Shekswess/llama3_medquad_instruct_dataset huggingface dataset:
Question: What causes Kidney Stones in Children ?
Answer: Kidney stones can form when substances in the urinesuch as calcium, magnesium, oxalate, and phosphorousbecome highly concentrated due to one or more causes:
                
- Defects in the urinary tract may block the flow of urine and create pools of urine. In stagnant urine, stone-forming substances tend to settle together into stones. Up to one-third of children who have stones have an anatomic abnormality in their urinary tract.  - Kidney stones may have a genetic cause. In other words, the tendency to form stones can run in families due to inherited factors.  - An unhealthy lifestyle may make children more likely to have kidney stones. For example, drinking too little water or drinking the wrong types of fluids, such as soft drinks or drinks with caffeine, may cause substances in the urine to become too concentrated. Similarly, too much sodium, or salt, in the diet may contribute to more chemicals in the urine, causing an increase in stone formation. Some doctors believe increases in obesity rates, less active lifestyles, and diets higher in salt may be causing more children to have kidney stones.  - Sometimes, a urinary tract infection can cause kidney stones to form. Some types of bacteria in the urinary tract break down ureaa waste product removed from the blood by the kidneysinto substances that form stones.  - Some children have metabolic disorders that lead to kidney stones. Metabolism is the way the body uses digested food for energy, including the process of breaking down food, using foods nutrients in the body, and removing the wastes that remain. The most common metabolic disorder that causes kidney stones in children is hypercalciuria, which causes extra calcium to collect in the urine. Other more rare metabolic conditions involve problems breaking down oxalate, a substance made in the body and found in some foods. These conditions include hyperoxaluria, too much oxalate in the urine, and oxalosis, characterized by deposits of oxalate and calcium in the bodys tissues. Another rare metabolic condition called cystinuria can cause kidney stones. Cystinuria is an excess of the amino acid cystine in the urine. Amino acids are the building blocks of proteins.
Question: What is (are) Kidney Stones in Children ?
Answer: Four major types of kidney stones occur in children:
                
- Calcium stones are the most common type of kidney stone and occur in two major forms: calcium oxalate and calcium phosphate. Calcium oxalate stones are more common. Calcium oxalate stone formation has various causes, which may include high calcium excretion, high oxalate excretion, or acidic urine. Calcium phosphate stones are caused by alkaline urine.  - Uric acid stones form when the urine is persistently acidic. A diet rich in purinessubstances found in animal proteins such as meats, fish, and shellfishmay cause uric acid. If uric acid becomes concentrated in the urine, it can settle and form a stone by itself or along with calcium.  - Struvite stones result from kidney infections. Eliminating infected stones from the urinary tract and staying infectionfree can prevent more struvite stones.  - Cystine stones result from a genetic disorder that causes cystine to leak through the kidneys and into the urine in high concentration, forming crystals that tend to accumulate into stones.
Question: How to diagnose Kidney Stones in Children ?
Answer: The process of diagnosing any illness begins with consideration of the symptoms. Pain or bloody urine may be the first symptom. Urine, blood, and imaging tests will help determine whether symptoms are caused by a stone. Urine tests can be used to check for infection and for substances that form stones. Blood tests can be used to check for biochemical problems that can lead to kidney stones. Various imaging techniques can be used to locate the stone:
                
- 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 procedure is performed in a health care providers office, outpatient center, or hospital by a specially trained technician, and the images are interpreted by a radiologista doctor who specializes in medical imaging; anesthesia is not needed. The images can show the location of any stones. This test does not expose children to radiation, unlike some other imaging tests. Although other tests are more useful in detecting very small stones or stones in the lower portion of the ureter, ultrasound is considered by many health care providers to be the best screening test to look for stones.  - Computerized tomography (CT) scans use a combination of x rays and computer technology to create threedimensional (3-D) images. A CT scan may include the injection of a special dye, called contrast medium. CT scans require the child to lie on a table that slides into a tunnel-shaped device where the x rays are taken. The procedure is performed in an outpatient center or hospital by an x-ray technician, and the images are interpreted by a radiologist; anesthesia is not needed. CT scans may be required to get an accurate stone count when children are being considered for urologic surgery. Because CT scans expose children to a moderate amount of radiation, health care providers try to reduce radiation exposure in children by avoiding repeated CT scans, restricting the area scanned as much as possible, and using the lowest radiation dose that will provide the needed diagnostic information.  - X-ray machines use radiation to create images of the childs urinary tract. The images can be taken at an outpatient center or hospital by an x-ray technician, and the images are interpreted by a radiologist; anesthesia is not needed. The x rays are used to locate many kinds of stones. A conventional x ray is generally less informative than an ultrasound or CT scan, but it is less expensive and can be done more quickly than other imaging procedures.
Question: How to prevent Kidney Stones in Children ?
Answer: To prevent kidney stones, health care providers and their patients must understand what is causing the stones to form. Especially in children with suspected metabolic abnormalities or with recurrent stones, a 24-hour urine collection is obtained to measure daily urine volume and to determine if any underlying mineral abnormality is making a child more likely to form stones. Based on the analysis of the collected urine, the treatment can be individualized to address a metabolic problem.
                
In all circumstances, children should drink plenty of fluids to keep the urine diluted and flush away substances that could form kidney stones. Urine should be almost clear.
Question: What to do for Kidney Stones in Children ?
Answer: Families may benefit from meeting with a dietitian to learn how dietary management can help in preventing stones. Depending on the underlying cause of the stone formation, medications may be necessary to prevent recurrent stones. Dietary changes and medications may be required for a long term or, quite often, for life. Some common changes include the following:
                
- Children who tend to make calcium oxalate stones or have hypercalciuria should eat a regular amount of dietary calcium and limit salt intake. A thiazide diuretic medication may be given to some children to reduce the amount of calcium leaking into the urine.  - Children who have large amounts of oxalate in the urine may need to limit foods high in oxalate, such as chocolate, peanut butter, and dark-colored soft drinks.  - Children who form uric acid or cystine stones may need extra potassium citrate or potassium carbonate in the form of a pill or liquid medication. Avoiding foods high in purinessuch as meat, fish, and shellfishmay also help prevent uric acid stones.
Question: What is (are) Autoimmune Hepatitis ?
Answer: Autoimmune hepatitis is a chronicor long lastingdisease in which the body's immune system attacks the normal components, or cells, of the liver and causes inflammation and liver damage. The immune system normally protects people from infection by identifying and destroying bacteria, viruses, and other potentially harmful foreign substances.
                
Autoimmune hepatitis is a serious condition that may worsen over time if not treated. Autoimmune hepatitis can lead to cirrhosis and liver failure. Cirrhosis occurs when scar tissue replaces healthy liver tissue and blocks the normal flow of blood through the liver. Liver failure occurs when the liver stops working properly.
Question: What is (are) Autoimmune Hepatitis ?
Answer: Autoimmune diseases are disorders in which the body's immune system attacks the body's own cells and organs with proteins called autoantibodies; this process is called autoimmunity.
                
The body's immune system normally makes large numbers of proteins called antibodies to help the body fight off infections. In some cases, however, the body makes autoantibodies. Certain environmental triggers can lead to autoimmunity. Environmental triggers are things originating outside the body, such as bacteria, viruses, toxins, and medications.
Question: What is (are) Autoimmune Hepatitis ?
Answer: Autoimmune hepatitis is classified into several types. Type 1 autoimmune hepatitis is the most common form in North America. Type 1 can occur at any age; however, it most often starts in adolescence or young adulthood. About 70 percent of people with type 1 autoimmune hepatitis are female.1
                
People with type 1 autoimmune hepatitis commonly have other autoimmune disorders, such as
                
- celiac disease, an autoimmune disease in which people cannot tolerate gluten because it damages the lining of their small intestine and prevents absorption of nutrients  - Crohn's disease, which causes inflammation and irritation of any part of the digestive tract  - Graves' disease, the most common cause of hyperthyroidism in the United States  - Hashimoto's disease, also called chronic lymphocytic thyroiditis or autoimmune thyroiditis, a form of chronic inflammation of the thyroid gland  - proliferative glomerulonephritis, or inflammation of the glomeruli, which are tiny clusters of looping blood vessels in the kidneys  - primary sclerosing cholangitis, which causes irritation, scarring, and narrowing of the bile ducts inside and outside the liver  - rheumatoid arthritis, which causes pain, swelling, stiffness, and loss of function in the joints  - Sjgren's syndrome, which causes dryness in the mouth and eyes  - systemic lupus erythematosus, which causes kidney inflammation called lupus nephritis  - type 1 diabetes, a condition characterized by high blood glucose, also called blood sugar, levels caused by a total lack of insulin  - ulcerative colitis, a chronic disease that causes inflammation and sores, called ulcers, in the inner lining of the large intestine
                
Type 2 autoimmune hepatitis is less common and occurs more often in children than adults.1 People with type 2 can also have any of the above autoimmune disorders.
Question: What are the symptoms of Autoimmune Hepatitis ?
Answer: The most common symptoms of autoimmune hepatitis are
                
- fatigue  - joint pain  - nausea  - loss of appetite  - pain or discomfort over the liver  - skin rashes  - dark yellow urine  - light-colored stools  - jaundice, or yellowing of the skin and whites of the eyes
                
Symptoms of autoimmune hepatitis range from mild to severe. Some people may feel as if they have a mild case of the flu. Others may have no symptoms when a health care provider diagnoses the disease; however, they can develop symptoms later.
Question: How to diagnose Autoimmune Hepatitis ?
Answer: A health care provider will make a diagnosis of autoimmune hepatitis based on symptoms, a physical exam, blood tests, and a liver biopsy.
                
A health care provider performs a physical exam and reviews the person's health history, including the use of alcohol and medications that can harm the liver. A person usually needs blood tests for an exact diagnosis because a person with autoimmune hepatitis can have the same symptoms as those of other liver diseases or metabolic disorders.
                
Blood tests. A blood test involves drawing blood at a health care provider's office or a commercial facility and sending the sample to a lab for analysis. A person will need blood tests for autoantibodies to help distinguish autoimmune hepatitis from other liver diseases that have similar symptoms, such as viral hepatitis, primary biliary cirrhosis, steatohepatitis, or Wilson disease.
                
Liver biopsy. A liver biopsy is a procedure that involves taking a piece of liver tissue for examination with a microscope for signs of damage or disease. The health care provider may ask the patient to temporarily stop taking certain medications before the liver biopsy. He or she may also ask the patient to fast for 8 hours before the procedure.
                
During the procedure, the patient lies on a table, right hand resting above the head. A health care provider will apply a local anesthetic to the area where he or she will insert the biopsy needle. If needed, he or she will give sedatives and pain medication. Then, he or she will use a needle to take a small piece of liver tissue, and may use ultrasound, computerized tomography scans, or other imaging techniques to guide the needle. After the biopsy, the patient must lie on the right side for up to 2 hours and is monitored an additional 2 to 4 hours before being sent home.
                
A health care provider performs a liver biopsy at a hospital or an outpatient center. The liver sample is sent to a pathology lab where the pathologista doctor who specializes in diagnosing diseaselooks at the tissue with a microscope and sends a report to the patient's health care provider.
                
A health care provider can use liver biopsy to diagnose autoimmune hepatitis and determine if cirrhosis is present. People often have cirrhosis at the time they are diagnosed with autoimmune hepatitis. A health care provider can also use liver biopsy to look for changes in the severity of liver damage prior to ending treatment for autoimmune hepatitis.
Question: What is (are) Whipple Disease ?
Answer: Whipple disease is a rare bacterial infection that primarily affects the small intestine. The infection may spread to any organ in the body; however, it more commonly affects the
                
- joints  - central nervous system, which includes the brain, the spinal cord, and nerves located throughout the body  - heart  - eyes  - lungs
                
Left untreated, Whipple disease gets worse and is usually life threatening.
Question: What is (are) Whipple Disease ?
Answer: The small intestine is part of the upper gastrointestinal (GI) tract and is a tube-shaped organ between the stomach and large intestine. The upper GI tract also includes the mouth, esophagus, stomach, and duodenum, or the first part of the small intestine.
                
Most food digestion and nutrient absorption take place in the small intestine. The small intestine measures about 20 feet long and includes the duodenum, jejunum, and ileum. Villitiny, fingerlike protrusionsline the inside of the small intestine. Villi normally let nutrients from food be absorbed through the walls of the small intestine into the bloodstream.
Question: What are the symptoms of Whipple Disease ?
Answer: Signs and symptoms of Whipple disease can vary widely from person to person. The most common symptoms of Whipple disease are
                
- diarrhea  - weight loss caused by malabsorption
                
A person may not have diarrhea. Instead, other signs and symptoms of Whipple disease may appear, such as
                
- abnormal yellow and white patches on the lining of the small intestine  - joint pain, with or without inflammation, that may appear off and on for years before other symptoms  - fatty or bloody stools  - abdominal cramps or bloating felt between the chest and groin  - enlarged lymph nodesthe small glands that make infection-fighting white blood cells  - loss of appetite  - fever  - fatigue, or feeling tired  - weakness  - darkening of the skin
                
People with a more advanced stage of Whipple disease may have neurologic symptomsthose related to the central nervous systemsuch as
                
- vision problems.  - memory problems or personality changes.  - facial numbness.  - headaches.  - muscle weakness or twitching.  - difficulty walking.  - hearing loss or ringing in the ears.  - dementiathe name for a group of symptoms caused by disorders that affect the brain. People with dementia may not be able to think well enough to do normal activities such as getting dressed or eating.
                
Less common symptoms of Whipple disease may include
                
- chronic cough.  - chest pain.  - pericarditisinflammation of the membrane surrounding the heart.  - heart failurea long-lasting condition in which the heart cannot pump enough blood to meet the bodys needs. Heart failure does not mean the heart suddenly stops working.
Question: What are the complications of Whipple Disease ?
Answer: People with Whipple disease may have complications caused by malnutrition, which is due to damaged villi in the small intestine. As a result of delayed diagnosis or treatment, people may experience the following complications in other areas of the body:
                
- long-lasting nutritional deficiencies  - heart and heart valve damage  - brain damage
                
A person with Whipple disease may experience a relapsea return of symptoms. Relapse can happen years after treatment and requires repeat treatments.
Question: What are the treatments for Whipple Disease ?
Answer: The health care provider prescribes antibiotics to destroy the T. whipplei bacteria and treat Whipple disease. Health care providers choose antibiotics that treat the infection in the small intestine and cross the blood-brain barriera layer of tissue around the brain. Using antibiotics that cross the blood-brain barrier ensures destruction of any bacteria that may have entered the patients brain and central nervous system.
                
The health care provider usually prescribes IV antibiotics for the first 2 weeks of treatment. Most patients feel relief from symptoms within the first week or two. A nurse or technician places an IV in the patients arm to give the antibiotics. IV antibiotics used to treat Whipple disease may include
                
- ceftriaxone (Rocephin)  - meropenem (Merrem I.V.)  - penicillin G (Pfizerpen)  - streptomycin (Streptomycin)
                
After a patient completes the IV antibiotics, the health care provider will prescribe long-term oral antibiotics. Patients receive long-term treatmentat least 1 to 2 yearsto cure the infection anywhere in the body. Oral antibiotics may include
                
- trimethoprim/sulfamethoxazole (Septra, Bactrim)a combination antibiotic  - doxycycline (Vibramycin)
                
Patients should finish the prescribed course of antibiotics to ensure the medication destroyed all T. whipplei bacteria in the body. Patients who feel better may still have the bacteria in the small intestine or other areas of the body for 1 to 2 years. A health care provider will monitor the patient closely, repeat the blood tests, and repeat the upper GI endoscopy with biopsy during and after treatment to determine whether T. whipplei is still present.
                
People may relapse during or after treatment. A health care provider will prescribe additional or new antibiotics if a relapse occurs. Some people will relapse years after treatment, so it is important for patients to schedule routine follow-ups with the health care provider. Most patients have good outcomes with an early diagnosis and complete treatment.
                
Health care providers treat patients with neurologic symptoms at diagnosis or during relapse more aggressively. Treatment may include
                
- a combination of antibiotics  - hydroxychloroquine (Plaquenil)an antimalarial medication  - weekly injections of interferon gammaa substance made by the body that activates the immune system  - corticosteroidsmedications that decrease inflammation
Question: What to do for Whipple Disease ?
Answer: A person with Whipple disease and malabsorption may need
                
- a diet high in calories and protein  - vitamins  - nutritional supplements
Question: What is (are) Prolactinoma ?
Answer: A prolactinoma is a benign noncancerous tumor of the pituitary gland that produces a hormone called prolactin. Prolactinomas are the most common type of pituitary tumor. Symptoms of prolactinoma are caused by hyperprolactinemia --- too much prolactin in the blood --- or by pressure of the tumor on surrounding tissues.
                
Prolactin stimulates the breast to produce milk during pregnancy.  After giving birth, a mothers prolactin levels fall unless she breastfeeds her infant. Each time the baby nurses, prolactin levels rise to maintain milk production.
Question: What is (are) Prolactinoma ?
Answer: The pituitary gland, sometimes called the master gland, plays a critical role in regulating growth and development, metabolism, and reproduction. It produces prolactin and other key hormones including
                
- growth hormone, which regulates growth  - adrenocorticotropin (ACTH), which stimulates the adrenal glands to produce cortisol, a hormone important in metabolism and the body's response to stress  - thyrotropin, which signals the thyroid gland to produce thyroid hormone, also involved in metabolism and growth  - luteinizing hormone and follicle-stimulating hormone, which regulate ovulation and estrogen and progesterone production in women and sperm formation and testosterone production in men
                
The pituitary gland sits in the middle of the head in a bony box called the sella turcica. The optic nerves sit directly above the pituitary gland. Enlargement of the gland can cause symptoms such as headaches or visual disturbances. Pituitary tumors may also impair production of one or more pituitary hormones, causing reduced pituitary function, also called hypopituitarism.
Question: What are the symptoms of Prolactinoma ?
Answer: In women, high levels of prolactin in the blood often cause infertility and changes in menstruation. In some women, periods may stop. In others, periods may become irregular or menstrual flow may change. Women who are not pregnant or nursing may begin producing breast milk. Some women may experience a loss of libido-interest in sex. Intercourse may become painful because of vaginal dryness.
                
In men, the most common symptom of prolactinoma is erectile dysfunction. Because men have no reliable indicator such as changes in menstruation to signal a problem, many men delay going to the doctor until they have headaches or eye problems caused by the enlarged pituitary pressing against nearby optic nerves. They may not recognize a gradual loss of sexual function or libido. Only after treatment do some men realize they had a problem with sexual function.