Shekswess/llama3_medquad_instruct_dataset huggingface dataset:
Question: What causes Prolactinoma ?
Answer: In some people, high blood levels of prolactin can be traced to causes other than prolactinoma.
                
Prescription drugs. Prolactin secretion in the pituitary is normally suppressed by the brain chemical dopamine. Drugs that block the effects of dopamine at the pituitary or deplete dopamine stores in the brain may cause the pituitary to secrete prolactin. These drugs include older antipsychotic medications such as trifluoperazine (Stelazine) and haloperidol (Haldol); the newer antipsychotic drugs risperidone (Risperdal) and molindone (Moban); metoclopramide (Reglan), used to treat gastroesophageal reflux and the nausea caused by certain cancer drugs; and less often, verapamil, alpha-methyldopa (Aldochlor, Aldoril), and reserpine (Serpalan, Serpasil), used to control high blood pressure. Some antidepressants may cause hyperprolactinemia, but further research is needed.
                
Other pituitary tumors. Other tumors arising in or near the pituitary may block the flow of dopamine from the brain to the prolactin-secreting cells. Such tumors include those that cause acromegaly, a condition caused by too much growth hormone, and Cushing's syndrome, caused by too much cortisol. Other pituitary tumors that do not result in excess hormone production may also block the flow of dopamine.
                
Hypothyroidism. Increased prolactin levels are often seen in people with hypothyroidism, a condition in which the thyroid does not produce enough thyroid hormone. Doctors routinely test people with hyperprolactinemia for hypothyroidism.
                
Chest involvement. Nipple stimulation also can cause a modest increase in the amount of prolactin in the blood. Similarly, chest wall injury or shingles involving the chest wall may also cause hyperprolactinemia.
Question: How to diagnose Prolactinoma ?
Answer: A doctor will test for prolactin blood levels in women with unexplained milk secretion, called galactorrhea, or with irregular menses or infertility and in men with impaired sexual function and, in rare cases, milk secretion. If prolactin levels are high, a doctor will test thyroid function and ask first about other conditions and medications known to raise prolactin secretion. The doctor may also request magnetic resonance imaging (MRI), which is the most sensitive test for detecting pituitary tumors and determining their size. MRI scans may be repeated periodically to assess tumor progression and the effects of therapy. Computerized tomography (CT) scan also gives an image of the pituitary but is less precise than the MRI.
                
The doctor will also look for damage to surrounding tissues and perform tests to assess whether production of other pituitary hormones is normal. Depending on the size of the tumor, the doctor may request an eye exam with measurement of visual fields.
Question: What is (are) Intestinal Pseudo-obstruction ?
Answer: Intestinal pseudo-obstruction is a rare condition with symptoms that resemble those caused by a blockage, or obstruction, of the intestines, also called the bowel. However, when a health care provider examines the intestines, no blockage exists. Instead, the symptoms are due to nerve or muscle problems that affect the movement of food, fluid, and air through the intestines.
                
The intestines are part of the gastrointestinal (GI) tract and include the small intestine and the large intestine. The small intestine is the organ where most digestion occurs. The small intestine measures about 20 feet and includes the
                
- duodenum, the first part of the small intestine  - jejunum, the middle section of the small intestine  - ileum, the lower end of the small intestine
                
The large intestine absorbs water from stool and changes it from a liquid to a solid form, which passes out of the body during a bowel movement. The large intestine measures about 5 feet and includes the
                
- cecum, the first part of the large intestine, which is connected to the ileum  - colon, the part of the large intestine extending from the cecum to the rectum  - rectum, the lower end of the large intestine leading to the anus
Question: What causes Intestinal Pseudo-obstruction ?
Answer: Problems with nerves, muscles, or interstitial cells of Cajal cause intestinal pseudo-obstruction. Interstitial cells of Cajal are called pacemaker cells because they set the pace of intestinal contractions. These cells convey messages from nerves to muscles.
                
Problems with nerves, muscles, or interstitial cells of Cajal prevent normal contractions of the intestines and cause problems with the movement of food, fluid, and air through the intestines.
                
Primary or idiopathic intestinal pseudo-obstruction is intestinal pseudo-obstruction that occurs by itself. In some people with primary intestinal pseudo-obstruction, mutations, or changes, in genestraits passed from parent to childcause the condition. However, health care providers do not typically order genetic testing for an intestinal pseudo-obstruction, as they dont commonly recognize gene mutations as a cause.
                
Some people have duplications or deletions of genetic material in the FLNA gene. Researchers believe that these genetic changes may impair the function of a protein, causing problems with the nerve cells in the intestines.1 As a result, the nerves cannot work with the intestinal muscles to produce normal contractions that move food, fluid, and air through the digestive tract. Also, these genetic changes may account for some of the other signs and symptoms that can occur with intestinal pseudo-obstruction, such as bladder symptoms and muscle weakness.
                
A condition called mitochondrial neurogastrointestinal encephalopathy may also cause primary intestinal pseudo-obstruction. In people with this condition, mitochondriastructures in cells that produce energydo not function normally. Mitochondrial neurogastrointestinal encephalopathy can also cause other symptoms, such as problems with nerves in the limbs and changes in the brain.
                
Secondary intestinal pseudo-obstruction develops as a complication of another medical condition. Causes of secondary intestinal pseudo-obstruction include
                
- abdominal or pelvic surgery  - diseases that affect muscles and nerves, such as lupus erythematosus, scleroderma, and Parkinsons disease  - infections  - medications, such as opiates and antidepressants, that affect muscles and nerves  - radiation to the abdomen  - certain cancers, including lung cancer
Question: What are the symptoms of Intestinal Pseudo-obstruction ?
Answer: Intestinal pseudo-obstruction symptoms may include
                
- abdominal swelling or bloating, also called distension  - abdominal pain  - nausea  - vomiting  - constipation  - diarrhea
                
Over time, the condition can cause malnutrition, bacterial overgrowth in the intestines, and weight loss. Malnutrition is a condition that develops when the body does not get the right amount of the vitamins, minerals, and other nutrients it needs to maintain healthy tissues and organ function.
                
Some people develop problems with their esophagus, stomach, or bladder.
Question: What is (are) What I need to know about Erectile Dysfunction ?
Answer: Erectile dysfunction* is when you cannot get or keep an erection firm enough to have sex. You may have ED if you
                
- can get an erection sometimes, though not every time  - can get an erection, yet it does not last long enough for sex  - are unable to get an erection at all
                
ED is sometimes called impotence; however, doctors use this term less often now.
                

                
*See the Pronunciation Guide for tips on how to say the words in bold type.
Question: What causes What I need to know about Erectile Dysfunction ?
Answer: Erectile dysfunction often has more than one cause. Many diseases can damage nerves, arteries, and muscles. Some can lead to ED, such as
                
- high blood pressure  - diabetes, when your blood glucose, also called blood sugar, is too high  - clogged arteries  - heart and blood vessel disease  - chronic kidney disease  - multiple sclerosis, a disease that attacks the nerves  - treatments for prostate cancer, including radiation, surgery to remove the prostate, and hormone treatments  - injury to the penis, spinal cord, prostate, bladder, or pelvis  - surgery for bladder cancer  - Peyronies disease, in which scar tissue, called a plaque, forms in the penis
                
Unhealthy lifestyle choices, such as smoking, drinking too much alcohol, using illegal drugs, being overweight, and not exercising, can lead to ED.
                
Mental health problems such as the following can also cause or worsen ED:
                
- depression  - fear of sexual failure  - guilt  - low self-esteem  - stress  - worry
                
Even when ED has a physical cause, mental health problems can make ED worse. For example, a physical problem may slow your sexual arousal, which may make you more nervous and worsen your ED.
                
In addition, ED can be a side effect of many common medicines. A small number of ED cases result from low testosterone, a male hormone.
Question: Who is at risk for What I need to know about Erectile Dysfunction? ?
Answer: Erectile dysfunction affects men of all races and in all parts of the world. Men are more likely to have ED as they get older. For example, ED occurs in
                
- about 12 percent of men younger than 60  - 22 percent of men age 60 to 69  - 30 percent of men age 70 or older
Question: What causes What I need to know about Erectile Dysfunction ?
Answer: Having ED can cause you to feel depressed or anxious. ED may also cause low self-esteem. When you have ED, you may not have a satisfying sex life. You may not feel as close with your sexual partner, which may strain your relationship.
                

                
See Your Doctor if You Have Erectile Dysfunction, as Erectile Dysfunction Could Mean You Have a More Serious Condition   If you have problems getting or keeping an erection, and the problems last for more than a few weeks, you should talk with your doctor. ED can be a sign of other health problems, such as diabetes or heart disease.   When you meet with your doctor, you might use phrases like, Ive been having problems in the bedroom or Ive been having erection problems. Remember that a healthy sex life is part of a healthy life. Dont be shy about seeking help. Your doctor treats medical problems every day.   If talking with your doctor doesnt put you at ease, ask for a referral to another doctor. Your doctor may send you to a urologista doctor who specializes in sexual and urinary problems.
Question: How to prevent What I need to know about Erectile Dysfunction ?
Answer: You can prevent many of the causes of ED by making healthy lifestyle choices. Following a healthy diet may help prevent ED. Quitting smoking and getting physical activity are also important ways to prevent ED.
                
Physical activity increases blood flow throughout your body, including your penis. Talk with your doctor before starting new activities. If you have not been active, start slow, with easier activities such as walking at a normal pace or gardening. Then you can work up to harder activities such as walking briskly or swimming. Try to aim for at least 30 minutes of activity most days of the week.
Question: What is (are) What I need to know about Diverticular Disease ?
Answer: Diverticular* disease affects the colon. The colon is part of the large intestine that removes waste from your body. Diverticular disease is made up of two conditions: diverticulosis and diverticulitis. Diverticulosis occurs when pouches, called diverticula, form in the colon. These pouches bulge out like weak spots in a tire. Diverticulitis occurs if the pouches become inflamed.
                
*See the Pronunciation Guide for tips on how to say the words in bold type.
Question: What are the symptoms of What I need to know about Diverticular Disease ?
Answer: The symptoms for diverticulosis and diverticulitis are different.
                
Diverticulosis. Many people don't have symptoms, but some people have cramping, bloating, and constipation. Some people also have bleeding, inflammation, and fistulas. If you are bleeding, bright red blood will pass through your rectum. The rectum is the end of the colon that connects to the anus. The rectum and anus are part of the gastrointestinal tract, which is the passage that food goes through. Rectal bleeding is usually painless, but it can be dangerous. You should see a doctor right away.
                
Diverticulitis. People with diverticulitis can have many symptoms. Often pain is felt in the lower part of the abdomen. If you have diverticulitis, you may have fevers, feel sick to your stomach, vomit, or have a change in your bowel habits.
Question: What are the treatments for What I need to know about Diverticular Disease ?
Answer: A doctor may prescribe antibiotics and recommend following a liquid diet. Most people get better with this treatment. Some people may need surgery and other treatments.
                
- Surgery. Serious problems from diverticulitis are treated with surgery. Surgeons can clean the abdomen after infections and remove bleeding pouches and fistulas.  - Colon resection. If you get diverticulitis many times, your doctor might suggest taking out the part of the colon with diverticula. The healthy sections can be joined together. With the diverticula gone, you may avoid other infections.  - Emergency surgery. If you have severe problems, you may need emergency surgery to clear the infection and remove part of the colon. Later, a second surgery rejoins the healthy sections of the colon. The colon is separated for a brief time between surgeries, because rejoining the colon during the first surgery is not always safe. A temporary colostomy is needed between the two surgeries. A colostomy is an opening made on the abdomen where a plastic bag is connected to collect stool after food is digested. The surgeon makes the opening, called a stoma, and connects it to the end of the colon.
Question: What is (are) What I need to know about Diverticular Disease ?
Answer: Eat a high-fiber diet to help prevent problems. Talk to your doctor about using fiber products like Benefiber, Citrucel, or Metamucil. Daily use can help you get the fiber you need if you do not get it through your diet.
                
Ask your doctor about which food choices are right for you.
                
Eating foods high in fiber is simple and can help reduce diverticular disease symptoms and problems.
                
Try eating more of the following:
                
- Fruit. Raw apples, peaches, pears, and tangerines.  - Vegetables. Fresh broccoli, squash, carrots, and brussels sprouts.  - Starchy vegetables. Potatoes, baked beans, kidney beans, and lima beans.  - Grains. Whole-wheat bread, brown rice, bran flake cereal, and oatmeal.
                
Talk with your doctor about making diet changes. Learn what to eat and how to put more of these high-fiber foods in your diet.
Question: What is (are) Primary Sclerosing Cholangitis ?
Answer: PSC is a disease that damages and blocks bile ducts inside and outside the liver. Bile is a liquid made in the liver. Bile ducts are tubes that carry bile out of the liver to the gallbladder and small intestine. In the intestine, bile helps break down fat in food.
                
In PSC, inflammation of the bile ducts leads to scar formation and narrowing of the ducts over time. As scarring increases, the ducts become blocked. As a result, bile builds up in the liver and damages liver cells. Eventually, scar tissue can spread throughout the liver, causing cirrhosis and liver failure.
Question: What causes Primary Sclerosing Cholangitis ?
Answer: The causes of PSC are not known. Genes, immune system problems, bacteria, and viruses may play roles in the development of the disease.
                
PSC is linked to inflammatory bowel disease (IBD). About three out of four people with PSC have a type of IBD called ulcerative colitis. The link between PSC and IBD is not yet understood.
Question: What are the complications of Primary Sclerosing Cholangitis ?
Answer: PSC can lead to various complications, including
                
- deficiencies of vitamins A, D, E, and K  - infections of the bile ducts  - cirrhosisextensive scarring of the liver  - liver failure  - bile duct cancer
Question: How to diagnose Primary Sclerosing Cholangitis ?
Answer: Blood tests to check levels of liver enzymes are the first step in diagnosing PSC. Doctors confirm the diagnosis using cholangiography, which provides pictures of the bile ducts.
                
Cholangiography can be performed in the following ways:
                
-  Endoscopic retrograde cholangiopancreatography (ERCP). ERCP uses an endoscopea long, flexible, lighted tubethat goes down the mouth, beyond the stomach, and into the duodenum to reach an area in the digestive tract where dye can be injected into the bile ducts. X rays are taken when the dye is injected. ERCP also can be used to take a tissue sample or to treat blocked ducts. More information about ERCP is provided in the NIDDK health topic, ERCP (Endoscopic Retrograde Cholangiopancreatography).  -  Percutaneous transhepatic cholangiography. This procedure involves inserting a needle through the skin and placing a thin tube into a duct in the liver. Dye is injected through the tube and x rays are taken.  -  Magnetic resonance cholangiopancreatography (MRCP). MRCP uses magnetic resonance imaging (MRI) to obtain pictures of the bile ducts. MRI machines use radio waves and magnets to scan internal organs and tissues. MRCP does not involve using x rays or inserting instruments into the body. This safe and painless test is increasingly used for diagnosis.
                
Other testing may include ultrasound exams and a liver biopsy. Ultrasound uses sound waves to create images of organs inside the body. A biopsy involves removal of a small piece of tissue for examination with a microscope.
Question: What are the treatments for Primary Sclerosing Cholangitis ?
Answer: Although researchers have studied many treatments, none has been shown to cure or slow the progress of PSC. Treatment of PSC aims to relieve symptoms and manage complications. Medical treatment may include various medications to relieve itching, antibiotics to treat infections, and vitamin supplements. Instruments passed through an endoscope during ERCP can help open blocked bile ducts.
                
Liver transplantation may be an option if the liver begins to fail.
Question: What is (are) Prevent diabetes problems: Keep your nervous system healthy ?
Answer: Your nervous system carries signals between your brain and other parts of your body through your spinal cord. Nerves are bundles of special tissues that transmit these signals.
                
The signals share information between your brain and body about how things feel. The signals also send information between your brain and body to control automatic body functions, such as breathing and digestion, and to move your body parts.
                
The nerves in your spinal cord branch out to all of your organs and body parts. All your nerves together make up your nervous system.
                
Your nervous system is composed of the
                
- central nervous systemyour brain and spinal cord  - cranial* nervesnerves that connect your brain to your head, neck, and face  - peripheral nervous systemnerves that connect your spinal cord to your entire body, including your organs and your arms, hands, legs, and feet
                
*See the Pronunciation Guide for tips on how to say the the words in bold type.
Question: What are the treatments for Prevent diabetes problems: Keep your nervous system healthy ?
Answer: The treatment for nerve damage from diabetes is based on your symptoms. No treatment can reverse nerve damage; however, it can help you feel better. Your doctor might suggest taking low doses of medicines that both treat other health problems and help the pain of neuropathy. Some of these medicines include
                
- antidepressants  - anticonvulsants, or anti-seizure medicines
                
Other treatment options include
                
- creams or patches on your skin for burning pain  - over-the-counter pain medicines  - acupuncture, a form of pain treatment that uses needles inserted into your body at certain pressure points  - physical therapy, which helps with muscle weakness and loss of balance  - relaxation exercises, such as yoga  - special shoes to fit softly around sore feet or feet that have changed shape
                
Your doctor also can prescribe medicines to help with problems caused by nerve damage in other areas of your body, such as poor digestion, dizziness, sexual problems, and lack of bladder control.
                
Stopping smoking and drinking alcoholic beverages also may help with symptoms.
Question: What to do for Prevent diabetes problems: Keep your nervous system healthy ?
Answer: You can keep your nervous system healthy by taking these steps:
                
- Eat healthy meals and follow the meal plan that you and your doctor or dietitian have worked out.  - If you drink alcoholic beverages, limit your intake to no more than one drink per day for women and two drinks per day for men. Drinking too many alcoholic beverages can make nerve damage worse.
                
More information is provided in the NIDDK health topic, What I need to know about Eating and Diabetes.
Question: What is (are) Prevent diabetes problems: Keep your kidneys healthy ?
Answer: Blood pressure is the force of blood flow inside your blood vessels. Blood pressure is written with two numbers separated by a slash. For example, a blood pressure result of 130/80 is said as 130 over 80. The first number is the pressure in your blood vessels as your heart beats and pushes blood through your blood vessels. The second number is the pressure as your blood vessels relax between heartbeats.
                
High blood pressure forces your heart to work harder to pump blood. High blood pressure can strain your heart, damage your blood vessels, and increase your risk of heart attack, stroke, eye problems, and kidney problems.
Question: What are the symptoms of Prevent diabetes problems: Keep your kidneys healthy ?
Answer: In the early stages, diabetic kidney disease does not have any symptoms. Kidney disease happens so slowly that you may not feel sick at all for many years. You may not feel sick even when your kidneys do only half the job of healthy kidneys. Only your doctor can tell if you have kidney disease by checking the protein, or albumin, level in your urine at least once a year.
                
The first symptom of diabetic kidney disease is often swelling in parts of your body, such as your hands, face, feet, or ankles. Also, large amounts of protein in your urine may cause urine to look foamy. Once your kidney function starts to decrease, other symptoms may include
                
- increased or decreased urination  - feeling drowsy or tired  - feeling itchy or numb  - dry skin  - headaches  - weight loss  - not feeling hungry  - feeling sick to your stomach  - vomiting  - sleep problems  - trouble staying focused  - darkened skin  - muscle cramps