jshargo/mts-medical-trainset huggingface dataset:
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: Ms. XYZ is an otherwise fairly healthy 44-year-old right-handed aircraft mechanic.  On her date of injury, she reports that she was working on an aircraft when she fell between the airplane and a stand with about an 18-inch gap in between.  She injured her left knee and underwent two arthroscopic procedures followed by patellar replacement and subsequently a left total knee arthroplasty in Month DD, YYYY. The patient is seen with no outside images, but an MRI report of the left knee and office notes from Dr. ABCD. The patient reports that she has undergone a full course of physical therapy and complains primarily of pain in the anterior aspect of the left knee and primarily over the medial and lateral tibial components with pain extending proximally to the distal femur and distally down into the anterior tibial plateau area.  She has intermittent numbness and tingling in the posterolateral thigh and no symptoms at all into her feet.  She has axial low back pain as an ancillary symptom.  Her pain is worse with walking and is associated with swelling, popping and grinding.  She complains of pins and needles sensation over the area of the common peroneal nerve overlying the fibular head.  She has no dysesthetic or allodynic symptoms with light touch over the remainder of the knee and the femoral nerve area.  Heavy pressure and light percussion of the fibular head produce painful numbness, tingling, and pins and needles sensation. The patient underwent a left knee MRI in September of 2006 revealing nonspecific edema anterior to the patellar tendon, but no evidence of an acute fracture or a femoropatellar ligament avulsion or abnormality.  She has continued to complain of persistent instability and pain.  She is not working.  She has a number of allergies to different pain medications and feels that her back has been bothersome mostly due to her gait disturbances relating to her knee.  Her pain is described as constant, shooting, cramping, aching, throbbing, pulling, sharp, and stabbing in nature.  It occasionally awakens her at night.  It is better in recumbency with her leg elevated.   Exacerbating factors include standing, walking, pushing, puling.  VAS pain scale is rated as 6/10 for her average and current pain, 10/10 for worst pain, and 3/10 for her least pain.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: Oh, thank you, that's good.

assistant: Oh certainly, yes, it is. What treatments have you had for this knee, aside from surgery?

user: I've done a full course of PT for this.

assistant: Where is your knee pain?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: Ms. XYZ is an otherwise fairly healthy 44-year-old right-handed aircraft mechanic.  On her date of injury, she reports that she was working on an aircraft when she fell between the airplane and a stand with about an 18-inch gap in between.  She injured her left knee and underwent two arthroscopic procedures followed by patellar replacement and subsequently a left total knee arthroplasty in Month DD, YYYY. The patient is seen with no outside images, but an MRI report of the left knee and office notes from Dr. ABCD. The patient reports that she has undergone a full course of physical therapy and complains primarily of pain in the anterior aspect of the left knee and primarily over the medial and lateral tibial components with pain extending proximally to the distal femur and distally down into the anterior tibial plateau area.  She has intermittent numbness and tingling in the posterolateral thigh and no symptoms at all into her feet.  She has axial low back pain as an ancillary symptom.  Her pain is worse with walking and is associated with swelling, popping and grinding.  She complains of pins and needles sensation over the area of the common peroneal nerve overlying the fibular head.  She has no dysesthetic or allodynic symptoms with light touch over the remainder of the knee and the femoral nerve area.  Heavy pressure and light percussion of the fibular head produce painful numbness, tingling, and pins and needles sensation. The patient underwent a left knee MRI in September of 2006 revealing nonspecific edema anterior to the patellar tendon, but no evidence of an acute fracture or a femoropatellar ligament avulsion or abnormality.  She has continued to complain of persistent instability and pain.  She is not working.  She has a number of allergies to different pain medications and feels that her back has been bothersome mostly due to her gait disturbances relating to her knee.  Her pain is described as constant, shooting, cramping, aching, throbbing, pulling, sharp, and stabbing in nature.  It occasionally awakens her at night.  It is better in recumbency with her leg elevated.   Exacerbating factors include standing, walking, pushing, puling.  VAS pain scale is rated as 6/10 for her average and current pain, 10/10 for worst pain, and 3/10 for her least pain.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: I've done a full course of PT for this.

assistant: Where is your knee pain?

user: Mostly, it's here in the front of the knee, and then on both sides, like the inside and outside.

assistant: Does the pain go down your leg at all?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: Ms. XYZ is an otherwise fairly healthy 44-year-old right-handed aircraft mechanic.  On her date of injury, she reports that she was working on an aircraft when she fell between the airplane and a stand with about an 18-inch gap in between.  She injured her left knee and underwent two arthroscopic procedures followed by patellar replacement and subsequently a left total knee arthroplasty in Month DD, YYYY. The patient is seen with no outside images, but an MRI report of the left knee and office notes from Dr. ABCD. The patient reports that she has undergone a full course of physical therapy and complains primarily of pain in the anterior aspect of the left knee and primarily over the medial and lateral tibial components with pain extending proximally to the distal femur and distally down into the anterior tibial plateau area.  She has intermittent numbness and tingling in the posterolateral thigh and no symptoms at all into her feet.  She has axial low back pain as an ancillary symptom.  Her pain is worse with walking and is associated with swelling, popping and grinding.  She complains of pins and needles sensation over the area of the common peroneal nerve overlying the fibular head.  She has no dysesthetic or allodynic symptoms with light touch over the remainder of the knee and the femoral nerve area.  Heavy pressure and light percussion of the fibular head produce painful numbness, tingling, and pins and needles sensation. The patient underwent a left knee MRI in September of 2006 revealing nonspecific edema anterior to the patellar tendon, but no evidence of an acute fracture or a femoropatellar ligament avulsion or abnormality.  She has continued to complain of persistent instability and pain.  She is not working.  She has a number of allergies to different pain medications and feels that her back has been bothersome mostly due to her gait disturbances relating to her knee.  Her pain is described as constant, shooting, cramping, aching, throbbing, pulling, sharp, and stabbing in nature.  It occasionally awakens her at night.  It is better in recumbency with her leg elevated.   Exacerbating factors include standing, walking, pushing, puling.  VAS pain scale is rated as 6/10 for her average and current pain, 10/10 for worst pain, and 3/10 for her least pain.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: Mostly, it's here in the front of the knee, and then on both sides, like the inside and outside.

assistant: Does the pain go down your leg at all?

user: Yes, it goes down my, is this the femur?

assistant: Yes, that's the femur.
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: Ms. XYZ is an otherwise fairly healthy 44-year-old right-handed aircraft mechanic.  On her date of injury, she reports that she was working on an aircraft when she fell between the airplane and a stand with about an 18-inch gap in between.  She injured her left knee and underwent two arthroscopic procedures followed by patellar replacement and subsequently a left total knee arthroplasty in Month DD, YYYY. The patient is seen with no outside images, but an MRI report of the left knee and office notes from Dr. ABCD. The patient reports that she has undergone a full course of physical therapy and complains primarily of pain in the anterior aspect of the left knee and primarily over the medial and lateral tibial components with pain extending proximally to the distal femur and distally down into the anterior tibial plateau area.  She has intermittent numbness and tingling in the posterolateral thigh and no symptoms at all into her feet.  She has axial low back pain as an ancillary symptom.  Her pain is worse with walking and is associated with swelling, popping and grinding.  She complains of pins and needles sensation over the area of the common peroneal nerve overlying the fibular head.  She has no dysesthetic or allodynic symptoms with light touch over the remainder of the knee and the femoral nerve area.  Heavy pressure and light percussion of the fibular head produce painful numbness, tingling, and pins and needles sensation. The patient underwent a left knee MRI in September of 2006 revealing nonspecific edema anterior to the patellar tendon, but no evidence of an acute fracture or a femoropatellar ligament avulsion or abnormality.  She has continued to complain of persistent instability and pain.  She is not working.  She has a number of allergies to different pain medications and feels that her back has been bothersome mostly due to her gait disturbances relating to her knee.  Her pain is described as constant, shooting, cramping, aching, throbbing, pulling, sharp, and stabbing in nature.  It occasionally awakens her at night.  It is better in recumbency with her leg elevated.   Exacerbating factors include standing, walking, pushing, puling.  VAS pain scale is rated as 6/10 for her average and current pain, 10/10 for worst pain, and 3/10 for her least pain.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: Yes, it goes down my, is this the femur?

assistant: Yes, that's the femur.

user: Then this must be my tibia, it goes down the front of that too.

assistant: Does it go into your thigh at all?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: Ms. XYZ is an otherwise fairly healthy 44-year-old right-handed aircraft mechanic.  On her date of injury, she reports that she was working on an aircraft when she fell between the airplane and a stand with about an 18-inch gap in between.  She injured her left knee and underwent two arthroscopic procedures followed by patellar replacement and subsequently a left total knee arthroplasty in Month DD, YYYY. The patient is seen with no outside images, but an MRI report of the left knee and office notes from Dr. ABCD. The patient reports that she has undergone a full course of physical therapy and complains primarily of pain in the anterior aspect of the left knee and primarily over the medial and lateral tibial components with pain extending proximally to the distal femur and distally down into the anterior tibial plateau area.  She has intermittent numbness and tingling in the posterolateral thigh and no symptoms at all into her feet.  She has axial low back pain as an ancillary symptom.  Her pain is worse with walking and is associated with swelling, popping and grinding.  She complains of pins and needles sensation over the area of the common peroneal nerve overlying the fibular head.  She has no dysesthetic or allodynic symptoms with light touch over the remainder of the knee and the femoral nerve area.  Heavy pressure and light percussion of the fibular head produce painful numbness, tingling, and pins and needles sensation. The patient underwent a left knee MRI in September of 2006 revealing nonspecific edema anterior to the patellar tendon, but no evidence of an acute fracture or a femoropatellar ligament avulsion or abnormality.  She has continued to complain of persistent instability and pain.  She is not working.  She has a number of allergies to different pain medications and feels that her back has been bothersome mostly due to her gait disturbances relating to her knee.  Her pain is described as constant, shooting, cramping, aching, throbbing, pulling, sharp, and stabbing in nature.  It occasionally awakens her at night.  It is better in recumbency with her leg elevated.   Exacerbating factors include standing, walking, pushing, puling.  VAS pain scale is rated as 6/10 for her average and current pain, 10/10 for worst pain, and 3/10 for her least pain.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: Then this must be my tibia, it goes down the front of that too.

assistant: Does it go into your thigh at all?

user: Yes, it goes into the back of my thigh. I feel numbness and tingling back there.

assistant: Do you feel anything in the feet?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: Ms. XYZ is an otherwise fairly healthy 44-year-old right-handed aircraft mechanic.  On her date of injury, she reports that she was working on an aircraft when she fell between the airplane and a stand with about an 18-inch gap in between.  She injured her left knee and underwent two arthroscopic procedures followed by patellar replacement and subsequently a left total knee arthroplasty in Month DD, YYYY. The patient is seen with no outside images, but an MRI report of the left knee and office notes from Dr. ABCD. The patient reports that she has undergone a full course of physical therapy and complains primarily of pain in the anterior aspect of the left knee and primarily over the medial and lateral tibial components with pain extending proximally to the distal femur and distally down into the anterior tibial plateau area.  She has intermittent numbness and tingling in the posterolateral thigh and no symptoms at all into her feet.  She has axial low back pain as an ancillary symptom.  Her pain is worse with walking and is associated with swelling, popping and grinding.  She complains of pins and needles sensation over the area of the common peroneal nerve overlying the fibular head.  She has no dysesthetic or allodynic symptoms with light touch over the remainder of the knee and the femoral nerve area.  Heavy pressure and light percussion of the fibular head produce painful numbness, tingling, and pins and needles sensation. The patient underwent a left knee MRI in September of 2006 revealing nonspecific edema anterior to the patellar tendon, but no evidence of an acute fracture or a femoropatellar ligament avulsion or abnormality.  She has continued to complain of persistent instability and pain.  She is not working.  She has a number of allergies to different pain medications and feels that her back has been bothersome mostly due to her gait disturbances relating to her knee.  Her pain is described as constant, shooting, cramping, aching, throbbing, pulling, sharp, and stabbing in nature.  It occasionally awakens her at night.  It is better in recumbency with her leg elevated.   Exacerbating factors include standing, walking, pushing, puling.  VAS pain scale is rated as 6/10 for her average and current pain, 10/10 for worst pain, and 3/10 for her least pain.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: Yes, it goes into the back of my thigh. I feel numbness and tingling back there.

assistant: Do you feel anything in the feet?

user: Nope, my feet are completely normal, thankfully.

assistant: Are you having any back pain?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: Ms. XYZ is an otherwise fairly healthy 44-year-old right-handed aircraft mechanic.  On her date of injury, she reports that she was working on an aircraft when she fell between the airplane and a stand with about an 18-inch gap in between.  She injured her left knee and underwent two arthroscopic procedures followed by patellar replacement and subsequently a left total knee arthroplasty in Month DD, YYYY. The patient is seen with no outside images, but an MRI report of the left knee and office notes from Dr. ABCD. The patient reports that she has undergone a full course of physical therapy and complains primarily of pain in the anterior aspect of the left knee and primarily over the medial and lateral tibial components with pain extending proximally to the distal femur and distally down into the anterior tibial plateau area.  She has intermittent numbness and tingling in the posterolateral thigh and no symptoms at all into her feet.  She has axial low back pain as an ancillary symptom.  Her pain is worse with walking and is associated with swelling, popping and grinding.  She complains of pins and needles sensation over the area of the common peroneal nerve overlying the fibular head.  She has no dysesthetic or allodynic symptoms with light touch over the remainder of the knee and the femoral nerve area.  Heavy pressure and light percussion of the fibular head produce painful numbness, tingling, and pins and needles sensation. The patient underwent a left knee MRI in September of 2006 revealing nonspecific edema anterior to the patellar tendon, but no evidence of an acute fracture or a femoropatellar ligament avulsion or abnormality.  She has continued to complain of persistent instability and pain.  She is not working.  She has a number of allergies to different pain medications and feels that her back has been bothersome mostly due to her gait disturbances relating to her knee.  Her pain is described as constant, shooting, cramping, aching, throbbing, pulling, sharp, and stabbing in nature.  It occasionally awakens her at night.  It is better in recumbency with her leg elevated.   Exacerbating factors include standing, walking, pushing, puling.  VAS pain scale is rated as 6/10 for her average and current pain, 10/10 for worst pain, and 3/10 for her least pain.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: Nope, my feet are completely normal, thankfully.

assistant: Are you having any back pain?

user: A little, I feel something in my lower back, I'm not sure if it's related.

assistant: Does anything make your knee pain worse?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: Ms. XYZ is an otherwise fairly healthy 44-year-old right-handed aircraft mechanic.  On her date of injury, she reports that she was working on an aircraft when she fell between the airplane and a stand with about an 18-inch gap in between.  She injured her left knee and underwent two arthroscopic procedures followed by patellar replacement and subsequently a left total knee arthroplasty in Month DD, YYYY. The patient is seen with no outside images, but an MRI report of the left knee and office notes from Dr. ABCD. The patient reports that she has undergone a full course of physical therapy and complains primarily of pain in the anterior aspect of the left knee and primarily over the medial and lateral tibial components with pain extending proximally to the distal femur and distally down into the anterior tibial plateau area.  She has intermittent numbness and tingling in the posterolateral thigh and no symptoms at all into her feet.  She has axial low back pain as an ancillary symptom.  Her pain is worse with walking and is associated with swelling, popping and grinding.  She complains of pins and needles sensation over the area of the common peroneal nerve overlying the fibular head.  She has no dysesthetic or allodynic symptoms with light touch over the remainder of the knee and the femoral nerve area.  Heavy pressure and light percussion of the fibular head produce painful numbness, tingling, and pins and needles sensation. The patient underwent a left knee MRI in September of 2006 revealing nonspecific edema anterior to the patellar tendon, but no evidence of an acute fracture or a femoropatellar ligament avulsion or abnormality.  She has continued to complain of persistent instability and pain.  She is not working.  She has a number of allergies to different pain medications and feels that her back has been bothersome mostly due to her gait disturbances relating to her knee.  Her pain is described as constant, shooting, cramping, aching, throbbing, pulling, sharp, and stabbing in nature.  It occasionally awakens her at night.  It is better in recumbency with her leg elevated.   Exacerbating factors include standing, walking, pushing, puling.  VAS pain scale is rated as 6/10 for her average and current pain, 10/10 for worst pain, and 3/10 for her least pain.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: A little, I feel something in my lower back, I'm not sure if it's related.

assistant: Does anything make your knee pain worse?

user: Yeah, I can hardly walk anymore, it hurts so bad.

assistant: What kind of symptoms do you see when you walk on this?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: Ms. XYZ is an otherwise fairly healthy 44-year-old right-handed aircraft mechanic.  On her date of injury, she reports that she was working on an aircraft when she fell between the airplane and a stand with about an 18-inch gap in between.  She injured her left knee and underwent two arthroscopic procedures followed by patellar replacement and subsequently a left total knee arthroplasty in Month DD, YYYY. The patient is seen with no outside images, but an MRI report of the left knee and office notes from Dr. ABCD. The patient reports that she has undergone a full course of physical therapy and complains primarily of pain in the anterior aspect of the left knee and primarily over the medial and lateral tibial components with pain extending proximally to the distal femur and distally down into the anterior tibial plateau area.  She has intermittent numbness and tingling in the posterolateral thigh and no symptoms at all into her feet.  She has axial low back pain as an ancillary symptom.  Her pain is worse with walking and is associated with swelling, popping and grinding.  She complains of pins and needles sensation over the area of the common peroneal nerve overlying the fibular head.  She has no dysesthetic or allodynic symptoms with light touch over the remainder of the knee and the femoral nerve area.  Heavy pressure and light percussion of the fibular head produce painful numbness, tingling, and pins and needles sensation. The patient underwent a left knee MRI in September of 2006 revealing nonspecific edema anterior to the patellar tendon, but no evidence of an acute fracture or a femoropatellar ligament avulsion or abnormality.  She has continued to complain of persistent instability and pain.  She is not working.  She has a number of allergies to different pain medications and feels that her back has been bothersome mostly due to her gait disturbances relating to her knee.  Her pain is described as constant, shooting, cramping, aching, throbbing, pulling, sharp, and stabbing in nature.  It occasionally awakens her at night.  It is better in recumbency with her leg elevated.   Exacerbating factors include standing, walking, pushing, puling.  VAS pain scale is rated as 6/10 for her average and current pain, 10/10 for worst pain, and 3/10 for her least pain.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: Yeah, I can hardly walk anymore, it hurts so bad.

assistant: What kind of symptoms do you see when you walk on this?

user: I feel popping and grinding, and my knee swells up.

assistant: That numbness and tingling you feel in the thigh, do you feel that in the knee at all?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: Ms. XYZ is an otherwise fairly healthy 44-year-old right-handed aircraft mechanic.  On her date of injury, she reports that she was working on an aircraft when she fell between the airplane and a stand with about an 18-inch gap in between.  She injured her left knee and underwent two arthroscopic procedures followed by patellar replacement and subsequently a left total knee arthroplasty in Month DD, YYYY. The patient is seen with no outside images, but an MRI report of the left knee and office notes from Dr. ABCD. The patient reports that she has undergone a full course of physical therapy and complains primarily of pain in the anterior aspect of the left knee and primarily over the medial and lateral tibial components with pain extending proximally to the distal femur and distally down into the anterior tibial plateau area.  She has intermittent numbness and tingling in the posterolateral thigh and no symptoms at all into her feet.  She has axial low back pain as an ancillary symptom.  Her pain is worse with walking and is associated with swelling, popping and grinding.  She complains of pins and needles sensation over the area of the common peroneal nerve overlying the fibular head.  She has no dysesthetic or allodynic symptoms with light touch over the remainder of the knee and the femoral nerve area.  Heavy pressure and light percussion of the fibular head produce painful numbness, tingling, and pins and needles sensation. The patient underwent a left knee MRI in September of 2006 revealing nonspecific edema anterior to the patellar tendon, but no evidence of an acute fracture or a femoropatellar ligament avulsion or abnormality.  She has continued to complain of persistent instability and pain.  She is not working.  She has a number of allergies to different pain medications and feels that her back has been bothersome mostly due to her gait disturbances relating to her knee.  Her pain is described as constant, shooting, cramping, aching, throbbing, pulling, sharp, and stabbing in nature.  It occasionally awakens her at night.  It is better in recumbency with her leg elevated.   Exacerbating factors include standing, walking, pushing, puling.  VAS pain scale is rated as 6/10 for her average and current pain, 10/10 for worst pain, and 3/10 for her least pain.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: I feel popping and grinding, and my knee swells up.

assistant: That numbness and tingling you feel in the thigh, do you feel that in the knee at all?

user: Actually yes, it feels like pins and needles there.

assistant: What about this, when I touch the knee do you feel any abnormal discomfort or pain over the rest of the knee?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: Ms. XYZ is an otherwise fairly healthy 44-year-old right-handed aircraft mechanic.  On her date of injury, she reports that she was working on an aircraft when she fell between the airplane and a stand with about an 18-inch gap in between.  She injured her left knee and underwent two arthroscopic procedures followed by patellar replacement and subsequently a left total knee arthroplasty in Month DD, YYYY. The patient is seen with no outside images, but an MRI report of the left knee and office notes from Dr. ABCD. The patient reports that she has undergone a full course of physical therapy and complains primarily of pain in the anterior aspect of the left knee and primarily over the medial and lateral tibial components with pain extending proximally to the distal femur and distally down into the anterior tibial plateau area.  She has intermittent numbness and tingling in the posterolateral thigh and no symptoms at all into her feet.  She has axial low back pain as an ancillary symptom.  Her pain is worse with walking and is associated with swelling, popping and grinding.  She complains of pins and needles sensation over the area of the common peroneal nerve overlying the fibular head.  She has no dysesthetic or allodynic symptoms with light touch over the remainder of the knee and the femoral nerve area.  Heavy pressure and light percussion of the fibular head produce painful numbness, tingling, and pins and needles sensation. The patient underwent a left knee MRI in September of 2006 revealing nonspecific edema anterior to the patellar tendon, but no evidence of an acute fracture or a femoropatellar ligament avulsion or abnormality.  She has continued to complain of persistent instability and pain.  She is not working.  She has a number of allergies to different pain medications and feels that her back has been bothersome mostly due to her gait disturbances relating to her knee.  Her pain is described as constant, shooting, cramping, aching, throbbing, pulling, sharp, and stabbing in nature.  It occasionally awakens her at night.  It is better in recumbency with her leg elevated.   Exacerbating factors include standing, walking, pushing, puling.  VAS pain scale is rated as 6/10 for her average and current pain, 10/10 for worst pain, and 3/10 for her least pain.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: Actually yes, it feels like pins and needles there.

assistant: What about this, when I touch the knee do you feel any abnormal discomfort or pain over the rest of the knee?

user: No, nothing out of the ordinary there.

assistant: What about this, this is the fibular head, which is where you feel the pins and needles. I'm applying pretty heavy pressure here, how would you describe what you're feeling?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: Ms. XYZ is an otherwise fairly healthy 44-year-old right-handed aircraft mechanic.  On her date of injury, she reports that she was working on an aircraft when she fell between the airplane and a stand with about an 18-inch gap in between.  She injured her left knee and underwent two arthroscopic procedures followed by patellar replacement and subsequently a left total knee arthroplasty in Month DD, YYYY. The patient is seen with no outside images, but an MRI report of the left knee and office notes from Dr. ABCD. The patient reports that she has undergone a full course of physical therapy and complains primarily of pain in the anterior aspect of the left knee and primarily over the medial and lateral tibial components with pain extending proximally to the distal femur and distally down into the anterior tibial plateau area.  She has intermittent numbness and tingling in the posterolateral thigh and no symptoms at all into her feet.  She has axial low back pain as an ancillary symptom.  Her pain is worse with walking and is associated with swelling, popping and grinding.  She complains of pins and needles sensation over the area of the common peroneal nerve overlying the fibular head.  She has no dysesthetic or allodynic symptoms with light touch over the remainder of the knee and the femoral nerve area.  Heavy pressure and light percussion of the fibular head produce painful numbness, tingling, and pins and needles sensation. The patient underwent a left knee MRI in September of 2006 revealing nonspecific edema anterior to the patellar tendon, but no evidence of an acute fracture or a femoropatellar ligament avulsion or abnormality.  She has continued to complain of persistent instability and pain.  She is not working.  She has a number of allergies to different pain medications and feels that her back has been bothersome mostly due to her gait disturbances relating to her knee.  Her pain is described as constant, shooting, cramping, aching, throbbing, pulling, sharp, and stabbing in nature.  It occasionally awakens her at night.  It is better in recumbency with her leg elevated.   Exacerbating factors include standing, walking, pushing, puling.  VAS pain scale is rated as 6/10 for her average and current pain, 10/10 for worst pain, and 3/10 for her least pain.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: No, nothing out of the ordinary there.

assistant: What about this, this is the fibular head, which is where you feel the pins and needles. I'm applying pretty heavy pressure here, how would you describe what you're feeling?

user: Um, numbness, tingling, and then that same pins and needles feeling.

assistant: Is there any instability?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: Ms. XYZ is an otherwise fairly healthy 44-year-old right-handed aircraft mechanic.  On her date of injury, she reports that she was working on an aircraft when she fell between the airplane and a stand with about an 18-inch gap in between.  She injured her left knee and underwent two arthroscopic procedures followed by patellar replacement and subsequently a left total knee arthroplasty in Month DD, YYYY. The patient is seen with no outside images, but an MRI report of the left knee and office notes from Dr. ABCD. The patient reports that she has undergone a full course of physical therapy and complains primarily of pain in the anterior aspect of the left knee and primarily over the medial and lateral tibial components with pain extending proximally to the distal femur and distally down into the anterior tibial plateau area.  She has intermittent numbness and tingling in the posterolateral thigh and no symptoms at all into her feet.  She has axial low back pain as an ancillary symptom.  Her pain is worse with walking and is associated with swelling, popping and grinding.  She complains of pins and needles sensation over the area of the common peroneal nerve overlying the fibular head.  She has no dysesthetic or allodynic symptoms with light touch over the remainder of the knee and the femoral nerve area.  Heavy pressure and light percussion of the fibular head produce painful numbness, tingling, and pins and needles sensation. The patient underwent a left knee MRI in September of 2006 revealing nonspecific edema anterior to the patellar tendon, but no evidence of an acute fracture or a femoropatellar ligament avulsion or abnormality.  She has continued to complain of persistent instability and pain.  She is not working.  She has a number of allergies to different pain medications and feels that her back has been bothersome mostly due to her gait disturbances relating to her knee.  Her pain is described as constant, shooting, cramping, aching, throbbing, pulling, sharp, and stabbing in nature.  It occasionally awakens her at night.  It is better in recumbency with her leg elevated.   Exacerbating factors include standing, walking, pushing, puling.  VAS pain scale is rated as 6/10 for her average and current pain, 10/10 for worst pain, and 3/10 for her least pain.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: Um, numbness, tingling, and then that same pins and needles feeling.

assistant: Is there any instability?

user: Yes, and there's pain with it too.

assistant: Are you working right now?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: Ms. XYZ is an otherwise fairly healthy 44-year-old right-handed aircraft mechanic.  On her date of injury, she reports that she was working on an aircraft when she fell between the airplane and a stand with about an 18-inch gap in between.  She injured her left knee and underwent two arthroscopic procedures followed by patellar replacement and subsequently a left total knee arthroplasty in Month DD, YYYY. The patient is seen with no outside images, but an MRI report of the left knee and office notes from Dr. ABCD. The patient reports that she has undergone a full course of physical therapy and complains primarily of pain in the anterior aspect of the left knee and primarily over the medial and lateral tibial components with pain extending proximally to the distal femur and distally down into the anterior tibial plateau area.  She has intermittent numbness and tingling in the posterolateral thigh and no symptoms at all into her feet.  She has axial low back pain as an ancillary symptom.  Her pain is worse with walking and is associated with swelling, popping and grinding.  She complains of pins and needles sensation over the area of the common peroneal nerve overlying the fibular head.  She has no dysesthetic or allodynic symptoms with light touch over the remainder of the knee and the femoral nerve area.  Heavy pressure and light percussion of the fibular head produce painful numbness, tingling, and pins and needles sensation. The patient underwent a left knee MRI in September of 2006 revealing nonspecific edema anterior to the patellar tendon, but no evidence of an acute fracture or a femoropatellar ligament avulsion or abnormality.  She has continued to complain of persistent instability and pain.  She is not working.  She has a number of allergies to different pain medications and feels that her back has been bothersome mostly due to her gait disturbances relating to her knee.  Her pain is described as constant, shooting, cramping, aching, throbbing, pulling, sharp, and stabbing in nature.  It occasionally awakens her at night.  It is better in recumbency with her leg elevated.   Exacerbating factors include standing, walking, pushing, puling.  VAS pain scale is rated as 6/10 for her average and current pain, 10/10 for worst pain, and 3/10 for her least pain.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: Yes, and there's pain with it too.

assistant: Are you working right now?

user: No, I'm not right now.

assistant: Any allergies I should know about?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: Ms. XYZ is an otherwise fairly healthy 44-year-old right-handed aircraft mechanic.  On her date of injury, she reports that she was working on an aircraft when she fell between the airplane and a stand with about an 18-inch gap in between.  She injured her left knee and underwent two arthroscopic procedures followed by patellar replacement and subsequently a left total knee arthroplasty in Month DD, YYYY. The patient is seen with no outside images, but an MRI report of the left knee and office notes from Dr. ABCD. The patient reports that she has undergone a full course of physical therapy and complains primarily of pain in the anterior aspect of the left knee and primarily over the medial and lateral tibial components with pain extending proximally to the distal femur and distally down into the anterior tibial plateau area.  She has intermittent numbness and tingling in the posterolateral thigh and no symptoms at all into her feet.  She has axial low back pain as an ancillary symptom.  Her pain is worse with walking and is associated with swelling, popping and grinding.  She complains of pins and needles sensation over the area of the common peroneal nerve overlying the fibular head.  She has no dysesthetic or allodynic symptoms with light touch over the remainder of the knee and the femoral nerve area.  Heavy pressure and light percussion of the fibular head produce painful numbness, tingling, and pins and needles sensation. The patient underwent a left knee MRI in September of 2006 revealing nonspecific edema anterior to the patellar tendon, but no evidence of an acute fracture or a femoropatellar ligament avulsion or abnormality.  She has continued to complain of persistent instability and pain.  She is not working.  She has a number of allergies to different pain medications and feels that her back has been bothersome mostly due to her gait disturbances relating to her knee.  Her pain is described as constant, shooting, cramping, aching, throbbing, pulling, sharp, and stabbing in nature.  It occasionally awakens her at night.  It is better in recumbency with her leg elevated.   Exacerbating factors include standing, walking, pushing, puling.  VAS pain scale is rated as 6/10 for her average and current pain, 10/10 for worst pain, and 3/10 for her least pain.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: No, I'm not right now.

assistant: Any allergies I should know about?

user: Yes, actually, I'm allergic to a lot of pain medications.

assistant: Okay, have there been any changes in how you're walking?
system: You are a medical doctor conducting a patient consultation. Here is the patient's background information:

Section: GENHX
Patient Information: Ms. XYZ is an otherwise fairly healthy 44-year-old right-handed aircraft mechanic.  On her date of injury, she reports that she was working on an aircraft when she fell between the airplane and a stand with about an 18-inch gap in between.  She injured her left knee and underwent two arthroscopic procedures followed by patellar replacement and subsequently a left total knee arthroplasty in Month DD, YYYY. The patient is seen with no outside images, but an MRI report of the left knee and office notes from Dr. ABCD. The patient reports that she has undergone a full course of physical therapy and complains primarily of pain in the anterior aspect of the left knee and primarily over the medial and lateral tibial components with pain extending proximally to the distal femur and distally down into the anterior tibial plateau area.  She has intermittent numbness and tingling in the posterolateral thigh and no symptoms at all into her feet.  She has axial low back pain as an ancillary symptom.  Her pain is worse with walking and is associated with swelling, popping and grinding.  She complains of pins and needles sensation over the area of the common peroneal nerve overlying the fibular head.  She has no dysesthetic or allodynic symptoms with light touch over the remainder of the knee and the femoral nerve area.  Heavy pressure and light percussion of the fibular head produce painful numbness, tingling, and pins and needles sensation. The patient underwent a left knee MRI in September of 2006 revealing nonspecific edema anterior to the patellar tendon, but no evidence of an acute fracture or a femoropatellar ligament avulsion or abnormality.  She has continued to complain of persistent instability and pain.  She is not working.  She has a number of allergies to different pain medications and feels that her back has been bothersome mostly due to her gait disturbances relating to her knee.  Her pain is described as constant, shooting, cramping, aching, throbbing, pulling, sharp, and stabbing in nature.  It occasionally awakens her at night.  It is better in recumbency with her leg elevated.   Exacerbating factors include standing, walking, pushing, puling.  VAS pain scale is rated as 6/10 for her average and current pain, 10/10 for worst pain, and 3/10 for her least pain.

Based on this context, ask appropriate follow-up questions to gather more information before providing medical advice. Use the questioning patterns that doctors typically employ.

user: Yes, actually, I'm allergic to a lot of pain medications.

assistant: Okay, have there been any changes in how you're walking?

user: Yes, I had to change my walking pattern to take weight off my knee, and I think that has to do with my back pain.

assistant: That's certainly a possibility. How would you describe your pain?