. 2. Colchicine (0.5 mg twice daily or 0.5 mg daily for patients, 70 kg or intolerant to higher doses); use for 6 months is recommended as an adjunct to aspirin / NSAIDs. (Level of Evidence: A) \r\nClass IIa 1. Colchicine therapy of longer duration (>6 months) should be considered in some cases, according to clinical response. 2. CRP dosage should be considered to guide the treatment duration and assess the response to therapy. 3. After CRP normalization, a gradual tapering of therapies should be considered, tailored to symptoms and CRP, stopping a single class of drugs at a time. 4. Drugs such as IVIG, anakinra, and azathioprine may be considered in cases of corticosteroid -dependent recurrent pericarditis in patients not responsive to Colchicine. 5. Exercise restriction should be considered for non- athletes with recurrent pericarditis until symptom resolution and CRP normalization, taking into account the previous history and clinical conditions. 6. Exercise restriction for a minimum of 3 months should be considered for athletes with recurrent pericarditis until symptom resolution and normalization of CRP, ECG, and echocardiogram. 7. If ischaemic heart disease is a concern or antiplatelet therapy is required, Aspirin should be considered, at medium-high doses (1–2.4 g/day). 8. If symptoms recur during therapy tapering, the management should consider not increasing the dose of corticosteroids to control symptoms, but increasing to the maximum dose of Aspirin or NSAIDs, well distributed, generally every 8 hours, and intravenously if necessary, adding Colchicine and adding analgesics for pain control. (Level of Evidence: C)\r\nClass I 1. The mainstay of treatment of chronic permanent constriction is pericardiectomy. 2. Medical therapy of specific pericarditis (i.e. tuberculous pericarditis) is recommended to prevent the progression of constriction. (Level of Evidence: C)\r\nClass III 1. Routine viral serology is not recommended, with the possible exception of HIV and HCV. 2. Corticosteroid therapy is not recommended in viral pericarditis. (Level of Evidence: C)\r\nClass I 1. Effective pericardial drainage is recommended for purulent pericarditis. 2. Administration of intravenous antibiotics is indicated to treat purulent pericarditis. (Level of Evidence: C)\r\nClass IIa 1. Subxiphoid pericardiotomy and rinsing of the pericardial cavity should be considered. 2. Intrapericardial thrombolysis should be considered. 3. Pericardiectomy for dense adhesions, loculated or thick purulent effusion, recurrence of tamponade, persistent infection and progression to constriction should be considered. (Level of Evidence: C)\r\nClass IIa 1. Dialysis should be considered in uraemic pericarditis. 2. When patients with adequate dialysis develop pericarditis, intensifying dialysis should be considered. (Level of Evidence: C)\r\nClass IIb 1. Pericardial aspiration and/or drainage may be considered in non-responsive patients with dialysis. 2. NSAIDs and corticosteroids (systemic or intrapericardial) may be considered when intensive dialysis is ineffective. (Level of Evidence: C)\r\nClass I 1. In cases of pericarditis with suspected associated myocarditis, coronary angiography (according to clinical presentation and risk factor assessment) is recommended in order to rule out acute coronary syndromes. 2. Cardiac magnetic resonance is recommended for the confirmation of myocardial involvement. 3. Hospitalization is recommended for diagnosis and monitoring in patients with myocardial involvement. 4. Rest and avoidance of physical activity beyond normal sedentary activities is recommended in non- athletes and athletes with myopericarditis for a period of 6 months. (Level of Evidence: C)\r\n\r\nClass I 1. Radiation therapy methods that reduce both the volume and the dose of cardiac irradiation are recommended whenever possible. (Level of Evidence: C)\r\nClass I 1. NSAIDs at high doses are recommended as first-line therapy for acute pericarditis in children until complete symptom resolution. (Level of Evidence: C)\r\nClass IIa Colchicine should be considered as an adjunct to anti-inflammatory therapy for acute recurrent pericarditis in children: <5 years, 0.5 mg/day; >5 years, 1.0–1.5 mg/day in two to three divided doses. (Level of Evidence: C)\r\nClass IIb Anti-IL-1 drugs may be considered in children with recurrent pericarditis and especially when they are corticosteroid dependent. (Level of Evidence: C)\r\nClass III 1. Aspirin is not recommended in children due to the associated risk of Reye’s syndrome and hepatotoxicity. 2. Corticosteroids are not recommended due to the severity of their side effects in growing children unless there are specific indications such as autoimmune diseases. (Level of Evidence: C)", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the connection between dihydroxy-adenine urolithiasis and 2,8? And, what exactly is dihydroxy-adenine urolithiasis?", "role": "user" }, { "content": "More than 300 individuals with this disorder have been reported so far, out of which two thirds were from Japan, and a substantial number from France and Iceland. The estimated prevalence of APRT deficiency is 0.5 to 1 per 100,000 in the Caucasian population, 0.25 to 0.5 per 100,000 in the Japanese population and in Iceland the estimated point prevalence is 8.9/100,000", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "\"What does the term Sarcoma botryoides mean?\"", "role": "user" }, { "content": "Sarcoma botryoides is a rare subtype of embryonal rhabdomyosarcoma. The botryoides subtype of embryonal rhabdomyosarcoma accounts for about 10% of all rhabdomyosarcoma cases and arises from the sub- mucosal surface of body orifices such as the vagina, bladder and cervix. The most common clinical finding is vaginal bleeding. Sarcoma botryoides was first described by Guersant in 1854. Genes involved in the development of sarcoma botryoides include K-RAS gene and P53 oncogene. It is more commonly observed among girls aged 3 to 8 years old. If left untreated, patients with sarcoma botryoides may progress to develop direct extension to pelvic soft tissue structures. The mainstay of therapy for sarcoma botryoides is surgery and adjuvant multi-agent chemotherapy.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "How cost-effective is measles therapy?", "role": "user" }, { "content": "Measles is a highly contagious disease caused by a virus, that if not prevented may have a noticeable impact on the population. Although there is still not a specific antiviral treatment for measles, proper vaccination as primary prevention may have noteworthy impact on its incidence. Evidence of such is the incidence of measles in the US population, before and after the introduction of the measles vaccine. \r\nBefore the vaccine was introduced, almost all children got measles by the age of 15. At that time in the United States, about 450-500 people died every year, 48,000 were hospitalized, 7,000 had seizures and about 1,000 suffered permanent brain damage or deafness from measles. Today, with the adequate access to vaccination, there are only about 60 cases a year reported in the United States. Of these, most have their origin outside of the US.\r\nConsidering the impact of vaccination in the incidence of measles, the costs may be justified by the benefit of vaccination.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the medical history and what are the symptoms of vulvovaginitis that is caused by Candida?", "role": "user" }, { "content": "Definitive diagnosis is usually confirmed after obtaining cultures but cultures are not usually requested and the diagnosis is made based on the symptoms and physical examination.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the connection between glycogen and storage disease type II with regards to X-ray outcomes?", "role": "user" }, { "content": "There are no X-ray findings associated with glycogen storage disease type 2 (GSD type 2). However, an X-ray may be helpful in the diagnosis of the cardiac complication of GSD type 2, which include cardiomegaly.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What does a physical exam for salmonellosis look like?", "role": "user" }, { "content": "Depending on the severity of salmonellosis, patient's appearance may range from alert and oriented, being able to communicate, to severely dehydrated, hypotensive, with sunken eyes. \r\nA fever is often present\r\nTachycardia may be present\r\nThe pulse may be weak\r\nHypotension may be present\r\nTachypnea may be present\r\nPallor may be present\r\nMucosa may be dehydrated\r\nAbdominal distention may be present Abdominal tenderness may be present An abdominal mass may be present Hepatosplenomegaly may be present in immunocompromised patients\r\nMental status may be altered Obtundation may be present", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Could you define electrocardiography and explain the importance of the PR interval within it?", "role": "user" }, { "content": "The PR interval measures the time required for an electrical impulse to travel from the atrial myocardium adjacent to the sinoatrial (SA) node to the ventricular myocardium adjacent to the fibers of the Purkinje network.\r\nThis duration is normally from 0.10 to 0.21 s. A major portion of the PR interval reflects the slow conduction of an impulse through the AV node, which is controlled by the balance between the sympathetic and parasympathetic divisions of the autonomic nervous system. Therefore, the PR interval varies with the heart rate, being shorter at faster rates when the sympathetic component predominates, and vice versa. The PR interval tends to increase with age ;\r\nIn childhood: 0.10 - 0.20 sec In adolescence: 0.12 - 0.16 sec In adulthood: 0.14 - 0.21 sec\r\nShortens up to a rate of 140 to 150 beats per minute (bpm) through a withdrawal of parasympathetic tone PR may increase with increasing rate in the presence of digoxin or if the conducting system is diseased. If the atria are artificially paced the PR increases as the paced rate increases. Children have shorter PR intervals (0.11 at 1 year). Prolongation can be a normal variant: 6700 healthy airmen studied and 0.52% found to have a prolonged PR. 80% of the PR prolongations ranged from 0.21 to 0.24. In a second study 59 of 19,000 (0.31%) airmen had a PR of 0.24 or more. In healthy middle aged men, a prolongation of the PR in the presence of a normal QRS does not affect prognosis and is not related to ischemic heart disease. PR prolongation often signifies a delay in the AV node but may reflect intra atrial or His Purkinje disease.\r\nAV junctional and low atrial rhythms. Wolff Parkinson White syndrome. Lown Ganong Levine syndrome. Glycogen storage disease. Hypertension. Normal variant. Fabry's disease. Pheochromocytoma.\r\nAV block due to coronary artery disease, rheumatic disease. Hyperthyroidism. Normal variant.\r\nAcute pericarditis. Atrial infarction.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the objective of the pre-operative assessment?", "role": "user" }, { "content": "The American society of anesthesiologists recommends against routine preoperative laboratory testing in the absence of clinical indications . In specific circumstances, selective testing may be appropriate, such as in patients with underlying diseases or risk factors that would increase their risk for surgical complications. Also in specific high risk surgical procedures, these tests should be done. If there is no significant change in the clinical condition of the patient, it may be safe to use test results that were performed within the past four months. These tests include:\r\n1. Complete blood count (CBC): Anemia maybe presents in asymptomatic patients and it is common following major surgery. Postoperative mortality maybe predicted by the preoperative hemoglobin level . CBC test should be done for:\r\nPatients 65 years of age or older. Patients who are undergoing major surgery. Young patients who undergoing major surgery with the expectation to result in significant blood loss. Patients with a history that suggests anemia.\r\n2. Renal function test (RFT): Serum creatinine concentration should be ordered for patients over the age of 50 undergoing intermediate or high risk surgeries, also it should be ordered if hypotension is likely, or when nephrotoxic medications will be used. Mild to moderate renal impairment is usually asymptomatic. Dosage adjustment of some medications may be needed if the patient has renal insufficiency.\r\n3. Electrolytes: It is not recommended to be done routinely if the patient does not have a history of electrolytes abnormality.\r\n4. Blood glucose: Diabetes increases the operative risk in patients undergoing vascular surgery or coronary artery bypass grafting . Routine measurement of blood glucose is not recommended for healthy patients before the surgery, since some studies showed that unexpected abnormal blood glucose results do not often influence perioperative management .\r\n5. Liver function tests (LFT): It is not recommended to do this test routinely unless the patient has a history of liver disease .\r\n6. Hemostasis tests: It is not recommended to do prothrombin time (PT) or Partial thromboplastin time (PTT) blood tests routinely unless the patient has bleeding disorder or an unusual bleeding tendency . Some doctors have suggested to test all patients who undergoing intermediate to high risk surgeries. This avoids the chance that clinicians may forget to ask the patients about their bleeding history. The bleeding time is not useful in assessing the risk of perioperative hemorrhage .\r\n7. Urinalysis: It is usually done to detect any urinary tract infection which has the potential to cause wound infection after the surgery , especially with prosthetic surgery. If the test is positive, the patient should be treated with antibiotics and proceed with surgery without delay. Some studies showed that there is no reduction in the risk of postoperative wound infection if the patient treated with antibiotics before the surgery, and so, it is not indicated to test for Urinary tract infection before the surgery for every patient .\r\n8. Pregnancy testing: Pregnant women may need specific perioperative management, this includes specific anesthetic teqniques. An elective surgery may be cancelled or postponed in pregnant women. The American society of anesthesiologists recommends that clinicians consider pregnancy testing for all woman of childbearing age . Many institutions require pregnancy testing for all reproductive age women before surgery.\r\n9. Electrocardiogram (EKG): This should be done to detect any recent myocardial infarction (MI) which known to be associated with increased surgical morbidity and mortality , also it may be important as a baseline to be compared with the one postoperatively. In general, EKG alone may be a poor indicator of postoperative cardiac complications. The 2007 American college of cardiology/American heart association (ACC/AHA) Guidelines on perioperative cardiovascular evaluation states that ECG is not useful in asymptomatic patients undergoing low risk procedures . Also, the European Society of Cardiology 2009 preoperative guidelines do not recommend ECG in patients without risk factors . According to the 2007 ACC/AHA guidelines the 12-lead ECG are recommended for the following patients:\r\nPatients who are scheduled to undergo vascular surgery and have at least one of the following clinical risk factors:\r\nIschemic heart disease. Compensated or prior heart failure. Cerebrovascular disease. Diabetes. Renal insufficiency. It is less strongly recommended to perform an ECG for patients scheduled to undergo vascular surgery with no clinical risk factors.\r\nPatients who are scheduled to undergo intermediate-risk surgery with known cardiovascular disease, peripheral artery disease, or cerebrovascular disease.It is less strongly recommended to perform an ECG for patients scheduled to undergo intermediate-risk surgery with at least one clinical risk factor.\r\n10. Chest radiograph (Chest x-ray): Its not recommended to do this test routinely before the operations in healthy patients, many studies showed that an abnormal chest x-ray findings may occur frequently, especially in elderly persons . According to the American College of Physicians (ACP), if there is a suspicion of cardiopulmonary disease from the patient's history or physical examination, then this test should be done, also in those older than 50 years of age who are undergoing abdominal aortic aneurysm surgery or upper abdominal/thoracic surgery . The American heart association (AHA) recommends preoperative chest x-ray for patients with morbid obesity (BMI ≥40 kg/m2) .\r\n11. Pulmonary function test (PFT): This test only recommended for patients who have dyspnea or other abnormal respiratory clinical findings such as decreased breath sounds, prolonged expiratory phase, rales, rhonchi, or wheezes .", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Could you please provide me with the original text to rephrase it?", "role": "user" }, { "content": "Muller first coined the term desmoid in 1858 to describe tumors with tendon -like consistency. It origniates from a Greek word \"desmos\" meaning band or tendon -like. Gradner first described the development of desmoid tumors in FAP patients in 1951.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What diagnostic tests and procedures are employed in cardiology?", "role": "user" }, { "content": "A variety of blood tests are available for analyzing cholesterol transport behavior, HDL, LDL, triglycerides, lipoprotein little a, homocysteine, C-reactive protein, blood sugar control: fasting, after eating or averages using glycosylated albumen or hemoglobin, myoglobin, creatine kinase, troponin, brain-type natriuretic peptide, etc. to assess the evolution of coronary artery disease and evidence of existing damage. A great many more physiologic markers related to atherosclerosis and heart function are used and being developed and evaluated in research.\r\n(*) due to the high cost, LDL is usually calculated instead of being measured directly source: Beyond Cholesterol, Julius Torelli MD, 2005 ISBN 0-312-34863-0", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the information on Narcissistic Personality Disorder?", "role": "user" }, { "content": "Like other personality disorders, narcissistic personality disorder is diagnosed based on a psychological evaluation and the history and severity of the symptoms.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "\"Which diagnostic imaging technique, echocardiography or ultrasound, is used to identify Carcinoid Syndrome?\"", "role": "user" }, { "content": "Trans-thoracic echocardiography findings include thickening and retraction of immobile tricuspid valve leaflets with associated tricuspid regurgitation and immobility of the pulmonary valve cusps. Trans-esophageal echocardiography findings provide incremental assessment of the degree of cardiac valve involvement and the atrial septal anatomy in patients with carcinoid heart disease.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the disease called Werdnig-Hoffman?", "role": "user" }, { "content": "Fight SMA / Andrew's Buddies Families of Spinal Muscular Atrophy Template:NINDS SMA Support\r\nTemplate:Diseases of the nervous system\r\nit:Atrofia muscolare spinale\r\nTemplate:WH Template:WS", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What information is available concerning acetylsalicylic acid?", "role": "user" }, { "content": "Adprin B® Tri-Buffered Caplets® Alka-Seltzer® Effervescent Pain Reliever and Antacid Alka-Seltzer® Extra Strength Effervescent Pain Reliever and Antacid Alka-Seltzer® Flavored Effervescent Pain Reliever and Antacid Ascriptin® Arthritis Pain Caplets® Ascriptin® Enteric Adult Low Strength Ascriptin® Enteric Regular Strength Ascriptin® Maximum Extra Strength Caplets® Ascriptin® Regular Strength Aspergum® Bayer ® Aspirin with Calcium Regimen Caplets® Bayer® Aspirin Arthritis Pain Regimen Extra Strength Caplets® Bayer® Aspirin Caplets® Bayer® Aspirin Extra Strength Caplets® Bayer® Aspirin Extra Strength Gelcaps® Bayer® Aspirin Extra Strength Tablets Bayer® Aspirin Gelcaps® Bayer® Aspirin Plus Buffered Extra Strength Caplets® Bayer® Aspirin Regimen Adult Low Strength Bayer® Aspirin Regimen Children's Chewable Bayer® Aspirin Regimen Regular Strength Caplets® Bayer® Aspirin Tablets Bufferin® Arthritis Strength Caplets® Bufferin® Enteric Low Dose Caplets® Bufferin® Extra Strength Bufferin® Tablets Darvon® Compound Pulvules® Easprin® Ecotrin® Ecotrin® Adult Low Strength Ecotrin® Maximum Strength Endodan® Excedrin® Extra-Strength Caplets® Excedrin® Extra-Strength Geltabs Excedrin® Extra-Strength Tablets Excedrin® Migraine Caplets® Excedrin® Migraine Geltabs Excedrin® Migraine Tablets Gelpirin® Genacote® Genacote® Maximum Strength Goody's® Body Pain Powders Goody's® Extra Strength Headache Powders Goody's® Extra Strength Tablets Halfprin® Magnaprin® Arthritis Strength Magnaprin® Improved Norwich® Aspirin Norwich® Aspirin Maximum Strength PC-CAP® Percodan® Percodan®-Demi Roxiprin® St. Joseph® Aspirin Adult Chewable® Supac® Sureprin® Talwin® Compound Caplets® Vanquish® Caplets® ZORprin®", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What information is available regarding fever during relapses?", "role": "user" }, { "content": "Wearing proper clothing and insect repellent will help prevent infection. Lice and tick control in high-risk areas is another important public health measure.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the history and what are the symptoms of disseminated intravascular coagulation?", "role": "user" }, { "content": "Patients with DIC may have a history of abruptio placentae, amniotic fluid embolism, aortic aneurysm, blood transfusion reaction, drug exposure (e.g. amphetamines), eclampsia, giant hemangioma, graft-versus-host disease, HELLP syndrome, hemolytic transfusion reaction, liver disease, malignancy (especially acute promyelocytic leukemia), sepsis (esp. gram-negative bacteria), severe allergic reaction, transplant rejection, trauma (e.g. fat embolism, head injury), venomous snake and viral hemorrhagic fever.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What information does an MRI of the parathyroid gland provide regarding cancer?", "role": "user" }, { "content": "Assess the central part of the chest cavity (the mediastinum) Identify distant metastases", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What does the term Otospondylomegaepiphyseal dysplasia mean?", "role": "user" }, { "content": "Otospondylomegaepiphyseal dysplasia (OSMED) is an autosomal recessive disorder of bone growth that results in skeletal abnormalities, severe hearing loss, and distinctive facial features. The name of the condition indicates that it affects hearing (oto-) and the bones of the spine (spondylo-), and enlarges the ends of bones (megaepiphyses).", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What is the meaning of cardiotoxicity, and what are its typical features?", "role": "user" }, { "content": "Cardiotoxicity is the occurrence of heart muscle damage. The heart becomes weaker and is not as efficient in pumping and therefore circulating blood. Cardiotoxicity may be caused by chemotherapy treatment, complications from anorexia nervosa, drugs or chemical toxins.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What are the definitions of bleeding complications for patients with unstable angina, non-ST elevation myocardial infarction, and transfusion?", "role": "user" }, { "content": "Major bleeding:\r\nLife-threatening (fatal, intracranial, requiring surgical intervention or 4 units of blood or plasma expanders) Other major bleeding episodes (any event requiring transfusion of 2 or 3 units or judged to be disabling)\r\nMinor Bleeding: All other bleeding events", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "Which surgery is performed to treat endometrial hyperplasia?", "role": "user" }, { "content": "Total hysterectomy is curative for atypical endometrial hyperplasia or endometrial intraepithelial neoplasia. Surgery may also provide an opportunity for an intraoperative assessment of a concurrent carcinoma. Total hysterectomy may not be an option for patients who desire pregnancy or those unfit to undergo surgery and are treated conservatively.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What does the term \"inferior\" mean in relation to myocardial infarction?", "role": "user" }, { "content": "Inferior MI results from the total occlusion of either the right coronary artery in 85% of the cases or the left circumflex in 15% of the cases.\r\nShown below are an animated image and a static image depicting PERFUSE grade 6 thrombus in the RCA. Encircled in yellow in the image on the right is the thrombus area where you can notice an abrupt blunt cut-off appearance beyond which no dye is penetrating the artery.\r\n\r\nShown below are two animated images of the same case depicting TIMI grade 6 thrombus in the left circumflex. The image on the left shows the same thrombus before PCI and the image on the left shows the patent left circumflex after PCI.", "role": "assistant" } ]

[ { "content": "Answer the question truthfully, you are a medical professional.", "role": "system" }, { "content": "What factors increase the risk of developing pneumoconiosis?", "role": "user" }, { "content": "Risk factors in the development of pneumoconiosis are occupational. \r\nCommon risk factors in the development of pneumoconiosis include: Stonemasons, quarry workers, tunnellers, foundry, pottery workers (Silicosis) Construction workers Length of employment positively correlates Drilling Mining Sandblasting Concomitant smoking Textiles Shipbuilding Electronic shops Automotive industry Aerospace\r\nLess common risk factors in the development of pneumoconiosis include: Environmental exposure in buildings Community-acquired in neighborhoods", "role": "assistant" } ]