Druvith/medqa1 huggingface dataset:
Question:  What is (are) Graves' Disease ?
Answer: Graves ophthalmopathy is a condition associated with Graves disease that occurs when cells from the immune system attack the muscles and other tissues around the eyes.
                
The result is inflammation and a buildup of tissue and fat behind the eye socket, causing the eyeballs to bulge out. Rarely, inflammation is severe enough to compress the optic nerve that leads to the eye, causing vision loss.
                
Other GO symptoms are
                
- dry, gritty, and irritated eyes  - puffy eyelids  - double vision  - light sensitivity  - pressure or pain in the eyes  - trouble moving the eyes
                
About 25 to 30 percent of people with Graves disease develop mild GO, and 2 to 5 percent develop severe GO.1 This eye condition usually lasts 1 to 2 years and often improves on its own.
                
GO can occur before, at the same time as, or after other symptoms of hyperthyroidism develop and may even occur in people whose thyroid function is normal. Smoking makes GO worse.
                
1Yeung SJ, Habra MA, Chiu AC. Graves disease. emedicine website. emedicine.medscape.com/article/120619-overview. Updated 2010. Accessed December 10, 2011.
Question:  How to diagnose Graves' Disease ?
Answer: Health care providers can sometimes diagnose Graves disease based only on a physical examination and a medical history. Blood tests and other diagnostic tests, such as the following, then confirm the diagnosis.
                
TSH test. The ultrasensitive TSH test is usually the first test performed. This test detects even tiny amounts of TSH in the blood and is the most accurate measure of thyroid activity available.
                
T3 and T4 test. Another blood test used to diagnose Graves disease measures T3 and T4 levels. In making a diagnosis, health care providers look for below-normal levels of TSH, normal to elevated levels of T4, and elevated levels of T3.
                
Because the combination of low TSH and high T3 and T4 can occur with other thyroid problems, health care providers may order other tests to finalize the diagnosis. The following two tests use small, safe doses of radioactive iodine because the thyroid uses iodine to make thyroid hormone.
                
Radioactive iodine uptake test. This test measures the amount of iodine the thyroid collects from the bloodstream. High levels of iodine uptake can indicate Graves disease.
                
Thyroid scan. This scan shows how and where iodine is distributed in the thyroid. With Graves disease the entire thyroid is involved, so the iodine shows up throughout the gland. Other causes of hyperthyroidism such as nodulessmall lumps in the glandshow a different pattern of iodine distribution.
                
TSI test. Health care providers may also recommend the TSI test, although this test usually isnt necessary to diagnose Graves disease. This test, also called a TSH antibody test, measures the level of TSI in the blood. Most people with Graves disease have this antibody, but people whose hyperthyroidism is caused by other conditions do not.
                
More information about testing for thyroid problems is provided in the NIDDK health topic, Thyroid Tests.
Question:  What are the treatments for Graves' Disease ?
Answer: Treatment for Graves disease can sometimes affect pregnancy. After treatment with surgery or radioactive iodine, TSI antibodies can still be present in the blood, even when thyroid levels are normal. If a pregnant woman has received either of these treatments prior to becoming pregnant, the antibodies she produces may travel across the placenta to the babys bloodstream and stimulate the fetal thyroid.
                
A pregnant woman who has been treated with surgery or radioactive iodine should inform her health care provider so her baby can be monitored for thyroid-related problems later in the pregnancy. Pregnant women may safely be treated with anti-thyroid medications.
                
For more information about pregnancy and anti-thyroid medications, see Medications under the section titled How is Graves disease treated?More information about pregnancy and thyroid disease is provided in the NIDDK health topic, Pregnancy and Thyroid Disease.
Question:  What to do for Graves' Disease ?
Answer: Experts recommend that people eat a balanced diet to obtain most nutrients. More information about diet and nutrition is provided by the National Agricultural Library available at www.nutrition.gov.
                
Dietary Supplements
                
Iodine is an essential mineral for the thyroid. However, people with autoimmune thyroid disease may be sensitive to harmful side effects from iodine. Taking iodine drops or eating foods containing large amounts of iodinesuch as seaweed, dulse, or kelpmay cause or worsen hyperthyroidism. More information about iodine is provided by the National Library of Medicine in the fact sheet, Iodine in diet, available at www.nlm.nih.gov/medlineplus.
                
Women need more iodine when they are pregnantabout 250 micrograms a daybecause the baby gets iodine from the mothers diet. In the United States, about 7 percent of pregnant women may not get enough iodine in their diet or through prenatal vitamins.3 Choosing iodized saltsalt supplemented with iodineover plain salt and prenatal vitamins containing iodine will ensure this need is met.
                
To help ensure coordinated and safe care, people should discuss their use of dietary supplements, such as iodine, with their health care provider. Tips for talking with health care providers are available through the National Center for Complementary and Integrative Health.
                
3 Zimmerman MB. Iodine deficiency in pregnancy and the effects of maternal iodine supplementation on the offspring: a review. American Journal of Clinical Nutrition. 2009;89(2):668S672S.
Question:  What to do for Graves' Disease ?
Answer: - Graves disease is the most common cause of hyperthyroidism in the United States.  - In Graves disease, the immune system stimulates the thyroid gland to make too much thyroid hormone.  - Common symptoms of hyperthyroidism include nervousness or irritability, fatigue or muscle weakness, heat intolerance, trouble sleeping, hand tremors, rapid and irregular heartbeat, frequent bowel movements or diarrhea, weight loss, and goiter.  - People with Graves disease may also have bulging eyes, a condition called Graves ophthalmopathy (GO).  - Graves disease is most often treated with radioiodine therapy, which gradually destroys the cells that make up the thyroid gland. Anti-thyroid medications and surgery to remove the thyroid are sometimes used.  - The eye problems associated with Graves disease may require separate treatment.  - A pregnant woman who has been treated with surgery or radioactive iodine prior to becoming pregnant should inform her health care provider so her baby can be monitored for thyroid-related problems later in the pregnancy.
Question:  What is (are) Diabetic Kidney Disease ?
Answer: Diabetic kidney disease, also called diabetic nephropathy, is kidney disease caused by diabetes. Even when well controlled, diabetes can lead to chronic kidney disease (CKD) and kidney failure, described as end-stage kidney disease or ESRD when treated with a kidney transplant or blood-filtering treatments called dialysis.
                
Diabetes affects 25.8 million people of all ages in the United States.1 As many as 40 percent of people who have diabetes are expected to develop CKD.2 Diabetes, the most common cause of kidney failure in the United States, accounts for nearly 44 percent of new cases of kidney failure, as illustrated in Figure 1.3
Question:  What is (are) Diabetic Kidney Disease ?
Answer: The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the two kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid. The urine flows from the kidneys to the bladder through tubes called ureters. The bladder stores urine.
                
When the bladder empties, urine flows out of the body through a tube called the urethra, located at the bottom of the bladder. In men the urethra is long, while in women it is short.
                
Kidneys work at the microscopic level. The kidney is not one large filter. Each kidney is made up of about a million filtering units called nephrons. Each nephron filters a small amount of blood. The nephron includes a filter, called the glomerulus, and a tubule. The nephrons work through a two-step process. The glomerulus lets fluid and waste products pass through it; however, it prevents blood cells and large molecules, mostly proteins, from passing. The filtered fluid then passes through the tubule, which sends needed minerals back to the bloodstream and removes wastes. The final product becomes urine.
Question:  What is (are) Diabetic Kidney Disease ?
Answer: Diabetes is a complex group of diseases with a variety of causes. People with diabetes have high blood glucose, also called high blood sugar or hyperglycemia.
                
Diabetes is a disorder of metabolism the way the body uses digested food for energy. The digestive tract breaks down carbohydratessugars and starches found in many foodsinto glucose, a form of sugar that enters the bloodstream. With the help of the hormone insulin, cells throughout the body absorb glucose and use it for energy.
                
Insulin is made in the pancreas, an organ located behind the stomach and below the liver. As blood glucose levels rise after a meal, the pancreas is triggered to release insulin. The pancreas contains clusters of cells called pancreatic islets. Beta cells within the pancreatic islets make insulin and release it into the blood.
                
Diabetes develops when the body doesnt make enough insulin, is not able to use insulin effectively, or both. As a result, glucose builds up in the blood instead of being absorbed by cells in the body. The bodys cells are then starved of energy despite high blood glucose levels.
Question:  What are the symptoms of Diabetic Kidney Disease ?
Answer: People with diabetic kidney disease do not have symptoms in the early stages. As kidney disease progresses, a person can develop edema, or swelling. Edema happens when the kidneys cannot get rid of the extra fluid and salt in the body. Edema can occur in the legs, feet, or ankles and less often in the hands or face. Once kidney function decreases further, symptoms may include
                
- appetite loss  - nausea  - vomiting  - drowsiness, or feeling tired  - trouble concentrating  - sleep problems  - increased or decreased urination  - generalized itching or numbness  - dry skin  - headaches  - weight loss  - darkened skin  - muscle cramps  - shortness of breath  - chest pain
Question:  How to diagnose Diabetic Kidney Disease ?
Answer: A health care provider diagnoses diabetic kidney disease based on
                
- a medical and family history  - a physical exam  - urine tests  - a blood test
                
Medical and Family History
                
Taking a medical and family history is one of the first things a health care provider may do to help diagnose diabetic kidney disease. He or she will ask about the symptoms and the patients diabetes history.
                
Physical Exam
                
After taking a medical and family history, a health care provider will perform a physical exam. During a physical exam, a health care provider usually
                
- examines the patients body to check for changes in skin color  - taps on specific areas of the patients body, checking for swelling of the feet, ankles, or lower legs
                
Urine Tests
                
Dipstick test for albumin. A dipstick test performed on a urine sample can detect the presence of albumin in the urine. A patient collects the urine sample in a special container in a health care providers office or a commercial facility. The office or facility tests the sample onsite or sends it to a lab for analysis. For the test, a nurse or technician places a strip of chemically treated paper, called a dipstick, into the urine. Patches on the dipstick change color when blood or protein is present in urine.
                
Urine albumin-to-creatinine ratio. A health care provider uses this measurement to estimate the amount of albumin passed into the urine over a 24-hour period. The patient collects a urine sample during an appointment with the health care provider. Creatinine is a waste product that is filtered in the kidneys and passed into the urine. A high urine albumin-to-creatinine ratio indicates that the kidneys are leaking large amounts of albumin into the urine. A urine albumin-to-creatinine ratio above 30 mg/g may be a sign of kidney disease.
                
Blood Test
                
A blood test involves having blood drawn at a health care providers office or a commercial facility and sending the sample to a lab for analysis. A health care provider may order a blood test to estimate how much blood the kidneys filter each minute, called the estimated glomerular filtration rate (eGFR). The results of the test indicate the following:
                
- eGFR of 60 or above is in the normal range  - eGFR below 60 may indicate kidney damage  - eGFR of 15 or below may indicate kidney failure
Question:  How to diagnose Diabetic Kidney Disease ?
Answer: People with diabetes should get regular screenings for kidney disease. The National Kidney Disease Education Program recommends the following:
                
- urine albumin-to-creatinine ratio measured at least once a year in all people with type 2 diabetes and people who have had type 1 diabetes for 5 years or more  - eGFR calculated at least once a year in all people with type 1 or type 2 diabetes
Question:  What are the treatments for Diabetic Kidney Disease ?
Answer: A health care provider may treat kidney failure due to diabetic kidney disease with dialysis or a kidney transplant. In some cases, people with diabetic kidney disease receive kidney and pancreas transplants.
                
In most cases, people with diabetic kidney disease start dialysis earlier than people with kidney failure who do not have diabetes. People with diabetic end-stage kidney disease who receive a kidney transplant have a much better survival rate than those people on dialysis, although survival rates for those on dialysis have increasingly improved over time. However, people who receive a kidney transplant and do not have diabetes have a higher survival rate than people with diabetic kidney disease who receive a transplant.5
                
More information about treatment options for kidney failure is provided in the NIDDK health topics:
                
- Treatment Methods for Kidney Failure: Hemodialysis  - Treatment Methods for Kidney Failure: Peritoneal Dialysis  - Treatment Methods for Kidney Failure: Transplantation
Question:  What are the treatments for Diabetic Kidney Disease ?
Answer: People with diabetes should work with their health care team to prevent or manage CKD through the following steps:
                
- measure A1C levelsa blood test that provides information about a persons average blood glucose levels for the previous 3 months at least twice a year and keep A1C levels below 7 percent  - learn about insulin injections, diabetes medications, meal planning, physical activity, and blood glucose monitoring  - find out whether protein, salt, or liquid should be limited in the diet  - see a registered dietitian to help with meal planning  - check blood pressure every visit with a health care provider or at least two to four times a year  - learn about possible benefits from taking an ACE inhibitor or an ARB if a person has high blood pressure  - measure eGFR at least once a year to check kidney function  - get the amount of protein in the urine tested at least once a year to check for kidney damage
Question:  What to do for Diabetic Kidney Disease ?
Answer: - Diabetic kidney disease, also called diabetic nephropathy, is kidney disease caused by diabetes.  - People with diabetes have high blood glucose, also called high blood sugar or hyperglycemia.  - At the onset of diabetes, blood flow into the kidneys increases, which may strain the glomeruli and lessen their ability to filter blood.  - Higher levels of blood glucose lead to the buildup of extra material in the glomeruli, which increases the force of the blood moving through the kidneys and creates stress in the glomeruli.  - Many people with diabetes can develop high blood pressure, another factor in the development of kidney disease. High blood pressure, also called hypertension, is an increase in the amount of force that blood places on blood vessels as it moves through the entire body.  - Diabetic kidney disease takes many years to develop.  - People with diabetic kidney disease do not have any symptoms in the early stages. As kidney disease progresses, a person can develop edema, or swelling. Edema happens when the kidneys cannot get rid of the extra fluid and salt in the body. Edema can occur in the legs, feet, or ankles and less often in the hands or face.  - Once kidney function decreases further, symptoms may include      - appetite loss    - nausea    - vomiting    - drowsiness, or feeling tired    - trouble concentrating    - sleep problems    - increased or decreased urination    - generalized itching or numbness    - dry skin    - headaches    - weight loss    - darkened skin    - muscle cramps    - shortness of breath    - chest pain    - People can prevent or slow the progression of diabetic kidney disease by      - taking medication to control high blood pressure    - managing blood glucose levels    - making changes in their eating, diet, and nutrition    - losing weight if they are overweight or obese    - getting regular physical activity
Question:  What is (are) Simple Kidney Cysts ?
Answer: Simple kidney cysts are abnormal, fluid-filled sacs that form in the kidneys. Simple kidney cysts are different from the cysts that develop when a person has polycystic kidney disease (PKD), which is a genetic disorder. Simple kidney cysts do not enlarge the kidneys, replace their normal structure, or cause reduced kidney function like cysts do in people with PKD.
                
Simple kidney cysts are more common as people age. An estimated 25 percent of people 40 years of age and 50 percent of people 50 years of age have simple kidney cysts.1
Question:  What is (are) Simple Kidney Cysts ?
Answer: The kidneys are two bean-shaped organs, each about the size of a fist. They are located near the middle of the back, just below the rib cage, one on each side of the spine. Every day, the two kidneys process about 200 quarts of blood to filter out about 1 to 2 quarts of urine, composed of waste products and extra water. The urine flows from the kidneys to the bladder through tubes called ureters. The bladder stores urine until releasing it through urination.
Question:  What causes Simple Kidney Cysts ?
Answer: The cause of simple kidney cysts is not fully understood. Obstruction of tubulestiny structures within the kidneys that collect urineor deficiency of blood supply to the kidneys may play a role. Diverticulasacs that form on the tubulesmay detach and become simple kidney cysts. The role of genetic factors in the development of simple kidney cysts has not been studied.
Question:  What are the symptoms of Simple Kidney Cysts ?
Answer: Simple kidney cysts usually do not cause symptoms or harm the kidneys. In some cases, however, pain can occur between the ribs and hips when cysts enlarge and press on other organs. Sometimes cysts become infected, causing fever, pain, and tenderness. Simple kidney cysts are not thought to affect kidney function, but one study found an association between the presence of cysts and reduced kidney function in hospitalized people younger than 60 years of age.1 Some studies have found a relationship between simple kidney cysts and high blood pressure. For example, high blood pressure has improved in some people after a large cyst was drained. However, this relationship is not well understood.2
Question:  How to diagnose Simple Kidney Cysts ?
Answer: Most simple kidney cysts are found during imaging tests done for other reasons. When a cyst is found, the following imaging tests can be used to determine whether it is a simple kidney cyst or another, more serious condition. These imaging tests are performed at an outpatient center or hospital by a specially trained technician, and the images are interpreted by a radiologista doctor who specializes in medical imaging. Ultrasound may also be performed in a health care providers office. Anesthesia is not needed though light sedation may be used for people with a fear of confined spaces who undergo magnetic resonance imaging (MRI).
                
- Ultrasound. Ultrasound uses a device, called a transducer, that bounces safe, painless sound waves off organs to create an image of their structure. An abdominal ultrasound can create images of the entire urinary tract. The images can be used to distinguish harmless cysts from other problems.  - Computerized tomography (CT) scan. CT scans use a combination of x rays and computer technology to create three-dimensional (3-D) images. A CT scan may include the injection of a special dye, called contrast medium. CT scans require the person to lie on a table that slides into a tunnel-shaped device where the x rays are taken. CT scans can show cysts and tumors in the kidneys.  - MRI. MRI machines use radio waves and magnets to produce detailed pictures of the bodys internal organs and soft tissues without using x rays. An MRI may include the injection of contrast medium. With most MRI machines, the person lies on a table that slides into a tunnel-shaped device that may be open ended or closed at one end; some newer machines are designed to allow the person to lie in a more open space. Like CT scans, MRIs can show cysts and tumors.
Question:  What are the treatments for Simple Kidney Cysts ?
Answer: Treatment is not needed for simple kidney cysts that do not cause any symptoms. Simple kidney cysts may be monitored with periodic ultrasounds.
                
Simple kidney cysts that are causing symptoms or blocking the flow of blood or urine through the kidney may need to be treated using a procedure called sclerotherapy. In sclerotherapy, the doctor punctures the cyst using a long needle inserted through the skin. Ultrasound is used to guide the needle to the cyst. The cyst is drained and then filled with a solution containing alcohol to make the kidney tissue harder. The procedure is usually performed on an outpatient basis with a local anesthetic.
                
If the cyst is large, surgery may be needed. Most surgeries can be performed using a laparoscopea special tool with a small, lighted video camera. The procedure is usually done under general anesthesia in a hospital. The surgeon drains the cyst and then removes or burns away its outer tissue. This type of surgery allows for a smaller incision and quicker recovery.
Question:  What to do for Simple Kidney Cysts ?
Answer: Eating, diet, and nutrition have not been shown to play a role in causing or preventing simple kidney cysts.
Question:  What to do for Simple Kidney Cysts ?
Answer: - Simple kidney cysts are abnormal, fluid-filled sacs that form in the kidneys.  - Simple kidney cysts usually do not cause symptoms or harm the kidneys.  - Most simple kidney cysts are found during imaging tests done for other reasons.  - Treatment is not needed for simple kidney cysts that do not cause any symptoms.  - Simple kidney cysts that are causing symptoms or blocking the flow of blood or urine through the kidney may need to be treated using sclerotherapy or surgery.